Co-design of a Mental Health Platform
The Synergy Online System, a platform that delivers mental health care to young people, was built through iterative co-design with people with lived experience, health professionals and service staff. Each iteration focused on the needs of young people in a different population. The platform held promise in improving mental health service delivery for young people in vulnerable communities (ethnic minorities, rural communities, and people of low socioeconomic status) who typically have poor access to and use of mental health care services. To co-design the platform to meet their needs, we engaged young people, supportive others and health professionals living in vulnerable communities.
Context
The Youth Mental Health and Technology Team at the University of Sydney, researches and develops innovative treatments for young people with emerging mental health disorders. To support mental health service system reform, the Australian Government Department of Health funded Project Synergy, a $5.5M grant to co-design, build, and evaluate the Synergy Online System.
The Platform is a customisable digital tool kit designed to be integrated into in-person mental health services to facilitate shared decision making between clinicians and clients, helping clients meet their mental health goals using the most effective treatment.
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Clients complete an initial online evidence-based assessment to populate a dashboard giving them comprehensive feedback about their needs (such as sleep, mood, physical health, suicidal thoughts, and social connectedness). Clinicians can then use the dashboard to help inform clinical care and monitor outcomes. Clients can track their progress in real-time, primarily using self-reported psychometric measures, which is then reflected on their dashboard and used to continuously inform clinical care, enabling a collaborative approach to care.
Team
The team included academic researchers, UX researchers, clinicians, and technologists combing expertise in mental healthcare, clinical research and technology.
My contribution included project management, participant recruitment, co-design workshop ideation and co-facilitation, and the creation of personas and user journey maps.
Approach
A co‑design approach to mental health services is essential. It challenges the status quo and ensures the voice of people with lived experience are a co‑driver of change, innovation and leadership, leading to the design of higher quality and more efficient mental health care.
To illuminate what we didn’t know, better understand how to support people living in vulnerable areas, and create a solution to meet their needs, we conducted 7 (three-hour) co-design workshops. Each with 10 participants including young people (16 - 30 yrs), supportive others and health professionals from vulnerable communities in three areas in New South Wales: Central Coast, Western Sydney and the Far West.
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The workshops were designed to help us understand the pain points, frustrations, and barriers with existing health services, both in-person and online, concerning accessing and engaging with a service and the service's ability to appropriately meet young people's needs. We also wanted to learn about the​ needs and preferences for improving access to and receiving care from health services, in-person and online.
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The co-design process was iterative, whereby the learnings from each workshop informed the agenda of the next one. Although each workshop was unique, they concentrated on three stages:
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1
Discovery to illuminate what we didn't know and better understand their needs. As an example, we would have a prompted discussion about the community, access to health services and the internet.
2
Exploration to better understand the problem space and how best to address needs. An example of an activity to help us in this exploration would be to create personas and user journey maps of young people's everyday experience in the community accessing and receiving support from in-person and online services.
3
Prototyping to develop potential solutions to address their needs. For example, we would create solutions through prototype mapping. Using the created personas and user journey maps, they would map solution concepts to the user's pain points, frustrations and barriers in accessing and receiving support or needs.
After each workshop, the team debriefed reflecting on key takeaways and surprise discoveries to understand themes which served as a basis for further ideation and conversing in future workshops. After we completed all of the workshops, we reviewed the data from each workshop for themes. Similar findings were grouped, including personas, user journey maps, written comments made by co-designers related to real-life examples and transcribed detailed qualitative notes of the workshops.
Outcomes
Together with young people, supportive others and health professionals, we co-designed possible solutions for the platform to meet the needs of people living in vulnerable communities.
Two key learnings that came out of the workshops were:
1
The platform needs to be optimised for low connectivity. Poor network infrastructure is common, causing slow load times and poor functionality of feature-rich platforms such as the Synergy Online System, resulting in user abandonment and poor reviews.
2
​The design of the platform needs to consider users with low literacy, those not fluent in the English language and using older technologies. Health professionals frequently reported that patients have low literacy and/or English is a second language and would not use a platform if it was too advanced. Young people often reported using older devices.
An unexpected but interesting finding is that the Help functionality design needs further consideration. Young people want a tiered system of help based on their self-identified level of need (e.g. psycho-education, online chat or emergency services), not the current offering of a static list of emergency hotlines.
Deliverables
Reports
To share our findings with the broader team and stakeholders, we created a report for each workshop, including the workshop's goals, participant demographics, methodology, a list of key insights contextualised with supporting details, user quotes, and recommendations.
To communicate an understanding of the users and how we could design the system to meet young people's needs in vulnerable communities, we refined the personas and user journey maps from the workshops. We developed them into high fidelity designs segmenting the users by group: young person, supportive other and health professional.
Impact
The engineering team began to explore how to build the platform for low connectivity whilst still delivering a fast, functional user experience to avoid alienating potential users with low connectivity.
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'Design for all' became a priority, with the goal of making it possible for a diverse set of people to use the platform and ensure they have a sense of belonging. The design focused on usability, accessibility and inclusivity, with particular attention on people with low literacy, those not fluent in the English language or using older technologies.
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This study's findings led to a followup study that codesigned the Help functionality to meet the needs of young people at risk of suicide.
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Project Synergy's overall success led to an additional $30M investment from the Government to broaden the research from focusing only young people to people across the lifespan. To deliver the next generation of the Synergy Online System - the InnoWell Platform, the University of Sydney teamed up with PwC, developing InnoWell, a new company championing digital health care.
What I Learnt
You can control the workshop structure, but you can't control the output. Sometimes this means you may have to stray from your plan and adjust to the conditions of the day. If everything seems to be going wrong, don't show it to participants - go with the flow and adapt.
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Also, allow more time for participant recruitment than you think and have a contingency plan if only a few people show up to a workshop, like turning a workshop into a one-on-one interview session.