Ade Curwen shares his lived experience of co-production within mental health settings, particular highlights how important co-production is within the context of mental health service provision.
to this committee. I do want to introduce yourself. Hi. I am, uh my name is Adrian Cohen Agent Tell me, what co production can you share? An experience of co production? Yeah, I've been in, um, involved recently in a couple of projects with co production at one of the most important things. And it is really good at kind of address. It is kind of the power dynamics, especially when with some of the projects I've been involved with your working with clinicians, and it's often that inherent kind of power dynamic What we found. What I found working in co production is that it becomes flattened. Uh, and it's truly co production and working together I mean, who are the best people to improve services, people that use their services and then to have kind of this almost level playing field when there's a true exchange of ideas based on the ideas rather than the kind of, um, white coat God complex, which is still there with a lot of doctors and with co production? One thing that's often, uh, I've forgotten about almost is from my experience, how much the professionals you're working with get out of it themselves is actually a two way process. I do a lot of work now in med medical education, and with the senior lecturers I worked with. They've often shared with us how much that professionally they've got out of it, because it's a whole new way of working, especially medical education and also how much personally they've They've also got out of it as well. So I guess that leads me on my thing, actually into medical education. Believe it or not, I find this quite shocking that co production has been very rarely used in medical education, and I'm involved with East London Foundation Trust Uh, in London. She said that at the beginning for the intro. But there you go and we've just set up They just set up a department for this, and it's one of the first in the country. The first sessions we did with with second year medical stadiums and myself, another services of the carer, worked with two senior lecturers, and we co designed a stigma workshop as well as us talking about our own personal journeys and my personal experience of the mental health diagnosis. And it was true coproduction It's absolutely wonderful, the ideas that kind of came out from the sessions and how we all kind of worked together And I firmly believe that's the reason why after the first session was second in medical students, the feedback afterwards was very humbling. It was amazing how inspiring they found it. How now, Um, they're thinking about career in psychiatry, which they never thought about before, and it's a difficult career to recruit two and one of the things that really brought home to me The power in true true play production was that for the doctors was when I think it was seven or eight out of, I think 50. The session said that they will never, ever forget the experiences and listen to us sharing our stories and the workshop, and that they will take that into their own medical practise that every time there are GP every time they have a patient with mental health concerns, they will always think back to the session that we did that wouldn't have been so powerful without the framework of co production, because what was also important was drawing on the experience from the professionals by experience as well as the Soviets uses myself with lived experience. It was that combination which is a for me A true was the best word. Um, true synthesis, Really. I mean, it's the in that way of working It's one plus one equals 35. Even so, with the Medicaid, it's so, so powerful, so much so now starting to work with other trusts and other medical skills. Uh, and one thing we've always said to him as well, we're not just going to come in and do a session We want to work with the other lecturers to co produce something specifically and to look at particular areas that that work and now as well it's for is London Foundation Trust. Anyway, that is going to become part of the curriculum, as opposed to let's see what we can do this. But actually how that's a set part None of that would have happened without co production, because to produce something that was so powerful and so important, so, so important, which is why it shocked us that this is kind of the first time this has been done was because it was co produced and that that's interchange of ideas. I'm giving it a space to really breathe that any ideas can be explored. Co production gives that space that you can do that rather than just a meeting and chat up about ideas It's almost like it's a It was like It's a safe space, you know, just because one person says an idea, it doesn't make it better or worse than anybody else's idea. So there's much more of a free exchange. I think of ideas The other kind of springs to mind is a research project. I was involved in myself, another service user and carer and what we were doing. We were looking at the benefits of being involved in, uh in the NHS Trust I'm involved with is called People Participation. It's involving service users in all different aspects interview panels, everything like that many, many different things. But I guess that's a whole different conversation So a lot of people would say how they got so much benefit out of it. It really helped them on their recovery journey. But there was no data, and as we know, you know, um, people love the data, so it was decided that we would do their research projects Well, I didn't realise at the time to afterwards then. This is the first time a research project has been co produced right from the beginning, in everything from the topic guide for the questions, even to the ethical applications, not at times involved down the line to deliver it, but never been done before. Right at the beginning So we did the research projects. Ah, and it was qualitative listening to people and their stories and then transcribing etcetera. And then we produced an academic paper exploring experience, and so people participation in a British says trust the way I didn't quite realise, even though I was down in the end as first author was, it's the first time any academic world track this has been done in the world We didn't quite realise this because it was peer reviewed and it's on a fear that peer reviewed sites that anybody can see. So we hadn't realised that, let alone in this country as well, that this had never been done before and again, what was so beautiful about being involved in that project was it was the result again of true UK production in research which, with hindsight, um, would seem to be really difficult to do co production in research and we just kind of got on and did it. It was until afterwards We kind of realised Wow, this you can see what hasn't really been done But there's a lot of work, but it's so important to do that and again, this is the project wouldn't wouldn't have, wouldn't have achieved what we wanted it to achieve in the sense of really looking at people's involvements and the already the the really rich research data that it gave us. And I think one of the reasons why it was so successful was because it was also other services is interviewing people. And we felt such ownership of the project because we did get cope with his co create the whole thing and the senior research fellow professor that was involved with with it with us I remember him saying to us as well that he found it so fulfilling to be involved in it, but also really challenging to be involved in it as well. And I think that's an aspect of the co production, the kind of things that I've been involved with this is a bit different because it's kind of specifically within the NHS, but it's working with people that want to be challenged because it's a different way of approaching something approaching a project. An idea, um, it something that's challenging and wanting to work together to look at how we can work through these challenges because a lot of the time it's something that's so It's uncharted territory, I guess, because it's a way of working, which which is unusual for want of a better words There's a few companies that I've heard of that, um, that work in such a way that you could call it co production, that I wouldn't necessarily be the one that they'd use. But it's very rare in in a business sense for kind of co production to be used as a model. But there's no reason why not Uh, that's I guess that's a good with a good way of engaging your workforce, I suppose. But with the changes and the impact with the medical education is one that really sticks with me because I think it's a great example of how powerful co production can be and hell you can see the impact of co production can be as well. I mean, it's a game with the students, and it was it was life altering it because with the Copepods project can be that that powerful that try thinking kind of the difficult parts of it that kind of I kind of encountered, I think the main the main thing for me and I guess it might be quite common with kind of co produced work is kind of challenging people's perceptions And a lot of the time people aren't aware that that's the perception that they have. So that often took a lot of time. Um, because you want everybody to come on the same journey lie than tell them this is the journey You kind of Oh, I do when I would be involved with it is you kind of. I almost want to give them the map. And so yeah, there you go But it's up to you will partly take um, and I think that's when it is when it become Leedy powerful. Um, and really, when people join together and really work together, But I think that's one of the challenges, I think it's always there at the start of every project co production project is that first part of Well, okay, what is this? What's my role? So well, your role is exactly the same as everybody else's. That's if that's going to take a bit of a shift in the mindset, especially when it's like in the N H tests, where a lot of the ideas are so entrenched and it's 21 is in the fabric that people aren't quite aware that that's what it is is just the way things are done And again, that's what I find really exciting is that you're also taking people on the journey as well with you for in co production. Um, and it's with the medicine. It was great working with the lecturers and professors and seeing them as time went on, how they changed Um, that was great. I mean, that was that was worth the price of admission. By itself was saying that journey Thank you. You speak so eloquently passionate about go production and you've really spoken to sort of the process and how it can be used to do something really great. So I was wondering if you could sum up co production in a word of a sentence, like the value of coproduction, what would that be? Value? Um, okay, that I could do the word Um Mm. The sentence is turning into a paragraph, uh, paragraph, the value of the value of contraception. I think it's the value of co production is where is It's where people can make the most impact I mean to say it's so that working together, but that is, I think, almost trait when it comes to co production, because it's more than that. Two co produce. Something is really one of the most powerful things you can do because it's with everybody's involvement There's a there's a power in that, and the the end result for want of a better expression would always show that I think it's kind of I'm really do believe that you can look at two projects and you can tell which one's been co produced. There's something about it. It's like there's a there's a flavour to it There's a kind of bit intangible you really put your finger on. But there's something about it. It's more It's more whole. It's almost like it's a it's a holistic way of working. So with that, there's everything that goes along with that because it's it's a much more fulfilling as well, because it's really allowing people's ideas to be expressed and the whole process is holistic Not sure whether that's quite I answered your question there, but it was a yeah, it was really good. So I'm wondering if you had any final thoughts of views that you wanted to share about co production? Uh huh. Get involved I suppose it's for a lot of people are thinking, can seem off putting, but not quite kind of understanding it or feeling very apprehensive about becoming involved in something that's not a not, say, traditional way of working. I think that can be off putting for some people. But I think it's important to remember that everyone's in the same boat and working in a coproduction kind of way There's all that support there with your peers. That that's the big difference is that your peers and so everyone is around you to support you as well, because you'll end up supporting somebody else, Um, just by the nature of the whole thing. But it's so Yeah, I mean to to dip your toe in the water? Um, find something that you're passionate about, Um, that you really feel that you have something to say and then look for co produced projects are all set one up yourself That's as well the beauty of the co production got stand alone projects. But it's a I mean, I was to be in with me. So what the heck is this? I'm really nervous about becoming involved in this, and then it's like, Well, OK, I'll go along to one meeting, see how it goes So I think it's get involved. I mean, it's like anything else. Yeah, you don't know what they're putting He's going to taste like till you taste it. And I kind of my philosophy over the years, I guess I learned is, uh if you feel something is outside your comfort zone, then that's kind of the reason why you should do it. Thank you That's a really nice place to end. So I'm gonna if that's okay. If you pause the building and