Tackling complex problems, together

13 December 2018

We know that 1 in 4 UK adults will experience a mental health problem each year and back pain affects around a third of the UK population each year. Coping with either of these can be a challenge, and many people experience both at the same time.

A new collaboration between our Q Improvement Lab (Q Lab) and the mental health charity Mind, is focusing on this issue to see how care can be designed to best meet the health and wellbeing needs of people living with mental health problems and persistent back and neck pain.

We spoke to Libby Keck (Programme Manager, Q Improvement Lab) and Joanna Moss (Business Development Manager, Mind) about the collaboration.

Could you tell us about the work the Q Lab and Mind are doing together?

Libby: Q Lab is a new approach to making progress on complex problems in health and care, led by the Health Foundation and supported by NHS Improvement. We work on a single challenge for 12 months and bring together people with lived experience and professional expertise. Together, we look at what’s known about the topic, how it’s affecting people and systemic barriers, and then develop and test ideas to improve care or reduce the impact of the problem. 

Joanna: Together we are working on a project looking at how the support available for people experiencing mental health problems and back and neck pain can be improved. We’re also interested in how that fits into wider discussions about mental health and long-term physical health conditions. At Mind, we work with people with lived experience of mental health problems across England and Wales. Any project working on a complex health care challenge should have the people who are experiencing that challenge at its heart. We felt we could bring something valuable to the Q Lab, not least by supporting people with lived experience to get involved. 

What does collaboration mean for Q Lab and Mind? 

Libby: Collaboration is central to how we work at the Q Lab. During the Lab’s pilot project, which explored how patient-to-patient peer support could be made more widely available, we worked with around 200 people. We were amazed by the commitment of people within the health and care community to give time and energy towards working together on the peer support project

When designing the Lab’s second project, we could clearly see the opportunity of partnering with an organisation like Mind, which is embedded within a topic and is in a great position to take forward the work we do together, beyond the 12-month project. Being able to connect passionate people across health and care, including from the Q community, with an organisation that’s engaged and able to speak at a national policy level is really exciting.

Joanna: For Mind, collaboration is part of the way we work. We’re a federated organisation, with around 130 local Minds. One of our five core values is ‘together’ – by which we mean that we’re stronger in partnership. Alongside the Q Lab collaboration, we have many other collaborations: with local Minds, with other sectors and organisations. It’s a huge part of who we are.

What did you do to prepare for collaboration?

Libby: One reason collaboration is so important for Q Lab is that we have to build a rounded understanding of a topic and to do that we need a range of perspectives. It’s really important to then work effectively with the people involved. We carefully consider how we create and facilitate safe spaces and make sure people can see how their contribution is connected to the development of the work. I’d recommend taking a look at the Impact that Counts essay that we published in the summer, which discusses this in more detail.

Joanna: One thing I think Mind is bringing to Q Lab is best practice of collaborating with people with mental health problems and meaningfully engaging people with lived experience. We have shared the things we do to enable people to talk about personal experiences, and the importance of recognising different power levels within a conversation. A nice thing about this collaboration has been that I’ve felt able to say when we need to look at the way we’re working or talking. We’ve spoken about the language that’s used around mental health, and I’ve really noticed how that has changed the way Q Lab colleagues discuss mental health. That’s been important for us, because it feels like our views are respected.

Who are Q Lab and Mind collaborating with on this project?

Libby: So far, around 90 people have come forward to collaborate with us on this project. That includes quite a few people who work within the health and care sector and also experience mental health problems and pain, so that’s an interesting intersection. We have people with lived experience and people with a range of professional expertise, including primary and secondary care, musculoskeletal, rheumatology and mental health services. 

Joanna: We have been actively engaging with local Minds because we feel their on-the-ground delivery expertise and knowledge of local communities will be really valuable for anything we collectively end up testing. We’re excited about that and we’ve also been engaging with people with lived experience from Mind’s network. 

What methods are you using to draw out people’s diverse experiences?

Libby: When we launched the project in September, we asked the Q community and Health Foundation’s networks for initial suggestions in a survey. With over 140 responses, the early insights gave us a helpful steer. Then we did a series of research activities and workshops in October, with Q Lab participants adding to the research from their own experience and helping to prioritise emerging themes. 

Joanna: In previous projects at Mind, we’ve invited people with lived experience to interview other people with lived experience. We see a real richness to those conversations, where two people understand each other’s perspectives. We’re using that as a method in the Q Lab to better understand peoples’ lived experiences of mental health problems and back and neck pain. Additionally, although we’re based in London, we’re keen to meet people where they are. We’re working on the topic of pain, which has the potential to impact somebody’s mobility and we have a responsibility to try to ensure everybody can participate, even if they can’t travel or participate face-to-face.

Libby: We have an online group for this project, so there’s a space for participants to have informal conversations, make connections, share and learn together. People value face-to-face engagement, but we’re increasingly using online platforms – such as the Q website and webinars – that enable people to contribute in different ways.

Based on your experiences and reflections of the Q Lab collaboration with Mind, what would you say makes a good partnership?

Joanna: One of the interesting things about this partnership for us is that that neither organisation is the funder; we’re both contributing resources like staff time. Often when charities work in collaboration with other organisations there is a financial obligation between the funder and the funded, which changes the dynamic. It’s given us freedom to talk about the way we’re working together. From the outset, we’ve been open in discussing where we might have slightly different priorities or perspectives. For Mind, we’re interested in the tangible outcomes for people with lived experience of mental health problems. We’re seeing huge value in the process even though the process is not the primary outcome we’re focused on. 

Libby: It’s important to have that openness and the willingness to discuss our different priorities and perspectives. Lots of people talk about the importance of partnership work, but people talk a lot less about how you do that well. Working in partnership can mean that you need to challenge yourself and your usual ways of working, and that is not easy. 

Joanna: I think it’s important for people to think about why they want to work in partnership. Neither organisation is in this partnership for its own sake, there is a wider context which this sits within. Partnership working can be complex, but the overall impact you have by working together effectively can be greater than if you were trying to achieve something on your own.

Libby: Effective collaboration takes time and effort. You have to spend time forming a group of people you want to work with, getting to know people and setting expectations. The added value is significant, so it’s worth doing that early work. 

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