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Co-leadership to co-design in mental health-care ecosystems: what does it mean to us?

Alan Rosen (Australian Health Services Research Institute [AHSRI], University of Wollongong, Wollongong, Australia and Brain & Mind Centre [BMC], University of Sydney, Camperdown, Australia)
Douglas John Holmes (Department of Marketing and Communications, Global Engagement and Partnerships Division, The University of Newcastle, Callaghan, Australia)

Leadership in Health Services

ISSN: 1751-1879

Article publication date: 23 September 2022

Issue publication date: 27 January 2023




This study aims to demonstrate how service providers, service users and their families should be able to share the co-leadership, co-auspicing, co-ownership, and co-governance, of a the mental health-care ecosystem, at every level, as it develops upwards and wider, in a process of inclusivity, conviviality and polyphonic discourse, via the overlapping phases of co-creativity, codesign, co-production, co-delivery, co-evaluation, co-research and co-replication, to achieve outcomes of co-communal or organisational well-being.


“Co-design” is shorthand code for encouraging multiple pathways and trajectories toward forming and sustaining a sparkling web or vibrant network of inclusive opportunities for stakeholder participation and a collaborative partnership in organizational development, in these circumstances, for more effective mental health services (MHSs).


In a co-design framework, all partners should be entitled to expect and “to have and to hold” an ongoing equal stake, voice and power in the discourse from start to finish, in a bottom-up process which is fostered by an interdisciplinary leadership group, providing the strong foundation or nutrient-rich and well-watered soil and support from which a shared endeavor can grow, blossom and generate the desired fruit in ample quality and quantity.


The authors should be working toward co-design and co-production of contemporary MHSs in a mental health-care ecosystem.



Rosen, A. and Holmes, D.J. (2023), "Co-leadership to co-design in mental health-care ecosystems: what does it mean to us?", Leadership in Health Services, Vol. 36 No. 1, pp. 59-76.



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