Discovering what matters to communities when researching mental health
This Mental Health Awareness Week we’re exploring our role as researchers and designers in projects that centre mental health and wellbeing for young people. We are particularly curious about how we establish the right conditions for exploring these issues with our partners in the work – and how we can best share our lessons with others.
In this blog, we focus on three areas that have become especially important to us at Dartington:
the beginning of the projects and our own standpoint as we begin,
the process of establishing strong relationships that can hold complexity and trust, and
the sustainability and impact of our shared work on mental health.
We share some of our insights from our project work and some of the questions we’re still holding – with the aim of adding these to the conversation this Mental Health Awareness Week. This comes at a critical where 1 in 6 five to sixteen-year-olds are identified as having a probable mental health problem (Young Minds), and 83% of young people’s mental health needs worsened following the coronavirus pandemic.
One of our anchor points in working on issues of mental health and wellbeing is our integrated approach to research and design. We find this approach most helpful as it offers us different vantage points on this complex issue, and different approaches to help us work in pragmatic ways with people to both understand and design systemic responses. The integrated approach helps us blend the best of systems thinking and design practices with ‘what works’ evidence to produce a much richer picture of the complex drivers for mental health and wellbeing, as well the systems of support that either enable or constrain people’s experience.
Challenging assumptions and keeping an open mind
Our first learning is around unconscious assumptions and our own standpoint in approaching research and design. At Dartington, we work across different systems of support from health, social care, to social work and community development. It’s often our role to reconcile different perspectives on what helps and hinders mental health across these professional spaces, so that there is a more rounded understanding that makes best use of these different practice roles. Most importantly, we are working hard to interrogate our own practice – and to ensure that we centre children and young people’s needs in our work.
In our work with Midlothian Early Action Partnership, Scotland, we tried to make sure the process took away some of the assumptions made around the challenges people face or where change is most needed. We used an integrated approach to do this, firstly using systems thinking to map out the system of support, followed by literature reviews, and then journey mapping exercises with young people of all ages to understand how the system of mental health and wellbeing support operates from the point of view of young people. These voices and lived experiences helped to inform the Partnership on strengthening their existing responses to need but also challenged the system to think broader about the other challenges young people were facing, looking at their environment, their home and their school life, not just crisis-led situations, or cases as they come.
A journey map taken from the Midlothian Early Action Project (MEAP) - combining lived experience evidence with journey maps and systems thinking.
Adding in lived experience as a form of strengthening research and design responses helps to balance the necessary learning from previous research, alongside leaving any ideas or preconceived notions of what ‘good’ looks like at the door. This can strengthen decision-making, embolden needs-based work, and even challenge your own assumptions and judgement.
Our first lesson is that researchers and designers alike should encourage participation, collaboration, and co-production, to explore complex systems and issues – and that this collaboration should centre those with lived and living experience of the issue at hand.
Building equity into design to strengthen trust and relationships
Our second learning is that to make the research valuable in communities, a level of trust needs to be built up. Trust building takes time, dedication, and commitment. This is especially true with young people and matters related to mental health, so that they can feel safe in the beginning to share their experiences, challenges, and needs.
Part of designing the research process is to think about the ways in which equity is built into the process. In 2021 we developed our Equity Impact Assessment as we began learning how to design equity into our work and we’ve recently published a blog where we shared ways our thinking is progressing around developing equitable and anti-racist research practices. Being intentional and open about issues of equity at the start can significantly influence interactions in order to build trust.
Some practical things we’ve learned are around how to meet people where they are at – rather than expecting people to come too much into our world of research and design. For example, when considering physical space, holding place-based sessions in spaces familiar to participants, where they feel safe and have a degree of ownership can help, as opposed to inviting people to a workshop in a new environment. This will enable participants to feel comfortable and at ease to engage.
Another practical example is using open questions to generate dialogue, encourage participation, and ensure the sessions remain focussed. These questions can offer prompts for reflection as participants share their experiences and understanding with the research team whilst building up rapport and trust with the young people. Open questions can also allow for different interpretations, based on whether participants speak English as a second language or have alternate understandings of a concept - “mental health.” Researchers can learn from the understanding of what mental health means and looks like in different communities, allowing for reflection and collaboration to deepen knowledge. However, different ideas and levels of comfort with the concept of “mental health” can also impact developing trusting relationships.
Having a researcher who reflects the experiences/or demographics of the participants can contribute to building trust in a relationship. In the Becoming a Man project that aims to work with young men in Lambeth to explore mental health and develop positive well-being strategies, we learned that a facilitator from a similar background to the young people had a positive impact on the young men who participated. Being able to relate to someone from the same community who has experienced similar challenges, created a role model for the young men to look up to. This trusting relationship made it easier for them to be comfortable being vulnerable and exploring their experiences. You can read more about our Learning from Becoming a Man in our blog here.
All of these elements built into the research and design project can significantly increase the amount of trust in the community, particularly with young people and can change the perception of mental health support to be broader and more equitable in its responses.
Our lesson learned here is that a focus on equity ensures a robustness in the strength of relationships within the projects – and it is the strength of these relationships that drives change within local systems.
Embedding sustainability
Our third learning is on the importance of building in sustainability from the start of our work. It’s important to consider the legacy and long-term impact of the work, particularly in areas where mental health is concerned. Long-term issues such as mental health, require long-term commitment, which not all projects have the luxury of providing. But even with the resources we have, we think it’s imperative that we think about the existing capacity within local contexts to continue to take the research, design, and testing process forward in their own way.
In fact, it’s an issue of equity for us – all of the local systems that we work with have tremendous strengths It’s our role to ensure that research and design fit into those relationships and strengths so that Dartington’s contribution is a build on the work that is already happening locally (rather than a distraction which takes away from local resources).
One way we’ve been actively focused on sustainability is in our work with Kailo in Northern Devon and Newham, where we have begun to work with young people and local organisations as partners in the research and design work we’re doing. Together, we have co-designed with young people and partner organisations the priority areas that impact young people’s mental health in each location and will continue to co-design the Kailo framework that will support future interventions and testing. The co-creation of the research and design responses can have long-term positive impact and prevent the “dip in and dip out” style of research that some communities facing additional barriers to support may experience.
Our lesson learned here is that taking a strong focus on sustainability from the outset actually helps a project team consider the strengths and local relationships in a more robust way – one which considers the existing work that communities have been doing within their local system so that our work is a build on those assets.
Why does all of this matter to mental health?
It is important to dedicate enough time and planning to get mental health research and design right, and it’s an ongoing priority for us to ensure that being involved with a Dartington project is a supportive and strengthening experience for the communities involved.
Research and design should work with a community’s strengths as well as the local system’s needs. At Dartington, we work to understand where we sit in relation to these strengths and challenges before arriving at conclusions or recommendations. Using an integrated approach can support a team to realise impactful work – in collaboration with communities with lived and living experience of mental health. The integrated approach offers a combination of research and design to enable deeper thinking about what’s known and unknown from different points of view, and ensures that responses reflect those different forms of knowledge. These disciplines support each other and work together to deepen understanding about what really matters, the differences that lie above and beneath the surface, and how to tackle the issues young people face collectively.
Mental health themes and trends are constantly evolving and changing, as identified in the 2022 impact report by Young Minds. As we see a move in society towards talking more honestly and openly about the challenges we face, we recognise our responsibility as researchers and designers to create accessible conditions that enable listening to different experiences and challenges shared across communities, and to interpret and present this data in an equitable, sustainable, and beneficial way.