Co-production and mental health for older people

For co-production week, Dame Philippa Russell reflects on how important co-production is for older people with mental health issues - it's all about letting your birds sing.

As this is co-production week I reflect on co-production from a family carer’s perspective. As a family, I think we have ‘co-produced’ my son’s life pretty well. He is well supported and if I put the Making it Real ‘I’ Statements to him, I think he would agree that he is living the life he wants, in a place he likes and with people to support him.

But co-production and mental health can be another issue, especially for older people. Although mental health and wellbeing have gone up the national agenda, particularly for young people, we find older people’s mental health often tumbles off the agenda. As a society we don’t like older people very much, and yes, I am one of the ‘demographic timebombs’ who might one day inconveniently need care and money. But I can also see that age need not equate with ill health  and mental health challenges; we can ‘co-produce’ communities and support well-being.

Creative co-production and focus on what matters

My husband, who sadly died recently, had cancer, dementia and significant mental health problems. Life was unhappy, lonely, despite the people around him. I reflected on what could make a difference – maybe to re-engage someone in a world that they felt they had left? Co-production should be creative - and pictures are often the clue to personal anxieties. Co-production for us meant the wonderful art classes (for carers and the person with dementia) at the Pallant House Art Gallery in Chichester.

We valued the various specialists, focusing primarily on physical illness but interested in mental well-being, asking about the person and the family struggling to care.

We were fortunate in living in a ‘dementia friendly’ community where some very difficult behaviour would be tolerated. We know from Carers UK’s annual State of Caring that 78% of carers report anxiety or depression and anything that helps them is to be welcomed. Everyone can benefit from small adjustments; for us the seats and friendly staff in Marks and Spencer and the bank made going out possible.

Co-production is about relationships – living as a team with the carers, the nursing home, the nurses, the people who dealt with the domestic disasters when someone is very angry and not always aware of what he is doing. Co-production can essentially be shared care. For people with mental health conditions it is the double battle of coping with stigma as well as the behaviour and risks themselves.

Letting your birds sing

Could we do it differently?  A final reflection from Northern China!  My son, looking out of a 12th floor hotel window, saw every morning a group of older men and women walking to the park. They all carried bird cages, put the cages in a circle and then did their Tai Chi. An hour later the bird cages were picked up and carried home. When he asked, a waiter explained. Ah yes, he said, ‘many young people have left this town and the old people are lonely. They get depressed, they get ill. The City Council said let us give them a purpose that will keep them happy and well. The old people do not come to Tai Chi on their own, but we give them song birds and we say, your bird will not sing unless he can see other birds and sing together. You must bring them to the park when you do Tai Chi, let them sing in a choir with their friends and they will live long and happy’.   

I think that letting your birds sing is a very good analogy for co-production!  Co-production is not a service, it is a means of meshing all the good factors in your life together. Most importantly it is about valuing what is important to people and ‘thinking outside the box’.