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While there has always been some focus on the mental health of young people, the past 20 years in the province of Ontario and Canada more broadly have specifically heightened professional and policy interest and focus to ensure there are interventions into the lives of ‘troubled’ youth. Initiatives exist today in order to help with a variety of identified priorities concerning young people – everything from youth homelessness, to various strategies into mental health symptomatology, and of course the crisis of youth suicide.
Strategies include enthusiasm for interventions that target primary and post-secondary students via mental health awareness campaigns such as ‘Right By You’1 or others that specifically seek out the inclusion of youth themselves such as the ‘Jack Project’, an initiative created in 2010 by parents after their son Jack, a first year university white student, died by suicide at Queen’s University. There are also efforts by national organisations such as the Mental Health Commission of Canada to develop policy for young people that addresses access to psychiatric services in rural communities, particularly for Black and Indigenous communities who are deemed to be ‘at risk’.
I am starting with, and reflecting on, the experiences of younger people who may or may not come in contact with services of various kinds, because they will inevitably inherit the impacts of legislation and social policy we construct today. As such, I am interested in creating a future that is informed by the people most affected by government policies, and so on, with the caveat that such future processes think carefully about what meaningful participation and inclusion of young voices looks like.
The statement in the title by a Housing Officer in my local borough said so much. The focus on the provision of at best a house rather than a home ignores the impact lack of suitable housing can have on the human beings who are so often the recipients of the results of decisions made about them without them. Having made the transition from homelessness to now having a social housing tenancy and a further transition from long-term dependency on benefits, I have come to redefine my understanding of Squalor – one of the ‘giant evils’ Beveridge defined in his then groundbreaking report.
I believe he meant it in a ‘bricks and mortar’ sense. Having people living in squalid conditions was clearly the key challenge in those times. I have come to see it these days as having deeper connotations.
An archaic definition of ‘stigma’ is a brand on the skin. I see squalor as also being about mud that sticks. People forced to rely on benefits, and if lucky housed in social housing, are increasingly viewed as being of lesser worth – the ‘undeserving poor’, the ‘feckless’, and so on. I noted with horror the building of so-called ‘affordable housing’ in private developments with separate entrances for those lesser mortals. The creation of ‘poor doors’ with markedly less attractive fixtures and fittings and even segregated bins to make sure even the rubbish of the lesser is kept away from the throwaways of the privileged.
The UK Care Act 2014 defines housing as one of nine areas of ‘wellbeing’ which local authorities must promote and give proper attention to ‘the suitability of living accommodation’ (HM Government, 2014)
In 2015 the Building Research Establishment more than doubled its 2010 estimate of cost to the UK National Health Service (NHS) of poor housing from £600 million to £1.5 billion.
My journey to being active in disability campaigning started with a life-changing event when I got stabbed. It was 16 February 1995 and the date is etched on my mind. A young lady was being raped. I could have ignored the calls but I had to do something. At the time I was a bouncer at a city centre nightclub, but off duty. When I intervened I was stabbed repeatedly and that’s how I acquired my disability. I lost three weeks of memory as I was in intensive care and then six months in hospital while health and social care arguing over who would pay for stair lifts as I was living in a flat at the time. That introduced me to the physical and emotional journey of disability.
Later on I was diagnosed with post-traumatic stress disorder (PTSD) as a result of my trauma. I had to do a lot of mental health work too. I went to psychiatrists as I wanted to kill myself. I was angry at people and angry at the situation I found myself in. But the experience I lived through shaped the way I think of the world, and made me who I am. I suppose now you could say I’ve got a calling to fight for social justice because I hate bullies and I hate inequality, but I had to personally go though it to really understand it. I thought things were in place for disabled people, but on 16 February 1995 I woke up when I became disabled.
In order to answer the question in the title, this chapter presents a brief investigation into the origins of the concept of ‘co-production’ and an exploration of how it has functioned in UK social policy rhetoric since the mid-2000s. In doing so, it traces what could be termed its ‘ownership records’, to examine how the policy concept is being, or can be, implemented in practice. Critical questions, informed by international literature on the topic, are asked about the true potential of ‘co-production’ to facilitate radical power shifts towards disenfranchised or marginalised service users and citizens, and to fundamentally change how policy decision making and public service provision is done.
The origins and meaning of co-production as a way of facilitating power sharing and decision making with citizens and/or service users as equals in social policy and public service provision are somewhat confused or at least contested (Scourfield, 2015). It appears to be a policy idea that has gradually become ‘lost in translation’, even at early stages of conceptualisation, and as a result co-production can be as difficult to define as it is to do. Bovaird suggests that co-production comes in a variety of forms, and is often specific to particular contexts (Bovaird, 2007), while Ewert and Evers argued: ‘in a changed welfare environment, there is no dominant, coherent narrative for co-production … co-production refers to a fragmented set of activities, expectations and rationales’ (Ewert and Evers, 2014: 427).
Despite this, it is generally agreed that the first individuals to use the term were Elinor and Victor Ostrom, who developed the concept to describe relationships between citizens and public institutions, in the context of US public management research (Ostrom and Ostrom, 1977).
