ReliefLink: Modernizing
Suicide Prevention
Project Overview
Georgia Tech’s Junior Design capstone is a two semester long course that provides students with an opportunity to work on real-world software projects in partnership with local Atlanta Clients. My team partnered with Dr.Nadine Kaslow and the Nia project at Emory University to help modernize a suicide prevention application for a modern digital landscape with support on both iOS and Android.
Role:
User Experience Researcher
User Interface Designer
Software Engineer
Team Members:
Alexandr Shor
Eduardo Costa Trunci
Daniel Young
Rithvik Rajavelu
Yuting Shen
Project Duration:
January-December 2022
Problem
A Life saving application, fallen to the wayside
Suicide has and continues to be a prevalent issue in the US. Relieflink was originally developed as a suicide prevention application in 2013 by a team led by Dr. Nadine Kaslow. However, it remained un-updated since 2013. Dr. Kaslow and her team - The Nia Project - partnered with us to revitalize the app for the modern consumer on both iOS and Android. We knew that we’d have to start from scratch, but the original app design pointed us in the right direction for what features to include.
Solution
A psychiatrically-back friendly redesign to application-based suicide prevention
We designed a refreshed, cross-platform application with a modern and friendly user interface from which users can keep track of mood, create a safety plan in case of emergency, and perform coping activities to alleviate negative moods.
Background research
Finding out what happened in the course of a decade’s difference
While the original design worked off of psychiatric standards for suicide prevention-including the ability to create a safety plan, track mood, and create reminders for positive thinking-the app struggled with creating an intuitive design and in the end felt too clunky and clinical. In our time reviewing its functionality, we frequently encountered bugs and dead ends that would leave us stuck in important functions of the app.
Unupdated UI leads to cramped button spacing and features locked behind menu placement
An information architecture that is useful, but that is broken down by old ui
Mood trends and health centers useful features, but clunky and hard to understand in UI
Literature Review
Poring through the research on suicide and how apps can help
To get a better understanding of what makes a good application for suicide prevention in today’s day and age, we pooled together a comprehensive list of published papers regarding suicidality, risk factors, and effective solutions. Our key findings were
01
The most common risk factors in suicide are a lack of social support.
Most literature cites social isolation among the number 1 cause for suicide. Getting rid of the stigma of mental health awareness helps with this challenge
Suicide Prevention applications are most effective as tools of oversight
The main way in which mental health applications provide help is by providing easy mental health tracking, helping build a safety plan, recommending tools and strategies to alleviate suicidality, and offering quick access to helpful lifelines such as the national suicide hotline
02
Competitive Analysis
How the market changed since ReliefLink was used
Now that we had background information on suicide prevention and how they pertained to applications, we conducted a competitive analysis on existing apps on the market to see how they implemented suicide prevention tactics, where they were useful, and where they were found lacking.
Calm
- Helpful Guided Meditation
- Good Milestone/Award System
- Too many features locked behind a paywall
Mood Mission
- Gamifies Coping Strategies to encourage user retention
- Activities too boring on their own to be enjoyed
- locked behind a paywall
Virtual Hope Box
- Large Pool of Activities to help users
- Password which makes sense for the app but adds another barrier to app access
Headspace
- Responsive color palette based on mood
- Gamifies the flow and rewards the user for completed coping activities
- locked behind a paywall
Calm Harm
- Suggested Activities useful when user can’t think of activity
- Activities are timed to give users a framework for completion
- Password is needed
- UI is unorthodox, which dissuades user from using the application
Stay Alive
- Useful Onboarding
- Clean UI
- National Emergency Resources easily available
- Buggy
- While the UI is clean, it is also arguable TOO clean, and feels sterile rather than inviting
NotOK
- One Touch emergency contacts useful for easy access to support
- One-tap text removes guesswork
- Little to no information on where to access treatment/therapy
CALM
- GPS locator useful for finding nearby clinics
- Based on national psychiatric standards
- Offers crisis lines
- Out of date
- More focused on care providers instead of individuals at risk
Key Takeaways
01
We needed to make Suicide Prevention as easy of a task as possible by minimizing user work.
Being at risk can heavily demotivate users from healthy action. That’s why the most successful applications make user flows as intuitive and quick as possible. As we rebuilt ReliefLink, we aimed to keep this simplification in mind.
User retention is key, and we could encourage that through intuitive interactivity and guidance
While it’s important to keep the design simple in order to remove obstruction from user goals, it is also imperative to encourage user retention through increased user interactivity. Additionally, by building an application where each feature provides guidance on how to effectively use it, we can ensure that the user would not be overwhelmed even when presented with a host of available tools.
02
Feature Roadmap
Figuring out what features mattered most in our sprints
Since we were working within a time block of 6 2-week sprints, we needed to figure out what relevant features we wanted to develop in our MVP that met our earlier takeaways. We decided on
1
Relief Techniques
Coping strategies that users can search for, add, edit, and perform. Easy to perform, each one has an accompanying video to guide users through the activity so that users aren’t lost while performing the task.
2
Emergency Contacts
A list of trusted and dedicated emergency contacts the user could access at any time with just one tap. This allows users easy access to the people that matter most in a crisis.
3
Journaling
A psychiatrically proven useful tool to help put thoughts down into written word rather than keeping it in a users head.
4
NSH Access
A one-button access to the National Suicide Hotline accessible from anywhere in the app so that users have access to trained crisis professionals at any point
5
Crisis Plan
A dedicated space to let users create a plan so that when they are at risk or in distress, they have a plan that tells them what helps and who to reach out to.
6
Local Clinic Locator
A useful directory using GPS to help users find relevant nearby clinics and therapy. Live therapy is often the most useful for combatting mental health crises.
First Prototype
Our first designs centered on relief techniques
One of our earliest features was the idea of coping activities which the user could perform in order to alleviate stress or help with negative feelings. We knew that key to this would be the ability to perform the activity and then rate it.
Mid Fidelity Iteration
To produce a more friendly and visually interesting design, we leaned into the idea of shape and color variety.
First Semester Technical Demo
By the end of our first semester, we would have a working tech demo of this feature. In the video below, Suvan Adhikari narrates how Relief Techniques would work. we also began developing the contact feature, including the ability to add a name, phone number, and relationship.
User Feedback
Three avenues of feedback - Client, patients, and therapists
Throughout our development process and transition to full implementation within the second semester of the junior design capstone, one of the largest sources of help for iteration was our biweekly client meetings. Because our client was affiliated with the Emory School of psychiatry, we had access to both psychiatrist evaluation of our application as well as patient testimonials in regards to what worked and didn’t. Additionally, discussion with my own therapist yielded helpful improvements for several parts of the design.
Iterating on visual language
Color and shape needed to be standardized
A prominent issue raised with our early design is the unnecessary interaction complexity created from the variety of shapes and colors. Interviews with people who used the application yielded that the colors were too noisy and the shapes were too varied. This also was reinforced by coding issues when attempting to figure out what would decide the size of a single card. To balance a friendly design with a consistent design, we pushed color to the top of each card and made shape sizes consistent.
Iterating on contacts
no three contacts the same
As we continued work on the contacts feature, patient testimonials brought to our attention that different contacts would serve different purposes. You wouldn’t reach out to a therapist in the same way you would reach out to a friend. Through discussion with our client, we found that the three most common types of contact for suicide prevention were
Helping
Individuals with whom you could just talk about what’s going on
Distracting
individuals who you could distract yourself from suicidal ideation
Professional
Therapists, Psychiatrists, and individuals who are trained in helping mental health crises.
This became a part of our design through the use of color encoding. Each color was representative of a different type of contact for easy identification by the user
Iterating on journaling
affirmations - We can get it done!
Originally, the use of journaling was its ability to just track mood and externalize thought into word. However, through therapist discussion we found the idea of affirmations to be a useful tool. Creating affirmations for those that are new to the idea may feel foreign, so we created a series of prompts to help guide thinking, or the option to create custom ones for those that know what they want to say. Additionally, we added affirmation visibility to the front page of journaling as a way of encouraging positive thought.
Relief Techniques Iteration
Letting users customize their relief technique experience
Client feedback pointed to the idea that users would enjoy the ability to edit and add their own relief techniques, customized to their own needs. We decided to add this feature, and to avoid overwhelming the user made that only an option, not a requirement.
Final Result
A modern and friendly design that offers health-standard suicide prevention techniques with an inviting coat of paint
Relief Techniques Tab:
On the relief technique tab, users are able to perform Relief Techniques-coping strategies designed to target specific moods, whether it be lethargic, anxious, sleepless, or other. These activities are guided by way of a video for more complex tasks, or a timer and description for more simple tasks. Users are able to rate and favorite performed Relief Techniques and filter/search based on specific criteria, like rating, mood, time, performed, or favorite.
Users are also able to edit and add their own relief techniques, so that the page is fully tailored to their individual needs.
One-Touch Contacts Tab:
On the Contacts tab, users can create contacts for the express purpose of handling a crisis. In doing so, users can specify a name, number, relationship, and type. This differentiation allows for users to easily see who they want to reach out to, and for what reason they want to reach out.
Users can also edit their contacts to update preferences, and these contacts can later be added to the Crisis Plan
Affirmation Based Journaling
On the Journaling tab, users can externalize their inner emotions by creating a daily entry where they can record their thoughts and rate how they felt about their day. Users also have access to daily affirmations, which are helpful for guiding a positive train of thought as well as boosting confidence in oneself. The user can select from a number of prompt affirmation to take work off from having to think of it, or create their own. Each prompt offers the user a chance to reflect on something positive either happening in their life or something about them they feel confident in.
Built in Crisis Plan
As part of psychiatric recommendations, one of the best tools that suicide prevention applications can offer is the creation and maintenance of a safety plan in the event of crisis. The goal is to write down and be aware of symptoms of crisis, helpful solutions for a crisis, and useful resources to reach out to-including contacts and safe spaces.
Because of the design of the application, users have the ability to directly input relief techniques and contacts into the plan, thereby lessening the overall workload on the user to create their crisis plan. Additionally, users can input safe spaces and warning signs.
Final Takeaways
Understand Your Platform
As the lead UX designer, I took a backseat to the actual coding of the design. The rest of our team would create the skeleton of the project while I would go in and apply our prototype design to the skeleton. However, it can be too easy to get carried away with making the most “good” design and ignore the restrictions of your platform. Many of my designs for the application required countless hours of studying up on the Flutter framework in order to understand what could actually be feasible. Keeping in touch with your developers, therefore, is paramount to delivering a good design that won’t be set back by implementation difficulty.
Do the Research
A great design starts with good preliminary research, and succeeds with iterative, contextualized research throughout the process. Having mental health professionals and patient testimonials helped greatly in producing the final result, and would often yield insights we could never have thought of.
Working in sprints rather than bursts
Too often it could be easy to get through a huge chunk of the design in just one burst. However, the most productive sessions were ones that were split up into iterative sprints. This is because in working on the design through a multitude of sessions enabled more time for yielding useful insights in iterating on the design rather than making it a one-and-done process.