Using Lived Experience to Improve Mental Health Pathway Design
Mental health pathways shape how people access support, move between services and experience continuity of care. Increasingly, commissioners expect lived experience to inform how these pathways are designed and refined, not just how individual care is delivered. This article explores how lived experience can be used safely and effectively to improve pathway design, sitting within the wider framework of co-production and lived experience and aligned with established service models and pathways.
Why pathway design matters to lived experience
Pathways determine waiting times, handovers and thresholds, all of which strongly influence lived experience. Poorly designed pathways often result in frustration, repeated assessments and disengagement.
Using lived experience to inform pathway design helps address these systemic issues.
Operational example 1: Redesigning referral thresholds
Context: High rejection rates at triage caused repeated referrals.
Support approach: Lived experience panels reviewed referral criteria and communication.
Day-to-day delivery: Criteria were clarified and feedback improved.
Evidence of effectiveness: Reduced repeat referrals and complaints.
Embedding lived experience without undermining clinical logic
Pathway design must still reflect clinical risk stratification and resource reality. Lived experience input should inform how pathways feel and function, not override clinical thresholds.
Operational example 2: Improving transitions between teams
Context: Transitions between community and crisis teams were inconsistent.
Support approach: People with lived experience mapped transition pain points.
Day-to-day delivery: Joint handover points were introduced.
Evidence of effectiveness: Improved continuity and inspection feedback.
Commissioner expectation: system-level influence
Commissioner expectation: Commissioners expect lived experience to influence pathway design at a system level, particularly where services are integrated or jointly commissioned.
Regulator expectation: reduced fragmentation
Regulator expectation (CQC): Inspectors assess whether people experience fragmented care and whether providers have acted on known issues.
Operational example 3: Pathway mapping workshops
Context: A provider faced repeated feedback about confusing access routes.
Support approach: Workshops brought staff and service users together.
Day-to-day delivery: Access points were simplified and communicated clearly.
Evidence of effectiveness: Improved access metrics.
Governance and review mechanisms
Effective use of lived experience in pathway design requires formal governance, documentation and review. Without this, improvements are difficult to sustain.
Providers that treat lived experience as a strategic input rather than an add-on are better positioned for commissioning scrutiny.