Decolonizing Mental Health and Design
Stanford d.School’s workshop on Design Thinking is a great exercise in creative problem solving. Design Thinking, also known as Human Centered-Design (HCD), is the practice of empathizing with the user to build creative, intuitive solutions. The right time to use it is when there is a problem that may not necessarily have a straightforward answer, or when the current solution presents issues. The challenges with HCD involve removing oneself from common wisdom, and to observe before asking/suggesting solutions, i.e. removing the ego from the process.
More recently, criticism on human-centered design as a practice has emerged, claiming the practices of gatekeeping that are prevalent in the industry, and analogizing design to modern-day colonialism. This neocolonial view is exposed when designers assume they are the experts, and “know better” than the users. Additionally, “breaking into” design is proving to be more difficult. With expensive bootcamps, formal education, and networking within esoteric circles seemingly being the only way one can claim they’re a designer. In reality, anyone with empathy can design. It’s ideal if when building solutions, the designer steps down from the tech pedestal, and co-designs with who they’re building for.
This idea of decolonization especially exists when thinking about user testing on the global scale. In Decolonizing Global Mental Health, China Mills mentions that what psychiatry calls “mental illness,” is actually “a product of the colonial situation, of inequality and alienation” (Mills 2013). Oftentimes, the socio-historical context in which distress arises is overlooked. There is a disparity between the clinical psychologist and pharmaceutical companies that assume they know better versus the patient’s holistic, lived experience.
Anoushka Khandwala mentions how design thinking rhetoric is similarly exclusive: “to frame design thinking as a progressive narrative of global salvation ignores alternative ways of knowing” (Khandwala 2019).
What’s missing from HCD, and our approach to Global Mental Health, is context and empathy.
Stanford addresses some of this in its Empathy Field Guide, emphasizing that one should immerse, observe, and engage themselves with users “to discover people’s expressed and latent needs to meet them through your design solutions” (Plattner 2020). However, this statement still alludes to ownership in the design process, and creates a dichotomy of “my design” versus “their problem.”
For far too long, designers have remained married to the concept that what we do is neutral, universal, that politics has no place in design…Yet the choices we make as designers are intrinsically political: With every design choice we make, there’s the potential to not just exclude but to oppress; every design subtly persuades its audience one way or another and every design vocabulary has history and context. Learning about the history of colonialism will open our eyes to how power structures have formed society today, and how they dominate our understanding of design (Khandwala 2019).
There are certain situations where we cannot begin to identify with the lived experiences of the audience we need to communicate with, or solve for. To take GMH as an example again, Mills notes how the way we talk about mental illness and psychiatry has different implications in different regions. In the United States, mental illness is equated to physical illness in some contexts to communicate the severity of the issue. However, this same biological explanation in India implies that those who experience distress are less human, and increases stigmatization around mental illness. Although we may have knowledge about the use of language and how it perpetuates stigma, we may never fully understand how to solve for this without collaborating with those who have experienced it.
One proposed solution: We should begin thinking that we are designing with our users, instead of designing for them. Building solutions to complex problems involves a circular process of co-designing, in which the users probably know more than us. The most qualified person to design for the issue — whether it be solving for the GMH crisis, or running a design sprint at a large tech corporation — is the user, and we must listen and provide them with the resources to design solutions together. Additionally, lowering the barrier to entry and changing the language we use around problem-solving and design can aid in this mindset shift. We are all designers.
Sources:
- Mills, China. Decolonizing Global Mental Health: The Psychiatrization of the Majority World, Taylor & Francis Group, 2013. ProQuest Ebook Central.
- Khandwala, Anoushka. “What Does It Mean to Decolonize Design? Dismantling Design History 101. AIGA Eye On Design: Design + Politics. June 5, 2019.
- Plattner, Hasso. Empathy Field Guide. Institute of Design at Stanford. 2020.
