Community Engagement Initiative: Forum Theatre at MMM Nursing College, Chennai
Our community engagement initiative, conducted by the mixed arts group at SCARFindia, involved delivering forum theatre performances and workshops at the MMM Nursing College in Chennai. This initiative provided an excellent platform for students to engage in discussions regarding challenges in mental healthcare. Additionally, students had the opportunity to interact with service users and members after the session, fostering a deeper understanding of mental health issues within the community.
Announced! Selected applications for Small Scale Research Grants – India
We are pleased to announce the selected applications that will be funded via our Small Scale Research Grant Scheme in India
The PIECEs Small Scale Research Grant (SSRG) is an initiative for building research capacity and community engagement development within the ‘Improving outcomes for people with psychosis in Pakistan and India – enhancing the Effectiveness of Community-based care (PIECEs) research program*.
This grant scheme will be locally administered SCARF and will act as support fund to individuals or collectives who work as academics, students, researchers, program implementers, health workers, clinicians and advocates who support or work in Mental Health, Arts and Community Engagement and Mental Health Evaluation.
“It is a long path for mental health professionals with research interest to become experienced in research and be successful in applying for grants. The small scale research grant is a great opportunity for young researchers to gain this unique experience at this early stage of their career”, comments PIECEs Principal Investigador in India and Director at SCARF, Dr R Padmavati, endorsed by Co-Investigator Dr Lakshmi Venkatraman: “we are delighted that NIHR and PIECEs are supporting the young researchers through this . It has been very gratifying to see the amazing innovative ideas that have come in from the young researchers. We are looking forward to seeing the research outputs of these awardees”.
Funding disbursed in India and Pakistan for this programme is £25.000 per country. SCARF, our lead partner in India, received over open the scheme to early career researchers working within SCARF programmes and associated partners in Chennai. After being anonymised, analysed and scored by an independent panel, a total of five applications will be funded on the scheme.
According to Professor Victoria Bird, Lead Investigator on PIECEs Research the richness of the proposals made it difficult make the selection. “There were so much variety of promising new projects and research emerging on the topic of severe mental illness. We are very much looking forward to work collaboratively with the selected applicants to build capacity and nurture knowledge, and together achieve impact as wide as possible”.
See below the selected projects, which will be developed in the course of the next year. Participants will be fully supported by the PIECEs Research and Management teams to develop capacity around project management, reporting procedures and good clinical practices and any further training needed to deliver projects at the highest standards.
Congratulations to all the selected projects!
- Using Photovoice to empower persons with psychosis: A pilot study from a LAMI country
Project Lead: Kasthuri Divya G.
With increasing evidence supporting participatory approaches in research, the study aims to pilot photovoice- a well-researched methodology that has been used as a community-based tool, in a mental health service user population at the outpatient department of SCARF, India.
The study will be executed in 4 phases, with the aim of finding out whether photovoice can bring about a positive change through empowering persons with psychosis. This process will include recruitment and training of participants to communicate through photographs, as well as evaluation assessments. The study intends to evaluate the impact of photovoice as a participatory tool that facilitates subjective documentation of the lived experience of psychosis.
- Acceptability and feasibility of UPSIDES peer support model
Project Lead: Ms. Sonia Sims
The proposed project aims to assess the acceptability and feasibility of a peer support model – UPSIDES. Although the UPSIDES model has been piloted and is being implemented in different parts of the world, including Gujarat, India, this study is a first-time exploration of using peer support volunteers in our setting. The different sociocultural aspects of the study setting warrant an exploration of facilitators and barriers to implementing a peer support model. This is achieved by this pilot study through quantitative and qualitative assessments that will shed light on the process and outcomes of using the UPSIDES model. Regular debrief sessions with the PSVs will keep the researchers informed about the utility of the UPSIDES workbook as a tool to drive recovery-oriented conversations.
Notes from these sessions will also help in course correction of the UPSIDES model. UPSIDES being a flexible and adaptable model can benefit from the learnings gained through its implementation and can be customised to better suit the study setting. As a long-term outcome, possibilities to integrate peer support into the mental health system at the tertiary care center will be explored using the experience gained through the implementation of the UPSIDES model.
- ADEPT Project – Of the people, for the people, by the people: Development of an Advisory board for Experience-enriched service and research in Psychosis Treatment
Projetc Leads: Priyadharshni B , Krishna Priya K, Jagadeesan Settu, Amritha P, Greeshma Mohan, Vijaya Raghavan
The proposal aims to develop an advisory board manual for people with early psychosis by involving people with lived experience, caregivers and other relevant stakeholders as the board members and to assess the developed manual. The underlying principle of the proposed protocol is to use the participatory action research approach and we aim to involve end-users i.e., the patients of first episode psychosis and their caregivers at all stages of the study.
- Use of Theatre of Oppressed methods to provide a voice for People with Psychosis
Project Lead: Manikandan Pari
Psychotic illnesses such as Schizophrenia or Bipolar Disorder (BD) are a group of conditions that are categorised as severe mental disorders. The impact of the conditions is determined by various factors, not just the absence of specific symptoms or disorders in people living with psychiatric problems but by a multifaceted social process in which people are devalued and discredited because of a stereotyped social status or personal characteristic.
This study attempts to use the Theatre of the Oppressed to engage persons with psychoses, providing them with a platform to express their experiences, view these from several different perspectives and possibly work through the change to enable recovery. TO is a form of popular participatory community-based strategy that uses theatre as a tool for critical thinking and transformation. It is now used worldwide for social and political activism, conflict resolution, community building, therapy, and government legislation, through supporting and developing interactions with the audience. Participating in community-based theatre will also provide opportunities for social interaction and advocacy work.
- Operational research to evaluate Namma Area, an in-operational service for the persons with mental illnesses, using mixed method approach
Project lead: Dr (Major) Karthikeyan P R, Epidemiologist
The proposal intends to evaluate the ‘Namma Area’, a hangout space, the first of its kind established within the premises of SCARF (I), for people with mental illnesses, as part of community engagement. The evaluation is intended to be carried out adapting Operational/implementation – research methods using Pragmatic Robust Implementation Sustainability Model (PRISM) & RE-AIM evaluation framework. PRISM & RE-AIM framework has been adopted because the framework in itself designed to be used at all stages of research/program/policies/interventions from planning through evaluation and reporting and across different settings using both quantitative and qualitative approaches.
RE-AIM framework is often considered as ‘gold standard’ for decision making and guidelines. The elements of RE-AIM follow a logical sequence, beginning with adoption and reach, followed by implementation and efficacy or effectiveness, and finishing with maintenance.
*This research is funded by the National Institute for Health Research (NIHR) via its Research and Innovation for Global Health Transformation (RIGHT) programme. Grant number NIHR200824, using UK aid from the UK Government to support global health research. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK Department of Health and Social Care.
Selected Applications In Pakistan! Small Scale Research Grants
We are pleased to announce the selected applications that will be funded via our Small Scale Research Grant Scheme in Pakistan
The PIECEs Small Scale Research Grant (SSRG) is an initiative for building research capacity and community engagement development within the ‘Improving outcomes for people with psychosis in Pakistan and India – enhancing the Effectiveness of Community-based care (PIECEs) research program*.
This grant scheme will be locally administered by IRD Pakistan and will act as support fund to individuals or collectives who work as academics, students, researchers, program implementers, health workers, clinicians and advocates who support or work in Mental Health, Arts and Community Engagement and Mental Health Evaluation. “The SSRG initiative invests in innovative ideas for equitable and effective access to mental health care by the next generation of early career researchers from Pakistan and India“, points out Onaiza Qureshi, PIECEs Program manager in Pakistan
Funding disbursed in India and Pakistan for this programme is £25.000 per country. IRD, our lead partner in Pakistan, received over 100 applications from 26 different cities including: Abbottabad, Attock, Bahawalpur, Buner (Hangu), Chakdara (lower dir), Chitral, District Jaffarabad, Gharo, Gilgit Baltistan, Islamabad, Kandhkot (District Kashmore), Karachi, Lahore, Rawalpindi and Gujranwala, Larkana, Layyah, Mansehra, Mardan, Multan, Peshawar, Quetta, Sakhar, Tharparkar, Sindh and Thatta.
After being anonymised, analysed and scored by an independent panel, a total of six applications will be funded on the scheme. According to Professor Victoria Bird, Lead Investigator on PIECEs Research the richness of the proposals made it difficult make the selection. “There were so much variety of promising new projects and research emerging on the topic of severe mental illness. We are very much looking forward to work collaboratively with the selected applicants to build capacity and nurture knowledge, and together achieve impact as wide as possible”.
See below the selected projects, which will be developed in the course of the next year. Participants will be fully supported by the PIECEs Research and Management teams to develop capacity around project management, reporting procedures and good clinical practices and any further training needed to deliver projects at the highest standards.
Congratulations to all the selected projects!
*This research is funded by the National Institute for Health Research (NIHR) via its Research and Innovation for Global Health Transformation (RIGHT) programme. Grant number NIHR200824, using UK aid from the UK Government to support global health research. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK Department of Health and Social Care.
PIECEs Research site visits round-up: Arts & Community Engagement week in Pakistan
After a week long site visit in India ( which you can read all about it in our previous blog post here), the team flew to Karachi, Pakistan, for another week of activities regarding our Arts and Community Engagement work package.
The three members of UK team (Paul Heritage, Arts Co-I in the PIECEs Research; Renata Peppl, PIECEs Programme Manager and Mariana Steffen, Arts Projects Manager) joined the main partner on site, IRD Pakistan, and the Arts partner, IRC, during the first week of June.
After a week long site visit in India (which you can read all about it in our previous blog post here), the team flew to Karachi, Pakistan, for another week of activities regarding our Arts and Community Engagement work package.
The three members of UK team (Paul Heritage, Arts Co-I in the PIECEs Research; Renata Peppl, PIECEs Programme Manager and Mariana Steffen, Arts Projects Manager) joined the main partner on site, IRD Pakistan, and the Arts partner, IRC, during the first week of June.
Below you’ll find the highlights of the site visits.
Clinical site visit: Karwan-e Hayat and Forum Theatre session at Korangi Zia
The team started their first day of activities with a site visit to Karwan-e-Hayat (KEH), one of the local clinical partners in the PIECEs research project, and a long-time research partner with IRD. KEH was established in 1983 as a not-for-profit welfare organization, providing psychiatric treatment and rehabilitation services for people with experience of severe mental illness (SMI). It has both private and free of charge services. Inpatients and Outpatients are seen in the same facility.
During the site visit, the team was greeted by the organisation’s directors board and marketing team. They also had the opportunity to speak with both female and male inpatients on site about their experiences and challenges faced navigating SMI. Also, there was an opportunity to meet the clinicians who will take part in the PIECEs RCT (currently in the recruitment phase).
The visit was followed by a visual presentation of the site, and Professor Paul Heritage presented QMUL’s and People’s Palace Projects work within research and community engagement, which was received with excitement by the local team.
From there, the team followed to a Community Forum Theatre performance at Zia Colony in Korangi, one of the most deprived neighbourhoods in Karachi, in which IRD has been developing a number of outreach programmes, including the PIECEs Arts & Community engagement pilot phase.
A local church had kindly agreed to host the community engagement sessions, leading to the performance the team witnessed, which engaged the audience – formed mostly by young people and women – in discussion about mental health, stigma and networks of support.
Clinical site visit: Jinnah Post Graduate Medical Centre
The second day was marked by the site visit to our other clinical partner: Jinnah Postgraduate Medical Centre (JPMC), a government-run public general hospital, with a dedicated psychiatry department treating inpatients and outpatients. One of the biggest hospitals in Pakistan, JMPC was founded in 1963. It offers services for over 500 hundred mental health patients per day.
We were greeted by the clinical team who has been working on the PIECEs pilot and RCT recruitment, and visited the sites, within both the outpatient and inpatient facilities. Although facing a number of difficulties regarding public funding, the local team stressed the importance of the activities proposed by the PIECEs research and were extremely interested in developing the ideas around arts and community engagement within the facility.
Following a successful morning, both Pakistan and UK teams spent the afternoon on a strategic planning session, where the teams reviewed the arts and community plan, proposed a timeline and the team to work on the development of the activities.
Strategic Arts Meetings and Arts Advisory Board meeting
The third day in Karachi was a very strategic one, where the UK team had the opportunity to take part in the very first Theatre and Arts Advisory Panel meeting. The panel invited by IRD is formed by local artists, performers, community engagement experts and drama academics who gave provoking and thoughtful feedback around the initial programme proposed by the PIECEs research team. The meeting was key to understanding the local arts environment, building relationships with the advisory panel and exploring synergies for the Theatre of the Oppressed pilot company.
Using Performing Arts to Change Communities – Mehfil-e-Izhar
For the fourth day of activities, IRD Pakistan welcomed public health professionals, arts students, and theatre practitioners to a vibrant day of performances and discussions at the National Academy of Performing Arts (NAPA). The event showcased the work IRD Pakistan is doing in participatory arts (theatre) aimed at social change, mental health, and improving vaccine confidence.
Co-I Paul Heritage spoke about the utilisation of Theatre of the Oppressed and Arts as a tool for socio-political change and Mohammad Waseem (Founder of Interactive Resource Center) discussed the impact of Theatre of the Oppressed methodology in tackling social issues like child marriage, and bonded labour in Pakistan. Paul Heritage Queen Mary University of London, on the occasion spoke at IRD Pakistan’s #MehfileIzhar, about the use of participatory arts research in the realm of public health; “Arts can be a powerful tool to engage and activate communities for action against social injustices.”
IRD Pakistan’s project teams of PIECEs & #JeeloDobara performed moving pieces at the #MehfileIzhar at NAPA, Karachi, exploring how people with psychosis face stigma and discrimination, along with raising awareness and understanding about vaccinations.
NAPA’s own theatre and arts students performed at IRD’s #MehfileIzhar showcase in Karachi, through a series of performances, namely ‘Parivartan’, ‘Lahazil’ & ‘Ghootan’, using the arts to highlight the impact of societal pressure and discrimination on the mental health of individuals. Both guest speakers urged public health implementers, media students and policy makers to work together to strengthen the impact of their work for creating resilience in Pakistan.
Forum theatre workshops to end the week
To close our week long visit, Professor Paul Heritage led a Forum Theatre methodologies workshop with a number of IRD’s team members and arts facilitators, inspiring processes and techniques that will be used not only on the PIECEs projects, but in other projects where community engagement and arts as a research method are required.
PIECEs Research site visits round-up: Arts & Community Engagement week in India
After working for more than one and a half years virtually alongside our colleagues from India and Pakistan, it’s fair to say we were really looking forward to being together in person as soon as rules around the Covid pandemic were lifted.
The PIECEs team managed to deliver our first in person joint research team meeting in Dubai, where we agreed plans to visit the sites and partners we were working with in Chennai (India) and Karachi (Pakistan) to coordinate together our Arts & Community engagement packages, given that our RCT research package is already progressing at a fast pace.
For these work packages, we are aiming to develop innovative methods (like Theatre of the Oppressed techniques) to diminish stigma, create community resilience, improve dialogue among healthcare workers, carers and people living with severe mental illness and ultimately impact on public policies and community awareness around Schizophrenia.
This blog post is a brief round-up of our time in India and its highlights, where Arts Co-Investigator Paul Heritage (Queen Mary University of London/People’s Palace Projects), PIECEs Research Programme Manager Renata Peppl, PIECEs Arts Project Manager Mariana Steffen have joined our main local partner Schizophrenia Research Foundation (SCARF), and our arts partner Training Sideways (EVAM) in Chennai, from 25th to 28th May, for a packed week of activities.
Street Theatre Performance: Community Engagement at its best
The team arrived on a Sunday straight into the Pondy Bazaar area, where the SCARF team was presenting a street theatre performance with a group formed by local actors, social workers and SCARF members. Performing experiences of stigma, prejudice and exclusion faced by people living with schizophrenia and their carers, the group brought together a large and spontaneous audience, which were keen on participating both physically and verbally with the performance. Leaflets with further information to generate awareness around severe mental illness and how to get help were distributed at the end of the activity.
Visit to Bhavishya Bhavan Residential Centre and Forum Theatre Performance
The second day was marked by strategic planning meetings to discuss the Arts & Community work package and timeline, and was followed by a special event at Bhavishya Bhavan Residential Centre, a SCARF managed venue which hosts inpatients with experience of severe mental illnesses, most of them women. The research team was greeted by the local members and the residents on the patio, and then everyone was led by our arts partners Training Sideways (EVAM) into a performance room for a Forum Theatre session.
Drawing from experiences and stories shared by the inpatients previously, the group presented short scenes which portrayed challenges faced by people with experience of schizophrenia. The audience, formed mostly of residents of the centre, could then intervene in moments they thought could be handled different by the characters, exploring real practice scenarios in a way that empowers them to look for solutions and change the outcome of a given experience for the better.
The strategy breaks down the barrier between performers and audience, putting them on an equal footing. It enables participants to try out courses of action which could be applicable to their everyday lives. This methodology will be the basis of most of the work developed during the Arts and Community Engagement work package of the PIECEs programme.
Awards night and NAMMA Area Launch
To mark World Schizophrenia Day, the PIECEs team was invited to join the SCARF community to present the M. Sarada Menon award and the Maitri award, destined respectively to people with experience of schizophrenia, in recognition of their efforts to cope with their challenges and move forward in life, and caregivers, including friends and family members of persons with severe mental illness, in recognition of their support to the cause.
The event was marked also by a very special launch: the brand new Namma Area, a designated hangout space for mental health service users, inaugurated at (SCARF), as part of the projects associated with the PIECEs Research.
A first-of-its-kind initiative, the Namma Area has been conceived in such a way that the service users themselves can take charge of and engage in activities which they find interesting. “We have many patients who say they are lonely and feel upset at the lack of social life. Apart from inpatients who are unable to go out, there are patients whose families hesitate to send them out since they have their own concerns. Namma Area will be a comfortable and familiar space where they can meet other people, interact and engage,” said R. Mangala, Assistant Director, Media and Awareness, SCARF.
At the new space, people can read, relax, watch movies, exercise, listen to music, play games, and can also invite guest speakers. The facility will function on the SCARF premises at Anna Nagar from 3 p.m. to 6 p.m. on Tuesdays and Thursdays, and can be used by all mental health service users free of cost.
British High Commission Event: Arts as a tool for developing community engagement and wellbeing
On the 4th day of activities, the team was part of the talk ‘Art can build resilience, resistance and recovery for people and communities’. The spotlight was on art and its impact on the community at a panel discussion organised by SCARF India and Evam Entertainment in association with the British Deputy High Commission in Chennai.
The discussion was hosted by Oliver Ballhatchet MBE, the Deputy High Commissioner in Chennai, and moderated by Sunil Vishnu, Director of Evam Entertainment, focusing on how art can build resilience, resistance and recovery for people and communities.
Speaking on the day were R Mangala (SCARF India’s Assistant Director), Paul Heritage (People’s Palace Projects Director) and Sangeetha Isvaran, founder of the NGO Katradi. Paul highlighted how art can be used as a methodology to learn about the world. “The People’s Palace Projects brings together artists, activists, academicians and audiences as we focus on resistance and transformation as well as how it is linked to creativity and mental health,” he said.
Sangeetha spoke about how the organisation focused on empathy-based transformation through the arts. “Art is often seen as an entertainment or a spiritual experience. While it is these things, it is important, something that can also help us understand and communicate better,” she said as she delved into Katradi’s work with marginalised communities across the world.
Strategic Planning, Theatre of the Oppressed Workshop and Visit to Jana Sanskitri
The final two days of our visit were filled with practical meetings and capacity building workshops: during this time, we developed a strategic plan to move ahead with the second phase of our Arts & Community engagement activities. This centres on setting up of a theatre laboratory led by local artists, the SCARF team, people with experience of schizophrenia and carers, which will then use their own experiences to create performances that can generate further community awareness and open conversations around severe mental illness.
Professor Paul Heritage also led a Theatre of the Oppressed session for local artists and the SCARF team, focusing on specific activities used in the methodology: Rainbow of Desire, and more specifically, Cops in the Head.
The UK and India team then flew to Kolkata to for a full day immersion at Jana Sanskitri Centre for Theatre of the Oppressed, led by PIECEs Artist Consultant Sanjoy Ganguly.
Jana Sanskriti Centre for Theatre of the Oppressed was established in 1985 was the first exponent of Theatre of the Oppressed (TO) in India. Today the Centre is seen as one of the most important point of references to the global community of TO. For over 3 decades JS has addressed issues like domestic violence, child marriage, girl child trafficking, child abuse, maternal& child health, primary education & health care, illicit liquor, etc. – all through theatre.
During the visit, the team had the opportunity to experience a performance, ask questions and strategise with the company’s artistic director.
Here is a video where India Principal Investigator R Padmatavi , Director of SCARF, talks about her excitement and expectations around the arts and community engagement package:
Next up, the UK team moved to Karachi (Pakistan) for another inspiring week, which we’ll cover on a next post.
Note: This research was funded by the National Institute for Health Research (NIHR) via its Research and Innovation for Global Health Transformation (RIGHT) programme. Grant number NIHR200824, using UK aid from the UK Government to support global health research. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK Department of Health and Social Care.
News: PIECEs Research featured in India media outlets
PIECEs research and our main partners in India, Schizophrenia Research Foundation and Training sideways (arts partner) made the headlines with a serie of events marking the World Schizophrenia Awareness Day (24th May).
Click on the links below to read the full articles:
PIECES – Times of India- 24/05/22
PIECES – The Hindu- 25/05/2022
PIECES- New India Express – 26/05/2022
SCARF celebrated Women’s Month with Theatre of the Oppressed games and workshop
International women’s day was celebrated at SCARF, where staff – both women and men – where invited to join a programme organised by the local PIECEs research team, presenting games and techniques used as part of the Theatre of the Oppressed (TO) methodology. PIECEs team introduced themselves and started ice breaking activities, using TO games. Following that, three different games namely Walk circumspectly, Weave without a loom and Wise workout were played. The participants appeared to be enjoying as they were loud and laughing, attracting more people to join in the later half of the program. The group left the session asking for more gatherings like this to happen more often.
Some of the feedback the participants gave during the session:
“Had a good time with everyone participating”
“Please, organize more programs like this and include all staff”
“I haven’t seen so many people participating such activities in recent years”
“Because you guys didn’t single out anyone, everyone was interested to participate”
Community Engagement – Theory of Change workshops in Pakistan
*Text by Hufsa Sarwar, PIECEs Research Coordinator
When our team first started brainstorming ideas around engaging the wider community through the PIECEs project, we were very clear on one thing: it was imperative to put the voices and experiences of people with lived experience of psychosis front and center and make sure that our engagement strategies are relevant and representative to our stakeholders and target populations. This sentiment is echoed through the rest of activities taking place within the project; the Lived Experience Advisory Panel which overlooks and guides the research team, the Theatre of the Oppressed workshops involving people with psychosis and caregivers, and the adaptation of the DIALOG+ app based on feedback from both services users and healthcare providers. We therefore decided to hold a Theory of Change session with a group of people with psychosis, caregivers, and healthcare providers in Pakistan to identify key challenges to support contextual solutions, and to build capacity towards a user-led and participative approach to mental health research and advocacy.
Theory of Change (ToC) is essentially a method which aims to explain how different components of a programme can lead towards a specific impact or the required change. It works on mapping out the various outcomes, interventions, indicators, rationales and assumptions one needs to be aware of to properly design and implement an evidence based programme or strategy. Since our group consisted of people with differing academic and educational experiences and backgrounds, we tried to simplify the concepts and focus the discussion around the experiences and wishes of our stakeholders within the existing system and communities that they inhabit. Co-production is a novel concept in mental health programming for psychosis within Pakistan, and taking a lead in planning different aspects of a major programme even more so for our participants.
Initially, many seemed confused; however, when the research team started asking them about their daily experiences they bloomed and started expanding upon the challenges they faced, and to which they desperately wanted solutions. People with psychosis shared that they wanted to have better treatment outcomes, achieve independence and self-reliance in their overall lives, and be able to integrate within a society which was better educated on their condition. Healthcare workers discussed how they wanted to see a visible impact on healthcare systems, with more accountability and efficient methods in place. The caregiver group, which was extremely passionate and invested in the discussion, said that they wanted to see their family members with psychosis thrive and be able to contribute meaningfully to society, and lead happier and healthier lives. They also stated the importance of accessibility to mental health services for all – caregivers need extensive support as well, along with increased social engagement and reduced stigma for both people with psychosis and their families.
The two-day session opened our eyes to many of the hidden challenges that all three stakeholder groups face; it was also a space for them to share their own thoughts around potential solutions for these issues. This was an opportunity for both the research team and participants to start developing a co-produced model for community engagement with effective, equitable, and appropriate packages of care which can utilise and strengthen access to community resources and break through the existing power dynamics. We hope to continue engaging with the wider community and amplify their voices as we start implementing our interventions.