This is part two of a two-part article that draws on my recent presentation at the TheMHS 2021 conference. Part one is here.
I’ve written before that evaluators perhaps don’t attend enough to issues of power in their projects. When thinking about how to write about the challenges I’ve faced as a lived experience evaluator, I repeatedly returned to issues of power. This is not surprising – in the mental health system, consumers have been disempowered for time immemorial.
As commissioners and evaluators, we often don’t recognise the power we have. By its very nature, evaluation uncovers knowledges and experiences, and ascribes and legitimises them (or some of them) with values and judgements. Power must be part of this conversation if there is ever to be a meaningful shift in how lived experience is valued within these judgements.
Here I’ve drawn on the work of Maya Goodwill to organise concepts of power. It’s by no means the only way of thinking about power, and not necessarily better than others’ work, but I’ve found it a helpful tool for considering how to define, acknowledge and attend to power. Each of these elements of power is presented separately, but it’s also important to recognise how often they overlap. Power begets power.
Privilege is the power people get from their membership of social groups. This is not an unfamiliar concept in evaluation, and projects regularly struggle to get to grips with the notion of ‘representativeness’. As mentioned in the previous article in this series, evaluations still tend to rely on hierarchical project governance approaches (e.g. steering groups and chaired meetings). In practice, this limits the number of voices who can be involved in an evaluation and makes the matter of privilege a central power issue that projects have to grapple with.
Tight timeframes and budgets, and a simple lack of imagination, have constrained commissioning and evaluating teams’ thoughts around how to genuinely recruit and work with a diversity of lived experience. The field of evaluation, myself included, is disproportionately privileged, both in terms of who we are, and who we recruit to projects. This issue is often framed around certain groups being ‘hard to reach’, when in reality, it’s not their fault that they’re hardly reached.
When starting a project, think about the practical barriers that stop people from participating in evaluations. Number one, this is about remuneration. But it’s about so much more – such as, the physical and digital accessibility of your project, language and literacy, caring responsibilities, physical and psychological safety. Identify and address the places where your project entrenches, rather than challenges, privilege.
Access power is the power to influence who is included in the process. A significant challenge facing lived experience in evaluation is the way projects are initiated, funded and commissioned. Generally, that means it is the people with the most power in the mental health system (government, not-for-profits, service providers) who determine when an evaluation is required and who to invite in to participate in that evaluation.
There is a tendency for evaluations to be required to be done quickly and relatively inflexibly. This limits the time and ability to invest in iteratively involving people with lived experience throughout the process. Involving people with lived experience in your evaluation will take longer. It doesn’t take longer because people with lived experience have any less capacity than those without. It takes longer because genuinely sharing power takes longer – it takes longer to ideate, discuss and negotiate decisions, than simply determining the way forward as a smaller group of commissioners or evaluators.
Goal power is the power to influence decisions. This is not just about findings and recommendations, but the fundamental decisions about the evaluation playing field. As discussed in the previous article, there are many opportunities for lived experience leadership in shaping that playing field.
It’s also important when thinking about goal power to be explicit about what different stakeholder goals are. It is not unusual for stakeholders to have different goals for an evaluation. Additionally, goals may be similar but land in different priorities for different stakeholders. That’s ok. But the important thing about attending to goal power is surfacing these differences, and being transparent about where trade-offs are being made.
This can involve sometimes difficult and icky conversations, but it’s important they are had. The differences in values, priorities and power don’t go away just because they’re not spoken about. If anything, the power imbalance between people with lived experience and the system only increases when it’s ignored. For people with lived experience that lack of power can be all-consuming, and endlessly frustrating when it seems invisible to others, causing frustration, burnout and further trauma that impedes our ability to give to evaluations in a system that feels like it’s chewing us up.
The challenge I’ve seen too often is when it is the values of people with lived experience that consistently lose out in the reconciliation of ideas. Evaluation can be a tool to hold programs and services to account – these are the same programs and services that have for so long failed people with lived experience. To be honest to lived experience evaluation, we have to be honest in how we hold things to account, and what kinds of knowledge we value.
This also allows people with lived experience the agency to step away from a damaging project when we can recognise what’s really happening. It’s hard to do that when projects are speaking the language of lived experience, but not providing a reality that matches.
Role power is the power that comes from roles, and the power we have to influence the roles that people play in a project. For me this is about what types of knowledge are held to be legitimate, and how people get to use that knowledge. This is often a challenge in the mental health sector where certain roles in the system literally and legally hold power over others.
The roles that people with lived experience play in an evaluation are tied into a broader stigma and human rights conversation about when we believe people with lived experience and how we value their knowledge. In practical terms, this might require commissioners and evaluators to be more open to what they accept as evidence – many forms of research design and data collection that might not typically be ‘gold standard’ might actually deliver better outcomes in terms of trauma-informed, equitable research participation.
Rule power is the power to influence how stakeholders work together. Until recently, people with lived experience aren’t typically included on the evaluation team at all. Often when they are included, it’s in an advisory position.
Effective co-evaluation comes from layering lived experience throughout the project – at all the points I mentioned in the evaluation process map. This helps to counterbalance any risk of evaluation capture by narrow groups and perspectives.
Power is about having agency, and about being able to influence how things happen. As I wrote about in my previous article, genuine power-sharing can’t happen when most of the decisions are held by commissioners or evaluators. Without attending to power, we risk our evaluations replicating the disempowerment of those with lived experience in the mental health system. One of the most visceral traumas I experience as a peer evaluator is experiencing and witnessing losses of power that replicates losses of power in my life and care.
While I’m applying these concepts around lived experience in evaluation, I am absolutely indebted to those I’ve learnt from around concepts of power, especially consumers and social designers. There are a lot of giants whose shoulders I’m standing on. Please get in touch if you’d like more ideas of people you can read, talk with and learn from about power.