Using co-production to end stigma and discrimination

29th November 2017

This guest article from See Me explores:

‘How is See Me using co-production and lived experience  to end mental health stigma and discrimination and promote recovery?’

Co-production is a term that is often used… but not often meant; sometimes it is used to cloud rather than clarify. Here are just a few examples of things that are not co-production [1]:  consultation that results in an outcome that was not supported, consultation after the fact (informing), one-off activity that doesn’t engage or build capacity. At See Me, the engagement of people with experience of mental health problems is the golden thread running through everything we do, and we’re trying our best to be an exemplar of true co-production [2] – building upon the strengths of people and communities, addressing power imbalances and working with people interested in being catalysts for the change they want to see.

See Me Community Champions go through a 6-day participative training course, which covers many topics, including power, human rights-based approaches and approaches to reducing stigma. The training provides opportunities for participants to enhance their skills, including group work, public speaking, self-care and project planning. The emphasis is on people taking the reins, working together and developing their skills for working with others – as these will be essential going forward with their ideas and project. As the training is done in three blocks in a residential format, participants have lots of opportunities to get to know each other well and we often find that they form strong on-going and lasting connections.

Champions have developed projects such as You Matter Always – a self-help card focusing on a strengths-based approach; Don’t Judge a Book by Its Cover – events where people use literature and Depressed Cakes to share experiences and open up discussions about mental health and stigma; and Mind Over Miles, which through  running brings people together to talk about the benefits of physical activity and maintaining wellbeing. Networking and peer support at Champions’ gatherings are key components of connecting with and being accepted by others and have been reported as vital features in supporting the recovery of those involved.

Other volunteers have opted to get more involved in speaking and workshop opportunities, or business support roles – assisting with areas of organisational development that particularly interest them, such as fine-tuning See Me’s volunteer policies. Lots of our volunteers take part in Pass the Badge activities and supporting or organising local Walk a Mile events; whilst others have taken part in external events such as Pedal for Scotland and spoken at local Scottish Recovery Walks.

The Social Movement team are also supporting Community Champions to develop strong connections with others within their communities – either their local area or what they’re interested in – so that they can come together to share ideas, space, contacts and so on.  This – whilst supported by See Me resource and staff – is very much about facilitating organic networking, which empowers Champions and volunteers to develop the connections and ideas that are most important to them, in the areas related to stigma and discrimination that they feel are most relevant. It’s really important for us to work with people – therefore we start where people are at, either physically or mentally; not where we want them to be. This is a deliberate effort on our part to address some of the power imbalances that can naturally exist. See Me staff and volunteers will be taking part in community development training early in the New Year to enhance our skills and make joint plans based on achieving more together.

A Community Conversations toolkit has been co-developed with input from people with lived experience, and is currently being piloted in two areas. The toolkit is a workshop-based intervention which explores how the PANEL principles [3] can be used to empower people to be more aware of, speak about and claim their rights. This work is only one part of See Me’s continued commitment to Rights for Life.

Social contact – as well as being empowering for those involved and helping them to thrive through participation, peer support, enhanced self-esteem and a sense of control [4] – is one of the most effective ways we currently know of for reducing stigma and discrimination in the short to medium term.

Through our Stigma Free Lanarkshire partnership, and as part of a co-ordinated array of other activities, See Me and Lanarkshire Links delivered workshops alongside Community Champions to dieticians, nurses and newly qualified doctors within Hairmyres Hospital. These were intended to make staff more conscious of the impact of mental health stigma and discrimination on people’s lives, and encourage them to consider actions that they could take to deliver a stigma free healthcare environment. At the workshops Champions participated in group discussions and shared their experiences.

Recently we held a Health and Social Care Lived Experience Gathering, where we brought people together to discuss See Me’s latest thinking on its approach within this area, and more importantly to find out from them their experiences and work together to identify not only challenges, but some solutions. The primary intention of the gathering was to generate interest in our health and social care activity and create a network of people who we can work with in future.

Within our Education and Young People’s Programme we have developed the “What’s on Your Mind?” Pack over the period of two years with young people, who are also currently involved in delivering – within schools – elements of the pack, including Scottish Mental Health First Aid Training. We have also been co-producing tailored action plans with organisations as part of our See Me in Work programme – that arise from the results of internal staff surveys to assess areas where organisations may need to improve or prioritise.

Instead of giving out grants to Change Networks as we have done in the past, Community Champions are able to access financial support for pursuing projects. In order to make this as fair and equitable as possible, for any resource over £200, we have set up a panel, which includes two Community Champions (who will not be requiring financial resource for projects) and two members of the See Me Delivery Team.

See Me’s Pass the Badge campaign – which was conceived and developed by one of our first cohort of Community Champions – has been further co-produced to become a recently launched digital campaign. The Communications team worked with Rich from Abandon Ship on the creative side – his own lived experience of anxiety and panic attacks, and his openness of this, played a part in the choice to work with him. They also met with volunteers to discuss and develop the messaging, then surveyed all the volunteers to find out their preferences on the short-list and finalise the messaging. Debate and disagreement is healthy, and that’s how the final campaign has ended up slightly different to how it was envisaged at the start.

To end on a celebratory note: we will be having a volunteer gathering on 5th December to recognise the dedication and hard work of all of our volunteers and show how much it is appreciated. It’s self-evident, but seems important to reaffirm – we can’t deliver on ending mental health stigma and discrimination through a social movement in Scotland without bringing people along with us for the journey. And it’s important to us that the journey is an edifying and enjoyable one for those that choose to join us.

References

[1] https://www.thinklocalactpersonal.org.uk/co-production-in-commissioning-tool/co-production/In-more-detail/what-makes-co-production-different/

[2] http://www.govint.org/fileadmin/user_upload/publications/Co-Production_of_Health_and_Wellbeing_in_Scotland.pdf

[3] http://www.scottishhumanrights.com/media/1409/shrc_hrba_leaflet.pdf

[4] http://www.euro.who.int/__data/assets/pdf_file/0020/113834/E93430.pdf