Populating the model: the SC2.0 approach to co-design for mental health and substance use health system transformation

While existing literature describing the use of co-design has focused on its application within individual-level or group-level health interventions, the use of co-design to plan and support the implementation of mental health and substance use health stepped care (MHSUH) models and other MHSUH system transformation initiatives is more limited. In this commentary, the authors describe the Populating the Model Series, a co-design-based, system-level planning intervention specifically developed for sites implementing the Stepped Care 2.0 (SC2.0) model of care. The use of co-design, which is a core component of the SC2.0 model, distributes risk through engagement across the community, broadens the system of care to include and acknowledge informal and formal options, creates person-centricity, and incorporates access points and care modalities that are tailored to the intervention site’s context. Seven steps are identified within the Populating the Model Series including assessing intervention site readiness, understanding site context, planning and adjusting engagement of key groups for co-design, learning through workshop sessions and co-design, validation with key groups, understanding findings, and application of findings. This guidance provides an actionable process framework for the application of co-design in the planning and implementation of SC2.0 and other stepped care models.