Co-Production With Families, Carers and Support Networks in Mental Health
Families, carers and informal support networks are often central to a person’s mental health journey, yet their involvement can be fragmented, inconsistent or contested. Commissioners expect providers to work collaboratively with carers, while inspectors scrutinise consent, confidentiality and safeguarding. This article explains how providers structure co-production with families within co-production and lived experience and align it with service models and pathways without undermining the person’s rights or autonomy.
The complexity of carer involvement
Carer involvement is rarely straightforward. Relationships may be strained, capacity may fluctuate, and people may not always want family involvement. Co-production requires clarity about:
- who the person wants involved, and when
- what information can be shared
- how carers contribute to planning and risk management
- how disagreements are handled safely
Operational example 1: Co-produced carer involvement agreements
Context: Staff reported uncertainty about when and how to involve families, leading to inconsistent practice and complaints from carers.
Support approach: The provider co-produced a carer involvement framework with people supported and family representatives.
Day-to-day delivery: Each person completed a carer involvement agreement covering consent, preferred communication routes, information sharing boundaries and review points. Staff were trained to revisit agreements during reviews or changes in capacity.
Evidence of effectiveness: The service recorded fewer complaints about exclusion, clearer documentation around consent, and improved staff confidence when navigating family dynamics.
Commissioner expectation: carers recognised and supported
Commissioner expectation: Commissioners expect providers to recognise carers as partners in care where appropriate, offer them information and support, and evidence how carer input informs risk management and continuity.
Safeguarding, consent and capacity
Involving carers requires robust application of consent and capacity principles. Providers should evidence:
- capacity assessments where decisions are complex
- best interest decision-making where required
- clear safeguarding escalation routes
- respect for the person’s wishes even when contested
Operational example 2: Co-produced relapse and early warning planning
Context: Families often identified early warning signs before professionals, but this intelligence was not consistently captured.
Support approach: The provider co-produced early warning plans involving the person and nominated carers.
Day-to-day delivery: Plans documented carer-observed indicators, agreed responses, and thresholds for escalation. Staff reviewed plans during MDT discussions and updated them following any deterioration.
Evidence of effectiveness: Earlier intervention reduced crisis admissions and improved continuity. Documentation demonstrated collaborative risk management.
Regulator expectation: involvement is lawful and person-led
Regulator expectation (CQC): Inspectors assess whether family involvement respects consent, protects confidentiality and supports the person’s wellbeing rather than overriding their voice.
Operational example 3: Supporting carers through co-produced education
Context: Carers reported feeling blamed or excluded during crises.
Support approach: The provider co-produced carer education sessions covering mental health conditions, crisis responses and system navigation.
Day-to-day delivery: Sessions were delivered quarterly, with feedback informing service improvements. Staff used learning from sessions to refine communication during crises.
Evidence of effectiveness: Improved carer satisfaction, clearer communication during incidents and stronger partnership working were evidenced through feedback and reduced complaints.
Balancing relationships, rights and accountability
Co-production with families strengthens services when it is structured, consent-led and reviewed. Providers who evidence this balance demonstrate mature governance and person-centred practice.