Maximising the ‘co’ in co-design through facilitator actions: co-designers’ perspectives on what makes their participation in co-design meaningful

Abstract

Co-design is a participatory approach to service development and research that is increasingly expected within the mental health sector. It involves end users being involved throughout a design process, not simply by providing opinions, but through shared decision making. Evidence suggests that this approach results in solutions that are more appropriate for end users. However, achieving authentic co-design and avoiding tokenism is complex. There is limited exploration into what mental health end-users identify as maximising their opportunity to contribute within a co-design process. This paper addresses this unmet need through in-depth exploration of co-designer experiences in one project. The project involved the co-design of a mental health app (DRIV-R: DRIVing my own mental health Recovery). The design process involved users and providers of mental health services (referred to as co-designers) and the research team, a group of health and design researchers (referred to as facilitators). We use the insights and reflections shared by the co-designers throughout this project to explore the following research question: What facilitator actions and practices do co-designers identify as helping to maximise the ‘co’ in their co-design experience? All co-designers were invited to participate in an in-depth interview with a researcher with lived experience of mental health recovery who was not involved in the co-designing of the app. Twelve of the co-designers participated. De-identified data were analysed thematically using constant comparative analysis. Four overarching aspects or experiences were central to co-designers’ maximal engagement and contribution: personal motivation to contribute; ability to contribute; feeling safe and feeling that their contributions were valued. Co-designers reported that these experiences could be optimised by six facilitator actions: (1) Cultivating passion and motivation for the project; (2) Providing enough information; (3) Building equal, respectful and caring relationships with co-designers; (4) Facilitating group connection and cohesion; (5) Providing varied opportunities to contribute; and (6) Valuing contribution and evidencing impact. These findings support future mental health researchers, designers and practitioners to critique their approaches and extend the ‘co’ in their co-design activities. Findings from our study also contribute to what is now needed: best-practice implementation guides that will support the translation of co-design principles into practice. Not applicable.