Chloe Gration
Hi, I’m Chloe! I’m passionate about co-design and mental health. I use my co-design skills, as well as my own lived experience, to create better services and systems change. The recent Royal Commission into Victoria's Mental Health System highlighted the need for increased focus on suicide prevention. It recommended expanding the Hospital Outreach Post-suicidal Engagement (HOPE) program to include children and young people. For the past three months, I have been working with the mental health organisation Orygen to co-design the new Child and Youth HOPE service. This project has deepened my understanding of the critical role co-design can play in creating meaningful and lasting change.

Framing the Project

At the beginning of the project, I was trying to make sense of where the HOPE program fit within the larger mental health system. I was interested in the idea of the ‘missing middle’, a term used to describe people who are too unwell for primary care, such as GPs and headspace services, but not sick enough to qualify for more specialist care. I wondered how we might rearrange the 'missing pieces’ to create new connections and pathways to support young people falling into this gap.

Co-Design Process

Over the course of three months, as part of the Orygen team, I engaged in a series of workshops with young people with lived experience, as well carers and mental health clinicians. In developing these workshops, I realised that not only are we designing a new service but also the co-design process itself. I wanted to develop tools to enable participants to express themselves and encourage creative thinking and new approaches. I hoped that through these participatory activities we might start to shift existing power dynamics and open up new possibilities.

Service Outcomes and System Change

As the project progressed, I started to think more about the relationship between co-design, service outcomes and system change. I felt the pull and tension between the need for rapid service delivery and more significant long-term system reforms. I wondered whether we should be designing for the current system or aspiring towards deeper change. Over time, I recognised that we needed to do both. Not only were we designing a new service together, we also had an opportunity to start creating system change through shifting mindsets, sharing power and forming new relationships.

Reframing the Project

Upon reflection, I realised that how we frame a project is critically important as it can either limit or open up possibilities. Framing the project as a puzzle to be solved, whilst attractive in its simplicity, was ultimately a reductive and limiting approach. I’ve now come to think that planting a tree is a more appropriate metaphor that better represents the complexity of the service. Just like a tree, the service will require continued care and attention to sustain its ability to grow and thrive over time.

Growth Across Time

As I thought more about it, something that really appealed to me about the tree metaphor was this idea of organic and gradual growth across time. Within the co-design process, it can sometimes feel disheartening and as though we aren’t progressing quickly enough towards project outcomes. However, just like planting a tree, there is so much work that happens beneath the surface before we begin to see the new growth emerging. This work, whilst largely invisible, is foundational to the future success of the service.

System Transformation

I’ve now come to understand the HOPE project as one small part within a much larger interconnected system, like a tree in a forest. Whilst our local co-design process will soon draw to a close, the knowledge and ways of being we have developed will be shared and continue to strengthen the system as a whole. In this way, our work is part of the ongoing process of transforming our mental health system. I hope to continue contributing my co-design skills towards this work in the years ahead.
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