Adapting Group Model Building for Mental Healthcare: A Participatory Co-Design Approach.

Tari Forrester-Bowling, James J Lucas, Andrew D Brown, Stephanie Bennetts, Renae Carolin, Josh Hayward, Debbie Scott, Anna Peeters, James McLure
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Abstract

Countries around the world are experiencing both a growing need for mental health services and major gaps in the delivery of mental healthcare. The World Health Organisation's 2022 report on mental health emphasised co-designed and systems-level innovations responsive to the voice of those with lived experience. However, evidence for implementing such methodologies is sparse. Group model building (GMB), a participatory systems-based approach, has been used in various fields, but its application is limited within mental healthcare settings. It is recognised as a valuable tool for engaging stakeholders, including those with lived experience, in understanding and redesigning health systems and services. The participatory approach aligns with the mental health sector's shift towards co-design and person-centred care. This study assessed the acceptability of GMB as a method for co-design within mental healthcare, aiming to explore its potential for meaningful collaborative improvement and systems-level insights. Participants from a regional Mental Health and Drug and Alcohol Service (MHDAS) engaged in GMB workshops and focus groups. Eighteen individuals, including lived experience workers and healthcare professionals, provided feedback that informed adjustments to the workshops' design, language, timing and facilitation techniques, enhancing GMB's relevance for mental health co-design. The findings demonstrate the value and acceptability of the adapted GMB process in acute mental healthcare, marking a significant step towards evidence-based, person-centred service improvement. This study highlights the potential effectiveness of participatory methods in identifying and addressing systemic challenges, paving the way for future mental health reforms. Future work will focus on implementing and evaluating co-designed interventions, aiming for more inclusive and effective mental healthcare and advancing innovation and reform in the field.

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将小组模型构建应用于心理保健:参与式共同设计方法。
世界各国对心理健康服务的需求与日俱增,但在提供心理保健服务方面却存在巨大差距。世界卫生组织 2022 年心理健康报告强调了共同设计和系统层面的创新,以回应那些有亲身经历者的呼声。然而,实施此类方法的证据并不多。小组模型构建(GMB)是一种基于系统的参与式方法,已被用于多个领域,但在精神卫生保健领域的应用却很有限。它被认为是一种宝贵的工具,可以让利益相关者(包括那些有生活经验的人)参与进来,了解并重新设计医疗系统和服务。参与式方法与精神卫生部门向共同设计和以人为本的护理转变的方向一致。本研究评估了全球监测局作为精神卫生保健领域共同设计方法的可接受性,旨在探索其在有意义的合作改进和系统层面洞察力方面的潜力。来自一个地区性心理健康与药物及酒精服务机构(MHDAS)的参与者参与了 GMB 研讨班和焦点小组。包括生活体验工作者和医疗保健专业人员在内的 18 人提供了反馈意见,并据此对工作坊的设计、语言、时间安排和引导技巧进行了调整,从而增强了 GMB 与心理健康共同设计的相关性。研究结果表明,经过调整的 GMB 流程在急性期精神医疗保健中的价值和可接受性,标志着在以证据为基础、以人为本的服务改进方面迈出了重要一步。这项研究强调了参与式方法在识别和解决系统性挑战方面的潜在有效性,为未来的精神卫生改革铺平了道路。今后的工作重点将是实施和评估共同设计的干预措施,旨在提高精神卫生保健的包容性和有效性,推动该领域的创新和改革。
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