Abstract

Author(s): Kathryn Thorburn¹, Shifra Waks¹, Bani Aadam1, Professor Mark F Harris¹, Dr Catherine Spooner¹, Professor Karen R Fisher²

1. Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia,

2. Faculty of Arts and Social Sciences, Social Policy Research Centre, UNSW Sydney, Australia

Introduction

Primary care is the main setting in which the physical health needs of people who experience mental health issues are addressed. However, mental health service users and primary care providers report significant barriers to accessing and providing physical healthcare, with obstacles occurring at the individual, practice, and systems levels. Co-design, a process for developing solutions to complex problems that privileges lived expertise, provides a forum where service users and providers can collaborate to improve healthcare services and relationships.

Method

This research involved co-designing a practical approach to improving mental health service users’ physical health care in primary care settings and the research design for testing it.  It also explored the co-design process, how outcomes were achieved and the co-designers’ experiences. People with lived experience collaborated as co-designers, co-researchers, co-facilitators, and members of the lived experience advisory group.

Records and documents from co-design activities were collected. Co-designers’ experiences of the process were obtained via group and individual interviews. Transcribed audio-recordings of individual and group interviews, project documentation and images were coded and analysed thematically.

Results and findings

Six people with lived experience and five service providers (including GPs) participated in the online co-design. Thirty barriers to physical healthcare and 12 potential solutions were identified. The Physical Health Conversation Guide (PHCG) was selected (based on feasibility and impact), developed and prototyped. The research findings emphasise the influence of concurrent dual processes in creating the conditions for new understandings, relationships, and action, with time as a key mediating element.

Discussion

Co-design recognises the value of lived and other expertise in co-creating new knowledge. For its generative potential to be realised, the co-design process needs to create and hold space for emergence, uncertainty and shifts in power. This research has implications for the translation of co-design principles in a range of healthcare settings.