Mental Health Tetris


In brief: Visual experimentation of mental health concepts using Tetris blocks.

I have been thinking about ways to represent various concepts in mental health using basic shapes. I started to play around with squares to see what I could come up with, but ran out of creative juice quickly. Recently, I stumbled upon the work of Graphic Patrick who created some clever posters about mental health terms which inspired me to return to my square experiment. What I came up with were Tetris-inspired visuals, as you can see above and below.

I was a big fan of Lego and Tetris when I was a kid, so I’m not surprised that my experiment led me to create some visual concepts inspired the very building blocks that kept me creative and busy during my childhood. I received a Game Boy for my birthday (way back when it was first released) and was absolutely thrilled that it came with my very first portable video game: Tetris. Really, this was the best tech toy a kid my age could get for her birthday in the early 90s <<YouTube video: 3mins of pure Tetris nostalgia here>>

Tetris aside, I decided to experiment to see if the notion of adding/removing building blocks (perhaps representing positive and negative events/stressors?) could help describe some topics in mental health. My intent here is to find alternative/complementary ways to explain complex mental health issues. I realize Tetris may not be the best analogy, as I don’t consider mental health a “game” of sorts nor something you can really “win” or “lose” at. But for the sake of trying something different, I selected a few issues that I thought would be worth exploring. And yes, this is an exploration that aims to challenge me and my own understandings of mental health and hopefully encourage others to think differently too. Using Tetris as a back drop is meant to describe terms in a playful and accessible way but is not intended to minimize their seriousness or depth. The decision to position the blocks the way I did here comes from both the way the game is constructed as well as the player experience.

Illustrated are the concepts of recovery, depression, bipolar, ocd, coping, and determinants of mental health. I’d rather not provide an extensive explanation of each image, rather, I’ll let you interpret it for yourself. I’ve included a definition of each term below each diagram for your consideration. As always, feedback and ideas are welcome.

An aside: When I googled “Tetris” and “mental health” to see if there were some existing work in this area, I came across articles referencing an Oxford study suggesting that playing the game could possibly prevent PTSD flashbacks. Some food for thought.

tetris_rec“Recovery is understood as a process in which people living with mental health problems and illnesses are empowered and supported to be actively engaged in their own journey of well-being. The recovery process builds on individual, family, cultural and community strengths and enables people to enjoy a meaningful life in their community while striving to achieve their full potential.” (Toward Recovery & Wellbeing, MHCC)


“Depression is a medical illness that causes a persistent feeling of sadness and loss of interest. Depression can cause physical symptoms, too.” (Mayo Clinic)


“Bipolar disorder — sometimes called manic-depressive disorder — is associated with mood swings that range from the lows of depression to the highs of mania. When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts in the other direction, you may feel euphoric and full of energy. Mood shifts may occur only a few times a year, or as often as several times a day. In some cases, bipolar disorder causes symptoms of depression and mania at the same time.” (Mayo Clinic)


“Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by unreasonable thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). With obsessive-compulsive disorder, you may realize that your obsessions aren’t reasonable, and you may try to ignore them or stop them. But that only increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts in an effort to ease your stressful feelings.” (Mayo Clinic)


“Coping is the process of attempting to manage the demands created by stressful events that are appraised as taxing or exceeding a person’s resources” (Taylor & Stanton)


“Multiple social, psychological, and biological factors determine the level of mental health of a person at any point of time. For example, persistent socio-economic pressures are recognized risks to mental health for individuals and communities. The clearest evidence is associated with indicators of poverty, including low levels of education.” (WHO Fact Sheet)


Toward a Visual Understanding of Mental Health


In brief: Achieving buy-in and support for a mental health agenda within an organization starts with clearly defining the concept of “mental health” in a manner that is succinct, memorable and easy to share. Without a cohesive understanding around mental health, it is challenging to mobilize people in favor of the cause. There are many definitions of mental health that exist but I find that one of the most accessible, personally relevant and understandable explanations is conveyed in a diagram based on Corey Keye’s work around the notion of flourishing. Here I adapt Keyes’s work in order to create a new visual piece (above) for your consideration that takes into account the environmental determinants of mental health.

Note: I talk about mental health strategy development here within the context of my work as mental health coordinator for two major post-secondary institutions in Ontario.

How do you design conditions that shift the thinking, actions, and attitudes of a group of people organized around a particular mission or goal?

It’s tough. I would never assume organizational change to be a trivial task, particularly when one is looking to produce a system-wide cultural shift around mental health. Mental health is often a challenging, interrelated and ambiguous concept as it captures a large slice of the “health and wellness” pie, and is influenced and constructed in multiple ways. Accordingly, it is difficult to find a way to fully capture the social, historical and cultural complexity embedded within the term “mental health” in a few words. Generally speaking, people also tend not to identify with mental health as being a core aspect of their livelihood as it is commonly assumed that “mental health = mental illness, so it doesn’t affect me.” However, unless “mental health” itself is well understood within an organization, rolling out a mental health strategy is tough to achieve. Fertile ground for change starts with a clear definition. Here are some I have been working with that are widely used in public health:

The capacities of each and all of us to feel, think, and act in ways that enhance our ability to enjoy life and deal with the challenges we face. It is a positive sense of emotional and spiritual well-being that respects the importance of culture, equity, social justice, interconnections, and personal dignity (Public Health Agency of Canada)

Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community. In this positive sense, mental health is the foundation for individual well-being and the effective functioning of a community. (WHO)

These definitions are helpful for the most part, but are arguably challenging to remember, rather intangible and aren’t necessarily worded in a way that is memorable. They also do not explain the relationship between mental health and mental illness, the latter of which is commonly understood as being synonymous with mental health and helpful to differentiate. This is not to say these definitions aren’t easy to understand per se, more that it can be difficult to personally relate to them. Expecting someone, particularly one who does not have a public health background, to relay this language/wording to someone else may not be an easy task…at least that’s what I’ve found from my experience.

There is however one explanation of mental health from Corey Keyes that I have found most helpful. Keyes introduces the notion of the Mental Health Continuum, an understanding of mental health that is grounded in positive psychology, happiness and the concept of flourishing. He describes the “…operationalization of mental health as a syndrome of symptoms of positive feelings and positive functioning in life. It summarizes the scales and dimensions of subjective well-being, which are symptoms of mental health. Whereas the presence of mental health is described as flourishing, the absence of mental health is characterized as languishing in life.

Unlike the other definitions offered, it is the visual representation of Keyes’s concept of mental health that is most powerful. Figure 1 (below) is adapted from Mental Health for Canadians: Striking a Balance (the original diagram available at CMHA Ontario) and visualizes the continuum of mental health:

  • Y-axis: Optimal mental health (aka Flourishing) at one end vs poor mental health (aka Languishing) at the other
  • X-axis: Serious mental illness at one end and no symptoms of mental illness at the other

As such, a person can be flourishing with or without symptoms of a serious mental illness. At the same time, one can be in poor mental health and yet living without mental illness symptoms.


All of the explanations above have their strengths and weaknesses, but there is something in particular I like about the visual as a starting point: It embodies the simplicity and complexity of the concept of mental health, all at once. I have found this to be one of the best ways to describe mental health because I am not limited by my own words, rather, I have a tangible map of mental health that is applicable to everyone: We all fit along these continuums and can locate ourselves with respect to where we are at now and where we might want to be. For me, this has been an excellent health communications tool. Not only is the visual easier for people to remember, it does not require a linear or fully verbal explanation.

As you can see in the visual above, I decided to take Figure 1 two steps further. Figure 1 is helpful but limited in that it conveys a more individualized understanding of mental health. Consequently, it visually misses the social and cultural conditions that are also at play in shaping mental health experiences. Alas, Figure 2 offers a third continuum labeled as “environments” (z-axis) that aims to represent external determinants within the greater community/organizational ecosystem that affect mental health. Finally, I added Figure 3 as a way of illustrating where can set our goals when it comes to building a mentally healthy organization. Thus with or without the presence of a mental illness, we should be striving to support people and designing environments where optimal mental health can be achieved.

As always, your thoughts and feedback are appreciated in the comments below. To me, the third dimension of “environments” is a helpful construct — I’d be curious to know if you think this helps portray a fuller picture of mental health. While it may not always make sense to use a visual explanation for mental health, I think it certainly has a lot of utility and carries with it a depth of meaning that could not otherwise be conveyed through words or text alone.

The Elements of Design Thinking (Version 2.0)

As a follow up to my original post on the Elements of Design Thinking (Version 1.0), I present to you the Elements of Design Thinking Table, Version 2.0.

This second version builds on the feedback from version 1.0, and has been organized differently into families and periods based on my ever-evolving understanding of the concept of Design Thinking. I have had the good fortune of interviewing incredibly intelligent and insightful designers and design thinkers through a research study I am co-leading called Design Thinking Foundations. My learning through this project has prompted me to reorganize the elements the way I have and has brought some more clarity to my own personal definition of design thinking. As my Adobe Illustrator skills have also evolved (for the better, I hope!), I give you a more polished graphic above.

As you can see, there are more elements then last time, but I suspect the list will keep growing and the elements will continue to be reorganized. Compared to the first version, this one has fewer gaps — maybe indicative of some cohesive thinking around my own definition of design thinking?

In any case, I’m still facing the challenge of determining if something is truly an ‘element’, that is, a basic building block of design thinking, rather than a higher level concept that would be constructed from a combination of these elements. Understanding how these elements relate to one another in order to formulate higher level “molecules” is a design challenge in itself. I think it’s worthwhile putting some more thought into this though as it might help visually and conceptually explain the varying approaches and unique interpretations of design thinking that people have. For instance, you’ll probably notice how I have included elements that reflect my public health background such as “Sj: Social Justice”. This is an element I would expect to be very prominent in building a design approach or stance in health promotion, but probably not for someone working in the area of business design, for instance.

In this 2.0 version, I have included definitions below for each of the elemental categories for some additional context:

Mindset: Elements that refer to ideas, constructs, and attitudes with which a person approaches a situation

Meaning: Elements indicating the significance of design

Humanize: Humanizing elements that bring design closer to human nature or human use

Interaction: Social elements denoting the ways things effect or relate to one another

Process: Elements emerging throughout the creative/design process

Understanding: Elements representing mental processes for comprehending information

Included here as well is a “2.0” version of the Design Thinking trading cards that pair with this version of the table. I’ve included a preview below, and the full pdf can be downloaded here: DT Trading Cards 2.0. Currently, they are only one sided but have been resized into full sized playing cards (2.5×3.5 inches).

The next steps for the Table and cards are to more fully put together the definitions of these concepts…and any suggestions in this area are more than welcome! Be prepared for further iterations and more text!

I’m also excited to discuss the periodic table of design thinking further with the Plexus Institute today! Feel free to join in on the conversation by phone at 1PM EST, it should be a lot of fun 🙂 Details are in the link.

The Art of Type

“Learn the rules first, then break them”

Those are some wise words from my typography prof at OCAD U.

I’m three weeks into my intro to typography course and so far I’ve really enjoyed it. I’m learning a lot and I am developing a much deeper appreciation for the communicative power of type. My understanding of type is a design system that has been created and developed over the span of years, decades and millenia for the purposes of conveying meaning and messages in some sort of organized manner. Type is also something I’ve always taken for granted having grown up with word processing programs and having the luxury of selecting from a vast list of typefaces at the single click of a mouse, from the Swiss-born “Helvetica” to the corporate standard, “Times New Roman”, to the seemingly nonsensical “Wingdings”.

On day one of class, we began learning about the contrasts of type. In no particular order (and extremely simplified here) are seven contrasts we learned about:

1. Size – Scale of type

2. Weight – Thickness of the letter forms

3. Form – Caps/lower case/italics

4. Structure – Typefaces (e.g., Helvetica, Arial, Futura)

5. Colour – Color of the type

6. Direction – Orientation of the type

7. Texture – Leading and spacing

For my first class assignment, my job was to demonstrate one of each of these rules, while keeping everything else constant. This was a much harder task for my classmates and I to complete because of our natural inclinations to creatively play with several elements at once. However, as I quoted my prof above, we were reminded to learn the rules first in order to break them. As a result, this assignment turned out to be a real test in using type alone to convey emotion and meaning.

And so, I practiced and came up with my final seven examples (above) using one of the more versatile typefaces, Helvetica. After a couple of class critiques, I hope the contrast behind each example is quite clear. The order goes: Color, texture, direction, size, weight, form & structure. The quote is from Col. Stefan J. Banach, a man who has brought design thinking to military strategy.

From this assignment though, one thing I have been reflecting on is the notion of “rules” in typography.

Having rules doesn’t necessarily seem to imply there is a “right or wrong” way of doing things, but more that there are principles behind the practice of design that have “worked” over centuries and are instructive to theory and practice. And importantly, these are rules that can be broken, and always are.

In health promotion, we don’t have “rules” per se…there are some guiding and unifying principles, but to me, it’s not as standard or clear. I would describe the rules of type I’ve learned about as “modifiers”, if you will — they are ways to shape the very essence of the design you’re working with through its literal and figurative meaning in order to better communicate with an audience. I found these rules rather instructive and thought about how these elements could be applied to the work I do as a community health promoter. My thinking: Perhaps there are elements which help create a unique aesthetic for each and every health promotion initiative we plan, create, and carry out. Here’s one way of looking at it (and for the purposes of this example, I use “program” to describe a general “design program” we may create for health promotion — an intervention, strategy, process, policy, engagement, etc.):

1. Size – The scale and reach of the program

2. Weight – The impact of the programming on participants and the greater community

3. Form – The activities that comprise the contents of the program

4. Structure – The type of program it is, be it an outreach program, educational workshops, etc.

5. Colour – The visibility of and levels of diversity represented in the program

6. Direction – The anticipated process and outcomes of the program, and the values and beliefs guiding it

7. Texture – The feel and visceral experience of the program as experienced by all involved and affected by the program

When framed this way, I actually find these design principles to be quite a helpful way of communicating a health promotion aesthetic that may not always be immediately visible or understandable in the work we do. In designing future health promotion initiatives, I will have to track my process and see if these principles fit or if there are any others to add to the mix…A good design challenge for myself moving forward.

And before I end off this post, I just wanted to include this gem that my prof showed us at the end of our first class to remind us not to take our typefaces too seriously: A video from College Humor called Type Conference

The Pre-Flight Safety Demonstration

During the flight if the cabin pressure changes, an oxygen mask will drop automatically from the panel above you. Remain seated. Pull the mask toward you. Use the support strap to hold the mask over your mouth and nose. Adjust your mask. Breathe normally.

Air Canada Safety Video

My mom always gives good advice. She is a very thoughtful and intelligent woman. She has also worked incredibly hard her entire life and, having moved to Canada from Hong Kong during her teenage years, she learned at a young age how best to take care of herself and her loved ones, even as she faced adversity as a woman, a woman of color, and a newcomer. Not surprisingly, she trained as a social worker and has spent her life supporting and counseling others in need of help. I love talking to her because she has the ability to be amazingly compassionate while being completely honest and up front with me. She can always cut through what I call the “fluffy bull****” (getting too entangled and debilitated by emotions) and just get straight to the point.

I have always turned to my mom for advice on love, life and relationships. And more recently, I reached a point at which several seemingly unrelated and rather problematic issues in my life became entangled with one another into a gigantic, messy knot. I was burnt out, overwhelmed, and felt powerless to create any change in my life. In other words, I wasn’t at my healthiest, physically, mentally, or emotionally. It wasn’t good. Despite this, I had deadlines to meet, work to finish, and projects I wanted to press forward with. I tried to find distractions and things I could work on, but I couldn’t find my focus…or motivation. But then I remembered some valuable words that my mom once shared with me a while ago when I was in a similar situation.

She gave me the analogy of flying on an airplane. As in the quote above, when the cabin pressure drops in mid-air, oxygen masks will drop from the upper panel and you’d better put one on. Most importantly though,

Always secure your own mask before assisting another person.

That last point was key: If you aren’t minding your own health and safety first, you are not going to be in a position where you can help others.

I was at a training with Anima Leadership last week on conflict resolution and brought up this point. It became a useful and logical reminder to myself and other participants to make sure that we are in position to be ready and as healthy as possible to approach conflict. Otherwise, it may turn into this sort of situation. It’s also a point that came to mind when I was at a Conference last week listening to Robin Sharma speak. He was talking to an entrepreneurial-minded crowd, and reminded us that we had to take care of ourselves first: Our state of health and wellbeing would translate into our work, our relationships, our start-ups and/or our companies. If we are a reflection of our business and vice versa, how could we expect people to engage with either if we are unwell? I think this is true for design too. If we neglect our health and identity within the design process and we forget to breathe (something so very basic and essential to our survival), we cannot produce “good” design.

This advice has helped me get through murky waters time and time again. I’ve learned that sometimes I need to be a little selfish and take care of me first, but that in the end, this is to the benefit of the work that I do and the people around me.

The next time I’m sitting through the pre-flight safety demonstration, rather than roll my eyes and think “I’ve seen this a million times before!”, perhaps getting a reminder won’t be so bad. After all, turns out it’s pretty useful advice.

Thanks mom.