perspective. Application logging can provide low-level client interaction information that would otherwise not be possible to capture. It can provide useful information both inside a session on a desktop PC and outside the session, logging client interactions on their mobile phone.

The clinical pilot of Mobile Mood Diary provided an idea of the potential of even relatively sparse logging information. Even basic data, such as the time a mood was recorded and how much time was spent on a task, can provide valuable information. As mobile devices become more powerful, it will be possible to record more detailed interaction information without any perceivable performance impact on the system.

As long as it is done sensitively, with the awareness and consent of the client, the logging of client interactions holds promise for providing the designer with contact-free interaction feedback. For the designer, who is distanced from the clinical setting, such data offers a glimpse into the clinic and the client’s world, and encourages a degree of empathy with the client. For example, mood diary data may reflect a client going through a very difficult time.

that her “client reported wanting to avoid her phone when she felt in a low mood.” Other issues we have encountered include teenagers who lived in remote areas, where there was no access to a mobile network, and teenagers who did not have suitable phones.

When possible we try to provide a range of options for clients to engage in therapeutic activities. Mobile Mood Diary clients can record moods using a paper diary, their mobile phone, or a PC.

Finally, while there are clear benefits to using digital devices over paper, such as increased reliability, the potential for greater privacy, and saving admin time, it is important to consider the substantial legacy of paper-based materials in therapy. My Mobile Story was designed to allow therapists to easily incorporate existing paperwork into the system, thereby helping them to continue to work with familiar materials in a new medium and taking advantage of a large, existing body of therapeutic content.

to develop trust in the therapy. We can begin to do this through principles of transparency, client control, and privacy. It is also important to remember that engagement with the therapy itself is important, as is supporting the development of a trusting relationship between the client and therapist. Tools should be designed to give therapists the confidence to use them and to introduce them to clients.

This is just beginning in a field where HCI holds much promise for providing a safe and discreet space for reflection, personal development, and meaningful dialogue. Ultimately, it can deliver broader benefits for supporting the personal management of mental health.

Lessons Learned One key point that has emerged from our work is the need to provide a range of options for clients. In a survey of teenage peers, we found that while 85 percent would prefer to use their mobile phone for diaries, a further 15 percent would prefer alternatives such as paper. Preferences are subject to change—one therapist reported

ABOUT THE AUTHORS

Mark Matthews designs
systems to help engage
people in therapeutic activ-
ities. He has worked in this
area for six years on proj-
ects ranging from therapeutic computer
games to mobile diary systems and online
virtual environments. Matthews’ research
interests include designing for sensitive
and restricted environments, mobile
design, and the use of play to develop rela-
tionships. He has recently submitted his
Ph.D.

Summary

Designing for mental health care involves designing for engagement, for practicality, for privacy, for user control, and for discretion. Mental illness is a very serious and worsening problem with a substantial social stigma that prevents constructive dialogue about the problem.

Design work should seek solutions that put young people at ease, make them comfortable, strengthen the relationship with the therapist, are trusted and worthy of trust, and help

Gavin Doherty is a perma-
nent faculty member at
Trinity College Dublin and
has led a number of proj-
ects in the area of technol-
ogy in mental health. His
research interests include design methods,
language technology, design for mobile
devices, and visual decision support in
complex domains such as health care and
manufacturing. Doherty obtained his D.Phil.
in the HCI Group at the University of York.

November + December 2009

DOI: 10.1145/1620693.1620697
© 2009 ACM 1072-5220/09/1100 $10.00