TAMARA HESSE
Georgia HOPE
Feature within an existing website
Role
End-to-end UX Designer
Duration
Ongoing
Client
For over 25 years, Georgia HOPE has become the largest private mental health service provider in the state of Georgia, with over 500 staff members, serving 4,000-6,000 clients per month. Georgia HOPE works directly, and in partnership with individuals, families, the Department of Family and Children's Services, schools and the community. By providing a variety of services, Georgia HOPE's clients are able to maintain stability in an outpatient environment.
Goals
Georgia HOPE's goal has always been to increase access to services by minimizing challenges and meeting the patient where they are. They provide in-home therapy, including telemental health and online therapy, as opposed to requiring their patients to travel.
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Improve access to clinical intervention
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Decrease higher levels of care (i.e. ER visits and hospitalization)
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Establish connection. Once connection is established between the provider and user, the provider is immediately on the path to diffusing whatever the crisis is.
Challenge
In keeping with the goal of increasing access, Georgia HOPE requested that I develop an online crisis intervention feature within georgiahope.org. The feature connects a user directly to a licensed on-call therapist at the click of a button during a mental health crisis.
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Ability to access on-call crisis management with the click of a mouse/ finger
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Ability to auto connect to 988 (National crisis and suicide lifeline)
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Access to feature from every page of the website.
Result
The result is a direct messaging platform that allows the user - (whether that is the patient, or someone connecting on behalf of the patient) to immediately connect to a licensed therapist, trained in crisis management, who can quickly assess the situation, taking into account the users medical history, and provide next steps in an effort to diffuse the crisis, or contact the proper authorities if necessary. The feature also allows visitors that are not currently Georgia HOPE patients to access 988 - the recently enacted crisis and suicide lifeline. The feature uses voice-over IP, and a ring circle to connect individuals by phone, video, or direct message, and ensuring someone is always available.
*Georgia HOPE has recently approved the prototype and will begin usability testing soon.
Georgia HOPE's goal has always been to increase access to services by minimizing challenges, and meeting patients where they are.
Research
The research for this project particularly challenging, due to the fact that actual users could not be interviewed due to HIPAA (Health Insurance Portability and Accountability Act) compliance. However, I was given direct access to the CEO, State Director of Operations, and a Licensed Therapist who were invaluable resources throughout the entirety of the project.
An enormous amount of Secondary research was conducted to understand the following:
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The process a patient currently goes through during a mental health crisis?
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What is effective or ineffective about the current process?
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What follow-up protocols are in place for patients who go through a mental health crisis?
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Demographic information regarding mental and behavioral health in the US/ Georgia.
Stakeholder interviews were conducted to understand the following:
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The process a patient currently goes through during a mental health crisis?
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What is effective or ineffective about the current process?
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What follow-up protocols are in place for patients who go through a mental health crisis?
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How the Crisis Intervention feature could work?
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The potential benefits vs. risks of the Crisis Intervention feature.
Key Takeaways
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Of Georgia HOPE's 4,000-6,000 monthly clients, 75% of which are adolescents, ages 4-18.
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The Top 2 Diagnosis for this age group are:
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ADHD
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PTSD
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10% of the child adolescents Georgia HOPE serves are at a higher risk for crisis. (i.e. physically aggressive or suicidal)
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In instances of crisis, GH therapists help guide the parent or guardian in actions to take, and/or suicide assessments if necessary.
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Parents/ Guardians often become overwhelmed or panic and take the child directly to the ER, which is often costly, traumatic, and ineffective.
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Mental health conditions and substance use disorders are the leading cause of disease burden in the US, surpassing both cardiovascular disease and cancer.
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Only 12% of individuals with substance use disorder, and 45% with mental health disorders receive specialty services. Underscoring pervasive challenges to care access and coordination.
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Disparities in access to behavioral health disproportionally impact communities of color.
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All patients ages 6 and older with State of Georgia Healthcare Coverage must be seen within 7 days after ER visits or hospitalization for mental illness.
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All patients of Georgia HOPE are seen within 12-24 hours of a mental health crisis. All of which is documented in their digital health record.
Of the 4-6,000 monthly patients at Georgia HOPE, 75% of which are adolescents, ages 4- 18, with the top 2 diagnosis being: ADHD and PTSD.
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Mapping
In an effort to better understand the ecosystem around a Georgia HOPE user in crisis, I chose to map out the applicable players to understand their potential connections. Additionally, I wanted to understand how BOTH the user and Georgia HOPE processes through a crisis situation.
Meet Pam
Pam is a 52 year old mother and grandmother. Caretaking is in her bones. She loves every patient that walks into the dental office where she works. Some of those patients she has watched grow from children to adults. They are like her kids. Being a grandmother is by far her favorite job. She does face some challenges however, that she never really expected. One of Pam's grandsons suffers from severe PTSD. He often spends the night with her because his mom works nights. They recently started seeing a therapist at Georgia HOPE and she is so excited to know there is someone on call if they have an issue after business hours.
"The first time I took my grandson to the ER during one of his episodes, It was awful. We waited and waited. People were staring. I felt awful for my baby. I should have kept him home. They did NOTHING for us. They didn't know how! ER's are for physical health, not mental. " - Pam
Georgia HOPE Service Blueprint
The service blueprint helps us to understand the process that the user, therapist and additional support goes through in the event of a crisis, using the new Crisis Intervention feature. As you can see by the timeline, a user most likely couldn't even arrive at the ER in the amount of time it takes to engage the feature and get a qualified individual to begin addressing the situation. Furthermore, critical follow-up is immediately triggered, the incident is documented, all of which is critical to the patients continued progress.
User Flow
The User Flow shows us the process of how the user accesses and uses the Crisis Intervention feature. The feature is very simplistic in nature - only a couple of screens. The reason why is because in a crisis, the patient or guardian is typically not in a calm frame of mind to be reading extensively or answering several questions. Once the user has accessed the feature, they can choose their method of communication - voice, video or direct message. The therapist has access to their records so they can better assess the situation and/or need for 3rd party assistance. The incident is then thoroughly documented so follow-up and treatment can begin.
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The Crisis Intervention feature is designed to be as uncomplicated as possible. There are very few questions and screens. The goal is immediate access to provide the user with the help they need as quickly as possible.
High Fidelity Wireframes
Desktop
A CTA similar to this will be inserted on every page of the website.
An example of what the user sees if they initiate a voice call.
A modal pops up once a user clicks the CTA. The user can then enter their name and submit if they are an existing client. If they aren't, they can immediately connect to 988 via Georgia HOPE's VOIP.
An example of what the user sees if they initiate a video call, and they are waiting for it to connect.
Once the users name is entered, a direct message style dialog box appears. The therapist will further identify the patient if necessary and verify who they are speaking with. At any time, a user can initiate a voice or video call.
An example of what the user sees once both parties are present on the video call.
Mobile
Usability Testing
*With recent completion and approval of the Crisis Intervention feature prototype, the product will soon be tested for usability. How to accomplish this testing is currently under review.
Objectives
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Determine if the user can follow the task flow.
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Assess whether there are features that are missing that may enhance usability and overall experience.
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Assess user pain points.
Suggested Methods
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Focus Group testing with current clients.
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Usability testing with current staff members.
Iterations/ Hindsight
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Due to the cluttered look and the possibility of being overlooked, I would change the layout/ placement of the CTA on the homepage.
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With more firsthand information from the client, I would have been able to better determine what form this feature needed to take. Is it better as a CTA on the website or would an application be a better option.
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As Georgia HOPE and I continue to develop this product, I intend to complete the provider side of the product - What the feature looks like for the Georgia HOPE therapist providing the service.
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