There exists a stigma around mental health in villages in rural India. Children experiencing mental stress go unacknowledged. This has resulted in an increased number of cases in alcoholism, substance abuse, anxiety and depression, and suicide rate.
The process entailed thorough user research and understanding of the context through interviewing the target group. Tools like the stakeholder map and service blueprint allowed me to view the problem from a zoomed out perspective. This brought to the surface many design challenges, which after several modifications lead to the final outcome.
Designing a three step service between students, teachers and trained counsellors to initiate a conversation around mental health and provide them with the required help.
Back home in India, our house help (Aisha - name changed to maintain privacy) who comes daily to help out with the house chores is from a small village on the outskirts of Delhi. She came into the city to find work. While conducting user research, I realized that I can get the most authentic, real life insights by conducting a user interview with her.
क्या आप जानते हैं मानसिक स्वास्थ्य क्या है ?
Do you know what mental health is?
I don’t know what it exactly is, but it must be to do something with health. I don’t like thinking about illnesses or health in general. I get very uncomfortable.
क्या आप यह बताना चाहेंगे कि आप असहज क्यों महसूस करते हैं ?
Would you mind explaining why you feel uncomfortable?
It brings back bad memories of when my daughter feel ill back in my village and it took us one hour to reach the hospital. I don’t want to even talk about it.
क्या आपके बच्चे जानते हैं कि मानसिक स्वास्थ्य क्या है ?
Do your children know what mental health is?
I don’t think they do. They will know if it is taught in school.
क्या आपके गांव में कोई मानसिक स्वास्थ्य केंद्र है ?
Based on your knowledge are there any mental healthcare centre in your village?
I don’t really know. There is a hospital which is quite far away and a small clinic in the village. Also we don’t have the time to think about mental health. We need to put food on the table for our children as that is our priority. If something is physically wrong we notice it and act.
I started the conversation in an informal manner as I usually do when I speak to her.
I spoke to her in Hindi which is a language she is most comfortable in.
Once we had redeveloped our rapport, I asked her if I could ask her a few questions for a project I am working on. To my surprise she was excited to contribute in any way possible.
अब जब मैंने समझा दिया है कि मानसिक स्वास्थ्य क्या है और इसके सामान्य लक्षणों के बारे में संक्षेप में बता दिया है, तो क्या आपको लगता है कि आपके बच्चे इससे जूझ रहे होंगे ?
Now that I have explained what mental health do you think your children might have struggled with it?
Both my children seem to be healthy. They have never said anything.
I proceeded to conclude the conversation as I could feel that Aisha was starting to feel uncomfortable.
Sara, a 14 year old girl lives in Darya Ganj, a village on the outskirts of Delhi, India. She attends a Government school called Saraswati school. She comes from a low income family as a result of which there is immense economic pressure on them. She struggles to manage the household, study and work to help put food on the table for her younger siblings. She is mentally and emotionally drained and is unable to focus on any task.
Rural residents often travel long distances to receive services, are less likely to be insured for mental health services, and providers are less likely to recognize a mental illness.
Chronic shortages of mental health professionals exist and mental health providers are more likely to practice in urban centers.
Some rural residents may not be able to afford the cost of care.
Rural residents may be more susceptible to the stigma of needing or receiving mental healthcare in small communities
I put together a stakeholders map which allowed me to recognise and design keeping in mind the immediate users, direct users and indirect users.
Breaking down the service into the following components to get a better understanding of the different actions.
Students have a number of printed check-in sheets in their notebooks which they can fill out regularly.
Students, whom the counsellor has reached out to, interact with the counsellor and perform some calming exercises based on what they are experiencing.
The two main user experience activities to be performed by the student include filling out the check-in sheet and interacting with the counsellor.
Providing check-in sheets allows for the activity to remain anonymous among classmates. This in turn allows the student to be honest with their responses.
Check-in sheets made available to students in their notebooks instead of being distributed by the teacher. This prevents the impact of the power dynamics between the student and teacher from interfering.
This confidential interaction between the student and counsellor, which includes conversations and performing calming exercises, is a step towards providing the concerned individual with the accurate help.
INTERACTION WITH COUNSELLOR
Keeping in mind the rural setting of the service, the overall design of the check-in sheet is simple. The decision of printing the sheet in greyscale has been taken keeping in mind their access to colour printers and desire to spend money on the same.
use of local language (hindi)
In order to make the interaction more accessible, the check-in sheets are in Hindi, which is the most spoken language in India.
The three options are phrased in a manner that allows the user to relate their present feelings to a feeling they have felt before.
For example : If a student is not feeling good, then they highlight the option which states 'bad, like calculus'. This makes it easier for them to pin point what they are feeling, as they know what studying calculus feels like.
In order to create a documentary to promote Samvedana, I carried of several rounds of video prototyping and user testing. Having designed this service, I decided to act it out myself, in order to give the viewer the most detailed insights on Samvedana.
who am I designing the service for
where will this service take place
what is the problem that the service will solve
explaining the service
what change could this service bring about
Designing for the lower economic strata
This project gave me the opportunity to design for a community that is often overlooked when talking about advancement. Due to lack of awareness regarding the benefits of advancement, communities living in rural India are not receptive to change. Thus Samvedana allowed me to dive deep into understanding this user group and to learn to adapt my designs according to their lifestyle and thought processes.
Designing a flow/story
Designing a service with multiple touch points and stakeholders involved has strengthened my ability to tell a story. Presenting Samvedana as a documentary, gave me the opportunity to explain the service in great detail giving the viewer the whole narrative from the problem to the solution.
Attempting a new medium
Presenting Samvedana in a video format exposed me to a number of filming and editing tools which I had been hesitant to use before. Acting out the scenes and stitching them together, writing the script and recording voice overs, finding suitable sound effects and dabbling in text animations were all elements out of my comfort zone. However, I was confident that only dynamic media would to justice to explaining Samvedana.
Presenting Samvedana to the real user group
Due to the short duration of this project, I was unable to present Samvedana to the real user group to get their thoughts on the effectiveness of this service. I do hope to do so, when I return to India.
Considering the possibility of introducing Samvedana
As a result of the thorough research I have done for this project I am keen on taking it a step further and possibly introducing it as a service in villages. However, there are certain factors like recruitment of professional counsellors, training teachers and introducing students and their families to Samvedana which will have to be considered.