Service Design-in’ at Kalda
An asynchronous interview with Charlotte Fountaine, co-founder and Service Designer of Kalda.
Q: Ciao Charlotte, please introduce yourself.
A: I’m Charlotte, I’m the co-founder and Service Designer of Kalda, the LGBTQIA+ mental wellbeing app. My co-founder Daniel and I started Kalda 2 and a half years ago. It was September 2020, during the COVID lockdown in London. We realised we’d both struggled with our own identities. We weren’t able to find affordable, relevant mental health support. We started Kalda because we wanted to bring gender and sexuality-affirming support to everyone.
The question we started with was:
How might we provide affordable gender and sexuality affirming mental health support at scale?
My job involves building the Kalda app. I carry out research to understand what people need from Kalda. The role is super-varied. Since we started Kalda we’ve: built the app, published it on the iOS and Android stores, and got users from across the world using it. We’ve conducted 2 health evaluation trials on the app. This showed that in just 2 weeks the app has a clinically significant impact on reducing anxiety and depression.
As a Service Designer, I’ve been able to prototype different elements of the service. We started with a hypothesis that peer support would be a key component of Kalda. As a result, we created a Facebook group and got people chatting on there before we put out our first app. It was difficult to move that vibrant community from Facebook to our new app. We learned on an app single-player mode content was more effective. People want trusted mental health support from LGBTQIA+ therapists, so that’s what we built into the app.
We also prototyped mindfulness sessions: we’ve run over 80 sessions. This created a strong community of people who connect with each other. Through these mindfulness sessions we’ve seen people: form new relationships, get new jobs, and move houses and countries. Having a space where people can connect is key to the Kalda service.
Q: What does Kalda do?
Kalda is an app where people can access video self-therapy courses on all things gender and sexuality. If you’re exploring your sexuality or managing gender dysphoria, there’s a course for you. We also provide daily self-care activities: gratitude journaling, queer affirmations and more.
As well as the app we provide mindfulness sessions on an ad-hoc basis, and have a Whatsapp community where people can connect.
Q: How do you define Service Design?
A: I define service design as the design of services. I got this definition from this blog post by Lou Down. A service is something that a user interacts with to do something. Design is the practice of creating something new, or improving something in a user-centred way.
The things we use during the service design process — user interviews, service blueprinting, user journeys, are just tools to create effective services. It is not service blueprinting that makes you a successful service designer. It’s implementing services that are useful to people that makes you a successful service designer.
I believe that as service design is still a relatively new discipline, we can get lost in our own tools. Delivering a service blueprint shouldn’t be the outcome of a project. Happy users who have got some more value out of the service should be the outcome. That’s not to say that tools aren’t useful. But we must focus on the impact that our work has on the user and the staff delivering a service.
Working on Kalda has allowed me to be involved with every aspect of the service design process. The inception of a new service — in this case a new mental wellbeing app. The prototyping and testing. The delivery of the service. Finally the maintenance, which can sometimes be overlooked in service design. Maintenance includes running the service, but also continuously improving the service.
For Kalda that maintenance process is collecting more data on how well the app is working for people. We look at our metrics with the whole team every single week. We speak to users each week — usually on the phone. This gives us a picture of what we need to improve. We produce our Kalda content in-house: this includes our affirmations and video courses. Another aspect of maintenance is things like social media and promotion of the app.
Q: What’s the current Service Design setup at your company?
A: We’re still a pretty small team, and we work with lots of freelancers to get a huge amount done. I think startups are actually quite good at service design in general — they just don’t usually call it that. When you’re creating a new product, everything is service design. All the work is in service of the user experience.
Q: Let’s talk about your Service design work. What are the most unsexy bits you worked on?
A: Most of it isn’t sexy! Building the app and constantly promoting it is really hard work. Everything we do that Kalda has been on a tight budget, so we’ve been really creative with how we do things. As part of promoting Kalda I really had to put myself out there by creating Instagram and TikTok reels advertising the app. It didn’t come naturally to me but I’m constantly learning.
The hardest aspect of creating a start-up is gaining funding and having enough revenue to keep going. Going to lots of pitches and investor meetings can be disheartening when they don’t understand the vision. We want Kalda to be in schools, in people’s pockets and a go-to resource for our community. We need funding to do that.
Q: What are the bits you are most proud of?
A: I’m proud of launching the Kalda app with a walking app called Sweatcoin in June 2022. We got 500 users in the first month of launching. We also worked with Sweatcoin to raise money for Gendered Intelligence, which supports the trans community.
I’m also proud that we have courses on topics such as embracing being non-binary and exploring your gender. I think it’s really hard to access support from trans therapists. Not everyone can afford one-on-one therapy and there aren’t enough therapists around.
It’s been amazing to run health evaluation trials on Kalda and see it working for people. And see people enjoying and forming a community around the mindfulness sessions.
Q: What is a health evaluation and how do you run it?
A: Me and my cofounder Daniel both have a background in health evaluation. He ran trials for MyCognition, an NHS-approved medical device where he was Head of Product. I designed Public Health England’s digital health evaluation service. For this reason, we’re both very passionate about evaluating the effectiveness of what we’ve built with Kalda. The most important thing is understanding whether it’s having a positive impact on users’ mental health.
We ran 2 ‘before and after’ studies. We used the Patient Health Questionnaire and General Anxiety Disorder (PHQ-9 and GAD-7) to understand people’s mental health before engaging in Kalda, and then we did another survey at the end to understand their mental health afterwards.
We deliberately used all the same metrics that they do within the NHS. Using common metrics means that services can be compared like-for-like, and people can make better commissioning decisions in the future.
We ran a 6-week group therapy course, and conducted this before and after study. And then later we ran a 2-week study on the app, and that also gave us an opportunity to gather loads of user feedback, as well as the health metrics.
Q: How do you prove the impact of Service Design?
A: I love this question. I think that’s something that as an industry we’re starting to pay more attention to. It’s the most important thing: what gets tracked gets impacted. That’s a phrase that my cofounder Daniel often says.
We focus on 2 things. Retention metrics show us how many users are coming back each week to the Kalda app. We’re constantly looking at how we can improve this. The second is understanding our health impact, as mentioned earlier. We conduct PHQ9 (Patient Health Questionnaire, 9 questions) and GAD7 (Generalised Anxiety Disorder Assessment, 7 questions). There are other really important metrics like conversion from freemium subscription to paid, and cost of acquisition on marketing channels. Understanding these metrics allows us to continually improve the service.
Q: What’s the plan for the future?
A: We want to create more Kalda courses, and make sure that everyone in the community is able to access affordable support. Particularly race and the intersectionality of being LGBTQIA+ and a person of colour is something we want to talk about. We’d love to scale Kalda further, and keep improving the service we deliver through the app.
Q: A service you wish you had designed
A: I am a massive fan of SH:24 — they deliver self-testing kits for STIs. They are one of the first companies to do this. Before that, you had to queue up in a clinic — difficult to do if you’re working or have caring responsibilities. Also difficult to get tested in person if you’re in a vulnerable position like being a survivor of domestic abuse. So that’s a service I would love to have been a part of.
On the other hand, a service I think doesn’t work in the way it should that I’d love to improve is the Student Loan Company. When I was a student they didn’t pay my loan on time, I had months of chasing them and trying to release the funds to pay my bills. Later, when I graduated and it was time to pay the loan back, they had no trouble locating me and my information! Trying to deliver a quality service at scale is difficult, and I would love the challenge of improving student loan delivery.
Q: How can people follow you?
A: Kalda: kalda.co
Linkedin: linkedin.com/in/charlotte-fountaine
Twitter: twitter.com/cifountaine
Service Design-in’ is a collection of thoughts and interviews with Service Designers working within organisations. If you want to share your views, please reach out.
