Making mental health care as routine as physical health for veterans
Stanford d.school course
Design for Health: Helping Patients Navigate the System
Sherman Leung, Aliza Hoffman
challenge: How to increase access to mental health care for veterans through the VA?
Mental health services can be crucial for veterans attempting to return to civilian life, but are extremely under-utilized. Our team’s mission was to understand what specific barriers exist to accessing mental health care and to redesign one specific facet of this system.
We interviewed 6 veterans and 2 healthcare professionals at the VA to understand frustrations and needs. We gained several insights that informed our next steps:
The VA is perceived to be attached to the military system rather than an independent health care system, which creates a psychological barrier to accessing care.
There are issues for access on both sides: lack of human resources at the VA make it difficult to provide sustained, regular mental health care to veterans. On the other hand, veterans don’t want to commit to receiving help for their mental health challenges, often not showing up to appointments or not participating in treatments.
Veterans go through a series of mental health screenings before officially returning to civilian life — these are supposed to points of entry but instead feel like barriers to returning home.
Every veteran has a unique set of mental health needs.
“VA—that’s military. I don’t want anything to do with it.”
"I didn’t disclose anything [in my screening] because I knew if I did, I wouldn’t be able to see my kids in 12 hours. It’s not hard to figure out what you need to say to ‘skate by’ and just get out of the uniform and get off the base."
After distilling our interviews down to key needs and insights, we reframed what we heard into the following ‘how might we…’ statement to represent the main challenge we wanted to solve.
How might we make mental health care as routine as brushing your teeth?
From there, we spent about a week brainstorming solutions that would begin to de-stigmatize mental health for veterans while incorporating it into a part of their daily routines. We found that many veterans found solace in physical activity and after several feedback sessions with veterans and professionals on some of our potential solutions, we came up with Swift.
Introducing Swift, a wearable that tracks both your physical and mental fitness through biometric tracking and daily check-ins. Through a mix of objective and subjective measures, we hoped Swift would offer tangible, personalized mental health tracking while also reducing the stigma by combining with an activity many veterans find enjoyment in already.
Based on insights gleaned from needfinding, our team made three key assumptions about our users when creating Swift. We next set out to see whether these assumptions held when tested with three veterans over the course of a week.
Assumption #1: Veterans value tracking mental/physical fitness through biometric data and daily check-ins.
We tested this assumption by simulating check-ins with our veterans through daily text messages. These messages asked about current mood via the Photographic Affect Meter (developed by Cornell's Interaction Design Lab) -- veterans picked one of sixteen pictures which best described the way they were feeling that day. At the end of the study, they were asked for feedback. All veterans surveyed mentioned that they would feel comfortable sending their biometric data to their provider.
"The check-ins allowed me to communicate without any consequences or repercussions.” -Veteran
"I want them to monitor this stuff - because they don’t believe me when I describe these sleep issues." -Veteran