Modelling a Best Practice Approach to Co-Design for Mental Health System Reform

Each year, one in five of us will experience mental health challenges. Mental Health Reform Victoria (MHRV), part of the Mental Health and Wellbeing Division in the Department of Health, was created to deliver on the Royal Commission’s Interim Report recommendations. A central recommendation of the Royal Commission (RC) was that people with lived experience of the mental health system participate in its transformation through co-production. Co-production runs much deeper than traditional consultation; people with lived experience co-plan inclusive participation, including framing problems and setting priorities; co-design solutions, co-deliver solutions and co-evaluate their effectiveness.

Creating productive space for co-creation is especially challenging in the mental health context. We enabled safe, meaningful and effective collaboration between people with lived experience, service providers and government. We used a learn by doing approach with MHRV to build capability in best practice co-planning and co-design within a complex mental health system. As a pilot, we co-planned a new suicide prevention service for children and young people. We delivered service guidelines that clarify what people with lived experience most want and need from this service. We then embedded best-practice guidance for co-design planning and implementation into a digital toolkit.

Our work formed an initial piece of co-design for Mental Health reform. Beyond project deliverables, it was the tip of the spear for a deep, sector-wide cultural and system transformation. Significantly, this pilot began to change mindsets around co-design. Clinical professionals saw it could be conducted with participant safety at the core. People with lived-experience found their ideas meaningfully informing future service models. Our digital toolkit enabled MHRV to embed lived-experience engagement and start to scale capability for future implementation of the recommendations. The new suicide prevention service for children and young people is operational at four metropolitan health services.

Alignment: Understanding MHRV’s mission and aligning on an approach to put co-design into practice. We focussed on a new Hospital Outreach Post-suicidal Engagement (HOPE) program for children and young people at risk of suicide and self-harm. Setting the conditions: Defining the conditions to facilitate co-design at a service level, including the need for a governance structure to ensure lived experience voices are heard at every level of decision-making. We defined an engagement approach, including mapping lived experience stakeholders, building connections and reaching out to key system partners. Planning: The project called for a design process with young people with mental health lived experience about suicide prevention. This is a sensitive topic and required comprehensive planning, with participant safety paramount. We worked with MHRV and advisors with lived experience to carefully design every touchpoint, from recruitment to support beyond the sessions. Facilitating: We ran workshops with a diverse group of young people with lived experience (aged 15+), carers and health professionals. We created an inclusive space for sharing and collective decision-making on key considerations and opportunities for the HOPE child and youth service. The outcome was a shared brief that acts as a guide for local co-design teams.