A few words on co-production in a changing world

By Chrystine Moon, singer-songwriter, political musician, feminist comedian

I've been struggling to write something on this for over a week now... … it feels ironic, trying to express the value of collaboration and co-creativity, sitting alone in my kitchen with just my laptop for company, amidst the alarming unfolding of the corona virus pandemic.

Here we all are, in our islands/bubbles/shelters or on the front-line, with whatever levels of comfort, privilege, safety or danger this affords us. Some, like myself, having time to reflect on our lives, needs and coping strategies whilst global catastrophe breaks out around us.

At the beginning of the year, there was much talk about the possibilities for positive social and environmental change resulting from the challenges of the pandemic, yet, as things play out, the sheer overwhelm of deficits in basic care, PPE provision, social inequalities, racism and exploitative employment practices , combined with a level of mortal fear as public health infrastructures are shockingly mismanaged, make it hard to hold onto visions of collective action for positive change.

I find I am experiencing deep soul searching, some personal healing, moments of fear and sadness.. moments of love & gratitude.... and a lot of time to think.. worry.. grieve.. and think some more...!

So, what of Co-Production?

As dialogue turns to monologue, here are some thoughts from me: I first heard of Co-Production when visiting 'Survivor's of Depression in Transition' (Sodit) , a Sheffield based, all-women mental health support project.

Like many before me, I arrived on the Sodit sofa with a wealth of unsatisfactory experiences regarding mental health support for intelligent, partially-empowered women who have survived complex trauma.

Sodit offers a space for women to share stories and affirm survivor strengths. So, there I sat, on the purple sofa, accepting tea, spitting pins and airing stories. There were nods of recognition, robust sighs and even exasperated laughter. .. and the planting of seeds... (metaphorically, that is, it's on an industrial estate in Tinsley, so no allotment out the back of this site!...) …but seeds of ideas were scattered... watered .... maybe even encouraged.

I'm also a Dramatherapist.

I worked in education, schools and special educational needs settings for thirteen years until my unmet support needs caught up with me and, unable to access the support I needed, I found myself engaged in an in-depth experiential “course” in the inadequacies of mental health support provision as mentioned above!

Unfortunately, my story is not unusual.

It results, I believe, from a shift in mental health practice over several decades. Whilst, on a surface level, at least, there is greater visibility and attempts to lessen shame and stigmatisation around mental distress, this has not been met with sufficient resources to respond with the necessary skill, depth and sensitivity that authentic therapeutic work requires. Budget cuts and service limitations result in quick-fix pseudo solutions that, at best, help only partially and, too often, leave so-called “ clients” feeling worse.

The movements to open up debate and conversations around mental distress and illness have fallen into traps of individualisation, off-the-peg pathological identities and, too often, a superficial and inadequate approach to the complex and delicate task of therapeutic work.

So,... What of Co-production?

Arriving to this discussion recently, with both my professional and “would-have-been-aservice-user-if-there-were-any-quality-sevices-to-use” perspectives; I believe the following questions are crucial for the concepts of Co-production to make meaningful and authentic improvements to health and social care.

1. What models of “health” and “well-being” are underpinning practice here? e.g. Is “well-being” the ability to cope with social injustice and deprivation  without breaking down personally? Or is it the the ability to honour understandable distress; to affirm and support individuals and, collectively, challenge, organise and change?
2. Are any attempts at Co-Production supported by adequately resourced social infrastructures? It's no good clapping on the doorsteps as hundreds die from inadequate protections, is it? Nor is it helpful to suggest real self-worth can be cultivated with a meditation app and a yoga class if people are unsafely housed or in poverty.
3. Are support interventions able to respond with appropriate levels of skill, time and tailored sensitivities to real human needs? It's important to take seriously the necessary levels of skill it takes to respond to trauma, vulnerability and distress. 
Whilst peer support can be brilliant, sometimes other structures may be necessary to provide the levels of skill and safety that are required. A mission statement of “equality” doesn't eradicate the need for careful assessment and response to real complex human needs in sensitive and sustainable ways.
4. Power. Who holds it? Shares it? Uses it? And how is it used? Concepts of Cooperation should not be used to fudge or dodge the dynamics of power in any human interaction. We need powers to engage in personal healing and social change. Authentic therapeutic work is powerful. Information is powerful. All powers must be shared with the fully informed consents of all involved.
5. Are invites to participation genuinely accessible and inclusive? Accessible and meaningful participation requires more than a multi-lingual email and a wheelchair ramp. Tho' these are also needed, to participate meaningfully in Co-Production, all parties must have sufficient awareness of their own needs and wishes and enough sense of entitlement to believe they can be met. For some of us, years of insufficient support or encouragement means that to arrive at this state will require work in itself. It's no use asking already disenfranchised and disillusioned women what they want without first repairing the damage that left us feeling what we want is so unachievable its not even worth thinking about!
6. Radical honesty. For ALL involved.

It seems to me at the heart of Co-Production is the dismantling of the “professional provider” and “service user” dynamic. This long-standing mythology has robbed “service users” of our strengths, talents and autonomous agency and “professional providers” of honesty and authenticity regarding our own limitations, needs and vulnerabilities. Having lived experience on both sides of this false fence, I know it disempowers those seeking help and burns out those attempting to give it. Plus , it deprives everyone of a more authentic and radically honest experience in which real healing, power sharing and co-creative solutions could thrive.


Chrystine Moon BA(hons) PGCE PGDipDth is a survivor of complex trauma, a Dramatherapist, a member of the LGBT+ and feminist communities, a sibling carer and freelance performer and singer-songwriter.