Authored by: Anonymous Project Consultant, Fulfilling Lives South East Partnership
A snapshot of the Fulfilling Lives South East Partnership (FLSE) client group highlighted how substance misuse and mental ill health are the most common problems for people on our caseload (94% and 96% of the project’s caseload respectively). Additionally, there is a high degree of overlap between the two conditions, with 90% of beneficiaries experiencing both.
In response, The Perspectives Project launched earlier this month, explores whether forms of psychological support can better enable access to formal treatment services. One of the key findings from this Project has been how (and to what extent) collaboration between the substance misuse and mental health services can lead to better access outcomes for people with multiple complex needs. As we disseminate our findings through various channels, it would only be fair to turn that lens inwards and look at our own practices of collaborating with people with complex needs in shaping the Project and creating reciprocal opportunities.
Broadly-speaking, the collaborative model is deeply embedded in the way Fulfilling Lives staff and projects operate, design, create and deliver. Our system change work is guided by the principles of coproduction and by lived experiences voices. This blog post will reflect on the internal process of collaboration and evaluate the making of The Perspectives Project against some of our own principles of what good coproduction should look like.
What do we mean by Coproduction?
We understand coproduction as a process of meaningful engagement, where all participants are considered as equal partners, who can share power, skills and experience and have influence over decisions made.
In our work, coproduction is seen as an attempt to create equal relationships between those involved in commissioning services, service providers and service-users; it ensures that people with lived experience are valued for their expertise as a result of their experiences of undergoing and overcoming challenges faced by multiple disadvantages.
We have identified core principles of reciprocity, equal opportunity, choice and valuing diversity, accessibility, ongoing learning, pioneering spirit and collaboration to define what makes good coproduction happen.
A collaborative process: Realising shared visions and valuing differing perspectives
From its inception in early 2020, The Perspectives Project was born out of a series of collective deliberations between members of the System Change, Learning and Impact, Client-facing and Service User Engagement teams, which included employees and volunteers with lived experiences of complex needs.
The discussions focused on how we could best take steps towards our stated project goal ‘all clients with complex trauma presentations to have access to psychological support to help prepare for accessing formal treatment.’ This was an area we all wanted to work on but we had a challenge – we couldn’t all agree on what this ‘psychological support’ should be.
These conversations highlighted that while there was shared consensus that psychologically informed therapeutic interventions prior to accessing formal substance misuse treatment were generally a good thing, there were differing opinions on what good psychological support meant in theory and practice.
Rather than privileging one opinion over another, the lack of a common position and the acceptance to sit uncomfortably with the unresolved questions gave rise to an interesting learning opportunity and an adventurous undertaking. The team found that there was a need to conduct an official study to consult and hear from a diverse range of expert voices to understand this issue better.
And thus, began the process of reaching out to an inexhaustive list of client-facing specialist and non-specialists professionals from across mental health and substance misuse services, as well as service users and peer mentors. What followed was a lengthy collaborative process of drafting and co-designing the questions we would ask our participants, then onto interviewing, transcribing, coding and analysing the data, cross-referencing interview transcripts, and finally reaching one of our major milestones of publishing our findings on 10 February 2021.
Creating shared ownership: Reflections by a former lived experience volunteer
I joined the Perspectives Project in May 2020, while I was volunteering with the Fulfilling Lives project in Brighton. One of the System Change officers attended our Action Group meeting to get feedback on the interview questions from a lived experience perspective. At the end of that meeting, they asked if we would like to get involved with the research project on a deeper level and I casually put my hand up.
At the time, I had been quite active in the creative recovery community. I had suffered a substance-induced psychosis in 2017 and I had been out of work for more than 2 years as a result of mental ill health, so in a way… the issue was quite close to my heart. Also, before I fell ill and on bad times, I worked as a social science researcher at the University of Sussex, but I had lost interest in research and lacked confidence in my skills. This project provided a real window of opportunity to get back on my feet and prove to myself that I still had it in me, that I was still good enough to work in an area that I was qualified and trained in.
I was quite surprised at how engaged I was, some of it may have been a direct result of the team’s appetite to give up and/or share control over important parts of the research process. I was also really well supported and mentored throughout. I felt a real sense of shared ownership and was invested in the direction the project was taking just as any other team member. I managed to confidently interview some incredibly influential people whose hands felt tied when discussing the enormity of the challenge at hand, and also those who were equally passionate and working creatively on the frontlines, despite all odds.
It was a truly rewarding process on a personal and professional level because months later, I used this experience to successfully apply for a job with Fulfilling Lives South East and here I am, writing this piece as Project Consultant and seeing this ongoing project through, as it passes its many planned milestones.
 Fulfilling Lives South East Partnership (2019) Manifesto for Change. Brighton Housing Trust. p.24
Available at: https://www.bht.org.uk/wp-content/uploads/2019/11/Fulfilling-Lives-Manifesto-for-Change.pdf
 Rieley, R., Dowding, K., Wallace, A., Harisson, I. & Bhonagiri, A. (2021) The Perspectives Project: Discussions on psychological support and complex trauma pre-substance misuse treatment
Available at: https://www.bht.org.uk/wp-content/uploads/2021/02/Fulfilling-Lives-T4-Psychological-Interviews-V22-1.pdf
Website – https://www.bht.org.uk/fulfilling-lives/
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Blog – www.fulfilling-lives-se.org