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Equalising power is part of co-design, but sometimes it can be challenging to notice our own power. These are some ideas and questions to explore, alone or in a group, which may be helpful.
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Episode Transcript
Thinking about Power
Equalising power is part of co-design, but sometimes it can be challenging to notice our own power. These are some ideas and questions to explore, alone or in a group, which may be helpful.
Power is
Your ability to influence outcomes
How much influence you have in relation to others
Related to privilege
Unchecked power can make spaces and outcomes inequitable and unsafe
Power is a huge influencer of people's experience in mental health care systems.
In the current system, consumers can be stripped of their power and human right to dignity and choice with involuntary and coerced admission, restraint and medication.
Family, supporters and carers can also be — and feel — powerless when they are not kept informed of their loved one's experience and their caring role is compromised.
Professionals can also feel powerless in a rigid medical system with limited resources and a hierarchical structure. Power can take different forms and change in different scenarios.
Unchecked power can make spaces and outcomes inequitable and unsafe.
Types of Power
The following descriptions offer five types of power at play in mental health care systems.
As you read or listen, the reflection prompts to think about what types and how much power you might hold in a co-design group, where the group is made up of people with experience as consumers, carers or clinicians or providers of the mental health services.
How might you share and use this power as you work with others?
Expert power
Being perceived as holding important, expert knowledge. It is often tied to disciplines, seniority and qualifications.
Reflection: If you disagree with different people in the group, who is most likely to be believed?
Legitimate power
Your formal and/or legal authority, and is often related to your discipline, organisation and/or job role. You might have the power to end the group or change the topic. In a mental health space, it also relates to the authority you (and others in your role) can have over others. For consumers, this is a very significant power difference.
Reflection: What formal authority do you have in relation to the group, or the people in it, that may give you more or less influence?
Referent power
Being admired and/or agreeable. Referent power (or the lack of it) is often related to individual qualities but can be socially ascribed to particular groups or social roles which are perceived as admired or ‘other’. Referent power can be challenging for consumers to maintain while also sharing messages that are emotion-laden, hard to hear or push against the status quo.
Reflection: Do you tend to raise points that are consistent with dominant beliefs, or which challenge them? Do people tend to agree with you easily, or argue with you?
Coercive power
Being able to do something others do not want or withdraw something they value. You might be able to withdraw funding or support, or be critical in the media, or go on strike. You may be able to have someone medicated against their will. Coercive power doesn’t have to be exerted to have an influence, perception alone can increase influence. For consumers, past experiences of direct coercion in services can make this particular power feel very strong, especially if participating with a service they have used themselves.
Reflection: Do you have the ability to do things to others in the group that may prevent them from speaking openly?
Reward power
Being able to give things that others want or take away things they don’t want. This can include being able to provide ongoing employment opportunities, or funding, support or opportunities that others desire. Reward power, like coercive power, can rest with individuals, roles and organisations.
Reflection: Do you have the ability to give things to people that they really want, and how might this influence frank and free communication?
Two other types of power to consider
Informational power
Having information that others want or need
Connection power
Having access to people with legitimate, coercive or reward power
And a note on privilege
Most people hold privilege in some areas and lack privilege in others, and like power, it can be hard to notice. Some people have lots of privilege, and some people have hardly any at all.
Privilege can be another source of power and inequity.
Race, Class, Faith, Sexual orientation, Gender identity Disability, Mental health Health, Education level, Literacy, Past trauma, Age, Citizenship…
So there you have it
Thank you for listening to this guide. We hope you have found it useful. Please talk with others about what you have heard here and please pass this on if you think others would find it useful.
Good luck in your co-design project. Please reach out to us at the The Australian Centre for Social Innovation if you have any feedback or would like to talk further.
