There’s something special about being able to follow a project from its lumpy unformed beginnings and through the hard work of crafting it into a sense-making shape. Not only do you get to share in its growth and celebrate its launch but you also get to learn a lot about how good apps are made.
Now, I’m not a tech person, or a design person. I’m a mental health person. Over a number of posts I’m going to be sharing why Doc Ready has gotten to where it is so quickly and what this means for the way that we do mental health projects.
You Can Assume That ‘People Know Stuff’
Traditional public sector involvement mechanisms generally begin from the position that the problem has already been identified and that ‘stakeholders’ will feed into its eventual solution. The professionals set the agenda, shape the interaction then weigh up the contributions. The Innovation Labs that eventually gave birth to Doc Ready began from the point of view that ‘people know stuff’ and there are obviously lots of things that young people want sorted out around their mental health and the mental health of their peers.
Rather than assuming either people already know the solution to the problems they identify, the process should move through people knowing stuff about their own lives, to thinking about what that means, to thinking about how that might be changed.
This process can be seen in the way that Doc Ready only became Doc Ready in the second Innovation Lab. It began the day as an evolved Lab 1 idea about building a translator for GPs that would turn teen speak into doctor speak. The problem that had been identified was a real one – young people feeling that GPs didn’t understand them – but the solution wasn’t quite right. By the end of the day, our small group of participants had turned it around and the basis of what later became Doc Ready was established..
Consultation Isn’t Innovation Friendly
One of the basic rules of innovation is ‘listen to people, but listen to the right people’. Throughout Doc Ready’s development we spent time with people, checking all the way along the production process to see that what we were developing was in line with what people actually thought might work. This isn’t what usually happens in mental health.
Traditionally involving people with mental health difficulties in projects has been done in two distinct ways, neither of which is particularly innovation friendly.
The first way is consultation. Usually this involves asking people what they think of a particular thing prior to it being developed or put into action. It can also be asking them what they thought of that thing once it has been put into action (or ‘brought to market’ for all of you product development types). This can usually be reduced to the question:
‘How much did you like our goods and/or service? a) Loads, b) lots, c) quite a lot, or d) enough.
‘Crowdsourcing’ Doesn’t Work
The other is the strange beast that is now masquerading under a number of guises, the most recent of which is ‘crowdsourcing’. Crowdsourcing is actually a term that describes ways of people feeding in small bits of something (ideas, money, processing power) to build a bigger something. It doesn’t mean just asking people for ideas, like when a service or project will ask a group of people with mental health difficulties ‘so, tell us what you would like or tell us your ideas.’ This is often accompanied by lots of open gestures inviting people to share their ideas.
It may sound like this is more likely to generate good ideas for change, but usually it doesn’t. Putting people on the spot and asking what they’d like generally delivers responses that look very like what people have had before. Innovation is a process, not an end point It also makes no difference at all if the organisation doing the asking holds all of the cards and plays them very close to their chest, failing to give any indication of whether it financially or organisationally possible to take any of these ideas forward.
Neither Consultation nor Crowdsourcing Change Anything
Consultation doesn’t change things because it only asks how much people like your idea, product or service. It doesn’t really involve any collaboration at all. ‘Crowdsourcing’ looks as if it changes things but actually doesn’t, as the there is a fundamental dishonesty at work; we’ll ask you for your ideas but we’ll only do the ones that suit us and we’ll never tell you the reason why. It looks collaborative but is, in most cases, just a way of dressing up consultation as participation without fundamentally changing the way it works. ‘Crowdsourcing’ also assumes, being charitable, that people will be able to serve up innovative, practical, ready to go ideas at the drop of a hat. Being cynical, ‘crowdsourcing’ just assumes that no one who belongs to a category of people who experience difficulties could come up with a worthwhile idea in the first place.
People don’t necessarily know lots of things about apps, but they do know loads about their own lives and the lives of those around them. The point of involving people is to best establish the problem to be solved and then to work out the best way of doing so.
The nursery of the Innovation Labs didn’t begin from the point of knowing what the problems to be solved were. So Doc Ready’s birthing process avoided these two ways of getting input into solving social problems.
The Labs began this process by using various techniques to help young people identify what some of the problems and challenges they face. It also asked where other services or products in the marketplace were failing to help them.
Personas Do Work
The Innovation Labs used persona work (collaboratively making up a fictional character based upon real experience) to enable those involved to bring their knowledge of the real world of mental health difficulty to bear upon the question of ‘what could be made that would make better?’ The development of Doc Ready used the same technique.
Instead of saying to people ‘what are your problems and how do you want them solved?’, the process asks ‘what kinds of challenges might different young people with mental health difficulties face and how haven’t they been answered so far?’ Using persona allows people to move from just discussing their own experience to collaborating on ways of solving problems faced by others. In essence, it helps us to move on from either of the two traditional involvement mechanisms in mental health.
It doesn’t assume that people on their own will already know the answers to the problems that they identify; it instead assumes that innovative solutions to problems are more likely to come from correctly identifying the problems people face. If you don’t do that, you might put loads of effort into solving a problem that doesn’t really exist with a solution that doesn’t really match the issue it addresses.
What This Means for Mental Health Projects
For anyone’s involvement in a project to count for something it must have a weight and a value. The best way to give it that weight and value is to make sure that it is directed toward advancing the progress of that project. If you’re trying to build something for people to use, how can it make sense to leave people out of the process of building it? As we’ll see over coming posts, people and their involvement has been hard-wired into the development process of Doc Ready.
Often people who experience mental health difficulties are involved in projects on the basis that ‘they have lots of personal experience’ but in ways that are actively structured to minimise the importance of their contribution. Asking for people’s opinions or people’s ideas without any idea of how they’ll change the shape of your project might be market research, but it sure isn’t involvement.
And, as we’ll see, people’s experiences, ideas and insights are far more valuable to the development of a project like Doc Ready than that.
About Doc Ready
Doc Ready is the first Labs project to reach a public beta stage. We got to the point of having something that could be tested, used and refined as quickly as possible.It’s there now for you to use, play with, criticise and break at www.docready.org.
This is the first in a series of posts on why Doc Ready got to where it is so quickly and what this means for the way we make mental health services. You can read the other posts at How To Make A Mental Health Service That People Like and Why Behind Every Great App Is A Great Team
This is the best advice on involving young people I’ve ever read – thanks for taking the time to get it down! On the topic of personas, in anonymous online environments, we have asked young people to create personas of themselves and they’ve not only felt comfortable doing so, but have also thanked us for having the opportunity to reflect on themselves in that way. Do you think that online can offer a different kind of experience in this sense, or would you say we would still have been wiser to take the approach you’ve described?
Helen,
I think that it’s probably a matter of judgement.
The objective with personas is to make it possible for people to use their experience, ideas and insight in a way that can take the project forward. This differs from rooting the experience of involvement being telling people your hottest, sharpest, most painful experiences and then hoping that, somehow, somewhere, this interaction will solve your problems and resolve your challenges.
Anything that can bring lived experience to a problem in a way that can help to solve it is a good thing. This isn’t to say that here is no place for personal experience as evidence, but that’s more likely to change policy than it is to be useful for being involved in problem solving. A well told personal story can change the world but that change is of a different order to the information needed to solve a problem better.
Problem solving needs passion to be sure, but it also needs playfulness. It tends to get progressively harder to be playful around problems solving the closer you get to the most painful bits of your own experience.
Did the young people you mention say much about whether creating a persona made them see their own challenges in a different light?
Mark
Thanks Mark – I really admire they way you and the Labs are developing these projects. May I hitch on a bit of our experience in developing not an app, but some provocations about digital tech in later life for Nominet Trust?
We went through a crowdsourcing process, not so much for solutions, but what do you think is important, what insights do you have, We then ran a workshop to play those into a number of situation and personas.
http://socialreporters.net/?p=960
It sounds as if you have developed the approach in some depth, so more please!
Interesting, Dave. Yep, crowdsourcing has a place, but it can end up like the Henry T Ford quote “if you had asked people what they wanted they would have said faster horses”. So he made a car.
What the Labs have taught me is that innovation comes through listening, understanding and getting up close to people’s experiences, not necessarily asking them for ideas.
Hello Dave!
My problem isn’t with crowdsourcing, it’s with ‘tell us your ideas’ sessions run an delivered by people who have no stake at all in whether ideas can be taken forward or even an idea of whether they’re feasible. If you’re asking people for ideas with no notion of how any of their ideas, insights or wishes might be taken forward you’re acting in bad faith.
One of the things I’ll be talking about in a future post is the importance of feedback from the people in a position to ‘do’ the ideas being vital in this process. The makers/doers need to push back against suggestions or run with them ‘in real time’. Makers/doers make and do. They apply what they know about what is possible, realistic and ‘doable’ to the material constraints of the situation they’re making/doing in. People with ideas can be guided by the input of makers/doers just as makers/doers are guided by the input of people who experience particular situations and challenges. Get both collaborating and things get closer to happening.
I’m mainly kicking the idea that collecting some views, parcelling them up and then sending them *somewhere* is the same as involving people in co-production.
There’s nothing wrong with getting people’s ideas, but, as you know, that’s only the first stage of the process, not the process in its entirety.
Mark