Service Design Thinking For Campus Mental Health

helpseek

How can we better understand the thoughts, feelings, behaviours and experiences of a student navigating campus mental wellness services?

By answering such a complex question, we can learn how to improve all aspects of a student’s interaction with a service, starting from how they enter the service in the first place, to when and how they choose to leave the service. By placing the human experience at the center of the way we design health services, we end up improving not only the processes and efficiencies of the service, but creating services responsive to real human needs.

Service design’ is an innovative approach for improving how students experience and navigate campus mental health services. Through observational research, student/practitioner interviews, service ‘blueprints,’ and systems maps, we have been working towards the design of more humanistic and compassionate service experiences at OCAD U, and even across the greater mental health system. I’m delighted to be leading a project that is the first of its kind in Canada and working with prominent design leaders to do so. Here I’ll share some of our work to date.

In the summer of 2013, I led a workshop with the OCAD U Health & Wellness Centre to create an initial service map of counseling services (you can see a sliver of it above in the image for this post). By working with the entire clinical team, we were able to capture individual and group insights and understand the basic service journey of a student accessing mental health services.

service-process

Stages of mental health counseling services

Not surprisingly, when you ask people for their perspectives and observations of the same process from their different vantage points within the clinic, you start to stitch together interrelated but unique narratives. By going through the various stages of the service (help seeking, service entry, intake, counseling, exit, etc., see above) you can start to break down the complexities of the student’s experience. This served as a helpful exercise in elucidating and confirming process and, importantly, helped us start to construct an empathic understanding of the student. Layering the thinking, attitudes and behaviours of practitioners and students on top of this map has helped us identify positive and negative service experiences as well as opportunities for change.

The artifacts and insights from the workshop helped lay the groundwork for a couple of projects I initiated with the OCAD U Strategic Foresight and Innovation (SFI) Program with leading healthcare designer, Dr. Peter Jones. We are engaging SFI students as key stakeholders and researchers through a staged strategy of course work and project work. Through one-on-one interviews with practitioners and students (service users and non-users), and ethnographic research, we are visually mapping out the overall service structure and process. Our plan for redesign of the Centre will start by focusing on creating change within multiple layers of the service including its goals, service offerings, branding, evaluation and physical space.

Meaningful provision of mental health services also necessitates an understanding of how these interventions and changes interact with the wider University and provincial mental health system, which is why we decided to engage a second SFI team around the creation of a systems map of the postsecondary mental health system. Applying a systems lens enables us to situate OCADU’s mental health services within the greater service system.

I look forward to the outcomes of these projects and am particularly excited to see their impacts on the mental health system and the way we approach our strategy and redesign work. Service design in particular tends to be a less common practice in Canada, making this project a real test case for the postsecondary sector. Please let me know if you’ve done any work in this space – service design, systems mapping – on your campus. Feel free to comment below.

 

The Gendered Design Thinker

Women and design have a complex history – Or perhaps more appropriately, “a complex herstory”.

In learning more about design herstory, I have found myself reading literature that I was first introduced to in my undergraduate women’s studies classes about feminist critiques of design.  Much of this critical discussion (see Design and Feminism) focuses on the relationship between women and the built environment: How built spaces have and continue to be the embodiment of a patriarchal agenda, spatially (mentally, emotionally, and physically) segregating women and men into their respective private and public domains. Within this context, “pink ghettos”, the “feminization of poverty”, and urban design as monuments to male domination, money and power are common points of analysis. Moreover, a feminist perspective on design highlights the need for women to be fully integrated into the mainstream design agenda and better represented within the profession itself.  As a predominantly male-dominated field, there have been calls for better documentation and heightened visibility of female designers and their rich contributions to the field.

This of course is just a sliver of insight into design herstory, but hopefully gives you a sense of what I’ve been reading and the type of content that I have found to be predominant in the literature. Generally speaking though, it has been a challenge to find discussion around the overall female experience in design, and how gender and identity play into design process and design thinking.

What does it mean to be a gendered designer, and in particular, what does it mean to be a gendered design thinker?

…It’s a question that has been on mind a lot lately. While I do not have much literature to cite when it comes to the question above, it has nonetheless fueled a lot of further questions and thinking. For the most part, I have become curious about the way in which the socialization of women and gender roles contribute — for better or worse — to the way in which women experience and navigate the design process.

Below I pose three questions that I think are helpful in unpacking design thinking and advancing the dialogue around women in design. I don’t necessarily have answers rather, I offer explanations that I hope provide a snapshot into some of the connections I am drawing between women, gender and design.

ONE

Question: Are women socialized to be design thinkers?

Explanation: Let us think about the qualities of a design thinker. For argument’s sake, we will assume that design thinking is a creative process for creating something with intent. Design thinking can embody and privilege many different concepts, for instance, empathy, relationship building, collaboration, sensing, health, and aesthetics. So as a design thinker, it would be critical to have or develop an understanding of the concepts and be able to apply them to design practice. But, could it be that the qualities and concepts associated with design thinking are more aligned with the feminine and gendered qualities assigned to women? Central concepts like empathy, relationships, and sensing can arguably be regarded as feminine in nature and akin to the qualities that women are taught to embody as caregivers, mothers, and companions. Perhaps then, women are socialized in such a way that they have a high potential to be formidable design thinkers.

TWO

Question: Do women and men design (think) their way through a problem differently?

Explanation: Let’s take the example of failing in design thinking. I have read multiple articles about failing – that it is okay and encouraged to fail often and fail early in design. I agree, failing can be very healthy and a helpful and normal part of the learning process. However for the female design thinker, could failure be problematic? Given the disadvantage of women in design and the subsequent challenges gaining visibility and traction in the industry, perhaps failure is a more threatening concept for women than men? And perhaps, even if distally, this may suggest and reinforce historical perceptions of women as weak, irrational, and fragile. Finally, might this notion of failure be complicated and heightened by her diversity (e.g., she is a single mother, woman of colour, or a woman with a disability)? One might be risk averse if she generally has less social power or privilege to spare.

THREE

Question: What might a female-led approach to design thinking look like?

Explanation: If we think about the thought leaders, movers, and shakers in design thinking (Tim Brown, David Kelley, Bruce Mau, Roger Martin and John Thackara, to name a few), it is quite clear that it is a male-dominated school of thought. However, imagine taking a female-centered approach to the design process: Would this look different than mainstream design thinking as it exists today? Well, when it comes to women’s way of thinking, knowing, and doing, I think that a feminist approach to design thinking offers a helpful and refreshing way of challenging, critiquing, and leading a design process; this an approach that problematizes power dynamics, identity, hierarchy and equity and pushes for greater engagement in social activism, research and practice on the part of the designer. Not surprisingly, this is also how I envision a health promotion approach to design. In Design and Feminism, Leslie Kanes Weisman outlines ways in which feminist pedagogy can be useful for constructing a new model of architectural education — I would extend this further to say that this is a worthwhile approach for design in general — where students are taught to be “effective practitioners, problem solvers and leaders”. I will mention briefly here four feminist educational principles she discusses (p. 160):

1. Employ collaborative learning methods in which interdependent, team problem solving and cocreativity are practiced and rewarded over competitive, solitary problem solving and individual creativity.

2. Share authority and knowledge so that students are empowered to direct their own learning and so that people in other disciplines and with different life experiences can join in the discourse. In the future, the boundaries of the problem to be solved — not the boundaries of a single academic discipline — will determine what knowledge is needed and where it can best be found.

3. Emphasize ethical values, a respect for human diversity, and interconnectedness among all of humanity, the natural world, and the products of human design.

4. Eliminate false dichotomies by creating learning situations that connect academic theory with “hands-on” practice and by establishing collaborative relationships among designers, clients and user groups.

Adopting these principles could be a first step to a more inclusive, humanizing and woman-centered approach to design thinking and doing. However, we may have to starting taking a closer look at the community level before we are able to see who is practicing this approach and how within the greater design thinking landscape.

While I may not be able to offer answers, I think opening up a space to have a critical dialogue about gender, identity politics, and feminism is an important and worthwhile pursuit that can help continue to document and advance design and the women in this field. I realize I have also made a number of generalizations about women and design in this post but did so in order to play with the notion of the gendered design thinker.

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InDesign Note: I’ve resisted using the pen tool for the “Dana the Designer” image, and tried to use the handy pencil tool in an attempt to create a less polished look.

The Design Enzyme

In biology, enzymes are defined as a class of proteins that catalyze or increase the rate of a chemical reaction. They do this by lowering the activation energy of the reaction — that is, the minimum amount of energy required to start a chemical reaction.  Through this process (see image above), substrates (molecules that enter the chemical reaction) come together at the active site of an enzyme where the enzyme helps convert them into products. Importantly, the enzyme itself is not consumed by the reactions they catalyze nor disturb the chemical equilibrium of the reactions taking place. However, it is important to note that the performance of the enzyme can depend on various factors: inhibitors slow enzyme activity, activators enhance activity, cofactors activate enzymes, and particular cellular conditions (pH, temperature, etc.) may be required for the enzyme to function in the first place. Simplistically and in keeping with the example of the enzymatic reaction above, the formula for the chemical reaction could look something like this:

S1 + S2 + E ⇌ ES1S2–> E + P

Where S1 = Substrate 1; S2 = Substrate 2; E = Enzyme; and P = Product.

In thinking about design thinking and the metaphors of science as my colleague and mentor Cameron Norman has in his Censemaking Blog, I started thinking about how an enzyme makes for a wonderful way of describing a designer/design thinker (used interchangeably here). This is a rather loose metaphor, but bear with me.

In keeping with what I have described above, design thinkers can help facilitate or even accelerate a design process. “Substrates” such as things like people, policies, or physical environments or even concepts such as empowerment, participation, and respect, are convened or infused by a designer in order to create a design solution to a particular problem. However, the designer can be influenced and dependent on other factors such as stakeholders, co-designers, or policies that determine whether or not the design process can take place effectively, if at all. As a consideration, it may be that certain conditions or substrates may be essential to the reaction otherwise the process may flop or may not even be regarded having been guided by “design thinking”. In the end, a product or solution is developed. Unlike an actual enzyme however, I’d like to think that the designer is much more versatile and able to catalyze different types of reactions and able to produce unique design solutions using what substrates it has available. Being adaptable and flexible to the various contexts and substrates within a particular design process seems like a critical quality of a designer in catalyzing a meaningful reaction. In some ways, enzymes can somewhat exhibit these qualities:

since enzymes are rather flexible structures, the active site is continually reshaped by interactions with the substrate as the substrate interacts with the enzyme.[29] As a result, the substrate does not simply bind to a rigid active site; the amino acid side chains which make up the active site are molded into the precise positions that enable the enzyme to perform its catalytic function. In some cases, such as glycosidases, the substrate molecule also changes shape slightly as it enters the active site.[30] The active site continues to change until the substrate is completely bound, at which point the final shape and charge is determined.[31] Induced fit may enhance the fidelity of molecular recognition in the presence of competition and noise via the conformational proofreading mechanism .[32]

– Wikipedia

So maybe the enzymatic reaction for a design thinking process could be something like:

S1 + S2 + D ⇌ DS1S2 –> D + So

Where S1 = Substrate 1; S2 = Substrate 2; D = Designer; and So = Solution.

Anyways, just some biochem for you to consider.

The Elements of Design Thinking Trading Cards

As a quick follow up to my previous post on the Elements of Design Thinking, I wanted to share some ‘trading cards’ of the elements that I hope will help stimulate thinking, discussion and development of the Table. To me, the most useful way of being able to understand the relationships and relevance of the listed elements is to play around with them, re-arrange them, add new ones, and take away others. Feel free to print off the pages, cut out the cards and play around with them.
I’d love to hear what you come with up!


The Elements of Design Thinking (version 1.0)

What are the fundamental concepts and theories behind “design thinking”?

I have been thinking about this question a lot lately as I try to understand some of the underpinnings and history of design thinking. This got me thinking about the “fundamentals”, those core constructs at the heart of this process.

So, my background is in biological sciences and I have getting back to my biology basics through a bit reading I’ve been doing on the neuroscience of pleasure and addictions (The book I finished is The Compass of Pleasure by David Linden…an excellent read by the way!). This book talks about neurological pathways, diving into the fine details of neurotransmitter release, dendrites, dopamine channels, and the stimulation of nerves leading to the emotional, mental and physical responses of the brain and body. This reminded me of the fundamental biochemical pathways and components that comprise the human body and are essential to our livelihood.

When I think about the fundamentals of design thinking, I think about a variety of ‘messy’ concepts that have come together, informed by a multiplicity of disciplines and ways of thinking, feeling, and doing. That said, it’s hard to pinpoint the underlying constructs of design thinking…rather I see diverse collections of design thinking concepts that have manifested themselves into the forms of design thinking that I see and read about. In this sense, it seems that there are essential building blocks of design thinking that are expressed in various permutations and combinations, depending on the designer and context in which it is being practiced.

I was inspired by the periodic table of the elements in thinking about this. The periodic table has always been a point of fascination and brilliance to me. The fact that science has identified essential elements that comprise all human life and all matter is pretty cool. There is a beautiful order to the elements that dictates their very composition, behaviours, and relationships. The elements themselves are comprised of subatomic particles (protons and neutrons for instance) and there are still a lot of unknowns and things to discover as we dig even further (quirks, quarks, etc.). Amazingly, when grouped into periods (rows), families (columns), and blocks there are patterns of similarity, synergy, and difference that emerge.

The above image is an attempt (a very crude and incomplete attempt that is) to highlight some major concepts that have come up in my design, design thinking, and health promotion learnings that I felt were elemental to “design thinking”. Please note that I intentionally tried to avoid the inclusion of design methods and wanted to include only major themes rather than list too many sub-categories of potential elements (e.g., senses like “touching”, “smelling”, etc. were not listed individually but assumed to fall under the umbrella term “sensing”).

These elements have been organized into families and periods (very loosely) — this was sort of my own challenge to see if I could come up with some clear connections between these concepts across the table’s horizontal and vertical axes. As I expected, this was really really difficult and I don’t think I’ve managed to do it. What I’ve come up with is a 1.0 version of this table and I welcome feedback, new ideas, and alternative language, words, concepts, and groupings. After all, this is the start of an experiment…like a sketch on the back of a napkin that can be either a really great idea or a complete flop. Also, you’ll also notice gaps in the table where some concepts may have been missed or unaccounted for. Certainly this table is not as orderly (or ‘natural’) as Mendeleev’s!

Perhaps the use of a table is a bit too mechanistic, scientific, or generally just not amenable to design thinking? I will say that I think there is value in thinking about the design thinking elements that are core to all design thinking practice (e.g., I have proposed these elements in red) and how these can be blended together with various combinations of other elements to create a unique design thinking space for particular contexts, problems, and people. I also appreciate that these concepts/words can be adapted to fit the language and definitions of any designer and that they are visible in one space so they are made more explicit and clear. Moreover, the combinations of elements can potentially be weaved into various theories (e.g., of learning, education, behaviour change, and design) so that we can make better sense of all this”design thinking” stuff.

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UPDATE: My follow up post, Elements of Design Thinking “trading cards”, has a series of cards with the elements on them for you to print off and cut out if you’re interested in playing around with these concepts even further! Thanks.

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For InDesign-ers: I am having trouble applying colours to shapes/lines outside of the automatic swatches offered in the main palet (notice that I used the standard colours available in the palet for the image above). Is there a more extensive colour selection I can choose from? This has been an ongoing problem for me! Oy.