The Latrobe Health Assembly has undertaken a co-design process with service providers, government and people with lived experience to develop an innovative mental health cafe model for Latrobe City. The cafe has and continues to involve people with lived experience at all levels. It aims to: increase opportunities for peer support and social connection; reduce emergency department presentations for non-emergency mental health issues; and improve mental health consumer experiences and outcomes.
Mental health challenges are not 9-5, yet limited support services are available to those who need them in the evenings. Latrobe City's Mental Health Cafe has been developed to provide a safe, welcoming service where people can seek support and company in the evenings, providing them with an alterative to struggling on their own or heading to the emergency department for non-emergency issues.
A co-designed model has been developed specifically for Latrobe City. The need for this service was identified collaboratively by consumers, service providers and government. However, it was collectively acknowledged that developing a service like this would require an innovative, co-design process to ensure the development of a model suited to the unique geography, needs and opportunities of our local community.
Throughout 2021-22 an in-depth consultation and co-design process was undertaken to develop a model tailored to Latrobe. This model has now been endorsed and funded, with a 24-month pilot underway.
It is characterised by a peer-led model, evening operating hours, wellbeing supports, a recovery-oriented approach and a commitment to meaningful, ongoing participation of people with lived experience at all decision-making levels.
The service seeks to:
- innovate the traditional and medical model of mental health services
- harness lived experience expertise in the development of supports
- reduce unmet needs which impact on health and wellbeing but cannot be met by clinical services
- provide after-hours support
- provide a space where immediate face-to-face support is available
- provide a safe space for people experiencing psychological distress
- reduce non-emergency presentations at the emergency department
- increase help-seeking and service connection where appropriate
- provide a sense of purpose, connection, belonging
- provide peer support − to model recovery, build hope, confidence, self-esteem
Sharing power with those best-placed to act and championing the voices of those with lived experience were vital to the design process. People with lived experience, including carers, have played pivotal roles in this project from its inception. But in designing the service, the group felt strongly that the voices of those who are often heard the least needed to be sought out and championed. From the earliest meetings, group members stressed the need to engage the people who might use a service like this. Surveys wouldn’t suffice – the group knew that we needed to go to people and to create multiple avenues for participation.
Larter Consulting were engaged to lead an extensive consultation and co-design process. Hundreds of people with lived experience, carers, and other key stakeholders shared their views on what the service should look, feel, and be like. Feedback throughout this process highlighted its power. For instance, one participant shared that: “To have people listen to you and take into account your life, real experience is what’s needed. If I can help the next generation by contributing to this, that's wonderful.”
A series of co-design workshops were held to review the consultation findings and develop a model. Key decisions were made by those best-placed to do so. This included people with lived experience developing a range of non-negotiable recommendations to make the service welcoming, accessible, and suitably staffed. Service providers were also responsible for making key decisions in the model’s iterative development.
The task group’s willingness to relinquish control and champion diverse voices has resulted in a co-designed service that reflects the diversity of the people who will frequent it. An ongoing commitment to championing lived experience is also evident in the model itself, which includes diverse representation at all decision-making levels, a person-centred outcomes framework developed by people with lived experience, and a peer-led staffing model.
This project is now funded and Lifeline Gippsland is currently leading establishment of the service. Recruitment and fit-out of the cafe is underway, with doors anticipated to open by January 2023. Extensive evaluation planning is also underway to support continuous quality improvement and to assess the impact of the service. This evaluation will utilise an Outcomes Framework developed by people with lived experience during the co-design phase. A cost-benefit analysis is also planned to help inform the initiative’s sustainability into the future.
What Makes Your Project Innovative?
This project has provided opportunities for our organisation to be innovative in how we design and develop services with community. A large part of this was having the willingness to slow down and invest in shared sensemaking. Rushing to define the project and prioritising control over learning opportunities may have been a quick solution to mobilising the work – but this would have hindered both collaboration and innovation. Instead, group members demonstrated a willingness to lean into the unknown, be ambitious, and to learn how best to tackle this shared challenge together.
The task group’s willingness to relinquish control, champion diverse voices and employ a range of engagement methods has resulted in a co-designed service that better reflects the diversity of the people who will frequent it.
The cafe's commitment to centering lived experience at all decision making levels is also innovative.
What is the current status of your innovation?
This project is now in its establishment (or implementation) phase, after having spent the past 18 months generating ideas, designing solutions and developing a costed model and business case.
Latrobe Health Assembly has partnered with Lifeline Gippsland, who will lead the establishment and operations of the service.
We are currently in the 6-month establishment portion of a two year pilot (fully funded). Work has commenced on establishing strong governance for the project, including an unwavering commitment to centering lived experience at all levels of decision-making. A site is leased, with fitout underway, and the recruitment of staff is in progress.
We are on-track for the service to open its doors in January 2023.
Collaborations & Partnerships
This project has been deeply collaborative. The idea came from a forum which brought together local and state-wide providers, people with lived experience, carers, and other experts. A smaller taskgroup was formed to lead the work which included consumers, carers, service providers and government. The consultation and co-design process included input from hundreds of relevant stakeholders. A number of companies have also approached us to support the service (eg. via donations, volunteering)
Users, Stakeholders & Beneficiaries
Co-design participants praised the opportunity: “To have people listen to you and take into account your life, real experience is what’s needed. If I can help the next generation by contributing to this, that's wonderful", "an adventure like this cafe is needed in the Latrobe Valley". Government and service providers have also commended the process and remain eagerly involved in the establishment phase.
Results, Outcomes & Impacts
The impacts of the co-design process have been very positive. Tangible results have included the high rates of engagement and the collection of quotes and testimonials from co-design participants and other participating community members and service providers.
The success of the process is also reflected in the fact that the model developed has been endorsed and funded for a 24-month pilot.
Evaluation of the service's impacts will be monitored closely by an external evaluation team. This team will measure the impacts of the cafe using an outcomes framework that has been developed by people with lived experience. Indicators of success include: guest experience surveys, engagement in art and stories, low staff turnover, occupancy rates, number of unique and return visits, demographic data, number and nature of partner organisations, quality improvement framework, emergency department data, hospital data, and staff/volunteer feedback.
Challenges and Failures
Doing extensive community engagement during Covid presented a range of challenges, however these didn’t curb the team’s commitment to delivering a diverse and inclusive process. Hundreds of people with lived experience, carers, and other key stakeholders still shared their views on what the service should look, feel, and be like. This required diverse engagement methods including in-person, SMS, email, phone, and virtual meetings.
Conditions for Success
Undertaking this work required a commitment from leadership and the task group to lean into the unknown. At times this group’s early work was slow and exploratory, but the work being done was crucial. By building rapport, engaging key stakeholders early, and investing time in shared sensemaking, the group laid strong foundations which continue to deliver benefits.
Rushing to define the project and prioritising control over learning opportunities may have been a quick solution to mobilising the work – but this would have hindered both collaboration and innovation. Instead, group members demonstrated a willingness to lean into the unknown, be ambitious, and to learn how best to tackle this shared challenge together.
Learnings from this project are already informing other projects within our organisation.
To help ensure that these learnings are documented and shared more widely we are working on ways to disseminate insights, including publishing reflections like this one.
The co-design process and model developed for our community are not overly complex. Rather, their success has hinged on our ability to genuinely commit to the time, flexibility and relinquishing of control that is required to truly collaborate on co-designing a place-based intervention.
Some key learnings have been that:
- Collaboration takes time. Invest early in shared sensemaking to ensure the vision is shared, understood and has strong buy-in. Rushing this may speed things up initially but will lead to challenges down the track.
- To benefit from the power of diverse conversations and inclusive decision-making, we need to work in diverse and agile ways
- Implementation - making the innovation happen
16 November 2022