Service users and service design

Now that co-production of services is the gold standard, you would have thought that service users across the country, whether the services they receive are co-produced or working towards that as a goal, would feel far more involved in their local service and feel that their voice was represented within its design. In my experience, however, this is not the case. I feel that this is something to do with the mixed responses that service users receive towards their attempts at involving themselves in their services, and also in the highly variable attitudes of service providers towards researching and implementing service user views.

Service users, as is evidenced by my last blog on the Design in Mental Health Conference, are a highly diverse bunch with enormous capacity and a wide range of specialisms. As I said last week, Marion Janner took her experience as an inpatient and turned it into a programme to implement positive change across the country. Sarah Wheeler, who I also namechecked, took her experience of isolation and turned it into Dragon Cafe, a community of people who meet on a Monday and support each others mental health through diverse creative activities and through making a difference by educating young psychiatrists. James Leadbitter took his interest in design and art and how it is outworked in mental health environments and created Mad Love, a highly imaginative and challenging response by service users to mental health design which has provoked architects and piqued responses from the mental health establishment as well as the art world. Clare Allan used her talent for fiction to create the characters in Poppy Shakespeare, which took the lid off mental health units for a wider audience and was broadcast on Channel 4. There is so much talent out there and potential to make a difference, the unique routes that this might take determined by individual service user interests, talents and specialisms. However there is a perception among even the most progressive NHS trusts that to open themselves up to feedback is only to invite negative commentary. That ideas have to come from outside, and be commented on by the service user community. The more progressive view, that service users can generate the ideas themselves, seems to be slow to permeate.

To a certain extent this is a problem with consultation itself. While for example James Leadbitter’s Mad Love project went nationwide looking for service users who were interested in design, and found a massive network, service user consultation tends to be local rather than national. In addition, it tends to attract the same self selecting group. And there is after all in all research projects a perception that consultation only identifies problems rather than proposing solutions.

However, there must be a way to aggregate service user views. In the project that I am proposing, Mental Snapp, there is an intention to use video as a feedback mechanism. The idea is that services can create closed groups to assess and evaluate services, and also that in recording video, the service user has the option to make it available on a national level to researchers to work out what makes for the most effective service. The ambition is that service users, who have so many talents and specialisms, can draw together and aggregate their voices by special interest groups as well as by local area, so that their collective wisdom can be tapped. In creating Mental Snapp, I was aware that I was proposing a solution that was self generated, but was also a net result of conversations and conclusions and brainstorming with service users over 15 years in the field. I created it as an individual, in conjunction with my business partner Tex Dunstan, who isn’t a service user himself but has experience as a carer. However, it isn’t an individual project in that trace elements of everyone who has influenced my thinking in the mental health arena reside in it. It is also now no longer an individual project in that we are inviting and are open to feedback, have a group of service users who are acting on the advisory panel, and are starting to do workshops and consult on the idea both off our own back and also in conjunction with an NHS Trust. We are beginning to coproduce our service user led project in conjunction with the professionals.

For more information on Mental Snapp, to support us, join our mailing list and input on the idea of getting service users more involved in design both locally and nationally, please see www.mentalsnapp.com. And for all those service providers out there doing consultation and coproduction, keep doing it, keep the vision and expect ideas – there are plenty.

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