The Stretch2Engage framework guides organisations to improve and increase meaningful engagement of people with lived experience in service design and evaluation in the mental health and alcohol and other drugs public and non-government sectors.
The framework is founded on values that acknowledge meaningful engagement of people with a lived experience, their families, friends and supporters is a human right, fundamental to citizenship.
Meaningful engagement requires organisations to think and act differently. Stretch2Engage places the responsibility for engagement on service providers, not on people using services.
This approach changes how engagement is understood, resourced and implemented, and emphasises the need for organisations to build their engagement capability.
About the Stretch2Engage framework
In early 2017 the Commission published Stretch2Engage: best practice principles for service engagement and summary.
The framework calls on services to ask the question ‘How can my organisation more effectively engage?’.
It builds on thinking developed through other approaches including consumer participation and experience-based co-design and takes this thinking further by:
- Placing the responsibility for engagement clearly with organisations, rather than with people who use their services
- Moving away from representative approaches to engagement in favour of those in which organisations engage directly with a broad range of service users and carers
- Emphasising the importance of organisations building their capacity to undertake effective engagement, which will often require a change in organisational culture
- Seeing service engagement as a core part of organisations’ business as usual, undertaken by all staff, rather than as a periodic event or specialist activity.
Stretch2Engage includes seven value domains:
- Stretch2Be Curious: Eager to know or learn
- Stretch2Be Clear: Initiatives are transparent in their reason and are easily understood
- Stretche2Be Champion: Vigorously lead, promote and support the organisation in their engagement initiatives
- Stretch2Be Creative: Use of imaginative methods to evoke new ideas
- Stretch2Be Collective: Intentionally seek out and engage people from diverse backgrounds and experiences
- Stretch2Be Comprehensive: Willing to explore all aspects and embrace divergent views
- Stretch2Be Committed: Pledge to ongoing service engagement initiatives
Stretch2Engage was developed by a partnership (the Stretch2Engage Partnership) between the Queensland Alliance for Mental Health (QAMH), Queensland Network of Alcohol and Other Drug Agencies (QNADA) and Enlightened Consultants.
Stretch2Engage in practice
During 2018 and 2019 the Stretch2Engage Framework was piloted in Queensland.
Seven organisations participated, ranging across public, private and government AOD and MH services in metropolitan Brisbane and Toowoomba. The pilot sites were:
- Belmont Private Hospital’s Brisbane Centre for Postnatal Disorders
- Metro South Hospital and Health Service’s Logan Adolescent Drug Dependencies Early Response Service (LADDERS)
- Queensland Injectors Health Network (QuIHN)
- Toowoomba Consortia:
- Darling Downs Hospital and Health Service’s acute mental health unit
- Toowoomba Clubhouse
- Sunrise Way
The Commission engaged the Stretch2Engage Partnership to lead the pilot.
The pilot tested the Stretch2Engage Framework to better understand its value in improving the service engagement capacity of AOD and MH services.
The project introduced the Framework to organisations and assisted them to implement it in their unique and diverse settings.
A participatory, action learning approach was used to build shared understanding through workshops, coaching, reflection and peer learning.
Organisations were provided with information, tools and training in technical engagement methods. With guidance from the Stretch2Engage coaches, each organisation deepened its understanding of service engagement and implemented new engagement approaches.
Stretch2Engage pilot evaluation
The Commission engaged Lirata Consulting to evaluate the Stretch2Engage Framework pilot.
Lessons from the evaluation were shared with pilot organisations as the project progressed.
The mixed methods design included a literature scan, document review, key stakeholder interviews and focus groups, a pre- and post- survey of pilot organisation staff, collection of significant change stories, and collection of cost data. Data collection occurred in three rounds (baseline, midpoint and pilot completion).
In total over 100 stakeholders were consulted, including management and staff of pilot organisations, people using services, Stretch2Engage coaches, and representatives of the Commission and the Stretch2Engage Partnership.
The evaluations showed an increased capacity of pilot organisations to undertake meaningful engagement with people who use their services. This in turn led to an increase in engagement activity.
A number of factors impacted on the sustainability of these improved engagement practices including:
- organisational culture and commitment
- prioritising and resourcing engagement activity, and
- embedding engagement systems and processes as part of business as usual.
Potential roadblocks to further implementation of engagement thinking and practice include the competitive funding environment many organisations experience, other competing organisational priorities, and difficulties in changing longstanding cultural values and attitudes in some settings.
Multiple additional positive impacts for stakeholders were identified:
- improved service delivery and collaboration
- improved staff morale
- skill development and opportunities for career advancement
- benefits for people using services and their carers through improved feedback mechanisms and better services, and
- increased organisational efficiencies through reduced absenteeism and more streamlined service provision.
There was increasing recognition that small, cost effective changes could make a significant difference to engagement practice and service user experience. Positive impacts on broader sector thinking were evident through information sharing and collaboration.
- 90% of staff surveyed believed that project participation had increased their organisation’s engagement capacity
- 75%+ of staff surveyed agreed that the Stretch2Engage Pilot Project changed the way their organisation thinks about engaging people who use services, and their families and friends
- ~70% of staff surveyed believe that sustaining changes made during the pilot will be ‘somewhat’ or ‘very easy
The following resources have been developed to assist organisations to implement Stretch2Engage.
While Stretch2Engage was developed for the MH and AOD sectors it has wide applicability to other sectors seeking to engage with the people they serve.
- Stretch2Engage Framework and Commission summary
- House model A3 and House model A4 – a simplified layout to assist with understanding the framework
- Hero Cards (print) and Hero Cards (web) – question prompts across each of the seven value domains
A series of short videos showing the experiences of the pilot sites and tips for implementing Stretch2Engage:
- Video 1 - Stretch2Engage, The Story Part A
- Video 2 - Stretch2Engage, The Story Part B
- Video 3 - Stretch2Engage, The Story Part C
- Video 4 - We thought we were already doing good engagement
- Video 5 - Practical examples - Darling Downs Health
- Video 6 - Practical examples - Karakan
- Video 7 - Practical examples - Ladders, Metro South Health
- Video 8 - Practical examples - QuIHN
- Video 9 - Practical examples - Sunrise Way
- Video 10 - Practical examples - Toowoomba Clubhouse
- Video 11 - Practical examples - Belmont Private Hospital
- Video 12 - Challenges to implementing Stretch2Engage
- Video 13 - Leadership, culture and sustainability
- Video 14 - Challenging services to engage more effectively
- Evaluation report and summary
- Evaluation Infographic
- Evaluation Theory of Change – detailed and summary
- Evaluation toolkit: