Designing a mental health start-up
How three passionate humans are using design-thinking to try to crack one of the biggest challenges of today: the mental illness epidemic.
This is the story of Fewl, an early-stage start-up using the principles, mindsets and tools of design thinking to improve the lives of people providing or receiving mental health support. I’m not saying our approach is perfect, but it’s certainly different. In a world full of complex issues and failed solutions, there’s value in finding new ways of doing, and sharing them for others to learn.
Starting from the basics, design thinking is a human-centred approach to innovation. It is a collaborative way of solving problems, developing new solutions and testing them. It can be applied to a range of complex issues, including the most pressing social challenges of our time. Designers don’t replace specialists, but rather play the role of facilitators, harnessing the collective wisdom of both experts and experts by experience. The easiest way to think of design thinking is as a five-step process of understanding, defining the problem, ideating, prototyping and testing. It is also far more than that: it’s a set of tools and mindsets that can be used by anyone to approach social issues in a novel way.
Fewl is attempting to use design thinking to improve access to mental health support. Using design thinking is not just about making a product visually appealing, it is about creating something desirable, feasible and viable. Ultimately, we think it’s the best possible way to create positive social change. Read on for a full timeline of our process and how design thinking has made all the difference.
Step 1: Understanding
Our team came together out of a shared passion for mental health and a desire to create positive change. All three co-founders have lived experience of mental illness and a desire to put our skills to use in the service of others. Our starting point was deep empathy and curiosity.
Our research focused on the question: why are people in need not receiving mental health support? We found out that in England, up to three-quarters of people who need mental health support don’t receive it. It’s even worse for members of marginalized or discriminated groups.
We kicked off our research with a series of in-depth interviews with mental health professionals working across the public and private sectors. We used our unique positionality to conduct auto-ethnography, seeking mental health support through a variety of channels and recording our experiences. We tested out multiple services from an observant point of view, conducting “service safari”.
We engaged people living with mental illness through in-depth interviews and a listening campaign. We asked over 450 people the same question: what was stopping them from seeking mental health support?
Step 2: Defining the problem
Our research helped us identify the many barriers that individuals face that might prevent them from receiving the mental health support they need. These barriers are both internal(attitudes and behaviours) and external (obstacles in the health system). The barriers are both on the user side (faced by individuals seeking support) and the provider side (faced by the professionals providing support).
After identifying these barriers, we needed to narrow down our problem definition further to make it actionable. We wanted to identify “leverage points”, or points in the system where a small strategic change can have a ripple effect that positively transforms the system.
After numerous conversations and drawing up countless maps, we identified our leverage point: mental health assessment. Incorrect assessment has a series of undesirable consequences: incorrect diagnosis, overmedication, incorrect and repeated referrals. Ultimately, poor assessment causes individuals with mental illness to go without the help they need when mistakes in diagnosis and referral cause them to quit the support-seeking process. On the other hand, smarter mental health assessment could have a series of desirable consequences: capturing the mental health needs of the UK population and macro trends, giving individuals with mental illness a tool for self-management and making self-referral easier.
Step 3: Ideating the solution
Based on our research, we set out to improve mental assessment for both the assessor and the individual being assessed. We ideated solutions using personas, ideation canvases and lots of sticky notes.
The idea we came up with: a safe and user-friendly portal that assesses mental health patients ahead of their first consultation with a GP or mental health professionals, giving assessors a snapshot of patient needs and risk level to inform diagnosis, referral and treatment.
We focussed on the parts of the assessment process that can be automated and don’t require the subjectivity of the assessor, freeing up their time and their mind. Automating a part of assessment ensures that assessors can spend consultation time on the things only they can do- establishing rapport, comforting the patient, exploring specific areas in detail and deciding the next steps, together. It also means that high-risk patients are detected more quickly and receive support immediately.
One of the key components of our solution is the creation of a safe and friendly online environment where individuals can complete mental health tests and record information about their mental health in the way that feels most comfortable to them. We make it easy by offering information, easy read versions of questions, and optional questions that individuals can answer to help us paint a full picture of their needs. The information is stored and can be easily shared with other mental health professionals, avoiding the trauma of repeated assessment. It can also be used for self-managing mental health and observing changes in one’s own mental health over time.
Step 4: Prototyping
After ideating a solution, the next step is to make sure it is wanted, needed and useful to the people it is meant to help by creating prototypes and testing them. A prototype is a low fidelity representation of an idea. Ours were made using tools like Figma and Dialogflow that create the look and feel of a real product or service. There are many tools available out there, with the simplest being offline representations or paper prototypes.
Step 5: Testing and Learning
After developing each of our prototypes, we tested them with our target user groups to ensure the service was wanted and needed. The key to testing is to not only find out what people say they want and do but to observe what they actually want and do.
We used testing to get proof of our concept, prioritise our features and refine our look and feel. Some of our tests were conducted through Maze, a platform where users complete “missions” to help us see how intuitive our interface is. If you’re curious, our latest test is still live here. Some of our tests were classic interviews where we asked people to give us feedback on our features and how they might use them in their lives.
We collected feedback in cycles of two or three weeks, and then went back to the drawing board to learn and make a new, better version. Each cycle of learning and re-development is called an iteration, and it helps us get closer to the best possible service we can create. This is an open-ended process, as we will never stop learning and improving.
Step 6: Developing our MVP
The next step in this journey is to launch our minimum viable product (or MVP). This isn’t actually a step in design thinking, but we view it as an extension of our testing and learning stage. We will be launching a beta version of our service in Spring 2022, inviting our early adopters to participate in shaping Fewl. We are excited to get Fewl out in the world and generate evidence of the potential of design thinking to change the way we approach social issues.
