Kim Corace, Ph.D., C.Psych.
Every day, we see the alarming realities of escalating rates of substance use and related harms, worsening mental health, and declining well-being. Almost 200 lives are lost every day due to substance-related harms in Canada. The harms are devastating to clients, families, and our communities. For those who need care and treatment for their substance use health and mental health concerns, many cannot get the care they need and deserve. Access to care is challenging, in part due to numerous systemic and structural barriers, wait times are long, and there never seems to be enough health professionals, including our members. The result: People continue to suffer. The situation is untenable.
Continuing to deliver services and care in the ways we “always have,” doesn’t seem to be working. And trying to do more of the same with more professionals, doesn’t seem to be a viable stand-alone solution. At first glance, this may feel hopeless, overwhelming, and something we can’t possibly even begin to tackle. Despite these challenges, there lies great opportunity in front of us. So, what can we do differently? Where can we start?
Over the last number of years, I’ve experienced first-hand the positive impacts of co-leading and co-designing the development and implementation of mental health and substance use health service delivery models with people with lived/living expertise (PWLLE). In fact, our PWLLE co-leadership model was crucial to the successful launch of a new coordinated access to mental health, substance use health and addictions service in our region. The central principle of this service is that it is both responsive to the needs of clients and families, and that PWLLE are integral to all aspects of the design and implementation of the service as leaders and partners. PWLLE are co-leaders on all the governance structures of this service, including the system-level regional and oversight committees. Our guiding principles and collaborative governance structures enable and facilitate shared decision making between PWLLE leaders and the other partners (i.e., healthcare organization leaders, clinical leaders, and community leaders). Together we accomplished what we haven’t been able to in the past, and I owe this success to our co-leadership model.
While I’ve mentioned a large system change initiative where the PWLLE co-leadership model has been highly effective in producing impactful outcomes, I have incorporated this model in the other work that I do as well, including quality improvement projects, clinical intervention development, peer-reviewed research studies, and teaching curriculum design.
Co-leadership with PWLLE represents a significant shift in how we have done things in the past—and is the very shift that we need to tackle our untenable situation in the sector and drive change for the future. Unfortunately, this isn’t something that most of us (including myself) are taught or exposed to in graduate school. We need to seek out these learning opportunities outside of our formal training. Given the incredible benefits that this approach brings, Psychology professionals may want to explore how to integrate this into the work we do.
While numerous other changes and solutions are needed to transform our system and improve the health and wellness outcomes of the people we serve and our communities, co-design and co-leadership with PWLLE is foundational to this work. I hope this starts a conversation in our practices, in our research, and with our students and colleagues. As a profession, we are committed to making efforts to continually improve service delivery and our profession. I invite you to reflect on your own quality and practice improvement efforts- and how PWLLE co-leadership may move us closer to where we collectively need to be.