CoLab Torre Cimabue. A territorial Lab for a community based mental health
CoLab is a container of ideas and activities, a flexible space where individuals, families, practitioners, and citizens meet, participate, create, get informed, learn, grow, have fun, and share.
Co-Lab acts as a bridge between mental health specialistic services and the resources of the local community. It promotes mental health and psychosocial well-being by becoming from time to time an information and planning space, a listening desk, a meeting place, a training room or a workshop.
Regional
Italy
Brescia
Mainly urban
It refers to other types of transformations (soft investment)
No
No
Yes
2021-10-01
As a representative of an organisation
Name of the organisation(s): ASST Spedali Civili di Brescia Type of organisation: Public authority (European/national/regional/local) First name of representative: Luisella Last name of representative: Alessandrini Gender: Female Nationality: Italy If relevant, please select your other nationality: Italy Function: Grant Officer Address (country of permanent residence for individuals or address of the organisation)<br/>Street and number: Piazzale Spedali Civili 1 Town: Brescia Postal code: 25123 Country: Italy Direct Tel:+39 030 399 6968 E-mail:luisella.alessandrini@asst-spedalicivili.it Website:https://www.colab-brescia.it/
URL:https://www.facebook.com/CoLab.brescia Social media handle and associated hashtag(s): CoLab Torre Cimabue #colabbrescia #salutementale #recoverynet corsifor
The CoLab Project (Community and Coproduction Laboratory), created within the 'RecoveryNet project: laboratories for a community psychiatry' funded by Fondazione Cariplo, is a connecting space, a bridge, between the Psychiatric Services of the Department of Mental Health and Addiction and the local community. It is a place of proximity open to those interested in sharing issues related to mental health, a lively context of meetings and experiences where awareness of mental well-being in contrast to stigma is promoted, a point of listening and information.
It is a node in the territorial network, a meeting and orientation point that, around the idea of personal and collective well-being, supports paths of individual and community change. It is a place of proximity for families, with the possibility to learn more about mental health and psychosocial well-being issues and opportunities in the area, to talk with operators and users who are 'experts by experience' to approach an issue that is often the subject of prejudice and fear.
CoLab promotes and supports collaboration and synergy among the different actors in the local community (public bodies, Third Sector, groups and individuals) with the awareness that the well-being of individuals and communities is a collective responsibility and everyone can contribute.
The main objectives of the project are:
- The promotion of mental health and psychosocial well-being
- Providing outreach, free-access and flexible spaces in a welcoming and nonjudgmental atmosphere
- Urban and social regeneration activities
- Enhancing the local community and the territorial network as active agents of well-being
- Promoting different art forms that offer tools to facilitate the activation of processes of change and stigma reduction from the perspective of culture and beauty that heal
Inclusion
co-design
recovery
local community
mental health
The CoLab Project envisaged the identification of a space in the southeastern part of the city of Brescia that could have rooms for group activities and workshops, multimedia spaces for holding courses and events, spaces for operators, etc. Several solutions were evaluated and the choice fell on a venue owned by the City of Brescia in the "San Polo" neighborhood, on the second floor of a 16-story building used for social housing. The premises, with a total area of about 500 square meters, had been used in the past as a day care center for the elderly and had, for some years, been abandoned and left to decay. In agreement and with the contribution of the Municipal Administration of Brescia, a number of actions were put in place with the aim of recovering these spaces, with a view to sustainable interventions and urban regeneration:
- sanitization and securing of the environments
- internal requalification and adaptation to fire regulations
- redevelopment of the furniture
- creation, on the outside wall of the Colab, of a mural with the youth of the neighborhood, in order to raise awareness of the care of spaces and fight against degradation; giving life to an abandoned space helps to recover it and return it to the inhabitants
CoLab also hosts cultural activities as part of the 'Bergamo - Brescia capitale della cultura' initiative, with a view to culture that heals and promotes spaces of marginality as an opportunity to activate a renewed community fabric.
From the perspective of sustainability, it was chosen to recover what was already present but abandoned, to give it a new life and new meanings and to return it to the community as a place that promotes well-being.
The interventions were made possible thanks to the investment of the Municipal Administration of Brescia and to the funding from the Recovery.Net Project, to which were added the interventions promoted by the neighborhood realities in favor of the redevelopment of outdoor spaces.
The Co-Lab project is the result of a long process of co-design facilitated by the Design Department of the Politecnico di Milano, which has seen psychiatrists, psychologists, operators, users, family members and local stakeholders reflecting on a territorial lab model that could respond to multiple needs.
The co-design process aimed to qualify the service model and the physical space of the Co-Lab, and to stimulate a culture of collaboration. The goals of aesthetics and quality of experience were aligned with the need to profoundly transform the culture and practices of the mental health department, creating an environment that is collaborative and experimental, but at the same time welcoming and open for users, family members and the territory.
Specifically, the Co-Lab project aimed to
-Upgrade indoor and outdoor spaces: the co-design process has led to the aesthetic and functional upgrading of the co-lab spaces, enhancing the typical vaulted windows and niches, with a tone-on-tone color choice; the upgrading of indoor spaces is now being followed by that of outdoor spaces, through the creation of a mural and projects in the making to restore and preside areas with a high level of degradation and abandonment;
-Improving the quality of the experience of users and family members: at the heart of the Co-Lab's effectiveness is the creation of a welcoming, flexible and open environment in which patients feel motivated to participate as they are not judged based on performance and in which their experience takes on new value;
-Transforming the culture of services and local communities: the process of co-design has activated a path of cultural change signaled by the support received from the Department of Mental Health management and the recognition of the role of the Co-Lab as a bridge between the care institution and the local area; the active collaboration with the local area and associations is stimulating a new perception of mental health as a common resource
One of the main characteristics of the CoLab Project is that it is a place of proximity, open to citizens and service users with free and flexible access. Although it is run by a Health Authority (ASST Spedali Civili di Brescia) no prescriptions are required for access and participation in all proposed activities is free of charge.
Moreover, having chosen to be in a suburban and public housing context allows the proposals to be enjoyed by people who are diverse in terms of cultural, ethnic, social aspects and personal needs. Special attention is paid to fragile individuals, especially people suffering from a mental disorder and their family members. Attention that also translates into specific projects, such as the one dedicated to young people to counteract the outcomes of the pandemic, activated in September 2022 (www.YouthColab.it).
The redevelopment of the spaces, which has also been initiated in the outdoor spaces adjacent to the CoLab (creation of a mural), makes it possible to offer opportunities for active participation and relationships among the residents of the neighborhood as well.
All this is made possible by the collaboration between non-competing actors involved, with a focus on reading and generating responses to the local social needs; the different actors provide skills and resources, each for its own mission, and together take care of the community with a return of benefits for all.
Finally, the communication management, a prerequisite for the widespread participation in the proposed activities, assumes a relevant role in the CoLab. To this end, a Communication Group, consisting of young patients from mental health services and local youth, supported by two experts in communication and web design, is permanently active and manages the website (www.colab-brescia.it) and all social communication.
The co-design of the Recovery.Net project's territorial Co-Labs involved: 1)the development of a cross-cutting workshop for all 3 territories in Brescia, Mantua, and Castiglione delle Stiviere with 26 participants, i.e. service providers and patients, project partners, and civil society representatives; and 2)a contextual research and subsequent 2 co-design workshops for each local context.
For the CoLab in Brescia, after the first co-design workshop (December 2018) and a contextual research of the San Polo neighborhood, the second workshop (March 2019) involved 34 participants -including clinicians, service providers, patients, patient experts, and local stakeholders- to revisit the scenarios that emerged in the first workshop, keeping in mind the needs and resources of the neighborhood.
Finally, a third workshop (28 October 2019) with 22 participants (patients, clinicians, practitioners and local stakeholders) began to define the activities of the Co-Lab and design the spatial and stylistic configurations of the individual rooms. Based on these insights, the Design Department of Politecnico di Milano developed specifications for the redevelopment of the spaces.
Once the Co-Lab was redeveloped and launched, the project recipients acting as ‘experts by experience’, have started to contribute to the planning and day-to-day management of the activities, taking care of the reception, participating in the dynamic mapping of the area, and co-producing initiatives (e.g., Recovery College courses) with civil society.
The impact of this process has been twofold. On the one hand, an attitude of collaboration between different actors was stimulated, fostering the protagonism of users and family members and a sense of belonging with the consequent active presence in the CoLab once opened. On the other hand, a dialogue with the territory was initiated, fostering an openness to collaboration and recognition of CoLab as a legitimate interlocutor on mental health issues.
The CoLab, since the project writing stages, has used the Co-design methodology and principles to facilitate the dialogue between different actors: experts by profession (operators of Mental Health Services), experts by experience (those who have experienced the disorder on their own skill), civil society and institutions.
The project's initial funding (active until March 2022 thanks to the Recovery.Net Project) allowed the identified physical space to be repainted and furnished, and the support of the Brescia Municipal Administration enabled its urban redevelopment.
At the end of the Recovery.Net Project's funding, the local entities (which had been involved in the network) addressed a letter of support for the project to the Brescia City Council and the Socio-Health Management of the Spedali Civili di Brescia and an invitation to the two entities to find useful solutions to continue with the Colab experience.
Also thanks to this initiatives, now the sustainability for the future is guaranteed by several factors, of which the main ones are:
- The Lombardy Region's recognition of CoLab as an "innovative psychiatry project"
- The investment of economic and personnel resources by ASST Spedali Civili di Brescia
- The commitment of users as experts by experience
- The support from the Municipal Administration of Brescia
- The collaboration activated by local community stakeholders
- The contributions (including financial) from the territorial network
- The collaboration among all the initial promoters of the project
The effectiveness of the CoLab as a network builder, through actions such as dynamic mapping and the investment in the figure of the Community Manager, has made possible the activation of civil society and institutional services in the logic of co-production, which enhances the contribution of all with a view to shared responsibility with respect to personal and community well-being.
The CoLab project, one of the most important outcomes of the Recovery.Net project funded by Fondazione Cariplo, involved the collaboration and integration of contributions from different disciplines.
- Mental health: different professionals (psychiatric physicians, psychologists, educators, psychiatric rehabilitation therapists, nurses) and also "experts by experience" were involved, enhancing the experiential expertise that was a key element both in the elaboration and implementation of the project objectives and in peer support;
- Study and research: three universities contributed to the implementation of the project. The Department of Design of the Politecnico di Milano for the co-design of the CoLabs, applying service design methodology; the Department of Psychology of the Catholic University of Milan for the monitoring of patients' individual paths and outcomes; and the Department of Sociology of the Bicocca University of Milan for the development of the methodology of 'dynamic mapping,' aimed at activating patients through the search for resources in a territory starting with individual needs;
- Local project partners (Associazione Il Chiaro del Bosco ONLUS, Cooperativa La Rondine, Associazione Teatro19): brought specific expertise mainly of a cultural nature (emotional writing workshops, Living Library, theater, ...).
- Local Community: brought social and relationship expertise, and knowledge of the local area and its dynamics.
Workshops and World Cafés, coordinated by a Steering Group representative of the different actors involved, have generated shared paths of reflection and action among the different actors, and CoLab has become a meeting place, facilitator of networks and incubator of ideas.
This process, which is still ongoing, has brought added value in terms of creativity, innovation, sustainability over time, and enhancement of resources and opportunities that otherwise would not have emerged.
During the year 2022, CoLab was attended by:
-97 users of Mental Health Services
-55 family members of people with mental distress
-160 citizens interested in wellness issues
-30 operators of Mental Health Services
The activities carried out are summarized as follows:
-250 groups with mixed participation of operators, patients, family members
-160 groups with individuals outside the Services and not related to patients
-27 Recovery College courses involving 210 people
The work dedicated to building the territorial network, thanks in part to the efforts of the Community Manager, made it possible to co-design and co-produce activities with 20 local entities (family associations, cultural associations, municipal services, voluntary associations, social cooperatives, clubs).
Numerous collaborations with individual citizens have also been activated.
This active and widespread participation has made possible the creation of an inclusive environment, attentive to needs and opportunities, directly benefiting those who participated in CoLab activities. Examples of a direct impact on the individual lives have been the job reintegration of two patients thanks to their participation in the co-design and dynamic mapping activities that have generated opportunities and supporting skills. Another patient was given the opportunity and funding to travel to an international conference in Canada organised by McMaster University, to present the CoLab project, in collaboration with the Politecnico di Milano.
The CoLab has generated processes of inclusion and stigma reduction that reverberated throughout the entire community, creating sensitivity and closeness to issues of personal well-being, redevelopment of spaces, and attention to various forms of marginalization.
The quality and innovation of the project was recognized with the inclusion of Colab Cimabue in the ADI Design Index, which is the annual selection of the best Italian design by the Italian Design Association.
At the European level, even in nations with an established civil rights sensibility, an increase in forms of institutionalization for people with mental disorders affecting all segments of the population is reported by various studies. It is a trend already seen in periods of economic crisis that put the weakest individuals, including people with mental disorders, in a condition of social vulnerability: the birth of asylums in the 1800s and the recourse to forms of institutionalization in the last century are part of this phenomenon that goes hand in hand with the crisis of welfare systems.
Even in Italy, despite a declared choice in favor of mental health services rooted in the territory, the data go in the direction of an increase in the number of beds and average length of stay in residential facilities with a contraction of resources invested in territorial interventions. In fact, more than 50 percent of mental health economic resources are absorbed by the residential facility system.
Moreover, territorial services are often busy managing emergencies in the outpatient service or, in some cases, at home; they find extreme difficulty to fit into the territorial network and create synergies. A kind of isolation that has increased during the period of the Covid pandemic.
The CoLab Project was born with the aim of creating a meeting space and a laboratory of ideas and activities to develop the territorial and community aspect of 'taking care' with the goal of generating individual and collective well-being. Alongside and in synergy with the Specialist Mental Health Services, there is the richness and potential of the local community and territorial network. The Colab therefore operates as an intermediate space (between Services and citizens) that develops and enhances territorial resources and individual skills, that is easy to access, and that works for stigma reduction and social inclusion.
Reference paradigms for the project were:
- the Recovery perspective that is understood as "the possibility of living to the fullest despite the limitations of illness" or other limitations that each person experiences in his or her life;
- The enhancement of the experiential knowledge of those who have experienced illness as a useful expertise for individual care pathways and the design of activities and services;
- The co-production between experts by profession, experts by experience and local community stakeholders.
Co-design workshops, theater and comparison laboratories, training courses on the Recovery Star and Recovery College models, and institutional tables were promoted within this framework. A 'Mapping Group' was activated for the specific purpose of implementing the process we called 'dynamic mapping,' that is, the activation of users in identifying resources in the area aimed specifically at the user's needs.
The figure of the 'community manager' turned out to be strategic in the facilitation of the construction of the network and its care over time, as well as the direct involvement of many actors in the design and implementation of various activities.
Service users, family members of patients, caregivers, citizens, third sector entities, and associations directly contribute to the co-design of activities and their implementation.
The CoLab was born as a replicable experience, having been started as an experimental reality within the Recovery.Net project in 3 territories: Brescia, Mantua and Castiglione delle Stiviere. The Brescia CoLab, as the most mature example of the activated laboratories, represents in itself a replicable territorial service model for community-based mental health inspired by the principles of Recovery and Co-production.
The heart of the Brescia CoLab is represented by an iterative and co-produced process of mapping the resources of the territory, followed by the initiation of moments of dialogue and confrontation with civil society, leading to the co-design and co-production of targeted initiatives.
This cyclical process facilitated by the figure of the Community Manager, creates a virtuous circle of innovation and social inclusion, outside the institutional contexts of care.
As a laboratory on the ground, the CoLab functions as a bridge between the Department of Mental Health and local resources, offering multiple opportunities for Individual Treatment Pathways for service users and citizens sensitive to issues of personal well-being and mental health.
A foundational part of the CoLab was the extended and documented co-design process that could in turn be replicated and adapted in other contexts to foster a pathway of activation and collaborative imagination.
Finally, also transferable are the learnings about CoLab's key qualities: a multidisciplinary and multilevel approach to promote a systemic transformation of the mental health care ecosystem; an informal and flexible context and approach to co-production that reduces barriers to access for users, family members and associations; an open and less specialized idea of mental health that opens up multiple opportunities for collaboration with local actors; and a constant dialogue and confrontation with institutional tables and actors to promote the recognition as an innovative project within the regional context.
The main global challenges addressed by the CoLab in the local area are:
- De-institutionalisation of mental health care: the CoLab is proposed as a holistic, person-centred and community-based approach. CoLab represents a place of experimentation outside institutional dynamics and policies, guaranteeing a greater capacity to connect with the territory, reduce access barriers for users and their families, and organise preventive initiatives. Resilience and flexibility of CoLab derive from trained staff able to develop new tools and with a genuine interest for learning;
- Humanisation and personalisation of care: the CoLab is based on a community-centred care model, understood both as an informal and welcoming environment and as services tailored to the context and its characteristics. The processes of co-design and co-production acknowledge individual and community needs and resources, enabling a more personalised and effective recovery pathway;
- Reduction of the stigma and self-stigma for those suffering from a mental health problem: the CoLab is proposed as a neutral, non-judgemental, non-performance-oriented environment in which to deepen self-knowledge and awareness about mental health and wellbeing. The CoLab fosters the creation of supportive community networks for the construction of shared paths and the exchange of experiences.
- Regeneration of urban places and suburbs: The CoLab aims to be an engine of physical and social regeneration for the San Polo neighborhood, starting from shared planning initiatives, activation of the residents of the Cimabue Tower and involvement of the associations on site. Through a 'culture that heals' perspective CoLab promotes educational and cultural initiatives that create synergy with existing resources and preserve abandoned places while regenerating the neighborhood's identity.
