So welcome everybody to our GIB seminar for this week. This week we have a topic in the clinical health theme, and we're very excited for our presenter today and his topic. So first of all, I'm going to hand over to Michaela, who will run through housekeeping, and then I'll introduce our wonderful speaker for today. So hi, everyone. Thank you for joining the Social GIB seminar series. Dispute housekeeping rules. Just a reminder that this seminar is being recorded and will be available on the Psychology Events page and YouTube. Upon entry of the webinar, you've all been muted, and we ask that you please stay muted for the duration of this seminar. If you have any questions, you can write them in the question box below at any time, and we'll have question time at the end. We will also have the option to unmute you, if that's what you prefer. Okay, cool. Thank you, and I'll hand off to our convener, Kristen. I am so excited to introduce our speaker today. We're really lucky. Dr. Brett Schultz, who is in the A&E Medical School as a senior research fellow, will be sharing his research with us today. Brett is a critical health psychologist who primarily undertakes research using qualitative methodologies in a range of different areas, with a particular focus on hearing from people with lived experience and co-producing research. I think this is a really fascinating and important topic for us, and we're really excited for you to share your research today, including some of your experience in the recent ongoing COVID-19 pandemic. So I'm going to hand over to you, Brett, and thank you so much for sharing your research today. So I can let you get started. Thank you. Well, thank you, Kristen, and thank you, everybody, for attending today. It's really, it's been something I've been looking forward to since early in the year. I think this was originally going to be a face-to-face seminar back in March, but of course with COVID and everything, it's now in this format, which in many ways is actually quite exciting. You know, the fact that we're able to have seminars, I can see people attending from overseas as well as from nearby. So wherever you've come from, thanks for joining us. I'd like to acknowledge the traditional owners of the lands that I'm currently sitting on, the Nongolongambri people, and I pay my respects to their elders and pay my respects to any Indigenous people who've joined us today. I guess maybe before I begin, I might just spend two minutes talking a little bit about me and how I got interested in co-production and sort of some of my experiences to help contextualise what I'll be talking about today. So as Kristen already mentioned, I'm based in the medical school here at the Australian National University, but I am a critical health psychologist. I've also had roles in nursing and midwifery, in psychiatry and public health, as well as in psychology departments. And that multidisciplinary approach to health has been something that has been absolutely a privilege and a real joy of my career. I think the opportunities to learn from people across disciplines is invaluable. The people that we often don't hear from in these multidisciplinary health teams, however, are the people that I'm going to refer to as consumers. So the people who service users of our health services or the people that we traditionally did research on. And I'm hoping to convince everyone today why that's a problem that we used to do research on and instead need to do research with. I'm going to use the term consumers for people outside of Australia just by way of context. That's the word that is often used within our policy context. It was also, it's a word that was chosen by the consumer movement to refer to themselves. Although I have to acknowledge that that's not by consensus and it's still a problematic word. But if you hear me use the word consumer, hopefully you understand why I'm using that word. And I guess the other thing that I just wanted to mention about how I got interested in co-production. A few years ago I started a role as a research fellow in a nursing and midwifery research centre which at the time was funded by the chief nurse here in the Australian Capital Territory. And that research centre also funded a consumer researcher. So somebody who was dedicated in a dedicated position who had a lived experience of mental health, it was a mental health research centre. And it was a fabulous time to be able to actually be engaged in co-productive work with somebody in a dedicated role. And since then I sort of haven't looked back and I've tried to look to co-produce almost everything I do. It's probably important therefore to acknowledge that this seminar that I'm giving today is not co-produced.  And in some ways, it's an opportunity lost that I didn't co-produce this seminar. But I guess regardless I'm going to be drawing on a lot of my experiences of co-producing other projects. The last thing I wanted to say before I actually move into the seminar is, oh gosh, it's actually completely gone from my mind. There was one other thing I wanted to say. It might come to me later. All right, so let's move into it. And I guess it makes sense to start a seminar about co-production by defining what I'm talking about when I'm talking about co-production. Whenever I talk about co-production, I always go to this resource that you can see here by Kath Roper, Slick Gray and Emma Cadigan called co-production, Putting Principles into Practice in Mental Health Context. Although it's about mental health, I think it goes across contexts and you can use this resource in many contexts. But essentially what I think is really important for us to remember is that we shouldn't call something co-production unless collaborative processes are occurring at every stage. So you can see in this diagram here that that includes from the planning stage of a project. So from very early on before you've even begun through to designing and evaluating and delivering the project. Those stages themselves might change depending on what project you're actually talking about. And that's not the important thing. I guess the important thing is that collaboration needs to occur throughout the life of a project to be considered co-production. And if co-production isn't happening at all of those stages, we can't really consider it to be co-produced. Actually, I remembered what that other thing is that I was going to say, which is that a lot of the examples I'll be talking about and the context I'll be discussing today come from my experiences in co-producing research. But I've also co-produced curricular educational materials, health services and health policy. And these principles of co-production are relevant regardless of whether we're talking about a research project or an education project or a policy project or what have you. So that's probably useful to keep in mind that I might keep referring to research, assuming that most people attending today are interested in co-production research, but that you could apply these same processes and principles to whatever project it is you might be looking at. So co-production needs to happen at all stages of a project. It also needs to acknowledge that there are empowering balances. So the people that who are consumers, who have traditionally been the people that we have done research on, have often been left out of discussions, have often been left out of projects, have often not had power. And I know sometimes, assuming many of you are in academia, I know sometimes it can seem like we in academia don't have very much power either as we're always grappling for resources, hoping to get funding. We're always hoping to influence. But I think we often forget that we do have quite a lot of power. Our knowledge is valued in society in a way that other people's knowledge is often not valued in society. And we are part of an institution that's quite a powerful institution. And I think whenever we start to even think about co-producing consumers, we do need to acknowledge those power imbalances exist. And they might be different depending on the people that you're co-producing with. So for example, in mental health, there's multiple layers of power imbalances and there's issues about stigma in society more broadly. If you're talking about co-producing with indigenous people, there's huge power differentials and issues that do need to be acknowledged and interrogated through the co-productive process. Related to that, co-production needs to recognize and celebrate expertise. As I was saying before, often academics, our expertise and our knowledge is inherently valued. People look to us as leaders, as knowledge producers, and often consumers' experiential expertise is not valued in the same way. It's often not thought of as valuable as our academic background. And if we want to co-produce, we need to recognize that we all have things to bring, all have skills, all have valuable knowledges, experiences that we bring to our project. And again, if we're not valuing everyone in a meaningful way, then we can't usefully co-produce. And my last point about co-production is not just a fancy new method. It's an approach to collaboration. And I think my next couple of slides might elaborate that on a little bit further. I guess what I want to also have a bit of a discussion about is what co-production isn't. So co-production has become a bit of a buzzword, not even just within academia but beyond. And this has been good in terms of people realising why it's important to co-produce. But at the same time it means that the word has been co-opted. It's sometimes used in really problematic ways. And we need to seek to avoid that. So here's just a few examples of what isn't co-production. And this first example comes from a paper that I read that was talking throughout about co-producing research. I've got a few screenshots from the paper that I'll share. The first one is from the aim. And you can see in the aim of this paper, they were talking about co-researchers, which I thought that sounds really exciting. It looks like they're doing... They're not only co-producing, but they have co-researchers who are caregivers who are actually interviewing. So they're doing some of the data collection in their study. In the results, they also talked about co-researchers and the way that co-researchers interacted in the data collection phase. And I thought, this is looking great. But when I went back to the author list, I didn't see any acknowledgement in the authorship of these co-researchers. There was a professor of palliative care and a reader and director of a cancer care research centre. And it struck me that if I was talking about co-researchers from any other discipline, if I co-researched with some nursing colleagues, for example, but they weren't part of the authorship team, then it would be really problematic for me to call them co-researchers. Now, I must admit, I don't know what the story behind this study was. Maybe they had discussions with these co-researchers and they didn't want to be authors. But I think it just goes back to my point earlier, where academics' knowledge is valued and our names are on papers and we're part of this institution of academia and knowledge production. But unless we are also co-authoring and valuing the people that we're collaborating with, then I think it's a bit rich to call them co-researchers. What I thought was even more problematic about this paper was that in the discussion section, and I have a very short screen grab there from it, in the discussion section, they were making claims saying that there was a need for caution in user involvement in sort of co-production. And I thought that was a little bit problematic given that these co-researchers weren't part of the authorship team and they were making claims and saying that these co-researchers were part of the team. And they were making claims about saying we shouldn't involve consumers as part of the teams. And I just thought that was really problematic. So I guess to me, what isn't co-production? One example is when there's no meaningful authorship. They're not actually treated as equals. My next example of what isn't co-production came from a tweet that I have a screen grab that I'll share in a moment. But I often hear people assume that co-production has to be done through qualitative methods. And I also hear people assume that qualitative methods equal co-production. And both of those claims sit really uncomfortably with me. I'll share this tweet, which I screen grabbed a couple of years ago. I was on my way to a qualitative health research conference when I read this tweet. And so I thought, oh, this is really interesting. And I kept this screen grab and I think about it a lot. This person said, hey, we qualitative researchers have always been doing co-production. We have theories and methods and lots of good practices that speak to these new ideas and the challenge they raise. And there's sometimes this assumption from qualitative researchers themselves, and I include myself as a qualitative researcher predominantly, who assume that because they use methods that listen to the voices of their participants, that that's co-production. But to me, those are two very different things. Co-production means that the group, whoever it is, that you are collaborating with are involved as equal members. They're not just participants in a study that you are doing a different method. I guess the other thing I heard recently was people said they were doing co-production when really they were just conducting focus groups with people. And that's not to say that focus groups or the qualitative research is bad. But what I think is a problem is when we claim we're doing co-production, but all we're doing is involving people as participants, not as collaborators. The last example of what I think we need to be careful about in co-production is that because co-production has become quite a buzzword and it's used beyond just the health disciplines and it's used beyond academia, is that sometimes people use it in different ways than we should be using it in health. So this example comes from a marketing journal where they talked about co-production as when customers of products take part or engaged, I guess, in part of the processes that would have traditionally been done by businesses. So you can see from this example they talk about checking yourself in for a flight or creating IKEA furniture at home as part of co-production. And while there's a lot of really important information and opportunities for collaboration with people in the marketing space and from business disciplines, I just think we need to be very careful about these kinds of takes to co-production that don't interrogate power. I think the issues of power are central to co-production in health given the way that consumers have been vulnerable, marginalised and continue to be at the lower end of the hierarchy if they're in the hierarchy at all. So still look at that literature. There's still a lot of really important literature in the marketing space but do be careful about how people are using co-production to make sure that you are using it in a way that seeks to interrogate power, recognises and celebrates consumers' expertise and it's not just some new method you're doing but an approach to collaboration. Okay, many of you because you're attending this seminar probably don't need to be convinced about why co-production is useful but I thought I'd just mention a couple of examples about why I think it's really useful. And the first example is that within health disciplines I don't think anybody has a more holistic understanding of health than consumers. And I'll show you an example. For those of you who are not here in Canberra, or who don't recognise this building, this is the multi-storey car park at the Canberra Hospital. And I'm not, I don't work at the Canberra Hospital but I do work at the ANU Medical School so I'm allowed to park in this car park for free, undercover, it has 24-7 security, and I can always get a park there, go to my meeting and come back and there's no problem. Consumers, however, often complain about this car park, there's no parks free for them, they've often got in tickets when they have had appointments that have gone over time. So even just when we're talking about designing a car park consumers have a very different picture and a more relevant picture than I have about how we should be designing car parks at a hospital. Now that's just one example but again just to talk about how consumers understand a hospital in a very different way to health professionals. You know, everybody, consumers and people who work in health settings complain about the kinds of food options that are available at hospitals. But health professionals don't understand what it's like to have a very small range of options available in a café while waiting for the results of the test or while caring for somebody or while worried that they are about to get a parking fine in the car park. I guess what I'm trying to say is that even if we, as health professionals, move through the same spaces as consumers and we experience them in completely different ways. And as health professionals we don't come from that perspective and we can't necessarily understand what it's like. So my first point about why co-production is useful is that consumers understand things in ways that non-consumers cannot. Even if we have very intimate experiences of the same places and the same kinds of scenarios. I guess this is probably summed up most usefully in a paper. I'm self-promoting a little bit here, but a paper that we published a couple of years ago called How Did I Not See That. And that How Did I Not See That was a quote from somebody who was collaborating with consumers in research. And in fact, most of our participants that we spoke to, these were all of the participants we spoke to, had collaborated with consumers in research. And again, this was in a mental health specific area, but I think the learnings apply across disciplines. And most participants had something to say along these lines that consumers saw things that non-consumers couldn't actually work out how they didn't see it as well because they thought that they had a lot of expertise and knowledge about a specific topic. But until they actually collaborated with consumers, they didn't realise what they couldn't see if that makes sense. Two more things about why co-production is useful. The first thing for me is that it saves time. A lot of people think that co-production takes longer. And I think doing these kinds of collaborative processes can be an investment in time, but they certainly save time in the long run. When I think about some of the projects that I've been involved in over the years that have turned out to be going down a dead end or that have turned out to be projects that could just not be completed for whatever, I think if I had co-produced from early on and I had actually meaningfully collaborated with consumers to better understand what was most important and most relevant to them, my projects would have been honed. I would have been looking at specific issues that were important and I wouldn't have come to quite so many dead ends. So it can take a bit of time to set up, but I think it saves you time in the long run. And the other example about why co-production is useful is that I think we're always looking for ways to better our research impact as researchers and one of the best ways that we can do that is by collaborating with people who understand the kind of impact we need. I always think about about a year ago I think it was maybe two years ago. COVID has made me forget, you know, the timeline of what happened when, but I wrote a systematic review collaboratively with a consumer. It was a systematic review about palliative care and the consumer that we co-produced that systematic review with was somebody who had cared for his wife as she was dying. And that systematic review had huge impact far beyond a lot of my other papers because it went to the media, people were interested in our collaborator, our consumer collaborator's story and how that influenced the research. They weren't interested necessarily in the academic expertise. They were more interested in what that research meant for somebody who had lived through that experience. That's just one small example, but hopefully it shows why collaborating with somebody who actually has lived through whatever it is that you're interested in means that there is more potential for impact in that research. Okay, so when can we co-produce? I'd like to say any time, any project you can co-produce. I guess you've just heard me give an example of even when you're doing a systematic review, you can do that in a co-produced way. It doesn't have to be a big project. It can be a small project. I have sometimes people sort of put off co-production because of what stage of career they're in, but I would say I have a PhD student who is doing wonderful co-production. So she's doing co-production of her PhD. She's looking at consumer leadership itself, but she has an advisory panel of consumer leaders as well as her academic supervisors, and they meet quite regularly. So she gets feedback from her supervisor. She gets feedback from her advisory panel who are also involved in all of her publications and everything that she does along the way. And it's a wonderful model. And I think it just serves that even in a PhD you can do co-production. So it doesn't have to be only people in senior positions who have access to lots of funding and access to lots of resources, for example. I also have some fun examples where you might not expect co-production. So all of these examples I'm about to show you come from a forthcoming special issue of qualitative research in psychology that I'm co-editing about allyship. So allyship towards any kind of consumer movement. And we ask people to consider when they were submitting their manuscripts to us for consideration for publication. We ask them to either co-produce their research or think about why they couldn't produce their research. Anyway, we have a wonderful forthcoming issue which I'll enjoy sharing with you all when I can. But I have for examples here of people who did co-produce their research in this special issue. And they all did it with different groups. So the first one comes from a paper that was conducted in a primary school. And you can see this is part of the abstract. But they say in this paper we present an innovative methodology for allyship and research alongside children. The project was inspired by a child and as adult researchers we embarked on reflexive processes to enable children to design and deliver their own research. Anyway, what I really liked about this paper is that this is one of the authors down here, William Davies. So I cut out the other authors. But you can see that there were child co-authors on this paper. And I thought that was wonderful. I think that we see in research very often. And it was, I guess, a really nice example of where these children who were considered equal partners in this research team were acknowledged. Their expertise was considered equal in terms of authorship as the other authors. So that was just a lovely example. There's a few more examples. So again, from that special issue, there's a paper called From a Stranger to A One of Us Ally, a new Confucian approach to community allyship. And that again had co-authors who were from the local Chinese community in Townsville here in Australia. And that was another example of where community members were, their expertise was considered equal to the academic's expertise. Again, from the same issue, there's a paper called Nothing About Us Without Us, Fat People Speak. And that was all of the authorship team included academics and people who were identified as fat advocates. And again, was a really nice example of people co-producing and knowledge of community members and experiences of community members being valued just like academic's expertise. And the last one, reflections on allyship in the context of a co-produced evaluation of the youth integrated therapies, mental health intervention, which was yet another mental health example of co-production, which included consumers, academics and consumer researchers in that authorship team. So I guess I just wanted to share those to say you could be doing co-production in anything that you're doing in a wide range. You could be doing research with children and you could still be engaging in co-production. You could be doing a PhD and still doing co-production. You could be a senior member of a research centre and setting up infrastructure for co-production. I guess it doesn't matter the context and it doesn't matter where you are in your career, you can be doing co-production. So all of that said, there's four things, I mean there's more than four things, but there's four things I just want to mention that I think are preventing us from actually achieving co-production. And the first one is funding. So I guess in academia we're often striving for funding anyway. But of course if we are going to meaningfully co-produce with consumers, then I think we need to make sure that we are paying them just as we would any other researcher. And that can be really tricky. And I guess here is where I want to share one of my failures and one of the times I wasn't able to do this very well. So this paper, it's actually the one that I mentioned a little while ago when I was talking about impact, consumer and care leadership in palliative care, academia and practice, a systematic review with narrative synthesis. The second author, Alan Bevan, was is a consumer researcher and was part of that research team. But at the time I didn't have access to funding and was not able to pay him as a research assistant as I would have liked to. Later on though I did have access to funding and we were able to pay him and to pay for him to attend a conference where we co-presented that research. But I guess it still sits kind of uncomfortably that this issue of funding. And I guess when we think back to I think the first slide where I said for co- production to really happen it needs to occur from the planning phases of research. And often when we're doing research we don't have access to funding in that planning stage. And so it can be really tricky if we're trying to co-produce research while we're still grappling to even find funding and if we can't pay collaborators as we would any other researcher that can be a real issue. In my, I'm going to come back to that. I'm just going to leave that hanging there and acknowledge that funding is a concern. And hopefully we can talk about some solutions at the end. Another thing that's preventing us from the ideal is stigma. So some of my examples, most of my examples I guess have come from mental health. Where often consumers are not thought to have capacity. You know they're often, in terms of mental health we often think that consumers of mental health services are dangerous, scary, you know all of those very stereotypical stigmatising attitudes that exist in society influence, influence our ability to co-produce. So that's, that is definitely a big issue. And again I'm just going to leave it hanging there for a moment and we'll come to solutions later. The third thing that I think is preventing us from ideal co-production is this expectation that people be representative. So I hear this a lot and I hear this sort of rhetoric being put forward in a lot of ways. So for example I've found myself sitting in a room often when we're talking about planning for a new research project for example and I've said that's great, let's do this research project and let's make sure we collaborate with consumers and we'll, let's, let's find some consumers who would like to come on board with this project. And, and sometimes people's reply to that will be, yeah but the kinds of consumers who want to engage with us are professional consumers or they don't really represent current consumers. And I find this, I find it problematic on a couple of levels. First of all when you know I think about myself as a psychologist I'm never asked to justify if I represent psychologists and in fact I'm never, I don't know that that would be possible or useful for me to represent all psychologists anyway. But also the idea I don't, I just it's often used to silence consumers views to say oh you know they're not actually representative, they don't represent most consumers, they don't represent current consumers. So it's, it's very problematic but it's not uncommon. I come across this all the time when people ask about representation. What I would say, what I think is important is, is that we, you know when we're talking about collaborating with consumers and particularly if we're looking at consumers in vulnerable or marginalised communities that we do need to try to our best to make sure we are engaging with diverse consumers and that we are engaging you know beyond just white middle class male consumers for example. So, so we do need to be concerned about representation but we shouldn't be concerned about representation in terms of it silencing us and it puts an unfair requirement on consumers that I don't see with other health professionals. And then the last thing that I think is preventing us from the ideal is a lack of flexibility and concerns around timing and pacing of projects. So, so in fact as I say I'm going to come to solutions so I don't want to talk too much about it but I guess it's just something that we do need to be aware of that within research ecosystems there's kind, there's all kinds of burdens upon us about that mean that we're not in flexible working conditions. So for example we're often working to timelines for grants, we're often needing to publish, we're often told that we need to be producing outputs and that can be a problem if we are also wanting to co-produce meaningfully. Alright, I will I'll move on but I do next want to talk about just briefly some of my most recent examples in the context of COVID to sort of point out that if we can do co-production even in COVID then we could probably do it anytime. So earlier this year I found myself in a position where I was coordinating the research response to COVID for the Australian capital territory when my boss was seconded to lead the COVID task force and one of the tasks that we worked on was making sure that consumers were part of the production of a triage process that we would use in the ACT if it ever got to the point here where capacity in the ICU was exceeded by demand. So essentially hopefully it's a triage system we would never use but we wanted to co-produce it with consumers to the extent possible. But of course earlier on this year all of our meetings were on Zoom and that presented a range of opportunities and challenges for us. So one of the benefits of co-producing in the context of COVID is that everything was on Zoom and one of the particularly marginalised groups that we wanted to co-produce with came from the disability sector and a lot of our colleagues in the disability sector who we were now meeting on Zoom instead of meeting at the hospital where they would have to find parking where they might have issues parking where they might have issues of accessibility depending on what building or what room we were in said actually this is wonderful. The fact that we're now meeting on Zoom means that we don't need to be worrying so much about all of those accessibility issues that are often a concern outside of the context of videoconferencing. Similarly a lot of the people we wanted to engage with were carers who said the same kind of thing they said it was wonderful that they were able to participate in these collaborative processes via videoconferencing without needing to leave their loved one which otherwise if we were having these co-production seminars or workshops in a room either at the university or hospital it could be really difficult. Someone at a seminar who was at last week who was from industry made a really simple but impactful impression on me when they were saying that if we want to do co-production we really need to think about accessibility for everybody because he says he works in industry at a meeting at a university it takes him 15 minutes to even find a park nearby the building that he needs to park at he then needs to find the correct building. Buildings at universities are either really poorly numbered or have bizarre names it's hard to find and it struck me it seems so obvious even as somebody who works in a university I often find it difficult finding if I'm in a new building or a new room but essentially our institutions physically are not set up very well to collaborate with people outside of those institutions so that was one of the great opportunities that Zoom presented to us however there's also some drawbacks of course so when we were talking about some of the really awful things that we had to talk about as is often the case if we want to collaborate with vulnerable or marginalised communities there was nowhere for us to debrief with them casually afterwards we couldn't provide a space to sit down and talk and we also one thing I noticed which I'm sure it's not just in terms of co-production I'm sure we've all noticed this as we've all been video conferencing primarily this year is that there's nowhere for those I guess impromptu conversations to happen which in co-production are often the great conversations somebody after a session might say have you spoken to this person you really need to be involving their organisation or this person in what you're doing and so that is a challenge and that is quite hard there's opportunities as well I can see there are participants joining us here from all over so it's certainly two sides of a coin and there's pros and cons but I guess even just the fact that we were able to think about applying these principles of co-production in the context of COVID about very difficult discussions via video conferencing means I think we can learn and we can do it anywhere okay I'd like to finish by just mentioning five steps that I think we can all take to move towards better co-production regardless of where we are at in career or discipline or focus of our research so the first step that I think we can all take right now is to read and cite consumer-led or co-produced work so make sure that whenever you start a new project you're seeing if people have already done co-production in that area or if there has been consumer-led work in that area and cite that work make sure that we value people who are doing this important kind of collaborative work my second point and it almost just seems so obvious and so try it that I hesitate to say it but what I do is listen just this morning I saw a news article where the federal government was talking about a co-design process with Indigenous communities and it was in the media because people were complaining to say actually this is not co-design we're not allowing Indigenous people to be heard and so I think there are people who are embarking on co-production but who aren't actually meaningfully engaging and aren't listening to what consumers' needs are or what co-production partners want or need so as I say it almost seems so simple because surely this is a rule that regardless of what research you're doing or regardless of what projects you're engaging hopefully you'd be listening but I think it still needs to be said and heard even when they are engaging in co-production my third point of what I think we can all be doing right now is build collaboration into your projects and your budgets so whenever you start a new project think about how you might co-produce and budget for that this actually is a screenshot from a grant that I put in last year and again I've lost track of time with COVID this year but essentially you can see there I asked for a research officer and my intention was to employ I haven't been able to use this funding yet because of COVID but my intention and hopefully next year I will be able to employ a consumer researcher as that research officer for this particular project so I think it's this goes back to the point I was talking about earlier around funding and sometimes it's really hard if we want to make sure that we are from the very beginning of a project from the planning phases if we are being co-productive but we don't actually have funding yet to pay consumer researchers it can be very tricky and I sympathise and there's broader issues around the academy and funding anyway so this is why I say build collaboration into your projects and budgets as much as possible and keep working on it and improving on it now if you are a senior professor in charge of a large project budget you can start thinking now about how you will employ consumer researchers but as I mentioned before even if you're a junior scholar, a PhD student there's still ways that you can build collaboration into your projects from early on and in some ways it goes back to my previous point about listening which is listen to the people that you want to collaborate with about how they want to be collaborated with and that will help you build them into the collaboration efforts my fourth step that I think you can all take now is to form alliances with the boss or those who do have power so a lot of my wins in co-production have been when I've been able to influence people who do have resources who do have access to funding who can make decisions about employing consumer researchers and to form alliances with them and show them why co-production in your research program is going to bring them value and I guess my final point that I think we can all do right now is to start somewhere and build on a co-production strategy I would say I certainly didn't get it right the first time I tried to do co-production and I'm still learning every single time I engage in a new co-production process and I also want to acknowledge in some of the earlier slides of this seminar I really heavily criticised some people who said they were doing co-production but weren't but but I want to also acknowledge the fact that we can all learn and we can learn about how we might improve our co-production processes and in fact we should be learning how we improve them you won't get it right the first time and there's always something that you can learn by listening to consumers that you want to collaborate with and building and each time getting better at that and not being afraid of something so I might leave it there and move to questions but thank you everybody and Kristen I might hand back to you to handle some of the questions thank you so much Brett that was wonderful thank you for all of your insights and your reflections it's nice to see someone being so thoughtful about that because it's a challenge but I think it's really important for us to be thinking about and doing more around that so thank you we do have one question that's already come in so of course people if you have questions feel free to pop them in the Q&A box and we can then go to you live you can also raise your hand and I can see that we have someone who has raised their hand already and we have a question that's come in through our Q&A box so we might start with the Q&A box and then we'll go to Mali who has their hand up so we'll start we can unmute you Vicki and ask your question if that's not possible we can read it out here we go Vicki's on now okay hi it's wonderful to be able to listen to Brett fantastic presentation thank you so interesting what I'm interested about is wondering whether you've experienced any barriers when dealing with ethics committees so for example do they kind of not get this notion of co-production and also do they then perhaps come back and say you're dealing with a very vulnerable population here therefore this study is particularly risky just wondering if you've had any experiences in that way yeah thank you Vicki and lovely to see you virtually I have certainly had issues with this I think it's gotten better and I guess in some ways we're a little bit privileged here at the ANU in that our ethics committee is chaired by somebody with lived experience who I believe identifies as a consumer researcher so in some ways we are lucky but there certainly have been comments that have come back from ethics committees asking us to justify why we would use I guess consumers and sort of implying that implying that it wasn't a co-production that it was a partnership and and so it is it's tricky I don't necessarily have an answer for how we get around that issue other than keep trying in fact I'm reminded of and sorry this is I'm slight tangent but it's really important the PhD student I mentioned earlier who is is working on a co-produced PhD with an advisory panel of consumers had real struggles with her ethics committee about um about assuming that there was a lack of capacity of these people who had gone through you know mental ill health and it struck me as so paternalistic and part of that problem about how we don't value consumer knowledge so I guess you know my answer is that we just need to keep trying maybe the more that we value co-produced research and the more that we push for it to be normalised that people will understand that these paternalistic views can be really problematic but I acknowledge it's a struggle and it's not easy Thanks Brett and I think like you say I think it's about education and just just keep pushing forward Thank you Thank you We've had a question come through on our chat from Polly and we've also got an anonymous question in the Q&A so what I might do is give Michaela time to unmute Polly if that's possible and I'll ask you the anonymous question first and then we'll go to Polly so the anonymous and big question is do you see many initiatives in Australia at the federal state or community levels to fund more co-produced research and in general do you see any moves in this direction in mental health research specifically in terms of calling for specific research in this area Yes and no so the NHMRC does now have a consumer panel so the NHMRC is interested in co-produced research at least from their end they're demonstrating it by employing consumers as part of their panels which is great to see whether that's translating to funding co-produced research I think is yet to be seen but I think people are starting to take it seriously I guess the other thing I've mentioned in relation to that question is that you can look to the UK where it has been required that consumers or patient and public involvement as they'd call it in the UK is part of every grant that goes in within the country which still does lead to tokenistic research which still does lead to check-boxing of people saying yeah we've collaborated with a consumer but that consumer hasn't necessarily been part of the team as an equal member so even where there are initiatives to fund that it can still happen tokenistically so I see it moving slowly but there's still some promising things on the horizon such as the NHMRC's panel Awesome thank you Brett we have a live question if Polly is able to unmute and then we'll go to Lily and after that Hi Brett thanks for that great talk and for all the resources and I'm really excited to seek out that book and all the different papers I'm interested in co-produced research but I'm also very interested in open science and I was just wondering I mean I don't really have much experience in co-produced research and I was just wondering how would you you know try and build that in the beginning to get your consumers sort of on board with you know doing open science research you know it's the how to really Yeah so first steps of engaging are often the hardest I would say I guess just from my experience and not necessarily saying that this is the best way but it's sort of the way that I have done it say for example that that systematic review I was talking about earlier in palliative care I actually I searched for a number of people who might be interested in collaboratively producing that from a consumer perspective and there were people that I met with and spoke to who I thought might be interested but weren't and that's fine and then eventually I think a colleague put me through to Alan who we ended up having a conversation and he seemed interested and I guess that was how it first happened so lots of conversations that didn't end up being partnerships and then stumbling upon somebody whose values were aligned and who did want to be involved and did want to co-produce and it sort of it went from there I don't know if that's necessarily answering your question other than to say I guess it's there can be a bit of trial and error and it can be a bit of a process to find people who do want to partner with you thanks so much that makes sense thank you thank you Polly we'll go to Lillian's question yep beautiful hi Brett thanks Matt I was a really interesting talk so I guess I have a really question related to Polly's question about the practical processes of collaborating with consumers so what tasks are and are not appropriate to assign to a consumer team member and how we sort of balance valuing their voice and their approach with meeting standards for academic rigour so I imagine if we want to include them say at the analysis stage which would like to include them at all stages that might require us training them in analysis approaches and I wonder if that training dilutes their perspective in some way so I guess if you have any sort of practical advice on how to include a consumer researcher yeah no thank you Lillian I guess I guess in terms of is there anything that's not appropriate to ask of them I think it goes back to my point about listening and finding out how people want to be engaged and how they want to be involved I remember this conversation a conversation I had with a very good friend who I respect a lot about co-production and he sort of made the comment saying oh you know but the consumers you might be co-producing with probably haven't read Foucault in as much detail as you and might not be able to analyse in the same way that you do you do and I kind of thought I felt like a bit of a failure there because I haven't read Foucault since underground but also and I mean that his point was not about Foucault specifically his point was that I guess you know as academics we have a lot of experience and application of theory and production of knowledge but I would say I would say that a lot of the kinds of analyses that I'm involved in are actually enriched by consumer perspectives as well so say for example if I was going to do a discursive analysis of something I would say that that's actually enriched by engaging with consumers rather than otherwise and I guess one important point that I do want to make about that is there's also of course non qualitative approaches and quantitative analyses which do require specific kind of analytical skills but I think consumers and you know community collaborators can be really meaningfully involved in any interpretation of analysis because when we're interpreting our analysis we're either applying theory or knowledge and that experiential knowledge can be just as important a part of the analytic process and the interpretation of the analysis as academic knowledge if that answers your question Yeah I think it does, thanks Thank you Lillian we have one more and I think that's going to take us to about time so I'll read this one out to another attendee with a great question that you can use to wrap up the talk the question is what have consumers said to you about their experience in co-producing research with you and any insights or challenges that they have encountered Yeah I would this is a perfect point where I'd love to have some of my consumer colleagues here to answer that question so that it's not sort of funneled through my interpretation I guess you know it's very broad and it changes for every project I might just mention go back to Alan again who produced the systematic review and palliative care with me who I think for him as I mentioned before his experiences of palliative care through caring for his wife, his wife who had died I think for him it was he did reflect on what it meant to be able to give back what it meant to be able to be involved and use those experiences to produce something as being a positive experience and I guess in relation to that last bit of the question about insights on challenges that they have encountered I'm not saying that there aren't challenges I'm sure there are and this does make me wish that I'd listened and you've inspired me to ask that question I guess just very broadly some of the challenges that we've spoken about in broad senses are things like the way that institutions still don't value lived experience in the way that they value academic experience and just one very practical thing I know I'm over time so one very practical thing is that for example when we submit manuscripts to journals for consideration for publication it asks you to put in your institution and your qualifications and where you got your PhD and all of those kinds of things that are very much situated to show why academic knowledge is privileged over consumers knowledge so there's a lot of these little institutional things that we take for granted that are a challenge and there's more but I might leave it there noting I'm already over time I apologize that's completely fine I wanted to say thank you I think we can keep this conversation going for a lot longer today and maybe we'll have to get you back to talk more about this I think it's been a wonderful seminar and thank you to you but also to everybody for engaging in it and the questions you've asked I think this is an area we can really think deeply about and think about the way we're doing, what we're doing and why so I wanted to say thank you very much to Brett and to everybody for your attendance and for participating as always we're back next week we have another gift seminar from our social personality theme and it is Dr Katie Greenaway from the University of Melbourne on the psychology of secrecy so I think that's going to be a fascinating topic as well so I will thank you all for being here thank you especially to Brett for taking time out today and wish you all the very best for your lunch and for the rest of the week we hope to see you all next week so thank you all thank you


International Firefighters Day is a time where the world's community can recognize and honor the sacrifices that firefighters make to ensure that the communities and environments are as safe as possible. It is also a day in which current and past firefighters can be thanked for their contributions.    But saying that, I think that we've also had some fire experiences here in Lagos where I've seen firefighters at work. So there are firefighters out there doing good work. So today we celebrate them. What have your experiences been? I don't know, not particularly. Any experience means, but I think that they're actually doing a very great job because before, when, I think so for you, because before, when there's a fire, or before they get there, the fire have finished, they have finished. There's no petrol to move the vehicle or there's no water. It's always one silly story or the other. But in recent times, when there has been fire, even if they get there, maybe towards the end of the fire shop, at least they get there. I have to give it to the emergency services in Lagos in particular actually. They've actually been trying. They can do better. I really don't know because I've never seen firefighters at work. So even in videos where there are actually fire incidents happening, I've only seen people around trying to put out the fire, but not actual, actual firefighters. Most times those videos are taken in the beginning of when these things happen. But even in the stories, I don't, I don't see where people say, Oh, they're trying. We're not saying that they're doing, they're doing it perfectly.  I served in Abiyakuta and on the way to my house, there's this fire station. When I first saw it, I'm like, Oh, there's a fire station here. And I passed there every day. And guess what? Every day I passed there, I always looked towards the fire station because I'm just marveled that there's actually a fire station there. So I think sometimes I'm just looking to see, are there people there? Are there people there? Is there anything happening?  I don't, I just see the truck. Most times it's why I stay. I just see the truck. I'm looking very dusty, but I don't see people at the fire station. So I'm just like, huh, do these people actually work? Is there anyone there? If there's a fire now with this work? And so I remember when they showed, I don't know if it was a governor or somewhere, a minister who was supposed to commission a fire station. And then when they got there, I think about five fire trucks, when they opened the fire trucks, they were actually dusty. There was no extinguisher inside. The normal things that you would find, he said, okay, open the tank. Let me see. There was no water inside. So the question he asked them, I think even, do we feature in life?  What would you use? And I said, I gave you puma there. You said that these are actually new fire trucks, those fire trucks. When you open them, these seats were dusty inside. We have several agencies in Nigeria that are just there for being their sake. They are not particularly doing the work. But for Lagos State, I think that's less of how low, but I mean. I hope they do more. Okay, so let's start with Jennifer. What did you find for us in the news? So Fina, the latest big brother in Nigeria, reality show winner who won about 100 million Naira, said that the show is actually very toxic. And when I posted it to the group, who I said she should return the money now, 100 million Naira, I think you can give it back. But I think that I sort of, I mean, I don't watch the show, but the franchise itself, this kind of feedback is not really unusual. I think the producers need to create an entertaining show. So they may lean. I mean, I tried to see in the story if she gave any context to why she said it, but she didn't. But you know, you can sort of put two and two together. No, but Big Brother is actually a very toxic show for, you know, it's a social experiment. And then they thrive on controversies a lot. So that's what actually makes it very toxic. Because if there's no controversy, there's no entertainment. Do you get it? So it is indeed a very toxic show. And if you're not emotionally strong, they always advise actually, if you're not emotionally strong, don't bother going for the show because people will throw you. There's going to be a lot of backlash from the things you did not say to the things you actually said, even when people, I mean, obviously misunderstood your words and all that. So it really is a toxic show. I think I saw one of the, I don't know if it was the past Big Brother, I think it was Beauty, who had said that the strategy she wanted to take into the house, by the time she got into the house, she had to change it because she had to change herself.  You have to do something. And that's why she was very toxic in there. She was always fighting for the smallest and tiniest things that actually did not make any sense. But she had to put on a show. And even the audience are also very toxic. So it's like, it's everybody. So I think the show needs to take a rest. To give away a hundred million in prize money, they don't need to restrategize or something. That's what the show is about. I stopped watching about two, three years ago. If you're not ready, don't go into it because it's really a game. So you need to, you can't go into a game where there are several other people contesting and you don't have strategies. And most times in this game, the villains win. Maybe not win, but the villains go far. Because they have to keep them on board to make it engaging. But yeah, Dami, what did you find for us? Okay, so what I found for us in news today is something very similar to what we'll be discussing anyway. So a year to be identified Nigerian police woman has distributed new pairs of socks to students who do not have them in Lagos. I mean, I think this is a very good act considering that we're talking about security, you know, police and non-police. And you know, when we're talking about, when we're talking about people, I mean, there's a good part that we should not live out. So I believe that this is, this woman is one of the good Nigerian police officers or people who are in this country.  What's their business if you don't have socks?  It could be from a place of normal just basic human decency. But what she did is actually very good. There's also one woman's video that I always see online. I don't know if she's the same person. But this woman, when she she crosses the children, so they have to literally pass beside her. And when she sees any one of them that is not properly tidy, you know, she like tries to tidy them up, dress properly. I don't know if he's the same person as well. But you know, things like that actually go a long way. Because for various reasons, some people probably don't even have parents at home. They may stay with their parents. And in this society, I don't know if it's just a Yoruba thing. Yeah, but there's just this thing that you're not the only parents of a child. We are exactly, we're just all to get exact. So I think that it's a very good act. Yeah, kudos to her. Well done to you for finding a positive story about the police today. So very quickly. So my story says Lagos government shot another popular grocery store over expired products. Now we talked about the civil service a couple of days ago, and I mean, there's just a lot of agencies and all. So this story says that on Wednesday, the Lagos State government shut down a popular store called Chimesier store located at 19 of Gundana Street off Allen Avenue in Akeja for allegedly selling expired goods to members of the public. It gathered the store was sealed during a sting operation. Now, I mean, why the story stood out for me? Because this was done by the Lagos State Consumer Protection Agency last copper. It was interesting. I mean, not enough backstory here. But the first thing that came to my mind was, oh, great, somebody's checking. But the second thing that came to my mind is, see, when you have so many small, we live in a country full of private sector businesses, SMEs and all. And I wonder what kind of quality checks, because if you go to most supermarkets in Nigeria, we like the small space, you cram all these things in there, right? So my point is, what processes do these kind of stores have to check? The guy may not even know that it expired because none of his staff have gone to check. They just bring new stock, they push the thing with the back, they put it in front. Things are certainly improved. I mean, I remember maybe back in the 80s, 90s, we used to deal with a lot of fake products. I mean, people like NAFTA can change a lot of things, SON. But these kinds of things, in my mind, I think, is it a honest mistake? But certainly when you then have an organization like this that is checking, the owners is on every single store, supermarket, anybody that is selling goods that can expire to certainly be out and checking because they're checking for you. Okay, so I think we should take a break now and while we come back, we'll jump right into the discussion for today. Please stay with us.


I had a conversation with this person the other day that was very very frustrated that despite all the things she was doing for her health she was still having this insomnia and this kind of anxiety that she had for a long time. Now she said that she'd been seeing many different healthcare practitioners and one practitioner that she really liked and she really respected he said that you know you need to stop being in fight-or-flight so much and she said you know I've stopped being in fight-or-flight I'm relaxing I'm taking it easy but it's been several months and my insomnia is not fully going away. Now having lived through this scenario myself I want to share an analogy and or a metaphor that would have really helped me when I was a patient in that situation and I think can really help you today. Hey I'm Dr. Alex Hine Chinese Medicine Doctor author of the health book Master of the Day and licensed acupuncturist. Now I've included a free link down below this video which has four daily rituals that can add years to your life with traditional Chinese medicine. Also if you'd like to become a patient of mine locally or online via telemedicine if you sign up for the email is below that'll notify you of my clinic and how to find me and book an appointment as well so it's the first link in the description. Chronic symptoms are often like the sprained brain analogy. Now I heard this in an interview and I really really loved it. It's been helpful to describe this to my patients and for me to understand it. So this person was being interviewed on a talk show and he was saying how he was telling a story of developing pretty severe depression for the first time and he was describing what it felt like and how difficult it was to get on with his life and just exist daily. Now what he was saying was he was confused as to why it was still happening even though he was meditating and he was exercising and he was eating healthy while this stuff was still happening to him and his physician said something very wise that you could think of it almost like a sprained brain where the body like in a sprained wrist it takes time to heal and regenerate it's taken this hit and now it has to heal and it's a certain fixed time period you can adjust it a little bit but that time period is what it takes the body to regenerate and restore itself.  Now I find this metaphor to be very very useful because sometimes you are doing everything right you are on the right path but your symptoms still are not going away and beyond it being frustrating and discouraging you can at its worst feel quite scary and hopeless because you feel like well am I going to feel like this forever and I don't know if I can live like this if it's going to be forever. So in Chinese medicine what's going on here one of the things that's very useful to think of it as is an organ imbalance in Chinese medicine. So in Chinese medicine for example a patient comes in and let's say they have insomnia or anxiety I find that these conditions are most often the largest chunk are successfully treated through the digestion so these patients frequently also have digestive problems but ironically you don't treat the depression or anxiety you treat it through the body and the most common pattern that I'm treating it through is through digestion. So if the person's doing all this work they're meditating they're eating right they're doing all this stuff why is it that months later they still have these symptoms and these symptoms have not fully gone away. In Chinese medicine we think about like organ deficiencies right like you say like spleen chi deficiency or kidney yin deficiency these kind of zong fu terms and I think it's helpful to think let's just say you experience a lot of bloating you never have any appetite you're thinner you're losing weight and that's part of your anxiety depression or insomnia picture. So your acupuncturist may say you have spleen chi deficiency and that your quote spleen it's probably spleen pancreas currently is in a state where it's not functioning properly and it's going to take a certain period of time for that deficiency let's just say it's been brought down in here for that deficiency to be brought up more towards a normal level now that just may be time it may be actively working on your diet and it may take a couple months it may be Chinese herbs it may be something else but it's helpful for me to think why is my patient still experiencing this why am I still feeling this this organ is in the process of healing itself again that's a Chinese medicine organ this organ is trying to reestablish homeostasis whether it's the kidney or it's the liver or the spleen or the stomach and as long as I plant the fertile seeds it'll get back to normal now another very useful analogy is that chronic symptoms are a flywheel gone out of motion gone just out of control so this is most applicable in illnesses of the nervous system so for example let's say you're an entrepreneur you're hustling you're running around you work long hours this is your baby you're going to make it happen you're working like crazy now you're good for a few years but then maybe after a year three or your four or your five you start to experience a little bit of sleep problems a little bit of acid reflux a little bit of anxiety never had those before so you slow it down a little bit slow it down a little bit but you're still working you're still making this happen you got this excitement there's stress there's all this stuff so eventually it gets a little bit worse a little bit worse a little bit worse until like you actually cannot sleep you have like debilitating anxiety or depression you cannot get out of bed but you've been exercising and meditating and doing all the right things and why is it still happening why is it even getting worse because that whole time as an entrepreneur you are pushing this wheel this flywheel this imagine this massive heavy wheel you're pushing it pushing it pushing it and after three years this physiological process has gained momentum and it's now it's this behemoth so heavy there's no human on earth that could stop it right away and it's just spinning and spinning and spinning and that's your nervous system and now you're having anxiety and you're having panic attacks and insomnia and no matter what you do you can't stop it at least not acutely right away and that flywheel has gotten out of control and it's going to take a certain period of time of you stopping and stopping everything as possible as much as possible before that flywheel will slow down before your nervous system can unwind before your digestion can balance itself the anxiety the panic attacks the depression the insomnia when the nervous system when that stops finally the nervous system is back in balance and those symptoms will begin to heal or go away but that momentum has already been attained through potentially years and so it can take a long time to slow it back down so if you're going through something like this that's scary and you feel like you're doing everything right you may be you just have to give it more time because you may be in a winter season of your life right now but you have to sow the seeds to make the fertile soil with these seeds so that when spring and summer comes and this is all this food and all this fruit is blooming and blossoming that's where you can harvest the rewards of which is really your healing but you may be in winter and there are a couple seasons before the peak of summer to get to where you can actually fully feel well again so don't lose faith remember these analogies because i hope they'll help you be patient and keep doing the right things to help you heal all right now again i've included a free link below this video it's a free download for daily rituals that can help you add years to your life with traditional chinese medicine there's also info if you sign up for email on how to become one of my patients locally or online via telemedicine all right before you go i have two related videos right here