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Massive Online Public Co-Design—Pathways of FamiliesWe acknowledge the Traditional Owners of the land on which we work, and pay our respects to the Elders, past and present. The ALIVE National Centre for Mental Health Research Translation is funded by the National Health and Medical Research Council (NHMRC) Special Initiative in Mental Health GNT2002047.Phase 2 Consensus Statement The Intermediary Horizon 2024: Pathways of Families and Implementation Actions

ContentsNOTE on language ABOUT the Phase 2 Consensus StatementWHO took partHOW the Consensus Statement was co-created POCKET MAP EDITIONS - A Guide to Interpretation of StatementsHow the analysis of the Annual Survey and Public Co-Design was completedWHAT’S INSIDE THE PHASE TWO CONSENSUS STATEMENT2

SuggestedCitationPalmer VJ, Tjung C, Bibb J, Moorhouse J, Orcher P, Banfield M, Maybery D and The ALIVE National Centre for Mental Health Research Translation Investigator Group. 2024. A massive online public co-design project to co-create the Phase 2 Consensus Statement – The Intermediary Horizon 2024 Pathways of Families and Implementation Actions. The ALIVE National Centre for Mental Health Research Translation: Melbourne, Australia.NOTE on languageThis Statement preserves the language used by people who are parents and living with mental ill-health, adult children of parents and carer, family and kinship group members who answered a survey in 2023 and took part in public co-design online. Everything in this Phase 2 Consensus Statement reflects the priorities of people sharing their lived-expertise. The research team included mental health lived-experience researchers, an Aboriginal and Torres Strait Islander co-design researcher, and interdisciplinary researchers from participatory design, visual design, music therapy and mental health primary care research.In this Consensus Statement you will see the terms parent/s living with mental ill-health, partners of parents, child of a parent living with mental ill-health and carer, family and kin members are used., alongside people with lived-experience of mental ill-health. These terms reflects how people self-identified when they signed up to the ALIVE National-Prato Lived-Experience Annual Priorities Survey (2023). We have retained these naming conventions in quotes from the 2023 survey presented in the Statement and sometimes changed illness in quotations to ill-health for consistency in language use.3

First off, we’d like to say, “thanks!”Thank you for taking the time to read this and especially if you were one of the 78 people who shared your priorities in the ALIVE National-Prato Annual Lived-Experience Priorities Survey 2023. Or, if you one of the 33 co-designers who contributed to how these pathways of families and implementation actions were shaped; thank you. This survey was approved by Monash University Ethics Committee (24861).The Phase 2 Consensus Statement – The Intermediary Horizon Pathways of Families and Implementation Actions brings voices of parents living with mental ill-health, partners and young adults (16+), and family members together to share priorities and action areas. We thank the Prato International Research Collaborative for partnering on this survey.These actions are used to set research goals in the co-designed ALIVE National Roadmap for Mental Health Research Translation. The Roadmap is used to establish integrated knowledge translation strategies, goals, activities and targets.ABOUTThe Phase 2 Consensus Statement & Who Took PartThe goals, strategies and targets of the Centre will be updated as pathways of Aboriginal and Torres Strait Islander people and Children and Young People, and more priority populations are co-designed in the Roadmap. This Consensus Statement sets the course of the pathways of families within the Centre’s research efforts – it does not reflect all families across the diversity of Australia and First Nations communities, there must be local efforts focused on implementation levers, and strategies are required.4

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Priorities were gathered from parents, adult children and family members in the ALIVE-PRATO Annual Lived-Experience Priorities Survey. Most priorities corresponded with ones identified in larger priority setting but they do provide a family, parent and child nuanced perspective. Some priorities are different.In Public Co-Design people talked about the priorities for action across from the survey analysis. This was considered within the three areas of mental health research, mental health care improvement/s and social determinants of health and social issues.The Consensus Statement shows priorities and implementation actions from over one hundred parents who live with mental ill-health, carer, family and kinship group members and a small number of adult children of a parent. HOWThe Phase 2 Consensus Statementwas co-created “Research has established that 21-23% of children grow up in a family with a parent who lives with mental ill-health.”(Maybery D. 2009) 6

What does the Blue mean?The Statements herein have been co-created from the shared priorities in the 2023 ALIVE-Prato Annual Lived-Experience Survey 2023 from parents, living with mental ill-health, family members, partners and adult children and through public co-design.The priorities that were commonly shared by families in the survey have been identified and evaluated against existing priorities for their nuanced meanings according to lived-expertise. These priorities have been further discussed in public co-design which has shaped this statement and implementation actions. Touch Points | Encountersare the places in people’s lives and care journeys where the encounters with service, organisations or staff, or processes of care shape experience in positive, negative or uncertain ways. These are important for directing where change needs to happen. Emotion Mapping | Prioritisationis a way to understand if people feel strong, mixed or uncertain, or not so strong connections with an experience, topic or priorities. People share whether they feel strongly or not and if the feelings are positive or negative. Strong feelings are a guide to agreements.The WHATImplementation ActionsWhat if experiences of care were more like what is above the row, instead of like the below ones?7

The 2023 Pocket Map Guide updated to the Roadmap priorities to show agreement and differences from the analysis of 365 consumer and carer contributions to the Annual 2022 Lived-Experience Priorities Survey. The blue stars and icons reflected renewed language and adjusted priorities from the review of progress in the ALIVE National Roadmap at the ALIVE Holistic Terrains Symposium 2023. Green denotes continued reference to the priorities by all groups who contributed to the survey.8

The 2024 Pocket Map presents the pathways of families and the priorities of parents living with mental ill-health, families and children. Priorities from the 2022 and 2023 Pocket Map are across the bottom and the priorities of families shared in the 2023 Annual Survey expand upward onto connected paths. Blue represents shared priorities with those identified in the 2022 and 2023 surveys and adjusted priorities from the review of the ALIVE National Centre’s co-designed Roadmap and progress at the Holistic Formations Symposium 2024. Green icons the policy and practice arrangements that are required to [re]form national mental health and wellbeing and the priorities from the National Centre’s 2024 Call to Action Casting the Net for What Matters and for Whom.9

HOW The analysis of the ALIVE National—Prato 2023 Survey for The Phase 2 Consensus Statement The Prato International Research Collaborative had set out a range of survey questions ahead of partnering with ALIVE national. The questions that were asked were subsequently grouped within the three priority areas of the roadmap and pocket map guide to establish the priorities for research, mental health care improvements and social determinants.RESEARCHThese priories are from questions that were asked about what characteristics or variables should be looked at in measurement or research and included what does 'recovery' mean in the context of families where a parent lives with mental ill-health, how does one know that recovery has been experienced, How should services find out if their intervention has achieved its goals/desired outcomes?IMPROVEMENTS TO CAREThe most important things that families want to see change in people’s lives (from receiving services). What the purposes of interventions or supports for families. What does it look like/what changes when an intervention is successful for a family? What does it look like/what changes when an intervention is NOT successful for a family?SOCIAL DETERMINANTSShould interventions include work to improve relationships within families and if so, which relationships should be improved and in what way (inside or outside of families). What characteristics of a family, an individual or their context/environment might affect the outcomes and experiences of families?11

The WHATImplementation Actions to Translational Goals12

MENTAL HEALTH RESEARCH WITH FAMILIESLived Experience in all aspects of researchGroup-Based Relational ModelsDifferences in Recovery Co-Designed Measures For what Matters for FamiliesThese priorities were identified by combined analysis of answers to what parents living with mental ill-health, family members and adult children of a parent shared in the 2023 ALIVE-Prato Annual Lived-Experience Priorities Survey said about what recovery looks like, the ways that services could find out if goals and outcomes had been achieved, and the ways people felt that the outcomes for care delivery could be measured. 13

What could ALIVE National amplify?• Create one place where you can see the research that is happening and the findings.• Become a mental health research warehouse with a novel search engine.• Share pre-made research packs for organisations to be able to talk about research and what it means independently of the researchers having to present this.What's holding implementation back?• Research findings remain inaccessible to public and communities for readability and application.• Support for organisations to implement the research findings faster.• Need for lay summaries of research for policy and practice.IMPLEMENTATION ACTIONS FROM PUBLIC CO-DESIGN FOR LIVED-EXPERIENCE IN ALL ASPECTS OF RESEARCH• Ensure diversity of perspectives in lived-experience research and practice. • Make the findings of research accessible so families can pick it up and read it.• Share the ALIVE National Research ‘Quick Guides’ in 2024.• Create packs for research sharing that focus on what does this mean for you as an organisation and a how to for services to understand the research.Lived-Experience in All Aspects of Research14

All individuals involved have their own lived experiences and individuals need to be recognised by this [and] not merely by a diagnosis or a label.(Family Member, Survey 2023)“”In order to share the findings [of research] to my colleagues I have to interpret it. If there was a pack or slides, I could just share without having to lose some of the messaging… (Family Member, Public Co-Design)“”Research plans can be jargon filled -make it accessible and feed into people's needs.(Family Member, Public Co-Design)“”15The ALIVE National–Prato Annual Lived-Experience Survey & Public Co-Design 2023

What could ALIVE National amplify?• Increase understanding about the role that family members play in supporting members of families with mental health issues.• Raise awareness about the amount of caring that is done by kids and the impacts on their well-being.• Recognition of cultural and diversity issues in providing support. Increased knowledge and awareness for support professionals.What's holding implementation back?• Assumptions about what family might mean for people from diverse backgrounds, stereotypes for single parent households.• A focus on individuals and lack of focus on role of trauma.Carers/families can be denied information.• Not enough focus on social and relational ways of working.• Relational is sidelined in dominant assessment and treatment approaches and measurement.• Availability of exemplary models of how to include family members (where appropriate) in decision-making.IMPLEMENTATION ACTIONS FROM PUBLIC CO-DESIGN FOR GROUP-BASED RELATIONAL MODELS16Group-BasedRelational Models • Whole of group approaches (where appropriate). For example, family systems models and collective approaches need implementation for families to be involved in planning and care.• Relational models need to be accompanied by a longitudinal engagement in care.• Ways to support children and siblings embedded in models of care. A focus on children is needed.• Implement age-appropriate approaches to identify what is important to each family member, focus on the collective but note that each individual is unique.

[I would like] to be involved, included and informed in the treatment plan of the parent with the mental ill-health.(Family Member, Survey 2023)””””Find out what is important to each member of the family. Use age-appropriate methods to do this. You want the family to be able to support each other and feel like they are a connected family.(Parent Living with Mental Ill-Health, Survey 2023)””It is desperately important that the various available services work collectively with the family. This would allow a coordinated service which would greatly increase positive outcomes, that would take into account the strengths and weaknesses of each individual. (Parent Living with Mental Ill-Health, Survey 2023)17The ALIVE National–Prato Annual Lived-Experience Survey & Public Co-Design 2023

What could ALIVE National amplify?• More awareness of what is available for different kinds of recovery. • Education and inclusion of the fact that carers are in a recovery process themselves.• What recovery means in a group-based approach.• Share stories and information about ways that families heal.What's holding implementation back?• More choice - there is some available but if you want a psychologist, it is too expensive, and if you want a counsellor you cannot get government assistance.• Stuck in a medical model of recovery, not person centred and holistic.• Recovery is an outdated term.• Rushing people through the system and pushing them out before they are ready for recovery.• A lot of judgement about taking or coming off medication.IMPLEMENTATION ACTIONS FROM PUBLIC CO-DESIGN FOR DIFFERENCES IN RECOVERY18Differences in Recovery• Advocacy for culturally and linguistically diverse communities during the recovery stage given the language and cultural barriers especially over differences with professionals.• Get back to the person-centred version of recovery and check in with families about what works best when this is appropriate.• Implement medication use in a safe way and provide choices. Provide more information• See recovery in group and family context. Respect the strengths the parent has and repair relationships.

Seeing healing as through relationships and not individually is important.(Child of a Parent, Survey 2023)””””Acceptance that the situation may be difficult - but not making mental ill-health a permanent part of the person’s story. (Parent Living with Mental Ill-Health, Survey 2023)””Recovery embraces all aspects of life, including housing, employment, education, mental health and healthcare treatment and services. (Parent Living with Mental Ill-Health, Survey 2023)19The ALIVE National–Prato Annual Lived-Experience Survey & Public Co-Design 2023

What could ALIVE National amplify?• What matters for measurement from the perspectives of people with lived-experience.• Service evaluation to establish If there are reduced contacts and needs are met due to the model of care in operation and services delivered.• Wellbeing measures and the importance of these in recovery with frequent check-ups on family members.What's holding implementation back?• Quantitative focused measurement only misses experiences and subjective outcomes.• Impacts may not be captured by the surveys, tools, or questions that are currently being asked.• There is a still a sense that in families where parents live with mental ill-health that there is stigma and shame, and that the family is looked down upon.• Recovery is a gap and longitudinal evaluations lag.IMPLEMENTATION ACTIONS FROM PUBLIC CO-DESIGN FORCO-DESIGNED MEASURES FOR WHAT MATTERS AND FOR WHOM• Involve people with lived-experience in the development of what is being measured and the evaluation of effectiveness. Ensure that cultural diversity is attended to.• Identify measures that can determine community connection, engagement and relationships as indicators of wellbeing and recovery of person living with mental ill-health. • Implement longitudinal surveys to establish the outcomes directly from a model of care.• Ask families for feedback and involve all of the family in this feedback (including children). • Explore the concepts of relational well-being. 20Co-Designed Measures for what matters and for whom

There needs to be continuous monitoring and checking in on gains made and if they aren't happening, why. You can't just start a program and then evaluate it a year later. (Adult Child of a Parent, Survey 2023)“”“”Communication with the family and individuals within it, both about their goals and expectations for intervention and the outcomes that they experience. It would also do well for the communication to be two-way, to ensure that expectations are realistic. (Adult Child of a Parent, Survey 2023)“”Qualitative data is important because people have nuanced experiences. (Parent living with Mental Ill-Health, Survey 2023)21The ALIVE National–Prato Annual Lived-Experience Survey & Public Co-Design 2023

The WHATImplementation Actions to Translational Goals22

MENTALHEALTH CARE IMPROVEMENTS WITH FAMILIES Holistic & Longitudinal CareMore than traumainformed carePeer to Peer Models The priorities of pathways for families have been established by combining the answers to four questions in the PRATO-ALIVE Annual Lived-Experience Priorities Survey and public co-design.These four questions were about the changes families want to see in their lives, the purposes of supports and interventions, and what makes change for families successful or unsuccessful.23

IMPLEMENTATION ACTIONS FROM PUBLIC CO-DESIGN FOR HOLISTIC AND LONGITUDINAL CAREWhat could ALIVE National amplify?• The needs of children and the impacts of being a young carer and how the impacts continue into adult life.• Ways to increase family confidence, compassion, education and facilitate thriving lives.• Greater understanding of families and groups living with mental ill-health from different perspectives.• Support for children of parents living with mental ill-health who sometimes can feel abandoned.What's holding implementation back?• Supports are targeted at individuals and delivered to individuals rather than the family, group or collective units.• Limited view of wellbeing of the whole family system. Parents are overwhelmed by caring for both children and a partner/spouse.• Punitive measures, no validation of person and familial resources and railroading of families when services are not working.24Holistic & Longitudinal Care• Longitudinal and life course models of care that recognise the impacts for children of growing up with parents and family members living with mental ill-health.• Support for children and parents to reconnect after a period of out of home care. Consideration of intergenerational trauma. • Services to support children are incorporated into support for parents and implement family counselling to identify and address any impacts of neglect or abuse.• Implement group-based models of care directed to families or caregivers. Provide access to trauma therapies for parents, children and offer perspectives to manage trauma responses.

I am no longer a young adult, I am now an adult, and instead of gaining increased freedom from my parent's mental illness and addiction, I now have to financially support my parent and have them live with me. There are also many long-term impacts for myself that are only just coming to light in regard to financial wellbeing. (Child / Family Member, Survey 2023)”””Ensuring that supports have a holistic focus, not just on the difficulties of having a parent with a mental [ill-health], ensuring there is support that encompasses all the family and their lives outside of the family including education, employment, social. (Parent with Lived-Experience, Survey 2023)””We have no say, because everything is done behind closed doors. We just get a call, that your sibling has gone off. Where …the nurse is already called, and the hierarchy has made the decision to have them removed. (Family Member, Survey 2023)”25The ALIVE National–Prato Annual Lived-Experience Survey & Public Co-Design 2023

IMPLEMENTATION ACTIONS FROM PUBLIC CO-DESIGN FOR MORE THAN TRAUMA-INFORMED CAREWhat could ALIVE National amplify?• That there is help before getting your children removed.• Promote appropriate trauma services and programs.• Ensure that all interventions use trauma-informed practices.• Help children to know that it is not their fault or responsibility to help to raise younger siblings.What's holding implementation back?• Family separation means that there is extensive trauma for the children being left behind. • Reliance on standardized measurements for assessment of need and dominance of medical models.26More Than Trauma-Informed Care• Consideration of intergenerational trauma and more than trauma-informed approaches. A one stop shop for all services related to trauma.• Expand beyond the Kessler 10 and Depression Anxiety Stress Screener 21 and screen for complex trauma and adverse childhood experiences.• Easier access for families to assessments for parents who do not want to engage with mental health and/or medical systems.• Keep families together and reduce intergenerational trauma by working with kids and parents together and separately.• Preventative approaches to address trauma on children.

Ideally non-medicinal treatments will be prioritised and medicinal treatments will be assigned with care. (Child / Family Member, Survey 2023)”””””Preventive interventions are intergenerational trauma are needed and independent pathways to support for children e.g. through school…[to] acknowledge impact on children. (Parent living with Mental Ill-Health, Survey 2023)”Exhaustion – sometimes it is just too hard to do it. (Public Co-Design 2023)27Parenting with mental ill-health is really hard, parenting children who are neurodiverse and who have mental ill-health is really hard. Being parented by a person with mental ill-health is really hard. This needs to be treated as an intergenerational issues, not one for quick fixes. (Parent living with Mental Ill-Health, Survey 2023)””The ALIVE National–Prato Annual Lived-Experience Survey & Public Co-Design 2023

What could ALIVE National amplify?• Understanding of family and group needs for support, and validation of individuals with lived-experience.• Provide the avenues for siblings to have support.• Ensure that spending time with peer workers and people with lived-experience of mental ill-health and carers of people living with mental ill-health is embedded within Health Professionals training to encourage a focus on recovery.What's holding implementation back?• Family members need avenues to express their views.• Often supports or interventions can cause a lot of stress and panic for families. • There is limited focus on reconnection with people emotionally in the group unit after being separated.• Opportunities for family peer models remain limited. • Peer models for children are less advanced than for adults.IMPLEMENTATION ACTIONS FROM PUBLIC CO-DESIGN FOR PEER TO PEER MODELS28• Implement support that meets the needs of all individuals involved and do not use labels to base treatment on, rather use the individual’s own experience and what works best for them.• Implement peer workers within training and education courses for clinical workforces to improve the ways of working together and to address tensions and misunderstanding.• Address areas where services stigmatise and discriminate against peer workers.• Deliver options within schools for children with peers providing support.• Respite and care in the home options are needed and peer support.Peer to PeerModels

Be open and realistic about projected care outcomes and INVOLVING, INCLUDING and INFORMING family members that are living and caring for the person living with mental [ill-health]. (Family Member, Survey 2023)””””We need more peer workers in hospitals and in the community. (Parent living with Mental Ill-Health, Survey 2023)””Use peer workers to ensure families feel safe connecting with services (Parent living with Mental Ill-Health Survey, 2023)29The ALIVE National–Prato Annual Lived-Experience Survey & Public Co-Design 2023

The WHATImplementation Actions to Translational Goals30

SOCIAL DETERMINANTS/ \SOCIAL ISSUES FOR FAMILIESAccessibility of Services Stable Housing & Stable IncomeImpacts of Stigma Cultural and Community ResponsivenessThe identification of the priorities in social determinants and social issues for families in the ALIVE National Roadmap drew together what people with lived-experience saw as social, individual, community and cultural contributors that intersect with well-being. 31

What could ALIVE National amplify?• Connecting with peer-to-peer services.• Need for support to broader family within service models and not being solely focused on an individual person.• Raising awareness about the availability of affordable programs that provide home support such as cooking, cleaning and gardening.What's holding implementation back?• Easier access to services when we need them. not having to wait 6-12 months just for an appointment. Blockages due to age or type of mental illness shared.• Free sessions under Medicare – people are still paying hundreds of dollars to see someone.• Accessibility of services across borders. Timely access to interpreters—the problem is often logistics rather than a shortage of interpreters.• The ecosystem is confusing knowing what services are there and what you can access.IMPLEMENTATION ACTIONS FROM PUBLIC CO-DESIGN FOR ACCESSIBILITY OF SERVICES32Accessibility of Services• Ability to access childcare at appointments or to have the meeting via telehealth.• Mental health supports for the broader family within services.• Ensure that follow up happens consistently and build in support for example have an agency that contacts carers when things are not as intense during crisis times.• Navigational help. Triage Services. The information being in one place.• Advocate for greater inclusion of practical support for families where parents are living with mental ill-health. • Training for workforces in culturally and linguistically diverse approaches.

”Ability to access financial support without the cooperation of parent or the parent’s doctor. (Adult Child of a Parent, Survey 2023)”Active support such as good, ongoing information about my own and my children's conditions, and different treatment possibilities. Access to services to relieve pressure points (cleaning, meals, transport to appointments). (Parent, Survey 2023)””””Being able to have support in taking kids out to enjoy school holidays/weekends. Being able to be on top of housework so that the kids don't feel embarrassed to have friends over.(Family Member, Survey 2023)33The ALIVE National–Prato Annual Lived-Experience Survey & Public Co-Design 2023

What could ALIVE National amplify?• Greater awareness within broader social support networks and groups such as schools, churches and other social settings of the impact on children of families where there is mental ill-health.• Models of care that enable safety and cultural empathy.• Breaking down stigma on community radio for older communities and culturally diverse communities. Letting people know that it is okay to talk about this.What's holding implementation back?• Judgements about what is happening to a person without really knowing what is happening.• Understanding that some people do not talk about mental health in different cultural settings.• There are many people in culturally and linguistically diverse communities who may not even identify as a carer and use the word carer.IMPLEMENTATION ACTIONS FROM PUBLIC CO-DESIGN FOR IMPACTS OF STIGMA34Impacts ofStigma• Programs that grow respectful relationships in schools. • Foster a generational shift through school-based programs and greater inclusion of Indigenous education in the school system.• Target stigma that exists for one area, for example, in what can be labelled as psychosis. • Resources relevant for queer folks and neurodiversity or different ways of learning.• Models of care that enable safety and ways to address self-stigma.

”Hiding the mental illness from family members and the 'outside world' is detrimental. More talking = less stigma. (Parent living with Mental Ill-Health, Survey 2023)”From my own personal experience l also believe that intervention will only be helpful if the focus is in the individual and or the carer /s friends etc A holistic and humanitarian approach is essential and health labels and symptoms are not focused on which can cause stigma (Parent living with Mental Ill-Health, Survey 2023)””””Stigma and discrimination impacting the ability to draw on additional support outside of the family unit.(Parent living with Mental Ill-Health, Survey 2023)The ALIVE National–Prato Annual Lived-Experience Survey & Public Co-Design 202335

What could ALIVE National amplify?• The importance of income for stability and well-being and the impacts that this can have on help seeking.• Microfinance models.• Outcomes are better when there is financial support, support available from the wider family network and secure housing.What's holding implementation back?• Low finances, limited support and no care or access to transport.• Cost of living. Families are on long wait lists.• The prices for rent are far too high comparative to what people received with a Disability Support Pension. There is nothing for young people who want to lived independently but who cannot afford it. • When leaving hospital without housing people end up in hotels and not long-term accommodation support. IMPLEMENTATION ACTIONS FROM PUBLIC CO-DESIGN FOR STABLE HOUSING, STABLE INCOME36Stable HousingStable Income• Provide safe, stable, secure and affordable housing to people with strong sense of community.• Do something to use empty houses and apartments.• Find innovations in the housing crisis., explore philanthropy models • Look at employment as part of recovery approaches with people.

””””Recovery embraces all aspects of life, including housing, employment, education, mental health, and health care treatment…spirituality, creativity, social networks, community participation, and family supports determined by the person. (Parent living with mental ill-health, Survey 2023)If I can only focus on where the next meal is coming from or where we are going to sleep tonight, non-immediate things like relationship restoration/ strengthening will not gain my attention, focus or priorities. (Family Member, Survey 2023)37The ALIVE National–Prato Annual Lived-Experience Survey & Public Co-Design 2023

What could ALIVE National amplify?• Importance of holding conversations in the workplace to reduce stigma and raise awareness.• Promote awareness that the concept of prevention may not be as familiar in culturally and linguistically diverse groups.• Focus on young people caring for adults and the home environment.• Cultural empathy in services and communities. What's holding implementation back?• Approaches do not fit with community priorities, and research is not fit for purpose.• Availability of video, audio and text about mental health and well-being in multiple languages.• We have become isolated. Social supports may be limited for family members.• Limited community awareness of needs of families when parents are living with mental ill-health.IMPLEMENTATION ACTIONS FROM PUBLIC CO-DESIGN FOR CULTURAL & COMMUNITY RESPONSIVENESSCultural and Community Responsiveness 38• Provide connection and information on mobile apps and software that can be used in conjunction with existing video, audio and text to translate material in real-time across different languages.• Identify different cultural conceptions of prevention and embed these in research and translation approaches.• Implement school-based, whole of community prevention approaches (speakers, sports people).• Focus on young carers who are supporting adults.• Recruit more culturally and linguistically diverse professionals to provide greater access to the corresponding communities.

Pathways don't always have to lead to clinical care, we need to move into community-based approaches. (Family View, Public Co-design)””””…find solutions that work for each member of the family and how to interact with communities. Make sure there are interventions to support the community to understand mental health and wellbeing and to lower stigma. (Parent living with Mental Ill-Health, Survey 2023)39The ALIVE National–Prato Annual Lived-Experience Survey & Public Co-Design 2023

This Phase 2 Consensus Statement “The Intermediary Horizon - Pathways of Families Implementation Actions” guide research goals and translational strategies within the ALIVE National Centre. You can use The Consensus Statements from the ALIVE National Centre roadmap for research, policy formulation, advocacy, service design and improvement, and to change professional practice sector wide. This can:• Increase the understanding of what parents with lived-experience of mental ill-health and children, family, kinship groups want in mental health care—and act on these priorities in practice;• Grow research-responsive agendas within grant proposals, funding calls and implementation research centred on the priorities where people with lived-experience of mental ill-health are decision-makers and active members of research, policy and practice teams;• Support the implementation and translation of innovations and models of care that address the priorities of those most impacted and which move beyond single solution, single issue focused approaches. • Lead to measures centred on what matters for people with lived-experience of mental ill-health and carer, family and kinship groups supporting people that are driven by lived-experience researchers. These actions support the ALIVE National Centre’s Call to Action Casting the Net for What Matters and for Whom which identified the policy and practice arrangements for holistic formation and regeneration of the mental health ecosystem with people with lived-experience of mental ill-health, mental health researchers, policy advocates and makers, and service providers at the 2024 Annual Symposium.40

The ALIVE National-ANU Lived-Experience Priorities Study 2024 is designed to increase the perspectives from people aged 16 to 24 years old who are living with mental ill-health and/or who are caring for someone with mental ill-health as a carer, family or kinship group member. The survey is open for longer this year, and you can choose your own adventure! We’d love to hear from you about the priorities for research that matter to you. Scan the QR code or visit the survey page here:https://alivenetwork.com.au/2024-anu-alive-national-lived-experience-priorities-survey/41Please keep sharing your priorities with us . . .

Thank YouVisit our socials for information on our activities and networks43