OVERVIEW:Discourse surrounding mental health and designing for those who experience difficulties in life is a stigmatised topic and area of practice. However, it is for that very reason that we should be focusing our design principles and re-evaluating our design ethics around protecting these people that are already under-represented and have misinformation spread around them.
The opportunity to work with Portable Design Studio and Mental Health Review Tribunal NSW (MHRT NSW) in assessing and designing an interactive experience to alleviate pain point points for mental health patients going through the tribunal system was a once in a life time role. Within a team of 4, our project aimed to address the inadequate environment and process that civil mental health consumers faced when attempting to self-express and self-advocate their feelings during MHRT reviews.
MAIN ROLEs/ tasks:
User Researching & Testing
Academic Research
Dashboard Designer
TIMELINE:
September 2023 - August 2023
TEAM:
Chance Logan
Radhika Nichani
Sanskriti Sharma
Jonathan Shaw
Our brief from Portable was to design an intervention in the current system of Mental Health Review Tribunal NSW, particularly at the intersection of justice and mental health. Our team of 4 began with a very indepth process of secondary research, the evaluate what the current thoughts, feelings and experiences are for civil patients going through the MHRT system.
Mental stress and unfamiliarity with the Tribunal procedures and panellists often prevent civil consumers from actively participating in the process and expressing themselves.
KEY TERMS
- Mental Health Review Tribunal NSW (MHRT): The Mental Health Review Tribunal is a specialist quasi-judicial body constituted under the Mental Health Act 2007. It has a wide range of powers that enable it to conduct mental health inquiries, make and review orders, and to hear some appeals, about the treatment and care of people with a mental illness.
- Community Treatment Order (CTO): A Community Treatment Order (CTO) is a legal order made by the Mental Health Review Tribunal or by a Magistrate. It sets out the terms under which a person must accept medication and therapy, counselling, management, rehabilitation and other services while living in the community.
- Civil consumer/mental health consumer: A civil consumer / mental health consumer is a person who has a lived experience of a mental illness or mental disorder. They can also be a person who is receiving treatment from a mental health service, either voluntarily or involuntarily.
- Tribunal panel members: The 3 members of the panel on the day, from MHRT NSW who come to review a civil consumer's journey of improvement and recovery, and make decisions on the consumer's return to society.
- Personal caregivers: The support team for the civil consumer, including a nurse, the doctor, a legal aid and a peronal relation such as friend or family.
As a team we delegated each member to research any pain points regarding the patient's journey. It was evident that a communication gap between the civil consumers and the tribunal members posed as the greatest distress to civil consumers, particulr during the tribunal review.
“All of the consumer participants described the experience of being treated under a Community Treatment Order (CTO) as characterised by problems with communication and understanding.”
"Communication with people with mental illness must obviously take into consideration their particular difficulties, including the effects of their impairments, medications and their vulnerability generally, on their capacity to understand and engage with the process. "
We used these insights to form our core question:
"How might we facilitate familiarity between the consumers and the MHRT panel, to mediate consumers’ mental stress at hearings so that they can feel more at ease expressing their views and advocating for themselves without feeling intimidated or burdened?"
ROOM ANALYsIS OF MHRT Reviews
To begin ideating solutions, we analysed the current journey that civil consumers undertake, including timeline, physical space, who and how they interact with at each touch point. Below are some photos we obseved in a video on MHRT's website detailing 'What to expect in a tribunal review':
Immediately it was easy to notice the large gap between the tribunal panel members and the civil consumer, with their support persons behind the patient.
We researched into better object design practices, and suggested the settings to be rearranged into a circular table, to further support MHRT bylaws denoting they must "allow [all parties] to ‘participate fully and effectively’ in proceedings" for procedural fairness.
As part of our early research phase, we researched current practices that alleviated mental stress and encouraged self-expression in parallel fields such as play-therapy engagement, mental well-being practices and gamification design. Many civil consumers commented that they "weren't even able to understand what the core purpose of the review was" and felt it was a bureaucratic opportunity for judgment on their lifestyle.
In our findings, I noticed that much of the stress, and inability to convey thoughts stemmed from the unfamiliarity and mistrust of the tribunal panel members. Many therapy practices encourage building the foundations of trust to facilitate conversation and showed significant improvement in communication as patients came to trust their therapists more.
Concurrently, our research we discovered Neurogrow, a gamified app that was developed to find a way to heal depression in older patients in healthcare. Part of their studies revealed that found that video games can be used to repair certain circuits in the frontal lobe of the brain, including training skills that often go unused, such as communicating need and problem solving. Research has also found that gardening is an activity that helps soothe the mind, and aids healing.
Hence, we thought:
"What if we redesigned the table they used in tribunal reviews to be an interactive, social object between the users where they engage in a fun, gardening game to relax, and build trust in the panel members, while also give civil consumers the tools to communicate their needs and self-expression"
A vital component to our game is to understand our user who attend MHRT hearing, the civil consumers, the panelists of the MHRT and other participants like the advocate, supporting member & the care team.
The initial proposal is an ice breaker session that happens before the hearing.
- As the game is set up, the users arrive and are seated as mapped out on the table.
- Once seated, they are given the choice of choosing an avatar and the game begins by simulating a gardening experience.
- The game thrives on collaboration and helps users be more at ease and through this a plant is grown as a small victory !
As a team, we developed an in-depth journey map of civil consumers' mood and all the touchpoints of the concumer's journey going throughout the MHRT system.
This sense of familiarity that was established during the game is then taken forward to the tribunal hearing, to help users self express and foster better communication.
Concept Creation & user flow
My team mate Sanskriti oversaw the user flow construction, and the two of us engaged in a bodystorming technique, to ideated a user flow engaging with the game, penning down ideas that branched from different stages.
initial interface design & primary affordances & signifiers
I primarily managed researching the design of the interface, and my main struggles included designing for 8 people, with 8 angles, on a large, spherical screen. I was delegated to answer the following:
"How might we design the main dashboard and round interface screens using affordances, signifiers and feedback mechanisms to let the user know what actions they have to complete, how to do the action, and finally that the action has been completed or successful?"
I decided to create a Wizard-of-Oz style prototype with large pieces of paper, to gauge the size of the table and the dimensions on a more anthropologic level.
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I created a prototype of the game to be used on the ipad, so it can lay flat on the table and tested with 4 users.
75%of users laid their forearms on the table, blocking the navbar.
100% of users intuitively used the navbar, at any point when they were confused or needed to take action.
It became obvious that what was instinctive to me wasn't intuitive to others. I returned to the designed and made new iterations considering the feedback receieved.
bloom design & figma usability prototyping
Now arguably one of the most difficult parts of design is developing low-fidelity wireframes, but the IA diagram helped me as a sort of jumping platform to design for. I cross referenced each screen that needed to be designed with the IA diagram, and developed the initial sketches.
Conducting usability tests, we tested with 12 users, analysing the userflow, the affordances, and most importantly if the game actually allowed users to feel more comfortable with communicating needs and trusting the other participants.
It became obvious that what was instinctive to me wasn't intuitive to others. I returned to the designed and made new iterations considering the feedback receieved.
These key changes were implemented from the initial design to the current one was combining the different aspects of the prototypes we had individually worked on. We combined the UI prototypes together into one collaborative storyline in the game.
- I had worked on the overall interface of the dashboard
- Sanskriti had iterated the flow & gameplay
- Jonathan looked into tactile choices of game mechanics
- Radhika prototyped using avatars and personalisation for expression and familiarity
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