Mental health consumers and primary care providers co-designing improvements and innovations: a scoping review

Co-design and co-production are increasingly used to improve and innovate healthcare practices and services to better address people's healthcare needs. Mental health consumers, especially people diagnosed with serious mental illness, experience considerable health disparities and barriers to primary care, while primary care providers experience barriers to addressing the healthcare needs of people diagnosed with serious mental illness. Both mental health consumers and primary care providers bring knowledge and expertise to improving mental health consumers' health care. This scoping review of the peer-reviewed and grey literature was undertaken to determine the extent and scope of co-design and co-production involving mental health consumers and primary care providers to address mental health consumers' healthcare needs. The review also sought to determine factors that enable or limit co-design and co-production involving mental health consumers and primary care providers. Twelve studies and reports of co-design and co-production involving mental health consumers and primary care providers were identified by the review. These studies showed that co-design and co-production were feasible and beneficial, and that there was significant scope for collaboration at the intersection of mental health and primary care services. Lessons learned from projects that have led the way include the need for (1) co-design/co-production practices that sustain equitable participation and address inevitable power imbalances when service users and service providers work together, (2) sufficient reporting on methods to ascertain claims of co-design/co-production and allow replication of these methods in similar healthcare improvement projects, and (3) co-design/co-production projects to be supported by other systems change strategies.