Trinity College Dublin | mark.matthews@tcd.ie
Trinity College Dublin | gavin.doherty@tcd.ie
The World Health Organization estimates that approximately one million people per year commit suicide. Mental disorders such as depression are responsible for more than 90 percent of these deaths. In fact, depression is the leading cause of disability in the developed world, and the human and economic cost of mental illness is reaching crisis proportions. The stigma surrounding mental health issues exacerbates the problem, and many people are unable or reluctant to engage in and access effective treatment.
Technology can help address these key problems of access and engagement, particularly for younger people. Interaction design has an important role in developing innovative and worthwhile applications that support the user in an effective way. Given the scale of the problem, even small changes in the effectiveness of mental health services could have a big impact.
Ethnographies, user observation, focus groups, cultural probes, think-alouds, interviews—these are just some of the tools designers have come to rely on. In mental health cases, the introduction of not just the technology but also the designer could be detrimental. What happens when you can’t talk to the user, when they can’t be
approached or observed, when they are effectively invisible?
The most significant challenge we have faced working with children and teenagers affected by mental health issues is how to develop useful systems where there is little or no direct access to end users? Software that does not consider users’ needs and is difficult to use can present another barrier to treatment. While the ethical restrictions that limit access are in place for valid reasons, they leave us with a need for new methods to address the lack of involvement of the end user.
Over the past five years, our group at Trinity College Dublin, in collaboration with the Mater Hospital Child and Adolescent Mental Health Services, has developed several systems in a range of services that are in clinical use today: “Personal Investigator,” a 3-D computer game; “Mobile Mood Diary,” a personal diary system; and “My Mobile Story,” a multimodal storytelling system. Design and evaluation activities have involved 26 different service providers, including schools, hospitals, charities, and specialist clinics.
public mental health services. When designing these technologies, we needed to consider the needs of both the adolescent clients and therapists. Adolescence is a critical time when many teenagers can feel vulnerable and isolated. Many mental health problems begin during this period. Not dealing with these problems as they emerge increases the risk of more severe issues in adulthood.
Most teenagers do not receive the support they need, and even those who do can find it difficult to engage with their treatment. As one therapist put it, “Young people are not used to walking in and talking to a stranger about their problems.” The challenge for therapists is to involve children and adolescents “in treatment and to work toward a change that the child may not view as necessary or even potentially useful” [ 1].
A further problem is that the materials and tools used to engage young people in the therapeutic process tend to be outmoded and can seem irrelevant to many teenagers; according to one young person interviewed “things on paper seem like an assignment—more likely not to do it.”
It can be just as demanding to design for therapists who may be concerned about negative impacts of technology.
[ 1] Kazdin, A. E. “Psychotherapy for Children and Adolescents.” Annual Review of Psychology 54 (2003): 253-276.
November + December 2009
Two End Users The goal of our research has been to develop effective support for young people attending
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