Mental Health Accessibility on University Campus
User Research
Prototyping
Design
I wanted to determine what challenges and barriers exist that prevent a student from successfully accessing mental health support resources. Then use the results to make design recommendations and guidelines.
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Motivation
I often heard stories from peers, friends and students I encountered about negative experiences with the mental health support provided at UBC and how it was often very difficult to access. This circling of such negative experiences posed a challenge to the health and well-being of students. I knew this because as a long-time mental health advocate, I was well-aware of how challenging it would be for students facing mental health struggles to reach out for help at all. If the systems put in place for accessing support with issues were not easy to navigate, had unnecessary hurdles, or were just inefficient—then students at the most risk of harm may not even access the services at all.
In a report on mental health support access at university campuses across Canada, a student at UBC reported that after having worsening depression they decided to seek out help at the UBC counseling center (Hensley, 2019). They arrived early when the office opened and after waiting at the office for a couple of hours and finally sitting down with someone, they were told they would need to wait eight weeks for an appointment—stating, "I had spent my whole morning telling someone how awful I had been feeling, and all they could tell me was that I had to wait even longer for help." (Hensley, 2019). The delay in time before a student who wants support actually is able to access this support can be detrimental for their academic career (Clark, 2017).
Research Goal
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What is the current problem?
I conducted field study and user interviews to understand how students access mental health resources on campus.
Field Study and User Interviews
To address the research goals outlined, a Field study or in other terms a user study was conducted with the following focal points:
Focal Points:
What are the pathways for accessing the mental health resources at UBC?
What level of awareness do students at UBC have of the resources available to them?
What barriers exist in the pathways that students take to access mental health resources at UBC?
How likely are students to access mental health support again after initial attempts?
How do students value the resources available at UBC to support students?
What do students think of the current services and systems to get to these services?
How satisfied are students who attempted to access services at UBC for mental health support?
Why do some students who do need mental health support choose not to access mental health resources that are available on campus?
Protocol
Originally the protocol for conducting the field study, was to have student participants be interviewed on campus or in a comfortable private environment. This was because an important consideration that should be made when conducting field study research is to utilize the surroundings of the user as a way to facilitate understanding (Welch, 2016). However, as a result of the covid-19 measures, all interviews were conducted remotely over audio or audio and video calls.
Interview Questions:
What do you know about the mental health resources on campus?
a. What resources are there?
b. How do you access the mental health resources?What experiences, if any do you have with accessing any of these mental health resources?
a. What are your impressions of these resources?
b. What have you heard about these resources from your friends/peers on campus?Would you be comfortable if I ask questions about what accessing these mental health resources has been like for you?
a. What worked well for you with regards to accessing resources?
b. What did not work well for you with regards to accessing these resources?
If there is anything that you would like to see added, modified, or removed from how students get mental health support on campus, what would that be?
a. WHY would you like that added, modified, or removed?
What did we learn about mental health accessibility?
Results
To analyze and understand what themes emerged from the qualitative data recorded in the interviews with participants, I used an affinity map to not critical incidents and comments made by participants. In affinity mapping, sticky notes are collected from all interviews and then combined into groups until themes start to emerge from them. This map can be found in the Appendix. Based on the interview data recorded from each of the participants, there were several main themes that emerged.
1. Long wait-times after initial interest in accessing resource impact how successfully students are able to access support services
2. Current process prevented ease of access to resources
Since the participants interviewed had mainly experience with UBC Counseling Services, much of the understanding about the current process of how mental health support is accessed gained in the Field Study, was limited to UBC Counseling Services.
a) Higher risk students are prioritized
Users (6) explained that in their experiences with UBC Counselling Services, they were prioritized based on whether they were at a higher risk. This crisis management makes sense, as relevant resources must be allocated to those most in need. However, for students who were not at a higher risk, during periods of high volume this impacted when they would see a counselor, and extend their wait-time.
b) Initial interaction with service does not always provide support, but is a tool for assessment alone.
Users (5) also reported that their first access point would not be to direct support from a counselor, rather it was for an assessment interview. reported that this impacted how supported they felt when being assessed by a counselor, as they attempt to access services. They reported that the assessment felt "rushed" and focused on fixing a short term problem, rather than long-term support. This in terms of our definition, would not constitute successful access to mental health support.
c) Repeat failed attempts to access can lead students to give up and not successfully access to support.
Some users also indicated (4) that students who have to loop through the process to access support services multiple times, struggle to successfully access support. This is because they started to feel disappointment and often leave UBC to find support or fail to access support altogether after repeated attempts.
3) Lack of knowledge about all the resources available and what resources fit best with the users' needs can prevent successful access
There were various levels of awareness shown by users in the study, some knew about a majority of available resources (3), but most only made mention of the services EmpowerMe and Speakeasy, and they all mentioned UBC Counseling services. This differing awareness of what each of the resources offered, also impacted for some users (2) how quickly they found a resource that fit with their needs.
How do you users currently access mental health services on Campus?
Based on findings from User Interviews, I built a user flow chart for how a student needing mental health support would navigate the current system for accessing mental health support services on the university Campus.
What are users experiencing when they try to access mental health resources?
Based on findings from User Interviews, I developed to task examples, or personas for the kind of challenges a typical student deals with when accessing mental health resources.
Alex
Alex is a student at UBC in his 3rd year who is experiencing mental health problems for the first time. He has a support system of trusted friends, but is not comfortable sharing what he is feeling with his friends. He does not know of many resources or places he can go for mental health support on campus. He's walked past UBC Counseling Services building on campus in the past and knows they have counseling for students for free. He is anxious about talking about his mental health because of the stigma he has, but works up the courage and decides to drop in to the office at UBC Counseling. He is told there are no more appointments available today, and he should come back tomorrow in the morning to secure an appointment. He feels disappointed, but decides to come back to UBC Counseling the next day. He’s been having trouble sleeping, and doesn’t wake up very early, so when he arrives at UBC Counseling and again cannot receive an appointment. Eventually, he decides to give up after another attempt, and he might talk to his friends for support or might not.
Jane
Jane is a student starting her first year at UBC. She has had diagnosed long-term mental health issues since before she started attending UBC. She is doing better at the moment, but she wants to find a reliable support network as she starts her university experience. She doesn't know anyone in Vancouver or at UBC yet, so she hopes she can find an on campus resource that could give her support while she transitions into university and in the long-term. She had a therapist back home, so she thought of getting support with UBC Counseling. She manages to contact them and meet with someone for an initial check in appointment. At the appointment she is asked a lot of questions, and she talks about how she has been doing well recently and feeling okay. As her issues don't seem to be very severe, she is told she will have to wait 3 weeks to see a counselor. She is frustrated but she waits 3 weeks and during that time feels very isolated without any support network around her. her issues flare up and she does not attend her courses. By the time that she sees the counselor she has a lot more intense issues to deal with.
Design Proposal
Prioritizing Design Goals
Based on the user personas and user-flow I gathered an understanding of the users goals and needs when they attempt to achieve the goal of accessing mental health support at UBC. With this in mind, we can relate these user goals to some design goals for a possible tool. Though this tool would aim to address the barriers and challenges experienced by the user, there are so many possible ways to design a solution to do so. As a result we need to develop design goals and give them a priority. These goals and their priority are listed below.
High Priority (should have)
Mitigate effects of wait-times by providing an avenue for more immediate support when available channels are at capacity and wait-times are high.
Quick access to crisis support if a student is in crisis, (at risk of harming themself etc.)
Medium Priority (could have)
Easily digestible and accessible information about resources that are available on campus and for students
Lower Priority (It would be good to have...)
Current and well-reviewed information on mental health issues that face students to build awareness and help students recognize issues they may be facing
Empathetic language across the interface, that follows mental health support best practices This might include language that validates the perspectives of students and makes them feel supported and respected as they vulnerably try to get support
Proposed Design
Based on the higher and medium priority goals established, I brainstormed some possible ways to achieve these two goals within an accessible mobile application. The hope is that a mobile application would be a different way for students to reach their smartphone, with a lower barrier of entry and seek out tools to help them. This application could include the following features:
Online-chat based peer support to be offered to students who need urgent, non-crisis support with little to no wait-time
Online-chat peer supporters could be able to refer students to more long-term support as needed and bypass wait times
A smart tool or guide for to help students who want support find the tools and resources that best fit with their needs
While these are key features, the application also needs to have a consideration for some of the lower priority but still important goals, to consider empathetic language and alignment with mental health support best practices. However, for the scope of this project and the time available, further research around mental health best practices would be needed to help support these goals for the application. With all this in mind I developed a design concept for a mobile application, ASAP Talkie.