Research:
Designing an Engagement
Introduction
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The purpose of this engagement is to include research, interactions, and some practical ideas for translation (via lived experiences) for people like Gary, the young indigenous man with an acquired brain injury who forms my personas within the PHN.
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The engagement has been made up of three parts:
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Immersing and mapping Gary’s territory to understand people, places and things within his world.
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Designing and engagement with a tactile toolkit to better understand the ‘lived’ experience’ of mental health struggles similar to Gary’s.
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A reflection of the process, and distilling the insights into a translation proposal for the Primary Health Network, North Western Melbourne, for implementation discussion and consideration.
For the first part, the idea of using Lego was unintentional, but came about as I found myself in forced isolation with my own family, as the world was hit by the COVID-19 pandemic of 2020. It was my 8 year old son’s adoration for the classic building blocks, and my pressing need to complete ideation for the first part of this engagement, that an idea started. He asked if he could help with my uni work, and despite my hesitance, I instead said yes. He helped map out my entire persona’s territory (Wyndam Vale and surrounds) using Lego, which kept him occupied, and me progressing with ideas on how I could design an engagement using items that people would have access to.
The second part, I’d hoped to design things in a way that could produce a set of feelings and circumstance as a result. Given I’d planned to have access to healthcare professionals, and this was no longer and option given the pandemic, I decided to involve people in the community who could give me their circumstance and feelings via a lived mental health experience, and a deeper insight to peoples’ wellbeing.
The approach I took was to design an engagement that has a two-pronged approach - by using a set of qualitative (four participants) and quantitative (80 participants) techniques to gather data that I could analyse and synthesise, and then turn it into insights. This was used to better understand and assist Gary with his mental health rehabilitation. Given access to Gary (or any support services and people around him) has been limited, the approach required a different way of thinking in the way a problem might ordinarily be approached.
Part three has been to better understand synergies and tactical and strategic ideas in line with an aspirational vision to assist mental health patients, like Gary, within a 14 day period (Instead of the current timeframe, which is often years).
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Persona (Gary)
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Figure: Persona "Gary"
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The Role of Design
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The role of design to understand this mental health territory has been critical. “As we know, there are known knowns; there are things we know we know. We also know there are known unknowns; that is to say we know there are some things we do not know. But there are also unknown unknowns—the ones we don’t know we don’t know.” (Donald Rumsfield). Sounds confusing, but rereading and breaking this down into consumable pieces has aided in understanding and guiding the research and findings to date.
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The mapping of Gary’s territory provided a great ‘mind map’ exercise to identify people, places and things he has access to, while highlighting gaps for other areas that are either unknown, or simply missing from what would help him lead a better quality life. It’s allowed for a greater first-hand insight into understanding his existence, and what it’s like to be Gary, by very much putting him in the centre of the thought process. This human-centered design approach is additionally great, because it can be used from the discovery phase, right through to implementation of an enhanced support service. By focusing on Gary and his world, and subbing other humans in as the world was hit with the COVID-19 pandemic, enabled me with an approach to understand his situation, and process for gaining insights and knowledge, and a lever to be able to propose some ideas (big and small) that could really make a massive difference to solving some life challenges for him.
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Gary's Territory
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Figure – Using Lego with my 8 year old son to map Gary’s world
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I used Lego as a tactile method to aide me in this whole process, which has provided the benefit of using a widely-accepted and loved ‘thing’, that is already familiar to many, in tackling an otherwise complex situation for me to begin to unpick. Using Lego to ‘build’ Gary’s world, and then co-designing with the community, created the space to prototype it, which is critical for someone like me who is a very visual learner. At a glance, I can see and absorb a lot of what Gary’s world looks like, and then start to feel and question his existence in that world. Secondarily, it prompts discussion, as it’s a reference point for others (stakeholders, such as family, service providers etc) to feed information into, or extract knowledge from, which ultimately works toward a greater shared understanding of Gary’s life, where the problems, gaps and opportunities might be.
To supplement the data captured, this was referenced against a systematic, cognitive behavioural approach used to teach self-regulation by categorising all the different ways we feel and states of alertness we experience into four concrete colored zones – The Zones of Regulation (Kuypers, 2011).
Figure: Tactile Toolkit I developed to identify and communicate feelings
Figure: The tactile engagement toolkit I designed. Evoking and
understanding feelings and mental health through tactile lego pieces
Figure: Participant using coloured Lego pieces to communicate feelings using the "Zones of Regulation"
Figure: Participants writing and mapping to coloured Lego pieces to replicate feelings
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Figure: Quantitative version of the toolkit - a survey
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Being able to co-design with others (participants, fellow students and tutors) created collaboration opportunities, real-time sound boards for feedback, developing of ideas that may (or may not) work to inform the direction in which to head, created opportunities for buy in and alignment from the co-design group. And critically for the Primary Health Network, has created a fairly quick view of potentially actionable items that can be referenced and discussed with PHN stakeholders, that can help the target community improve their quality of life, whom this is ultimately for.
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Figure: Quantitative survey data emerges
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Figure: Top 5 Quantitative survey results, mapped to the Zones
Figure: The Zones of Regulation. The framework designed to foster
regulation and emotional control by Leah Kuypers, MA Ed / OTR/L
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The role of design brings ethos and a process to many things, including the the mental health sector’s “wicked problems” (Rittel, 1973), which, as I have found, is a collection of grey areas, missing information, some knowns, limited/no access to key stakeholders, with a dollop of humanitarian crisis (in the form of a pandemic) to add to the challenge. It’s also raised that while solution mode has its place, the process in understanding underlying factors, secondary influences and role types (for example; people, technology, places, process, politics etc), is key in determining what some of the obvious and non-obvious factors might be. Additionally, applying an approach that includes deadlines has helped with planning and progress. Including ‘time boxing’ of activities, understanding their importance, relevance and weighting, has also been critical to determine time and effort distribution across the engagement.
For Gary, there are a number of tactical and strategic things that could help him, and many would not involve a whole lot of cost of time investment, therefore critically attainable. They involve getting a co-design plan in place (between support worker and patient), getting the right tools in place to remove some of the daily struggles that could make a massive difference in Gary’s daily existence, and having an overall vision and plan to get there.
Something additionally wonderful about this designed engagement is that some people requested (and are already using) the tactile activities within the community. It’s really humbling for me to have played a part in making a difference in peoples’ lives through human-centred design. A primary school teacher has requested to use the qualitative activity with 25 pupils in her classroom. One participant is using the Lego emojis with her own children to better understand what type of a day they’re likely to have. Another participant is using the Zones of Regulation and Lego emojis with her grandchildren to help them through their day. Multiple users from the quantitative survey reported it was a very cathartic experience, in a time where access to mental health professionals was challenging.
All in all, while human-centered design is not new to me, the field of mental health is, and everything that comes with it. Also playing in an area outside of digital has been a great experience, and seeing how the channels can (or can’t) interject at times. Hopefully for the the ideas for translation that follow, allow conversations to challenge the PHN around the the current support services for mental health patients, and might even be a vehicle to bring about change for the aspirational vision of 14 day change.
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Ideas for Translation
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Figure: Mapping a few aspirational pathways to assist with patient recovery and quality of life
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References
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Websites
ADCET. 2020. Inclusive Technology: Acquired Brain Injury. [online] Available at: <https://www.adcet.edu.au/inclusive-technology/acquired-brain-injury/> [Accessed 3 June 2020].
Blogfonts.com. 2020. Blogfonts.Com | Download Free Fonts For Personal Use. [online] Available at: <https://blogfonts.com/> [Accessed 2 June 2020].
Graham, D., 2020. Rumsfeld's Knowns And Unknowns: The Intellectual History Of A Quip. [online] The Atlantic. Available at: <https://www.theatlantic.com/politics/archive/2014/03/rumsfelds-knowns-and-unknowns-the-intellectual-history-of-a-quip/359719/> [Accessed 2 June 2020].
Health, S., 2020. Spire Health: Clinical-Grade Health Monitoring And Insights. [online] Spire Health. Available at: <https://spirehealth.com/> [Accessed 1 June 2020].
MindMaze. 2020. Mindmaze - The Neuroscience Company Expanding Human Potential. [online] Available at: <https://www.mindmaze.com/> [Accessed 3 June 2020].
Stonybrook.edu. 2020. What's A Wicked Problem? | Wicked Problem. [online] Available at: <https://www.stonybrook.edu/commcms/wicked-problem/about/What-is-a-wicked-problem> [Accessed 2 June 2020].
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