Co-producing a Recovery College in Essex

Overview

Southend Adult Community College was part of a pilot project enabling people who were dealing with mental health issues to access free short courses and have the effects of their mental health and wellbeing measured.

Following this, a group of organisations and people with lived experience came together and started a two year pilot recovery college project that would build upon this learning provision in a way that would work best for those accessing this support. Co-production at different levels was a really important part of how this recovery college was delivered.

Approach

The board establishing the recovery project was co-chaired with people who had lived experience of mental health issues. On this board were the local NHS mental health service provider, two local Clinical Commissioning Groups, Southend Council, voluntary sector mental health providers and adult community learning. Co-production at this strategic level between people with experience of mental health issues and these organisations continued throughout the delivery of the pilot. This way of working developed and evolved as the project bedded in. This involved workshops, formal governance and learning visits with a range of stakeholders. This way of working was built on openness to working together across these partners and consistent meaningful involvement of people with lived experience.

Staff within the recovery college were a multi-disciplinary team including some people with lived experience of mental health.

People experiencing mental health symptoms enrolled with the recovery college by choice and selected courses that they wanted to. Over time some students enrolled on peer support and facilitation courses to build their capacity to help co-produce new courses and co-deliver and improve existing ones. The power dynamic was navigated with care and sensitivity to allow students to contribute to co-production in a way that suited their circumstances and interests.

Impact and learning

Impact

• This was a working model of co-production where people reported a sense of belonging and learning. It allowed them to manage their mental health and improve their quality of life. Friendships and peer support networks were created organically between students.
• According to a peer-reviewed published evaluation by Anglia Ruskin University, there was a statistically significant reduction in mental health symptoms and an improvement in wellbeing for students attending the college. The college is a far less expensive way of delivering this improvement than through NHS mental health services alone.
• Tracking NHS numbers showed a reduction in the use of statutory secondary mental health services for students, although this doesn’t prove that the project was causing this. Information and data sharing agreements were put in place to measure this effect.
• A range of case studies were recorded of students maintaining employment, returning to employment, entering further education and volunteering.
• The service was fully commissioned through procurement with a 5-year NHS contract plus an option to extend for a further 2 years. By the end of 2019, nearly a thousand people had used the service.
• One student said of attending the college, ‘It’s given me hope. It’s given me options.’

Learning

What helped?

• Senior buy in and hands on involvement where needed, for example at the strategic level from all the different sectors.
• Commitment - it was not easy, and the process took years. But the pay-off was a seven-year (5+2) service, attractive to people with mental health challenges that created robust outcomes and was held in high regard – measured in student satisfaction.

What got in the way?

• Perhaps too many wider stakeholder meetings where the purpose of gathering was unclear. On the other hand, it showed the broad base of community interest and commitment.

What else did you learn?

• Co-production is not easy, but it leads to a richer learning experience and arguably better outcomes for everyone involved.
• You can’t share power if you don’t make it visible and be open about where it is in the room.
• Egos have no place in co-production.
• Co-production is about relationships between people as well as processes.
• Co-production is not a place that you get to, it’s a commitment and somewhere you are always reaching for – to do better.
• People won’t do co-production if they are not in a psychologically safe place.
• People will do co-production without any form of reciprocity, but it is more sustainable if there is an element of recognition and/or reward. It does not have to be financial, but it must at least cover expenses. Anything less is exploiting people’s good will.
• Systems and processes must not ‘other’ people with lived experience contributing to co-production. They must be inclusive and accessible with clear expectations upfront and agreed shared language.
• Co-production must be sustained. It is not a one-off event. It should be embedded throughout the life cycle of the project from co-design, delivery and evaluation feeding into quality improvement. It is also essential at the governance level.

Shared power principles should be adopted e.g. learning, subsidiarity, accountability and relationships.

Further information

This case study was created from written responses by Jessica Russell, Co-production Champion, Southend-on-Sea, SAVS. For more information, contact info@savs-southend.co.uk.

An evaluation of the recovery college has been published as: (Ceri Wilson, Matthew King and Jessica Russell) ‘A mixed-methods evaluation of a Recovery College in South East Essex for people with mental health difficulties’ Health and Social Care 27: 5.