GAME: playing a boardgame co-designed with a group of people with psychosis

This situated action aims to engage local community and conference attendees in testing, playing, and reflecting on a boardgame produced as part of a co-design project with people with psychosis. This project was part of a collaborative doctoral award with a mental health charity, exploring the role of co-design as a mode of treatment. The co-design project was not set up with the intention of developing this artefact, and the collaboration begun without a design brief. A broad design purpose emerged through time, that of expressing a notion of Stewardship, or taking care of, which resulted in the development of a boardgame, GAME. The situated actions at PDC provide a great context for trying out this boardgame. Playing it could be a greatly enriching way for PDC attendees to engage with the project and lead to further discussions about the nature and potential of participatory design

What are the effects of co-designing on participants’ mental health and does uncertainty play a role in this change process?

The purpose of this paper is to present the initial theoretical work undertaken in a PhD project which aims to understand co-design in the context of mental health, in particular the effects that designing has on participants with mental health problems, and the role that uncertainty may have on facilitating change in this context. The project was motivated by a series of co-design workshops that the author had facilitated in the past (20142017) with people with mental health problems who had reported some benefits. This experience suggested that by engaging with the inherently uncertain process of co-design in a calm and creative environment, new patterns of thinking, feeling and behaving may begin to emerge, often resulting in some progress in participants’ recovery. In this paper, an interdisciplinary review of relevant literature is presented alongside a speculative discussion of how and why designing may have an impact on mental health, specifically looking at the potential role of uncertainty in this process. We propose that uncertainty could be a key concept both as a potential explanatory factor of why change may occur in participants, and as a generative tool when drafting design activities for this target group. This review and discussion will inform the design activities that will take place in the collaborating mental health organization following successful ethics approval. Following an abductive approach, analysis will be oriented towards explaining what is observed in the co-design workshops, to generate an initial theoretical understanding of the mechanisms at play. The outcomes of the research should shed some light on the effects that designing could have in facilitating psychological change, and our understanding of uncertainty both in relation to design and psychology

Co-design As Healing: Exploring The Experiences Of Participants Facing Mental Health Problems

This thesis is an exploration of the healing role of co-design in mental health. Although co-design projects conducted within mental health settings are rising, existing literature tends to focus on the object of design and its outcomes while the experiences of participants per se remain largely unexplored. The guiding research question of this study is not how we design things that improve mental health, but how co-designing, as an act, might do so. The thesis presents two projects that were organized in collaboration with the mental health charity Islington Mind and the Psychosis Therapy Project (PTP) in London. The project at Islington Mind used a structured design process inviting participants to design for wellbeing. A case study analysis provides insights on how participants were impacted, summarizing key challenges and opportunities. The design at PTP worked towards creating a collective brief in an emergent fashion, finally culminating in a board game. The experiences of participants were explored through Interpretative Phenomenological Analysis (IPA), using semi-structured interview data. The analysis served to identify key themes characterising the experience of co-design such as contributing, connecting, thinking and intentioning. In addition, a mixed-methods analysis of questionnaires and interview data exploring participants' wellbeing, showed that all participants who engaged fairly consistently in the project improved after the project ended, although some participants' scores returned to baseline six months later. Reflecting on both projects, an approach to facilitation within mental health is outlined, detailing how the dimensions of weaving and layered participation, nurturing mattering and facilitating attitudes interlace. This contribution raises awareness of tacit dimensions in the practice of facilitation, articulating the nuances of how to encourage and sustain meaningful and ethical engagement and offering insights into a range of tools. It highlights the importance of remaining reflexive in relation to attitudes and emotions and discusses practical methodological and ethical challenges and ways to resolve them which can be of benefit to researchers embarking on a similar journey. The thesis also offers detailed insights on how methodologies from different fields were integrated into a whole, arguing for transparency and reflexivity about epistemological assumptions, and how underlying paradigms shift in an interdisciplinary context. Based on the overall findings, the thesis makes a case for considering design as healing (or a designerly way of healing), highlighting implications at a systems, social and individual level. It makes an original contribution to our understanding of design, highlighting its healing character, and proposes a new way to support mental health. The participants in this study not only had increased their own wellbeing through co-designing, but were also empowered and contributed towards healing the world. Hence, the thesis argues for a unique, holistic perspective of design and mental health, recognizing the interconnectedness of the individual, social and systemic dimensions of the healing processes that are ignited

Why designing may help treat psychosis

The paper presents some initial theoretical insights on why designing may help people with experience of psychosis. The paper reviews how psychosis has been discussed in the literature from a phenomenological point of view, and how it links to designing by looking at the themes of agency and embodiment. These insights are then used to formulate the hypothesis that the experience of designing, and design iteration, may pose a continuous force (and have an indirect effect) towards the coupling, or pulling together, of dimensions of experience such as perception, cognition and action which in psychosis are sometimes experienced as particularly fragmented. The paper contributes to our understanding of design and introduces the idea of design as treatment for the development of design projects to support mental health

Walking Heterotopias

The purpose of this walk is to stir dialogue among conference attendees and also others who currently have, or have had experiences of mental health problems, recruited for participation via a local mental health organization. In essence, the idea is to wander around the city in pairs, guided by conceptual maps as props or co-reflection tools, in order to discuss current notions around mental distress in an embedded way, through the walking. In 1967, Foucault spoke about heterotopias of crisis and heterotopias of deviation, thus places in which individuals whose behaviour is deviant in relation to the required mean or norm were placed, such as psychiatric hospitals. Now that these spaces are disappearing, how can we reconceptualise crisis and deviation? We experiment this through asking participants: What are the moments or instances that come to mind when we walk through the city, which relate to our notions and experiences of crisis and deviation

Co-design for wellbeing with mental health participants: from identifying a problem to creating prototypes

The paper provides an overview of a co-design research project organized in collaboration with a mental health charity. Clients with mental health problems volunteered to help explore how engaging in design activities may impact them. Often adapted to respond promptly to the context, a series of workshops aimed to engage people with mental health problems in exploring matters of concern, defining issues and responding to these through design within a frame of layered participation. For 10 weeks, activities took place once a week for approximately 2 hours, although participants could drop in and out at any time. Four participants engaged quite consistently throughout the process, working with the researcher/facilitator. Under the general notion of co-designing for wellbeing, the project was organized around 5 stages, called 5 I’s: Identify, Ideate, Invent, Initiate and Implement. The project concluded with interviews, and an event to showcase the process and design outcomes to others. The paper discusses the challenges and opportunities that emerged in the process and provides a short summary of participants’ insights on their experiences. Their accounts variably suggested that the project helped with thinking, coping with loss or grief, reflecting on one’s past, or adversely prompting hidden anxieties. The paper ends by discussing how this experience may help inform future projects within mental health and reflects on the potential role of co-design as an activity that promotes recovery in its own right

Co-design as healing: A multi-level analysis based on a project with people facing mental health problems

The present paper explores the notion of co-design as healing by focusing on a project with participants facing mental health problems, who met once a week, guided by open design processes. Reflecting on semi structured interview data, as well as relevant literature from different disciplines, the paper offers a conceptual framing of how co-design can be considered as a healing practice, at a systems, social and individual level. At a systems level, co-design allows working with complexity, and approaching mental health problems holistically. At a social level, co-design empowers collectives to negotiate what realities to change and how. At an individual level, codesign affects people’s wellbeing, by enhancing their sense of agency and connection, stimulating thinking and essentially providing a grounding embodied experience. The paper offers a lens through which to reflect and expand on what we do as designers, and supports the notion of co-design as healing with initial evidence from one project

Is designing therapeutic? A case study exploring the experience of co-design and psychosis

Background A co-design project, consisting of individual and collective design activities, was organized with clients of a mental health service, in order to explore its potential to support people with psychosis. The group met for approximately two hours, weekly, for six months, participating in design activities and collectively deciding on the project purpose and outcome – a boardgame. Methods The experience of one group participant (Anthony) is explored, selected as the first case study within an Interpretative Phenomenological Analytical (IPA) framework. Following IPA’s ideographic focus, Anthony’s case was purposefully selected, as it portrayed a detailed picture, informing theoretical reflection on designing as therapeutic. The paper includes Anthony’s first-hand account, combined with an analysis of data from three semi-structured interviews, photographic evidence and a reflective diary kept by the lead researcher. Results Results suggest that, for Anthony, design activity: a) helps developing a sense of agency b) is experienced as grounding in reality c) contributes to the development of inter-personal relationships, and d) has a different sense of rhythm than artistic practice. Discussion These results are contextualized within literature on the lived experience of psychosis and suggest that designing can be beneficial for people with psychosis, providing the backdrop for further research and practice