Creating 'consumer Choice' through co-design. Lessons learnt

Introduction

Although co-design is becoming common practice in the development and design of mental health services, the focus tends to be on why it is important rather than on what to do and how to do it. In 2021, the Victorian Department of Health, Australia funded a pilot initiative aimed to improve the exercise of meaningful choice for consumers in a local adult mental health inpatient setting. The first stage of the pilot involved a comprehensive multi-phase consumer-led co-design process. This presentation will discuss the practicalities and participant views of the co-design process which was conducted during the peak of the COVID-19 pandemic in Melbourne, the world’s most locked down city.

Method

The co-design approach undertaken aimed to engage and empower various stakeholders, address any power imbalance, in particular between staff and consumers, and participation challenges due to COVID-19 restrictions. The approach included workshops, an education day, and a pre- and post- workshop survey. Participants included consumers, carers and mental health care staff and was led by a consumer project officer.

Results

Although the project team sought to use a holistic and inclusive approach, gaining a broad range of views was challenging resulting in poor representation. Consumers and carers who participated reported feeling “seen and heard” but noted a lack of staff involvement and staff views.

Discussion/Conclusion

The team was cognisant of their efforts to ensure consumers and carers felt empowered to participate, however, on reflection, it appeared this resulted in a lack of ‘buy-in’ and participation by staff. Our findings highlight how efforts to address a power imbalance between two groups can result in a reversal of power.  We conclude that successful co-design and project implementation should be sensitive that empowering some can disempower others. We recommend an iterative, reflective process to address such challenges as they arise.