I recently attended an event at York University; run by the Social Research Council. I went as a Blogger and as someone with an interest in Mental Health policy. This interest has been borne out of my personal experience of using Mental Health services and wishing that this experience had been different and seeing the flaws in the system.
The event was concerned with ‘Co-production and commissioning services.’
Co-production is the fancy term for involving people ( who have used or use services ) in producing mental health services. People may be involved in delivering or designing services. This event was concerned with true Co-production which means involvement from the start which includes the commissioning of services.
Traditionally it has been Health Care Professionals who produce, deliver and shape these services. Commissioners currently decide which services are needed and where the money should be spent. But should people who use services also commission them?
There is currently a move towards people with lived experience becoming more involved in delivering services. Employing people with lived experience is logical as there is huge value in this lived experience at the same time it helps to dismantle the ‘Us’ and ‘Them’ culture. However cynics see Co-production as being a response to austerity and say that it is a way of making people responsible for their own health as though it is a personal achievement. Organisations often involve people who have used services but this is often as unpaid volunteers and then what happens to people in the long run?
We discussed the imbalance of power between professionals and people who use services. People agreed that more authentic relationships need to be developed and that “Professionals need to take off the protective mask and engage. ” For a service to be more effective it needs to be human.
Pamela Fisher of Leeds Beckett University saw Mental Health Services as political areas which cannot be left to professionals alone. So therefore does it makes sense that people be involved in commissioning?
Anne Rogers (University of Southampton) criticised the NHS for largely commissioning and creating a culture which depicts mental ill-health as a biomedical diagnosis which is to be treated with either medication or IAPT services or both. She talked about the importance of a person having diverse support networks and having ‘Weak tie relationships’ which may include a regular ‘hello’ to a fellow dog walker in the park. She explained that weak ties are particularly important as too invasive support such as an overbearing family could actually block people off from getting involved in other things. Diversity of support is important.
Commissioners do get things wrong. A table of people from Liverpool informed the room how their local Library was closed in order to be turned into a recovery college. A recovery college may sound great, but people actually wanted their local library. This resulted in a recovery service wasn’t used very much and no library. They wanted to know who decided this? Co-production can open these decisions up to scrutiny.
Currently if people who use services are involved in commissioning, it is often towards the end of the commissioning cycle when a lot of the decisions have already been made. We discussed how true Co-production needs to take place at the beginning of the commissioning cycle. When the public work alongside commissioners, questions are framed differently, and a different agenda emerges.
The event was one of a series of events by the social research council on Co-production. In attendance were a mixture of academics, people who work in the health services and people who have used services. They have their own blog which you can view here if you’d like more information or to be involved.
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