The co-design of a children’s health and wellbeing Local model of care to embed early mental health intervention and prevention within community ecosystems

The aim of this paper is to present the co-design processes for a conceptual design of a model of care for the Southern Melbourne Children’s Health and Wellbeing Local in Victoria, Australia – one of three pilot sites established under the National Children’s Mental Health and Wellbeing Strategy and recommendations of the Victorian Royal Commission into Mental Health, targeting children’s mental health and wellbeing. Methods: Using an experience co-design approach, the concepts for the model of care were developed in partnership with over 235 children, families, carers, kin, service providers, and intersectoral partners across culturally and linguistically diverse and First Nations (Aboriginal and Torres Strait Islander peoples) communities. Co-design used creative arts approaches, journey mapping and Lego serious play to establish experiential goals. The co-design also enabled identification of systemic barriers, including racism, stigma, distrust, and fragmented service pathways. Results: Systemic inequities that emerged through co-design included that carers, family and kin described deep-seated barriers shaped by past institutional harm, trauma and distrust towards health and mental health services and the government. This has created barriers to people engaging with and accessing new services. Five core elements to the model were outlined in the conceptual design: finding our way, feeling recognised and respected, open, playful, and connected. These elements reflect the priorities of community members for trauma violence-informed, culturally safe, and accessible care. Conclusion: The project highlights how co-design can identify inequities that are systemically caused which can further inform early intervention and prevention approaches within community ecosystems.