Blending approaches to increase community involvement in developing and
testing mental health solutions
Mental health solutions are traditionally developed by mental health professionals and researchers with limited input and ownership by users, their gatekeepers (e.g. families), and providers. This results in the creation of solutions which are unappealing and do not easily integrate into existing health and/or community systems. If we want to improve this, we have to radically change the way we develop, implement, and test solutions.
An effective solution is not enough to improve clinical outcomes. Solutions must also be attractive to those who need them and those who must provide them. To know what is attractive, these groups must be included in solution development and testing. We need to understand the perspective of would-be users. How do they understand the problems they have? What do they think they need to overcome? Who would they like to support them during this time? What would success look like? One approach which provides a framework for understanding these perspectives and incorporating them into the design and evaluation of solutions is human-centred design. Through a process of understanding perspectives and context, identifying a priority challenge, brainstorming possible solutions to that challenge, prototyping the best ideas and testing them out, a human-centred design approach increases the chances that a solution is one that a community wants to deliver and receive. Human-centred design techniques and tools have been used for within international development but its use in global mental health is limited.
While the content of an intervention is important, how it is delivered and its ability to be delivered within existing systems (e.g. health, social care, education) is vital to its long-term success. To address these issues both systems thinking and implementation science lenses must be used. Systems thinking is an approach which aims to identify, understand, and address the connections between the micro, meso, and macro levels of a given system. By combining it with human-centred design, you begin to have the information and tools necessary to model a solution and how it would work within a given system (or multiple systems), and explore what adaptations to the system(s) or the solution are needed to be made for maximum impact. Implementation science provides ideas and a means of optimising the implementation of solutions and ways to test its impact. Implementation science makes it possible to understand, not only if the solution itself is effective, but also how well the way it is delivered works.
To give mental health solutions the best chance of making a difference, it is necessary to understand the optimal mix of components necessary to make an impact, how to package it so that it attractive to users, gatekeepers, and providers, and how to deliver it efficiently and effectively within existing systems. To do this, a blended approach is needed. We propose a human-centred, systems-minded design approach, as first described by Thomas Both at the Stanford d.School, complimented by rigorous implementation science methods as a potential way to increase the availability of effective mental health solutions across the globe.
Evidence-based research is at the core of what we do. Click on the article for a digestible summary and a link to the original papers that inspire and drive our work.
STAY TUNED! We are currently working on writing and uploading more lay summaries (and short video overviews!) of key publications. Keep an eye out!