Step 3: Identify who you need to speak to and how best to go about it

Now that you have thought about the change you/others would like to see and where, the next step is to think about who to take this information to. Give thought to healthcare structures (see part 1) and consider at what level you would like to influence positive change.

• Do you want to see change in relation to one or more practitioners (e.g. your dentist, physiotherapist, etc.)?
• Do you want to see change in a specific service (e.g. GP practice, pharmacy etc.)?
• Is the change you seek relating to how decisions are made about healthcare in your local area (e.g. local authority stops commissioning a service run by the third sector?)
• Would you be seeking to influence change at national level (e.g. funding cuts, new healthcare policy, etc.)?
• Would an advocacy organisation best support you for this focus?
• Would using a complaints or feedback process, including Care Opinion, be suitable?

Now that you have identified at what level you want to influence, it is time to think about who to speak to - receptionist, administration worker, nurse, doctor, practice manager, councillor, local MSP, Scottish Government civil servant, etc. You can find information about how best to contact them by reaching out to the service or office they work in, by searching NHS Inform for the details or browsing the web to find contact details e.g. Scottish Government website.

Now that you have identified what change you want to influence and who you want to speak to about it, the next step is to think about how best to take your message to them.

There are many ways to influence change but key to your planning is thinking of audience

• Choosing the right tool for the job; certain communication tools will work best with certain audiences 
• Put yourself in their shoes. Is your message relevant to them? Why should they listen? This helps persuade them
• Use a different or unusual approach. There are a lot of different groups trying to influence change and many of them use similar methods that can get lost or even turn people off your cause.

Whether you are preparing to send an email, give a talk, or producing a leaflet, knowing your audience is key to successfully influencing change. Using the wrong messages or method of delivery can set back both you and the issues you want to address. Think about, plan and prepare what you would like to cover and the best method for that group and, if possible, ask others who work with that group of people what they might engage with. It is also important to consider the risks of being further stigmatised and/or discriminated against in this new interaction, and take steps to mitigate them wherever possible, even if, in some cases, it might mean not taking forward planned influencing action – your own and others’ safeguarding should always be prioritised.

Think about what has worked in the past for this group, perhaps they respond well to direct contact such as asking to have a meeting and discuss your issue. Perhaps something written would work better where they can take time to digest your message. You might even want to take an innovative approach and be creative. Although risky, trying something new especially if it gets over a powerful message in a creative way, can make a huge impact and it does not need to be a big change to be effective. An example of this might be to share a quote at the start of a written document as a poem or to use short videos as part of a media campaign with local voices.

Working with professionals can feel daunting especially if you feel they have more power than you do in creating change. Changes in the law and in practice over recent years cannot change the need for community members to feel empowered before, during and after interactions with professionals. Here are some areas to consider in creating healthy partnerships with professionals that benefit everyone. These tips also work with fellow peers!

Leave a communications trail: Written communications are vital as they provide an evidence trail of what was discussed and agreed that we can build action from and show our impact. Take notes at meetings, don’t rely on just the official minutes, and when these do come out check them from your own notes and send back amendments. This is particularly important around making agreements clear and timely, as well as handing over to others you might work alongside.

Role model the change: Change comes from action, if we can role model the change we want to see, we can influence others to listen to us and work with us. Practice seeing things from their perspective, understanding their business pressures and needs. Everyone has mental health; use this aspect to build peer relationships wherever possible.

Respecting different views: You can respect someone but totally disagree with what they are saying. By listening and giving them your full attention, you are showing them respect and increasing the chance that they will respect you.

Recognise that other people’s circumstances can affect their behaviour: Using empathy helps us to listen and feel able to speak out. We might feel someone is rude but then hear that they are in a great deal of pain that day or have had bad news. Although it may not excuse poor behaviour, considering someone’s health or circumstances can explain their behaviour and increase our confidence, and improves our ability to communicate with them. This is called taking a Trauma Informed Approach. There are great resources on this from NHS Health Scotland if you want to learn more.

Support others to speak out: Giving others a chance to be heard can improve your confidence and may help your audience to listen to your views later. This can build peer-support and can contribute to creating a social movement (link to part 1 page).

Tools to influence change

• Providing feedback on services: Care Opinion pass on stories to create change and some services have social media accounts you can contact directly.
• Giving talks: to schools, community groups, health professionals  Sharing personal experiences in the media: TV, radio, press, social media, online
• Creating art as discussion points: drama, postcards, poetry, creative writing
• Organising local events and publicity: fundraising, arts events, publicity stunts
• Campaigning and lobbying: writing letters, emails, reports
• Taking part in consultations
• Consulting fellow peers, asking opinions, looking for patterns or strong quotes that illustrate a need for change
• Creating resources for others to use: DVDs, resource packs.

The key is direct experience: It is powerful and effective. If you are thinking of using your experience(s) or supporting others to do so, then read the section on sharing your experiences.