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Taking Back “Experimentation”

PSSP Innovation

Northwest Toronto Service Collaborative’s Design Jam

By Josina Vink

It’s time to reclaim experimentation to enable people-powered innovation in mental health.

Mental health systems in Canada have a dark history with experimentation. In the 20th century, we tested some horrific therapies on people with “mental disorders” including hydrotherapy, insulin coma, and the medical surgery of lobotomy.  Because of the legacy of these tests and studies, there is some resistance to experimentation in the context of mental health today.

However, in the fields of innovation and design, the use of experimentation, testing, and prototyping is gaining a lot of ground as a valuable method for the improvement of public services.  In these circles, tests are not about experimenting on patients, but rather system stakeholders partnering with people with lived experience to co-design, try out, and refine new ways of working.

The good news is that we can experiment with large, complex issues at small scale with little resources, lots of participation and limited risk.  There are methods like paper prototyping, bodystorming, walkthroughs, and service blueprints that effectively bring to life ideas and enable early critique. We can learn a lot before we ever start implementing service changes.

This new wave of experimentation catalyzes the exploration of a large quantity of ideas, but encourages us to let go of those ideas that don’t work early. It thrives on input and feedback from diverse perspectives to strengthen promising practices.  This time, instead of experts leading the way, co-design methods place the people affected at the centre of the process.

It is in this vain that we see an emerging number of social labs popping up in Canada like the MaRS Solutions Lab, Alberta Government’s CoLab, UHN’s OpenLab and CAMH’s PSSP Systems Lab.  There are also incredible organizations like InWithForward prototyping new community services by partnering with people on the ground.  Plus, our work happening through the Service Collaboratives in Ontario, like the Peer Positive initiative, demonstrates that there can be a community-driven approach to systems change that learns along the way.

Early prototypes made in the PSSP Systems Lab

Early prototypes made in the PSSP Systems Lab

There is hopefulness in these methods for a better future, but not if we ignore the lessons of the past. I am optimistic that the current generation of health innovators will be thoughtful, ethical and responsive, modeling a better way to progress.

What do you think?
Can we take back experimentation?
Are social labs just another wave of expert-driven change?
What will it take to innovate responsibly in mental health?

6 Comments Post a comment
  1. Patricai Forsdyke #

    Psychiatry has certainly had its black moments as have other areas of medicine. So has sociology and psychology.But science has rendered better treatments. We should be wary of soft science and fads. The way forward has to come from very sound science in order to develop more effective treatments and a much better working knowledge of the brain.

    April 22, 2015
  2. Josina #

    I agree that advancements in hard sciences are critical to improving mental health, but I think we need progress in both soft and hard sciences to move us forward. Much of people’s experience related to mental health is impacted by society, relationships, and the social structures in place. These are all things that fall within the soft sciences and could benefit from participatory methods, like co-design.

    April 22, 2015
  3. Patricai Forsdyke #

    I wonder if you would make the above comment if you were talking about Leukaemia, Type1 Diabetes, Multiple Sclerosis, Ami-lateral Sclerosis I am not sure what you mean by “participatory methods, like co- design ‘ and ‘body storming’ ? Are you talking about Occupational Therapy ? Perhaps I misunderstand, perhaps not.

    April 22, 2015
  4. This is just another call for a return to the “usual social science rat’s nest of confounded variables” (Steven Pinker’s words). That approach created misunderstandings and myths about the medical nature of serious mental illnesses like schizophrenia, depression and related neurological diseases. And it probably delayed scientific investigation into them. Sociologists are looking for a return to the old days when non-replicable social studies ruled the treatment programs available to our seriously mentally ill loved ones. Remember how that “worked”?

    Our only hope to eradicate these diseases is by directing scarce research funds towards the cause and cure scientific research that has shown it can rid the world of other horrific diseases. And it can do the same for serious mental illnesses if we provide enough essential resources to our scientists to get the job done.

    April 22, 2015
  5. Josina #

    Thanks for your perspectives. This experimentation is less focused on mental health treatment and more focused on improving the systems and services that those treatments exist within. For example, experiments might test creative ways that we can improve access to services or accurate information. The intention is not to undermine the medical nature of mental illness, but rather to help services adapt to emerging evidence and changing community needs.

    April 23, 2015
  6. annick aubert #

    No we should not take back experimentation, Louis Pasteur after all was ……
    unconventional yet…..the world thanks him today. But if we as, it appears from the CAMH francophone group are asked to promote peer positive involvement, which translates as involvement of the families of the mentally ill and the mentallly ill themselves in decision-making, I must admit that I for a minute thought of a play called Marat-Sade, telling the story of the Marquis de Sade and the inmates of the asylum of Charenton taking over the institution .!!!
    I will though diligently study the paper we were given, and will put my silly thoughts aside..

    April 25, 2015

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