Recovery From Design

Through research, inquiry, and an evaluation of Recovery By Design, a ‘design therapy’ program that serves people with mental illness, substance use disorders, and developmental disabilities, it is my assertion that the practice of design has therapeutic potential and can aid in the process of recovery. To the novice, the practices of conception, shaping form, and praxis have empowering benefit especially when guided by Conditional and Transformation Design methods together with an emphasis on materiality and vernacular form

"For an App Supposed to Make Its Users Feel Better, It Sure is a Joke" -- An Analysis of User Reviews of Mobile Mental Health Applications

Mobile mental health applications are seen as a promising way to fulfill the growing need for mental health care. Although there are more than ten thousand mental health apps available on app marketplaces, such as Google Play and Apple App Store, many of them are not evidence-based, or have been minimally evaluated or regulated. The real-life experience and concerns of the app users are largely unknown. To address this knowledge gap, we analyzed 2159 user reviews from 117 Android apps and 2764 user reviews from 76 iOS apps. Our findings include the critiques around inconsistent moderation standards and lack of transparency. App-embedded social features and chatbots were criticized for providing little support during crises. We provide research and design implications for future mental health app developers, discuss the necessity of developing a comprehensive and centralized app development guideline, and the opportunities of incorporating existing AI technology in mental health chatbots

A Community-Engaged Research Approach to the Development of an Assessment Tool for Historical Data Collection of SAARA Client Population

Through collaboration between the Substance Abuse and Addiction Recovery Alliance (SAARA) and several community partners, a need was identified for a new measurement tool to gather comprehensive client histories for program evaluation and development. The purpose of this study was to (1) develop a culturally relevant and organizationally appropriate mechanism for the collection of comprehensive client histories and (2) to provide the opportunity for staff to engage in a new process of developing and implementing data collection strategies. As a result of the use of a community-based participatory approach, (1) a missed opportunity for program evaluation and development was identified, (2) a community-based research study was developed, (3) staff were invested in development of the tool, and (4) staff engaged in a capacity-building exercise in which they were provided the skills and tools needed to replicate this process independently in the future

Opportunities for Enhancing Access and Efficacy of Peer Sponsorship in Substance Use Disorder Recovery

Substance use disorders (SUDs) are characterized by an inability to decrease a substance use (e.g., alcohol or opioids) despite negative repercussions. SUDs are clinically diagnosable, hazardous, and considered a public health issue. Sponsorship, a specialized type of peer mentorship, is vital in the recovery process and originates from 12-step fellowship programs such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). To investigate sponsorship relationship practices and to identify design opportunities for digitally-mediated peer support, we conducted 27 in-depth interviews with members of AA and NA. We identified five key sponsorship relationship practices relevant for designing social computing tools to support sponsorship and recovery: 1) assessing dyadic compatibility, 2) managing sponsorship with or without technology, 3) establishing boundaries, 4) building a peer support network, and 5) managing anonymity. We identify social computing and digitally-mediated design opportunities and implications

Bringing new tools, a regional focus, resource-sensitivity, local engagement and necessary discipline to mental health policy and planning

Background: While reducing the burden of mental and substance use disorders is a global challenge, it is played out locally. Mental disorders have early ages of onset, syndromal complexity and high individual variability in course and response to treatment. As most locally-delivered health systems do not account for this complexity in their design, implementation, scale or evaluation they often result in disappointing impacts. Discussion: In this viewpoint, we contend that the absence of an appropriate predictive planning framework is one critical reason that countries fail to make substantial progress in mental health outcomes. Addressing this missing infrastructure is vital to guide and coordinate national and regional (local) investments, to ensure limited mental health resources are put to best use, and to strengthen health systems to achieve the mental health targets of the 2015 Sustainable Development Goals. Most broad national policies over-emphasize provision of single elements of care (e.g. medicines, individual psychological therapies) and assess their population-level impact through static, linear and program logic-based evaluation. More sophisticated decision analytic approaches that can account for complexity have long been successfully used in non-health sectors and are now emerging in mental health research and practice. We argue that utilization of advanced decision support tools such as systems modelling and simulation, is now required to bring a necessary discipline to new national and local investments in transforming mental health systems. Conclusion: Systems modelling and simulation delivers an interactive decision analytic tool to test mental health reform and service planning scenarios in a safe environment before implementing them in the real world. The approach drives better decision-making and can inform the scale up of effective and contextually relevant strategies to reduce the burden of mental disorder and enhance the mental wealth of nations

Impacts of the Recovery Movement on Treatment Adherence for Individuals with Schizophrenia Spectrum Disorders

The recovery movement presents a shift in the treatment of severe mental illness to a more person-centered approach. The current researcher hypothesized that the more recovery-oriented a treatment was perceived to be, the more participants would have attended appointments and adhered to their psychiatric medication regimen. The variables of empowerment, recovery assessment, attitudes toward treatment, and participatory decision-making were explored in relation to their possible correlation with increased treatment adherence. An archival data set was used. Participants included 215 adults who met criteria for a schizophrenia spectrum disorder. The participants generally rated their treatment as high on all four of the recovery measures, and treatment nonadherence was not particularly problematic for the sample explored in the current study. Participants’ reports of increased symptom severity and reports of positive quality of life were found to be associated with higher reported levels of appointment attendance. Participants’ reports of positive attitudes toward psychiatric treatment were found to be associated with reports of better quality and frequency of medication adherence. Measuring whether treatment is recovery-oriented may not be predictive of patients’ levels of service engagement. Recommendations for future research include using additional and qualitative measures to capture the full construct of service engagement, beyond measures of treatment adherence. Additionally, recovery-oriented treatment is aimed to be individualized; therefore, studies measuring the recovery-orientation of a treatment provider should include alternative treatments used to enrich the lives of the patients