No Health Without Mental Health: Innovative Solutions to Creating Change in Behavioral Health Care A Thesis Submitted to the Faculty of Drexel University by Kimberly D. Williams in partial fulfillment of the requirements for the degree of Master of Public Health May 2012
Participated in project to retool website content for the Thomas Scattergood Behavioral Health Foundation. Assisted in the creation of a design challenge for website. Ultimate goal was for dialogue and opportunities generated from design challenge to foster innovative and sustainable advancements by consumers, practitioners, and policymakers in behavioral health system. Utilized components of the design thinking methodology – human-centered design – for development of design challenge question. Components included collection and analysis of qualitative data derived from local community stakeholders who completed key informant interviews. Utilized interview data as inspiration for design challenge question. In addition, conducted literature review exploring historical evolution of United States behavioral health care system as well as the creation and implementation of modern social innovations through design thinking tools including human-centered design.
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No Health Without Mental Health:
Innovative Solutions to Creating Change in Behavioral Health Care
I would like to thank my advisor, Dennis Gallagher, MA, MPA. The opportunity for me to participate in this project would not have been possible without his recommendation. I am truly indebted and thankful for his generous guidance, motivating questions, thoughtful feedback, and unwavering support to both the overall project as well as the completion of this thesis.
I would like to express my appreciation and thanks to Joe Pyle, MA of the
Thomas Scattergood Behavioral Health Foundation for spearheading this project and initiating the collaboration with Drexel University. His commitment to the advancement of behavioral health care through collaborative and innovative efforts has been truly inspiring.
Additionally, I would like to thank Jason D. Alexander, MA of Capacity for
Change, Larry Geiger of Geiger Design, and John A. Rich, MD, MPH of Drexel University School of Public Health for their invaluable contributions throughout the entire course of this project.
I would like to extend my gratitude to the preeminent community stakeholders
who generously offered their time to participate in our key informant interviews. Their invaluable feedback regarding the current status behavioral health care elevated our project as well as my personal knowledge to a level of appreciation and awareness for which I am very grateful.
Special thanks to Arthur C. Evans, Jr., PhD of the Philadelphia Department of
Behavioral Health and Intellectual disAbility Services for his additional support and endorsement of the Scattergood Foundation design challenge.
Last but certainly not least, I would like to thank Katherine Carroll and Alyson
Ferguson for graciously allowing me to contribute to their Community-Based Mater’s Project as a part of my Block VIII Independent Study. Without their steadfast dedication to the project, this opportunity would not have been possible for me. I am sincerely thankful for their support, patience, and insight. I have no doubt that they will each make an immeasurable contribution to the field of public health in the years to come.
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TABLE OF CONTENTS
LIST OF TABLES ....................................................................................................... v
LIST OF FIGURES ....................................................................................................vi
2. BACKGROUND ...................................................................................................... 4 2.1 No Health Without Mental Health ....................................................................... 4 2.2 National and Regional Mental Health Care Policy .............................................. 5 2.3 National and Regional Mental Health Status ..................................................... 10 2.4 Social Innovation for Wicked Problems ............................................................ 12 2.5 Design Thinking................................................................................................. 13 2.6 Human-Centered Design.................................................................................... 15
2.7 “Web 2.0” and Social Media.............................................................................. 18 2.8 Philanthropy as a Change Agent ........................................................................ 19
2.8.1 Dorothy Rider Pool Health Care Trust ........................................................ 20 2.8.2 Advancing Colorado’s Mental Health Care ................................................ 21 2.8.3 “Philanthropy 2.0”....................................................................................... 23
3. THE SCATTERGOOD PROJECT ..................................................................... 24 3.1 The Scattergood Foundation .............................................................................. 24 3.2 The Scattergood Project ..................................................................................... 26
The inception of the Scattergood Project began when the president of the
Scattergood Foundation, Joseph Pyle, MA, approached faculty at the Drexel
University School of Public Health, Department of Health Management and Policy –
Dennis Gallagher, MA, MPA and John A. Rich, MD, MPH – and requested Drexel to
collaborate with the Scattergood Foundation on an initiative to retool the Scattergood
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website. In addition, Jason Alexander, MA, of the public interest consulting firm,
Capacity for Change, was brought on as a design thinking advisor for the project and
Larry Geiger of Geiger Designs was enlisted as the project’s graphic designer to build
the new website.
A final component of the project team included the recruitment of Drexel
students in the Master’s of Public Health (MPH) program. Initially, two full-time
students, Katherine Carroll and Alyson Ferguson, were recruited to participate in this
initiative for their Community-Based Master’s Project (CBMP), “Fostering Social
Innovation Through the Use of Web 2.0.” At a later point during the development of
the project, I joined the team to collaborate with the full-time students for the
completion of my Executive MPH Block VIII Independent Study. Throughout
September and October 2011, the full-time MPH students initially conceptualized the
project goals. As presented in a project proposal submitted to the Drexel University
IRB, these goals were identified as:
• Identify and prioritize system and policy gaps in the behavioral health system in Southeastern Pennsylvania using the human-centered design process.
• Evaluate the process of using human-centered design and Web 2.0 in respect to creating behavioral health content for public use on the internet.
• Create a question(s) to post on the Scattergood website for the behavioral health community to discuss and potentially create a solution using the human-centered design thinking process.
The students were tasked with collecting the necessary information and ultimately
creating a design challenge question for the revised Scattergood Foundation website.
The inspiration that would serve as the framework for the design challenge question
was obtained by utilizing elements of the human-centered design methodology in
order to identify some of pressing barriers, issues, and concerns within the behavioral
health community. The purpose of the design challenge was based on the dual goals
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of encouraging an open dialogue among community members and ultimately fostering
innovative solutions to the proposed behavioral health challenge.
It was noted that, as in any design project, the formulation of the goals and
objectives are the result of an iterative process, and subject to revision if necessary.
For example, it was initially expected that this design challenge question would be
posted in tandem with the release of the new website. As discussed during the
Deliver phase of this project, it would later be determined that the design challenge
release would be postponed until after the website went live.
3.2.2 Website Development
Starting in September 2011, Larry Geiger of Geiger Design began working on
the graphic design development of the new website and continued this process in
tandem with the rest of the project’s development. It was determined that the website
would be divided into four main quadrants or portals entitled: The Foundation,
Community Impact, Innovation Awards, and Design Thinking. The Foundation
quadrant will provide background and contact information for the Scattergood
Foundation. The Community Impact quadrant will describe the impact grantmaking
opportunities can have on communities, provide a database of current grants awarded
by the Scattergood Foundation, as well as the criteria and guidelines for new grant
applications. Each year, the Scattergood Foundation presents an award for an
innovative behavioral health solution, policy or project. The Innovation Award
quadrant will provide a background about the annual Scattergood Innovation Award,
a database of past winners and nominees, as well as the eligibility and judging criteria
for future contestants. The Design Thinking quadrant will provide some basic
information about design thinking in general and provide an example of a design
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thinking application. This quadrant will also host the Design Challenge, where a
behavioral health challenge question will be posed. Community members will be
encouraged to participate and engage in this challenge issue as well as create and
implement an innovative solution.
3.2.3 IRB Submission
To prepare the Institutional Review Board (IRB) application, the team
established the project mission, goals, methods, and overall timeline. In addition,
appropriate research level training compliance was confirmed for all applications
listed on the IRB submission by obtaining the following Collaborative Institutional
Training Initiative (CITI) program certificates: Human Subjects Research and Health
Information Privacy Security. Once completed, an application for human subjects
research was submitted October 2011 to the Drexel University College of Medicine,
Office of Regulatory Research Compliance. By November 2011, the project was
approved and deemed to be exempt from IRB review since the source of the research
data would be obtained from interviews with behavioral and public health
professionals. A secondary factor in this decision was based on the fact that the
research data would not include the collection of identifying medical data nor direct
interactions with behavioral health patients.
3.2.4 Interview Recruitment
Once IRB approval was received, the project was presented to several key
stakeholders in the community in order to recruit them for key informant interviews.
Access to many of the prospective stakeholders was facilitated by referrals from the
project committee members at the Scattergood Foundation as well as Drexel
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University School of Public Health faculty. During November and December 2011,
the Drexel full-time MPH students coordinated the interview recruitment process by
contacting these referrals, introducing a brief synopsis of the project, and setting up
times to complete the interviews.
3.2.5 Phase 1: Hear
The Hear phase consisted of a literature review and the completion of the key
informant interviews. A review of the literature was conducted in order to further our
academic knowledge base of the current behavioral health topics being explored.
This took place for the full-time students during the summer of 2011 and throughout
the spring of 2012 for myself.
The key informant interviews began once IRB approval was received in
November 2011. The interviews were conducted in order to collect qualitative data
from key stakeholders regarding behavioral health issues, concerns, and barriers in the
Southeastern Pennsylvania region and national landscape. The information these key
stakeholders offered during the interviews would serve as the framework for the
design challenge question. In an effort to gain a rich perspective regarding these
needs and concerns, a multi-disciplinary group of professionals were approached for
the interviews. As a result, we were able to collect stories and information from
individuals that represented a wide breadth of knowledge in the behavioral health
community and included backgrounds in: law, academic, city government, NGO and
advocate organizations, mental health practitioners, private insurance, and public
insurance.
The interview format remained informal to allow for a natural conversation to
emerge between the interviewer and interviewee. However, an interview guide that
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included a prepared introduction about the project and a list of question prompts was
approved by the IRB and utilized for the interviews (see Appendix A). In addition, a
team approach was incorporated into the process by having a primary interviewer lead
the discussion while a secondary interviewer listened and took notes. The discussions
were recorded with the interviewee’s permission so that the secondary interviewer
could later transcribe the interview. The final interview was conducted in January
2012, with the final transcription completed in March 2012.
Beginning in January 2012, an initial design brief was created that included
the content for the Design Thinking quadrant of the website. While this brief was
continuously revised as the project progressed, the initial draft served as a framework
for the information that would be provided in this section of the website. By February
2012, this initial design brief draft was released for the project team to review and
utilize as a reference for the Design Thinking quadrant (see Appendix B).
3.2.6 Phase 2: Create
The Create phase of the project was conducted between February and April
2012. It consisted of analyzing and synthesizing the information collected during the
Hear phase. The initial goal was to code the data in order to make sense of and
identify patterns in the information amassed from the key informant interviews. This
was completed by individual preliminary analyses of interview transcripts where key
phrases, words, and topics concerning behavioral health were documented. We then
combined our individual analyses of the transcripts into a classification of key words
and phrases. In order to verify our combined analyses of the data, the interview
transcripts were then uploaded into a software program called NVivo, which was
developed by QSR International specifically to analyze qualitative data. Using the
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descriptive words identified during the preliminary analyses, a query was run for the
NVivo program to identify the primary themes, which are referred to as “nodes” in
the NVivo software. The output from this query resulted in several themes or node
categories. The NVivo output was then reviewed to assess the quality of content in
each node and ensure that the context and classification of each categorization was
correct. To do so, the output data was compared to preliminary individual data
analyses to identify any missing references or descriptive words. This information
was loaded back into NVivo in order to run an additional query. By March 2012 the
primary behavioral health themes that were identified from the data analyses
included: public perception, funding, reimbursement, health care reform, workforce,
integration, recovery, wellness, evidence-based practices, and trauma (see Table 2).
Table 2. Key Informant Interview Themes
Note. Represents the number of interviews to mention each theme.
The secondary goal of the Create phase was to define the opportunities and
create potential ideas for a design challenge question. This was achieved by
0 2 4 6 8 10 12
Trauma Evidence-based Practices
Parity Incentives
Siloes Wellness
Treatment Integration Workforce
Health Care Reform Reimbursement
Funding Public Perception
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conducting several brainstorming sessions with the project team during April 2012 in
order to progress the design thinking from a level of divergent to convergent thinking.
These sessions evaluated the information collected and began to form distinct and
concrete criteria for the design challenge.
3.2.7 Phase 3: Deliver
Once all of the abstract inspiration and ideas that were collected during the
Hear phase were synthesized into concrete design challenge opportunities during the
Create phase, the aim of the Deliver phase was to formulate the design challenge
model, finalize the design challenge question, and identify the steps needed for its
marketing and implementation. This process began with the conceptualization of the
model by the full-time students in which the design challenge would be framed (see
Table 3). This model encompasses the individual components that are identified for
the design challenge question and will serve as the framework for its marketing and
implementation.
Table 3. Design Challenge Model
Product Ideas
Participants Amateur Individuals Professional Individuals
Sponsors Open and Free
Incentives Recognition Social Value
Intellectual Property Participant Retain Ownership Non-Exclusive License for Challenge Organization
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To ensure that an active level of interest and engagement was established for
the design challenge, several marketing plan strategies were devised. A part of the
marketing plan included a presentation of the project during the 165th American
Psychiatric Association National Conference on May 6, 2012. In addition, a “Share
Your Story” campaign was expected to be released on the new Scattergood website.
This campaign would provide a forum where individuals will be able to share
personal experiences relating to a mental health topic that would be posted on the
website. Another resource that was identified would be the email listserv of the
Scattergood Foundation grantees that could receive notifications and periodic updates
about that the design challenge that could help build awareness and increase the
number of participants for the challenge. In addition, the power of developing
partnerships with regional organizations was recognized as a useful tool to build
support and increase the level of community engagement in the design challenge.
Several potential design challenge questions were conceived during
brainstorming sessions in April 2012. Initially, it was determined that the design
challenge would be posted with the release of the new Scattergood Foundation
website on May 5, 2012. However, in keeping with the tradition of the design
thinking as a nonlinear and iterative process, it was questioned whether the
presentation of the design challenge should be postponed and released on the website
at a later date. In doing so, the Hear phase of the project would have been continued
an additional few weeks or months. The implementation of the final Deliver phase
including the release of the first design challenge would have been postponed until
late summer or early fall of 2012. This revised implementation plan was the result of
several meetings and brainstorming sessions where the potential design challenge
questions were reviewed. During those meetings it was discussed whether there
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would be a sufficient level of community engagement in the design challenge by May
2012. In an effort to heighten the level of interest, awareness, and engagement in the
community about this project, it was proposed that the process of divergent thinking
should be continued in order to obtain additional feedback from the website users
about potential design challenge questions as supplemental information to the key
informant interviews.
Apprehension regarding the level of community engagement was assuaged
when the project received an official endorsement from Arthur C. Evans, Jr., PhD,
Commissioner of the Philadelphia Department of Behavioral Health and Intellectual
disAbility Services (DBHIDS). In May 2012, he provided the following statement:
It is important for our field to reframe the issues as behavioral health and wellness, over illness and diagnosis. My experience is that people find it difficult to talk about mental illness. People are much more receptive when you talk about what you can do to be healthy mentally. We need to develop innovative ways to have that conversation. This design challenge is an excellent strategy for involving the community in our ultimate goal of improving everyone's mental wellness.
In addition, the DBHIDS agreed to serve as a co-sponsor of the design challenge by
partnering with the Scattergood Foundation to provide consultation and feedback
throughout the design challenge initiative. During the completion of the Scattergood
project, DBHIDS was in the process of implementing Mental Health First Aid
(MHFA) training sessions within the Philadelphia area (DBHIDS, 2012). MHFA is
an international, evidence-based certification course designed to improve mental
health literacy (MHFA, 2009). The program provides early intervention training to all
individuals in order to assist fellow community members who are experiencing
mental health issues. A key to this program is that it is designed for all community
members to participate regardless of whether they have a clinical or behavioral health
background. Trained individuals will be better equipped to recognize, comprehend,
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and respond to mental health issues or crises. In addition, they will be able to offer
their services until the crisis is resolved or professional treatment can be administered
(DBHIDS, 2012; MHFA, 2009).
To capitalize on this important public health initiative being undertaken by the
city of Philadelphia, the design challenge goals were modified to include a targeted
effort to support the MHFA program in some capacity. As of the completion of this
report, the first design challenge question was not yet finalized. The release of the
design challenge was due to be implemented by the end of May or June 2012.
3.2.8 Report Writing
The report writing process consisted of the full-time students and myself
synthesizing all of the information we amassed during this project as well as
recounting our experiences. Throughout my participation in this project I educated
myself about the subjects addressed in the project including mental health care
policies and treatment, social innovation, design thinking including human-centered
design, Web 2.0 and social media, as well as the role of philanthropy as a change
agent. This was achieved by a literature review that included accessing government
and NGO reports, journal publications, and media articles about these key topics. In
addition to my review of the current literature, I recorded my thoughts and accounts
regarding my participant in the active Scattergood project activities. These activities
were concurrently completed during my participation as a team member of the project
between January and May of 2012.
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3.3 Future of the Scattergood Project
As with any design thinking process, the search for further advancements and
improvements is ever present. Thus, the Scattergood Project set a precedent to
constantly be open to new opportunities in order to consistently grow and evolve from
their efforts. This is apparent in the decision to revise the implementation plan for the
design challenge. With the release of the design challenge being postponed, it
provides an excellent opportunity for future Drexel MPH students to actively
participate in the implementation and management of the initial design challenge with
the Scattergood Foundation. The goal is for the collaboration with the Drexel
University School of Public Health to continue to grow and for future Drexel students
to assist in the implementation of future design challenges on the Scattergood
Foundation website. In addition, it is hoped that the support provided by the
Philadelphia DBHIDS will encourage other partnership opportunities to develop.
Eventually, it is expected that the winning design challenge solution will be
implemented within the community. This may serve not only to improve behavioral
health care in the region, but also set an example for other communities to replicate
the innovative processes or programs presented in the winning proposal. In addition,
it is hoped that such initiatives will serve as a foundation for future design challenges
to be implemented by the Scattergood Foundation. Ultimately, I anticipate that the
dialogue and opportunities generated from the design challenge initiatives will
continue to foster innovative and sustainable advancements by the consumers,
practitioners, and policymakers of our regional and national behavioral health
systems.
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4. LESSONS LEARNED
4.1 Personal Narrative
Being involved in the Scattergood Project presented an unexpected
opportunity for me to expand the resources from which I could learn more about the
current public health systems and issues faced by the Southeastern Pennsylvania
region and the nation overall. It was also a unique way to absorb a large amount of
information regarding current behavioral health issues and needed improvements
directly from some of the foremost service providers and policy makers in the region.
My unconventional role in the project did result in some personal challenges
that I needed to address. Perhaps the greatest challenge was adjusting to my part-time
status in a full-time project. The students with whom I was working were enrolled in
the program on a full-time basis and thus able to devote much more time to this
project. Early in my involvement, I realized that my presence and participation would
be limited by my part-time status in the program and full-time job work commitments.
For example, I was not able to attend certain meetings or other project activities that
took place during business hours. I tried to compensate for this by participating in
any activities that took place during the evenings and, when possible, called into
meetings and some key informant interviews by phone. In doing so, my goal was to
demonstrate my dedication to the project while also not committing to more than I
was capable of providing due to the time and scheduling restraints.
It quickly became clear to me that I primarily had to adjust to expectations for
myself rather then my project team members. In fact, my team members were always
appreciative of any contribution I was able to make to the project and easily
maintained reasonable expectations regarding my level of participation. Due to my
personal dedication to the advancement of mental health issues and the reduction of
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mental illness stigmatization, I found it difficult to not devote the majority of my time
to this project. However, I knew that it would irresponsible of me to commit more
time than I was capable of delivering. Therefore, for the benefit of the project and my
own time management responsibilities, I had to realistically establish what I would be
capable of contributing. Once these expectations were established and my function
within the project became better defined, I eventually adjusted to this role.
Some of the more overarching project challenges identified by my team
members included adjusting to the application of design thinking methodology. In
doing so, we had to consistently remind ourselves that design thinking is a nonlinear
process that may include several iterations of the process as well as its expected
outcomes. This experimental and non-standardized approach first became apparent
during the key informant interviews as they were conducted in a conversational rather
than survey format in order to retain the consumer’s voice and opinion in our data.
Ultimately, this led to a richer experience as well as the collection of more compelling
and valuable information. A few technical challenges were also experienced with the
utilization of the NVivo program to code the project data. First, the NVivo software
license only permitted a maximum of two coders. Second, the program was only
available on one computer, which was located on the Drexel University campus. As a
result, the program was only accessible during business hours when the building itself
was open. This was particularly challenging for me since I maintained a full-time job
during this program and my participation in the project activities were primarily
conducted after standard business hours.
My overall experience in this project was primarily an extremely positive one.
Perhaps the most compelling and unanticipated result of this project experience was
the beginning inspiration towards a new career path for myself. I entered this
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program with the general and vague expectation that I would be attempting a career
change upon graduation. However, during the majority of this program, I had no
clear idea of what new direction my career path would take. My personal interests of
mental health and health care as well as my background in clinical research motivated
me to choose a public health program over business school or public policy-centered
programs. However I did not yet know how or where I wanted to transition from a
career in pharmaceutical clinical research. During the course of this program, I found
myself instinctively drawn to areas of focus that were tied to my personal interests
while also demonstrating an unmet need as possible opportunities for a meaningful
contribution to society. I believe that I discovered three areas of interest that fit these
desired criteria.
First, the field of public health needs to improve and increase the integration
of mental health prevention and promotion initiatives into its academic research and
curriculum, its field-based interventions, as well as its overall frame of thought as the
field itself continues to gain awareness and a more prominent position in society’s
infrastructure.
Secondly, the field of mental health needs to take advantage of the increased
focus on health care reform and utilize this momentum to advance the quality of and
access to mental health care. In addition, this is an opportunity to further promote the
integration of mental and physical health care into a unified health care system. By
participating in such a dialogue, mental health may finally establish itself as a vital
and integral part of overall health care and wellness.
Lastly, the increased use of design thinking methods has the potential to
revolutionize our increasingly fragmented health care system. In addition, this school
of thought and practice presents an exceptional opportunity to increase the
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understanding and awareness of mental health issues in our society as well as the
importance of mental wellness while also reducing stigma. This may just be the
disruptive innovation that is needed in order to fundamentally shift the way we view,
address, and discuss mental health concerns.
Had I followed the path of a more traditional Block VIII project in the form of
a research paper, I doubt I would have come to these same meaningful conclusions.
Instead I drew a tremendous amount of inspiration from behavioral health community
leaders we interviewed as well as the project group discussions with the advisors and
full-time students concerning topics such as Web 2.0, social media, design thinking,
and human-centered design to achieve socially innovative solutions. These
experiences led me to incorporate additional readings about these unfamiliar subjects
with my previously anticipated research on mental health and health care reform. As
a result, I feel that my project took a direction that I would not have considered had I
been left to my own devices while conducting traditional and solitary research for a
literature review based project. Luckily, I was able to participate as an active member
of a project team rather than simply as a passive consumer of information. This
expanded my horizons and opened me up to a new way of evaluating the current
systemic, policy, and social issues affecting behavioral health care.
4.2 Future Executive MPH Student Opportunities
At the inception of this collaboration between Drexel University and the
Scattergood Foundation, the goal has always been maintained that future MPH
students could participate in this project as it continues to evolve. Initially, it was
assumed that only full-time MPH students would participate as a part of their
yearlong CBMP. However, the opportunity fortuitously presented itself for me to
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contribute as an Executive MPH student in fulfillment of my Block VIII Independent
Study requirement. After having completed this project, I can conclude that this is
may serve as an exceptional opportunity for future Executive MPH students to
complete their Block VIII project and one that is ideally suited for someone who is
considering a career change or advancement after graduation. The aspects of this
project afford students the chance to meet many prominent professionals in the local
behavioral and public health communities. One is not as likely to receive this level of
exposure when completing the relatively solitary task of writing a traditional research
paper. By virtue of collecting qualitative data from behavioral and public health
professionals and implementing a design challenge with the same target audience in
mind as participants, future students may have several opportunities to engage with
such professionals on a remarkable level.
Since I believe students of public health should include behavioral health in all
aspects of their education, I may be biased in my willingness to promote working on
project that directly addresses behavioral health concerns of the region. However, it
is my opinion that the in-depth focus on social innovation and the usage of design
thinking techniques in this type of project will add a unique perspective and
unparalleled learning experience for Executive MPH students. I believe that the
application of design techniques to achieve socially innovative solutions is a
discipline that is still evolving and has yet to reach its full potential, particularly in the
field of public health. Therefore, this may serve as an ideal setting for Executive
MPH students at Drexel University to “get in on the ground floor” so to speak, expand
their skill set, and enable their public health career to advance in an exciting direction
they may have not previously considered.
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APPENDIX A: INTERVIEW GUIDE Introduction [Introduce interviewers] Thank you for taking the time to speak with us. This interview is taking place during the initial phase of our community-based Master’s project at Drexel University. The purpose is to provide us with a birds-eye view of the current climate surrounding behavioral health issues in the Southeastern PA region. We are seeking your input on what kinds of problems exist in the regional behavioral health system, which of these problems you consider most urgent, and what kinds of opportunities you believe exist around these issues. We do have a set of questions to ask you but encourage you to share any information or opinions that you think are relevant. The information from the interview will be used to help inform the development of an online design challenge [Hand out information brief on the project]. Following this first round of key informant interviews, we will administer a survey to a larger population of providers, academics and students. We will use the survey to further explore themes that arose during the interviews. Ultimately, the purpose of these actions is to develop a question for our online design challenge that is relevant, significant and informed by the community. It is our hope that the design challenge will foster innovative thinking and provide an online platform for engaging the regional community in an ongoing dialogue about behavioral health. Topic Area 1: Identifying Behavioral Health Issues (We are going to start off with a discussion around current and pressing behavioral health issues) We’d to like to start off just by hearing a bit about your “story” with regard to the field of behavioral health. Can you speak a bit about some of the experiences that have gotten you to this point in your career? How would you describe the current level of interest and engagement about behavioral health policy in our region? How might we raise the level of interest, engagement and excitement about behavioral health policy? What specific issues or questions within behavioral health policy should we prioritize? Optional Follow-Up: Who is affected? How are they affected? What kinds of barriers exist in addressing this issue?
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What ways could we engage more policymakers, providers, researchers and students this conversation? Who else needs to be a part of this conversation? Optional Follow-Up: Specifically, what are some other disciplines or professional fields that you believe should be involved? Topic Area 2: Successful examples in the community (Now we would like to explore what “success” in behavioral health policy means to you.) Can you give an example of a program, organization or policy in the region that you believe has had a positive impact on the behavioral health system? Optional Follow-up: Can you describe some of the components that contributed to the success of the [program, organization or policy]? What were some barriers that [program, organization or policy] faced or faces?
How did [program, organization or policy] circumvent or overcome these barriers? How would you describe the impact that [program, organization, or policy] has or had? Topic Area 3: Further Recommendations (Lastly, we’d like to close out the interview by asking you for recommendations about our project.)
Do you have any recommendations for other professionals or organizations that we should consider including in our survey? Do you have any recommendations for how we will advertise and recruit participation in our online design challenge? Are there any additional questions, concerns, or suggestions that you have for us?
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APPENDIX B: DESIGN BRIEF DRAFT What is The Scattergood Design Challenge? The Scattergood Design Challenge is a public web space dedicated to hosting conversations about innovation in the behavioral health system. Inspired by human-centered design methodology [see below], these design challenges will be primarily driven by site visitors. In other words, we’ll provide a question and some guidelines, but progress is dependent on user participation and collaboration. We envision the Design Challenge as a safe space for users to share ideas and inspirations so that we can work together to cultivate innovative ideas about behavioral health in the region and beyond. What is human-centered design? Human centered design is a process and set of techniques for generating innovative solutions. It is comprised of three phases: hear, create, and deliver. The Hear phase revolves around collecting inspiration from the people directly affected by the problem. The Create phase utilizes a workshop format to translate these inspirations into frameworks, prototypes, and/or solutions. In this phase, group members first brainstorm many options (divergent thinking) and then work to eliminate them (convergent thinking). The ideas that are selected to continue through the process are those that exist in an overlap of three lenses: desirability, feasibility and viability. The Design phase entails planning the transition from workshop to real world, through cost modeling, assessments, and implementation planning for the ideas that were emerged during Create. Who is allowed to participate? The Scattergood Foundation encourages all individuals or groups that have an existing interest or growing curiosity about their community’s behavioral health to participate in this design challenge. How will challenges be structured? The specific structure of each challenge will be built around the nature of the question and will vary from challenge to challenge. However, all challenges will follow the three key rules of human-centered design:
1. Use multi-disciplinary teams (all backgrounds are encouraged to participate) 2. Use dedicated spaces (the Design Challenge quadrant) 3. Use finite timelines (Each challenge will have a beginning, middle, and end
with set deadlines)
What is the scope of the challenges? Although the design challenge will be presented within the regional context of Southeastern Pennsylvania, we believe that the issues and discussions presented here will have relevance in communities across the country and encourage users from all over to participate. In addition, the behavioral health issues addressed within this challenge will be examined through a public health lens in an effort to create solutions that will generate system-wide changes for the targeted interventions and their programs.
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Will Scattergood implement the winning ideas? No, we envision the Challenge web space as a database of ideas. The larger scope of this project hopes to see community organizations and policymakers borrow inspiration from this database and take ownership of implementation. In addition, our goal is to address behavioral health issues and concerns that are of particular importance to community organizations and advocacy groups, and thus encourage organizations to submit challenge questions. [Contact info for submitting challenges?] What are the expected outcomes? The Scattergood Design Challenge does not only create solutions to genuine behavioral health problems but, also makes a positive impact in the field of behavioral health by creating a conversation and fostering innovation around policy and system issues. This challenge allows for community organizations, individuals, and other groups to exercise their creative thoughts, promote and nurture growth of current programs and initiatives, create new programs and initiatives, and attract positive participation and discussion about behavioral health. What does “success” look like? Success will be gauged by the types of interaction and collaboration, the long-term impact and influence, and community awareness and utility. The freshness of material, amount and type of feedback provided, and the continual evolution is of great importance to the project and will be tracked.
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APPENDIX C: LINKS FOR ADDITIONAL INFORMATION For additional information about the organizations and programs mentioned, please access the following links: Thomas Scattergood Behavioral Health Foundation http://www.scattergoodfoundation.org/ Department of Behavioral Health and Intellectual disAbility Services (DBHIDS) http://dbhids.org/ DBHIDS: Philadelphia Launch of Mental Health First Aid http://www.dbhids.org/dbhids-launches-mental-health-first-aid Mental Health First Aid USA http://www.mentalhealthfirstaid.org/cs/