Embedding service design in mental health services
Paola Pierri from UK mental health charity Mind explains how they have made service design central to the way they work, helping them do more with less.
Mind is a charity that provides advice and support to anyone experiencing a mental health problem in England and Wales. We also campaign to improve services, raise awareness and promote understanding of mental health. The Mind network is made up of around 140 local Minds across England and Wales, each independent charities that are affiliated to Mind. This network helps over 400,000 people through services as diverse as supported housing, crisis helplines, counselling and eco-therapy.
A significant proportion of local Minds’ funding comes from delivering local NHS and local authority services. These services have been under considerable and growing pressure over the last few years and, in 2013, recognising these unprecedented changes, we started looking at new, innovative ways to effectively do more with less.
This led to Service Design in Mind (SDiM), the result of a year-long project to explore and embed the principles and approach of service design into our organisation and our network of local Minds.
1. Making the business case for design: winning hearts and minds
Service design was just one of the possible ways to tackle the challenges facing the network, and it was quite a new approach for the third sector. The team had to make the case to senior managers to enable them to understand the benefits and buy into the idea.
We developed a business case, which included all the evidence that was then available from the Design Council on the value of design in private and public sector. We also drew on inspiring stories and presented a case study from one of our local Minds that had already used service design techniques and tools. The combination of numbers and powerful stories had an impact on staff, volunteers and the wider organisation, and was successful in winning hearts and minds.
The Management Executive Team at Mind decided to invest and allow us to investigate the potential of service design for the network.
2. Building on existing design expertise
When we started this project, there were several ways we could have used service design within Mind. For example, we could have commissioned a service design agency around a specific brief or run an exemplar service design project. Instead, we decided to capitalise on the existing design capabilities of our staff (which included service user engagement and participatory development approaches) to create a methodology for service design that was bespoke to us, that built on our current design practices and that was in line with our mission and values. Embedding service design within Mind was also a way to maximise the impact of service design on the whole organisation and to ensure the long-term sustainability of this new approach.
During this initial phase, having an internal manager with a good understanding of the value of the design and the design procurement process was key. We drew heavily on this knowledge and also commissioned an external service designer to support us in developing a clear business case for the work. They also helped us to draw up a list of service design agencies to be invited to participate to our tendering process.
In partnership with the agency Innovation Unit we started our ‘Design in Action’ project in January 2014. The first step was an inquiry into Mind’s current practices, behaviours and culture, alongside research into established service design models being used elsewhere. This helped us develop our draft Service Design in Mind methodology.
3. Testing our service design methodology
Design in Action was a four-month structured programme of work and support that developed, tested and refined our design methodology. We recruited five local Minds to prototype our service design resources so that we could learn more about their application in real-life contexts.
In order to truly understand the relevance and applicability of the methodology, we deliberately selected a combination of service-focused and organisational challenges, small and larger local Minds, and urban and rural locations. The five prototype sites worked together to learn and apply the service design process in their own organisations. Each site was supported by a design partner from Mind’s national office and a design coach from the Innovation Unit.
4. Making the value of service design visible
We learned very soon that service design projects generate huge amounts of information and insights, including lessons about service design itself and the support, capabilities and structures needed to do it well. Learning was key from the beginning of our project.
For organisation-wide learning to happen in a federated organisation like Mind, insights and processes need to be documented and disseminated throughout the life of a project and communicated at different levels of the organisation. We developed narratives that demonstrated the impact of service design through staff and service user stories, and we aligned the reporting on service design to the organisation’s KPIs.
5. Using external design support effectively
Our experience working with Innovation Unit was excellent. We sent the tender to more than 15 service design agencies and in it we tried to be as flexible as possible, focusing on key project outcomes and deliverables rather than a strict brief. This was done in order to give to the successful agency some room to include their input and build on the proposed project methodology, making the most of their design expertise.
Following the internal process at Mind for procuring specialist work from consultants, we shortlisted four agencies against a grid of criteria and we invited them for an interview. A panel, made of three managers from Mind, a local Mind CEO and an external service design expert, assessed the four proposals against a set of criteria:
- value for money (within the budget ceiling that we set in the tender)
- agency experience and expertise in the third sector
- the quality of their proposals against the outcomes
- the quality of their risk and contingency plans.
As a result of this process, Innovation Unit was appointed. Their added value was clear – they were as passionate about the project as we were, and generous in sharing their experience and expertise in a way that never felt ‘top-down’. We drew on their expertise extensively, both as service designers and as an external pair of eyes to look at our organisational culture and behaviours.
From the beginning, we established a relationship that focused on collaboration and mutual learning. Now that the Design in Action project has ended, they continue to work with us as ‘design mentors’. This model ensures that we have external design expertise and capacity to bring in as and when needed, helping us keep an open and exploratory outlook on service design that allows Mind to continually improve the methodology.
6. Service Design in Mind as the way we do things at Mind
We have always designed person-centred and innovative services at Mind. Design is not new to what we do but the Service Design in Mind methodology gives us a structured way for doing it and doing it better, allowing us to be more creative but in a rigorous way.
We are using our methodology not just for designing new services but also to better understand people’s needs and gaps in provision, to engage with people with lived experience and partners more meaningfully, to tap into creativity and to allow staff to grow and strengthen our organisation.
Service Design in Mind is now a national programme that is central to the Mind strategy and we are looking at how we can better integrate the design approach in business development, service user engagement, theory of change and much more.
7. Top three things you should consider if you are embarking in a similar programme
Hopefully this case study highlighted both the benefits of, and an approach to, embedding service design within an organisation, as well as why different models of collaborative partnership across sectors can (and should) be built. The work to embed service design at Mind has been both inspiring and energising so far. But there have been challenges at times, and some things have worked less well than anticipated.
These are the top three lessons learned I would like to share with you:
Lesson 1: Built a network of support
Make sure you have internal support from your colleagues and senior management, but also that you connect with a network of peers externally who have gone through a similar process. Being the only person talking about the value and benefit of service design in an organisation that doesn’t (yet) understand it can at times be isolating and generate frustration. Making connections with other managers that were going through a similar process has proved really beneficial in terms of shared learning, reflecting on our challenges from a different perspectives and peer to peer support.
Lesson 2: Research, prepare and plan
Put lots of effort into preparing and planning the work as this will pay off at a later stage. Getting to know the service design landscape in our field, mapping the design agencies to invite for our tender process, building a solid process of procurement involving different parts of the business, establishing and nurturing a positive relationship with our design partner, also based on values alignment, shared expectations and staff motivation, were all key elements that contributed to the success of the programme.
Lesson 3: Integrate service design into current programmes
Tying the service design work to current programmes and systems already in place within the organisation from the outset proved to be successful for us. It took time to integrate design into our internal programme planning process and to show impact on traditional KPIs, but people were able to make time and space at the beginning of the journey, so that service design felt more like an offer than ‘another thing to do’ in their everyday work plans. This was key to engage staff and local Minds in the process.