At DiUS, we’re passionate about creating a positive impact through technology. Designing and building solutions that help improve the communities in which we live and work, solutions that create shared value.

Recently, I was given the opportunity to work on a really impactful mental health project for the BlackDog Institute to redesign a treatment program for people with suicidal thoughts. The initial phase was a discovery piece that involved multiple workshops, collaborative concept designing and testing with people who have lived through these experiences. 

Navigating both the constraints placed by the current (remote working) environment and dealing with a delicate subject matter like suicide prevention provided some important lessons. 

Here are my top five learnings which I hope will help others running research work for similar contexts. 

# Recruit early and be flexible

Recruiting quality participants who fit the target audience profile and are good communicators requires effort—that should not be underestimated. It is important to prepare a precise recruitment specification and work with recruiters to understand the requirements. It’s also important to allow appropriate lead time for recruitment (I like to leave at least 5 days for market research agency recruitment and at least 10 days for customer list recruitment for list preparation and washing), to recruit standbys incase of cancellations and to offer more session times for flexibility. Mental health participants are more likely to be recruited from customer lists of community groups and businesses that support these communities, rather than from market research agencies.  Either way, a longer lead time is needed to allow people time to decide if they are able and willing to participate in activities that may trigger distressing thoughts, and to allow time for those recruited to mentally prepare themselves.  Recruiting extras or standbys will ensure a sufficient sample size in case participants don’t feel able to do or continue their session, and are not able to reschedule within the project duration.  Finally the recruitment criteria must be flexible, specific mental states can’t be switched on and off so it’s impossible to guarantee the persons’ mental state in their session. Instead it’s more important for participants to be able to objectively reflect, communicate and predict how they would react based on their experience of a specific mental state, and this is a skill that not everyone will have.

# Set session and activity expectations

Generally, there is not much expectation setting in recruitment apart from providing a high level description about the session (e.g. discussion about household and business’s telco products and feedback on concept subscription models), with the facilitation guide being worked on while recruitment is in progress. However, when recruiting mental health participants, it is important that as much detail about the session and activities are provided upfront to help them decide if they want to participate and to prepare themselves for the experience. This includes if the session is individual or group (including group size and criteria), session length, duty of care plan (incase they are triggered), and an overview of planned activities, discussion questions and surveys, and the anticipated depth of discussion. This means that a comprehensive draft of the facilitation guide needs to be prepared in advance of recruitment.

# Work in individual or small groups

I like to work with individuals, or small groups of less than 5 to manage the discussion and allow for everyone to have a voice. Mental health participants are better suited with intimate small group size as it lessens the chance of them being overwhelmed and triggering distressing thoughts. When designing workshops with large numbers, plan for small group activities and individual time with the mental health participants to capture feedback that they may not be able or willing to share in a group session.

# Check-in during and after sessions 

Checking that the participant is comfortable with the activity, asking if they have any questions before starting, and watching out for any signs of distress are basic care of good facilitation.  Mental health vulnerability means that distressing thoughts can be triggered at any time, but participants may not feel able to speak out about their discomfort thus potentially escalating  their thoughts into a crisis stage. Thus it is vital that these checks are not forgotten and that extra checks are made of their well-being during the session. Irrespective of whether distressing thoughts were triggered during a session, post session check-ins must be scheduled to ensure no harm has been caused by participating in the session. Ideally this should be done by a mental health professional. If feasible, offer participants the option to have a mental health professional, or their trusted supporter, available during the session. 

# Allow for time out 

Making sure the participants are not under pressure so they are relaxed and able to think and provide feedback clearly when taking part in activities is a key objective of the session planning. This includes prioritising activities into mandatory and time-permitting, designing activities to cover mandatory items such as rotating or splitting activities, and allowing suitable timings based on activity type. As mental health participants can be more vulnerable to pressure, the sessions should be planned with smaller mandatory activities and longer time allocated per activity to allow the participant to proceed at a pace comfortable to them. This will also ensure the maximum outcome if the participant needs to stop or take time out of the session.

Conclusion

The experience of working with mental health participants in this discovery project for the Black Dog Institute has reminded me of the importance of being empathetic and mindful of other peoples’ situations to get the best out of them. It was also a reminder that a user-centric approach moves beyond just designing the end product to be usable, desirable and valued, but extends to the process by which we interact with the end-users to elicit their experience to create the best end product design.