The Impact of Co-Design on Mental Health Programs

Mental health and addiction challenges are pressing issues in both Canada and the United States, affecting millions of individuals and their communities.

In Canada, approximately 20% of individuals experience a mental illness in any given year, with half of Canadians having had a mental illness by the age of 40. [Source]

Approximately 1 in 5 Americans suffer from a mental illness. [Source]

Despite efforts to address these concerns, significant gaps in service delivery persist. This article explores how co-design—a collaborative approach involving stakeholders in the development of services—can offer effective solutions.

Persistent challenges despite efforts.

Increased funding and policy initiatives have been introduced to improve mental health and addiction services, but significant barriers still hinder progress. A 2018 survey revealed that nearly 8% of Canadians with mood or anxiety disorders needed mental health care in the past year but did not receive it. [Source]

The U.S. faces a shortage of mental health professionals, with just 105 professionals per 100,000 people [Source]. These ongoing challenges highlight the limitations of current mental health and addiction programs.

Root causes of the mental health challenge.

The persistent challenges in mental health and addiction services can be attributed to several root causes:

• Limited access to services: Geographic disparities and insufficient service availability hinder access to care. [Source]
• Financial barriers: High costs and inadequate insurance coverage prevent many from seeking necessary treatment. [Source]
• Workforce shortages: A shortage of trained mental health professionals limits the capacity to meet demand. [Source]
• Fragmented systems of care: Mental health services are often uncoordinated across different levels of care, creating confusion and barriers for individuals seeking help. [Source]
• Cultural competence: Mental health services that lack cultural sensitivity may fail to address the unique needs of diverse populations. [Source]

The potential of co-design as a path forward.

Co-design involves collaborating with stakeholders—including patients, healthcare providers, and community organizations—to develop services that truly meet the needs of users. This approach can address the root causes by:

• Enhancing accessibility: Tailoring services to community needs can reduce geographic and financial barriers.
• Building trust: Engaging stakeholders fosters trust and reduces stigma associated with seeking help.
• Reducing fragmentation: Co-design helps create more coordinated mental health services, making it easier for individuals to navigate care and receive consistent support.
• Promoting cultural sensitivity: Involving diverse communities in the design process ensures that mental health services are tailored to meet the unique needs of different populations.

He Ara Oranga: A Model for Co-Design in Mental Health Reform

He Ara Oranga (New Zealand) stands out as a leading example of how co-design can drive meaningful, sustainable reform in mental health services. The He Ara Oranga report, published in 2018, places a strong emphasis on co-design—collaborating directly with individuals who have lived experience with mental health challenges. The report advocates for a shift toward community-driven solutions, highlighting the critical need to integrate those directly affected by mental health issues into the design of services that impact them.

1. Positive Outcomes for Participants: The independent evaluation of the Te Ara Oranga services reported significant success in improving outcomes for individuals and their families. Participants experienced benefits such as reducing substance use and achieving harm minimization. Additionally, many individuals found employment through the program, highlighting its effectiveness in supporting recovery and reintegration into the community. [Source]
2. Cost-Benefit Analysis: The Crows Nest evaluation indicated that the program's outcomes were favorable from a cost-benefit perspective. This analysis suggests that the financial investment in the program yields substantial societal benefits, reinforcing its value in addressing addiction issues [Source]
3. Reduction in Crime Harm: The evaluation utilized advanced data analytics to track progress and outcomes, revealing a 34% reduction in post-referral crime harm among participants compared to those who did not engage with the program. This significant decrease underscores the program's effectiveness not only in improving individual health but also in contributing to community safety. [Source]
4. Innovative Approaches: Te Ara Oranga is recognized for its unique partnership model that integrates police, mental health services, and community organizations. This collaborative approach has fostered a supportive environment for individuals seeking help, demonstrating a shift in how communities address addiction and mental health challenges. [Source]
5. Community Engagement: The program emphasizes co-design with local communities to ensure that services are tailored to meet specific needs. This engagement has led to improved trust between police and health services, facilitating better referral pathways for those in need of treatment. [Source]

Implementing co-design: steps forward.

To effectively implement co-design in mental health and addiction services, aligning key strategies with the core elements of community-driven design is essential. Consider the following approaches:

• Engage stakeholders early – Involving patients, families, and community members from the planning stages ensures that services are developed based on the real needs of the people who will use them. This approach helps create solutions that are both practical and relevant. [Source]
• Allocate resources for co-designed initiatives – Investing in both infrastructure and funding is critical for the success of co-designed programs. This ensures that these initiatives are supported and sustainable over time. [Source]
• Evaluate and adapt – Continuously assessing the effectiveness of co-designed programs allows for necessary adjustments to improve service delivery. Feedback loops with stakeholders are essential for ensuring long-term success. [Source]

Building better mental health services, together.

Co-design offers the chance to create mental health and addiction services that are not only more accessible, relevant, and impactful but also more efficient and cost-effective. By involving stakeholders in the development process, we ensure services are better aligned with the actual needs of communities, leading to stronger engagement, trust, and lasting success.

If we design programs without considering the needs of those they serve and those who will implement them, we risk creating ineffective solutions that lead to wasted resources, inefficiencies, and higher long-term costs. Embracing it, however, can help optimize resource allocation, improve outcomes, and ultimately save money by preventing the need for costly revisions or interventions later.