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222454 Visual Communication Design Research Project Ora Rachel Bolt - 15066386 Katie McKenzie - 14289119 Semester 2 group blog: katieandrachelhonours.tumblr.com Rachel’s semester one blog: rachelbolthonoursproject.tumblr.com Katie’s semester one blog: katiemckenzie222453.tumblr.com

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Contents 04

Glossary

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Introduction

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Context

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Research Question

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Process

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Ora

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Conclusion

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References

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Glossary

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Glossary Mood Disorder

A mood disorder is a mental illness that affects a person’s everyday emotional state. Some examples of mood disorders are depression, anxiety and bipolar disorder.

Psychological Distress

Psychological distress is a general term that is used to describe unpleasant feelings or emotions that impact your level of functioning.

Psychological Distress Level Psychological distress level based off PHQ-9 screening tool scale.

Wellbeing

The state of being comfortable, healthy, or happy.

Primary Healthcare

Primary health care relates to the professional health care provided in the community, usually from a general practitioner (GP), practice nurse, pharmacist or other health professional working within general practice.

Whakatinana

To implement, to bring about.

Cognitive Behavioural Therapy (CBT)

A type of psychotherapy used to treat and prevent mood disorders.

User-Centred Design

A framework where designers focus on the users and their needs throughout the design process.

Experience Design

Experience Design is about creating meaningful, personally encountered events through design

Transition Design

Design that takes practical steps towards a future vision and a potential way to solve complex and intractable problems. Transition design aims to make something more accessible, sustainable, visually more interacting and engaging.

Artificial Intelligence

Artificial intelligence (AI) is a term for simulated intelligence in machines. These machines are programmed to “think” like a human and mimic the way a person acts. AI works by combining large amounts of data with fast, iterative processing and intelligent algorithms, allowing the software to learn automatically from patterns or features in data.

Augmented Reality

Augmented Reality (AR) is a technology enriching the real world with digital information and media, such as 3D models and videos, overlaying in real-time the camera view of your smartphone, tablet, PC or connected glasses.

Te Whare Tapa Whā Model

A model that encapsulates a Māori view of health and wellness and has four dimensions: taha wairua (spiritual health), taha hinengaro (mental health), taha tinana (physical health) and taha whānau (social health). 5


Glossary

We are user-centred designers who explored the problem of the significant impact mental health disorders have on New Zealanders.

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Introduction Introduction

We are user-centred designers who set out to explore the significant impact mental health disorders have on New Zealanders’ and how design can contribute to improving it through the lens of creating a system and service.

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Context

Context What is Mental Health

Mental Health is the state of our psychological, cognitive, behavioural and emotional wellbeing. Fundamentally, mental health affects our thoughts, feelings and actions (Nordqvist and Legg, 2017). Mood disorders is a term used to group serious mental health illnesses such as depression and anxiety. Everybody has times when they feel upset and down, but mood disorders are different as they have significant and sustained affect a person’s everyday life (Nordqvist and Legg, 2017)

Mental Health Impact

Mental Health has a significant impact on New Zealanders. According to Merry and Stasiak (2011), depression disorder in young people is increasingly common, and affects at least one in five by the age of 18, with the rate rising steeply between the ages of 15 to 18. Internationally we placed the 34th country with the highest suicide rates. 606 people took their own life, 79 of them aged between 20-24 years old (Mentalhealth.org.nz, 2017). The New Zealand Mental Health Survey found that “half of all people who developed a major mental disorder in adulthood, had experienced the disorder by the age of 18” (New Zealand Guidelines Group, 2008, p. 5). Although mental health disorders have a significant impact on New Zealanders, research shows if we can create effective early interventions that target preventing the onset of these common mental disorders like depression, we can mitigate the recurrence of them in adulthood.

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One in five New Zealanders are affected by a depressive disorder by the age of 18.

(Merry, Stasiak. 2011)

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Context

In 2015/2016 the age group that had the highest psychological distress was those aged between 15-24 years of age (“Prevalence Of Psychological Distress.” 2016). According to Rosie Gordon (2018), our system comes in too late and only provides the care people need when they are in a critical state. There are currently 445,550 young people between the ages of 13 and 19 in New Zealand and approximately 55,000 of them have depressive symptoms that warrant intervention, yet over 80% of these are left untreated. So not only would designing for young people as the demographic address the immediate youth mental health problems, but it would also be more cost-effective in the long-term, and create a positive flow on effect (“Synthesis Report”, 2011).

Proportions of people with high levels of psychological distress By age group and sex, 2015/16

The Kessler Psychological Distress Scale

Mental Health System

Figure 1. Stats NZ (2015/16) Proportions of people with high levels of psychological distress. This data shows people who seek out help. Males are less likely to seek out help so this distorts the male percentages.

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“Our system responds to crisis only... We have less access to the resources to... prevent a person from getting to a point where they require mental health services. We come in too late.� (Gordon 2018)

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Current Mental Health system

Before

Psychological Distress Level: Minimal to Mild

Normal day to day Common varying mood with both good days and bad days.

During

Psychological Distress Level: Mild to Moderate

Event that causes distress This effects individuals thoughts, feelings and behaviours.

Situation Feeling: great, content

Feeling: stressed, upset

Think, Feel, Do Meet Malakai: He’s 14, has a few close friends and enjoys playing videogames

Malakai is happy with where he is at, he’s doing well at school and has just made the under 16 boys rugby team.

Malakai finds out his mum and dad are splitting up. He has trouble concentrating at school so his grades are dropping.

“Things are pretty good right now I guess”

“What am I going to do?! Who will I live with?

Health System Some students learn the Te Whare Tapa Whā model in school. Posters of the model are placed in the classroom. Individuals aren’t sure how to apply it to everyday life.

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After

Psychological Distress Level: Mild to Moderately Severe

Searches Resources Most resources use labels like “depression” & “anxiety”

Feeling: confused, stuck

He has good days and bad days but lately he’s been feeling quite low and decides to look for some help online. Everything he sees mentions depression or anxiety. “I wouldn’t say im depressed and don’t even really know what anxiety is!”

First point of contact resources: • • • • • • • •

Internet Digital Resources Helplines Health Professionals General Practitioner (GP) Counsellor Youth Worker Psychologist

Does mood improve?

YES

NO

Ruminating over negative thoughts This worsens mood and effects day to day life

Feeling: stuck

Does not actively seek help and contemplates suicide This is due to fear of stigma and embarrasment

Feeling: stuck, hopeless

Malakai finds himself ruminating over all the negative things happening in his life right now and starts to develop mild depression (though he doesn’t know it).

Malakai is reluctant to seek help and his mood disorder worsens. He contemplates suicide and finally calls an urgent helpline who refer him to the Emergency Department.

“I can’t even be bothered to play my videogames anymore”

“Life is shit”

Limited Resources Available

Urgent but not critical

Resources are availiable to facilitate individual to further help. Skills and tools such as Cognitive Behavioural Therapy are taught to improve mood disorders.

Wait in Emergency Department (sometimes this means waiting long hours which puts people off going to get help)

After appointments there is very little to help sustain skills, and follow up appointments are hard to get due to funding.

Crisis team sees individual and talks through a plan. Crisis team can refer individuals to health professionals such as psych nurses, Psychologists and Psychiatrists

Attempts suicide Not only negatively impacts the individual but also those around them.

Feeling: hopeless

Confused by the system and not feeling supported enough Malakai attempts suicide. “What’s the point...”

Critical State (e.g. attempting suicide) Emitted to the emergency department straight away. Crisis team sees individual and talks through a plan. Crisis team can refer individuals to health professionals such as Psych nurses, Psychologists and Psychiatrists

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Context

How might design contribute to improving young New Zealanders mental health by creating a proactive, evidence-based system that facilitates increased self-awareness?

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Aim Aim

According to Jacinda Ardern, there are problems all throughout the spectrum of the mental health system, from the primary care end all the way to the acute (2018). Our current mental health system has a lack of resources aimed at building resilience for before young New Zealanders develop psychological distress. This system is reactive to psychological distress, rather than proactive. Therefore there is a need for a resource that builds resilience and equips young New Zealanders with the evidencebased skills needed for when they face times of psychological distress.

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Process

Process Methods

We used transition design processes to build on the current resources. We looked into the strengths, weaknesses, opportunities and barriers of the current digital resources as well as health professionals. We also talked to people who play a part in creating mental health resources such as people from the Ministry of Health and the Auckland District Health Board. We used user-experience design techniques to find out how we could create a design solution that best suited the needs of our audience. We created personas, ran prototyping sessions, and a workshop with young New Zealanders. We talked to health professionals such as General Practitioners, Psych Nurses, Psychologists and Youth Workers to help inform our current and ideal system.

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Our main insights from the current resources were:

Digital Resources Weaknesses • • • • • •

Young people can not see themselves in current resources Current resources are reactive, not proactive Labels causes stigma and confusion Easily accessible Not very interactive and engaging Does not prompt or incentive to help sustain skills

Health Professionals Barriers • • • •

Cost Access Stigma Label


Current Resources

Figure 2. Collection of Mental Health Resources. 2018

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Process

Rachel’s Research Proposal

Figure 3. Bolt, R. (2018) Proposal. Own work.

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Katie’s Research Proposal

Figure 4. McKenzie, K. (2018) Proposal. Own work.

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Process

Rachel’s Brainstorm

Collaboration

At the start of Semester 2, we decided to work together as we both were working towards improving mental health resources for young New Zealanders and we were getting the same insights. We both did brainstorms and looked at our research proposals to merge our projects.

Figure 5. Bolt, R. (2018) Brainstorm. Own work.

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Katie’s Brainstorm

Figure 6. McKenzie, K.(2018) Brainstorm. Own work.

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Process

Personas

Looking at what our personas think feel and do to identify pain points, insights and needs. Our personas are informed by talking to health professionals and observing our audience.

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Figure 7. McKenzie, K. Bolt, R. (2018) Personas. Own work.


Ora Features

Pain points, insights and needs inform what features are needed for Ora.

Figure 8. McKenzie, K. Bolt, R. (2018) Features. Own work.

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Process

Formative Assessments

These are images from the formative assessments in week 4 and week 6. From week 1–4 we spent time brainstorming and merging our projects. Weeks 4–6 we spent time exploring the right tone of voice and how to engage our audience. 24

Figure 9. McKenzie, K. Bolt, R. (2018) Formative Assessment. Own work.


Workshop with Audience

We ran a workshop with two 15 year olds girls and also prototyped on a 13 year old boy. These sessions helped us to test the tone of voice and gain some valuable feedback and suggestions of how we can improve our solution.

Figure 10. McKenzie, K. Bolt, R. (2018) Formative Assessment. Own work.

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Process

26 Figure 11. New Zealand School Kids, n.d.


Audience Demographic

13–15 year olds: In order to be proactive and preventative, our research informed us to primarily target the demographic before the highest rates of psychological distress, 13-15-year-olds.

Transformational Needs

Engage Me Facilitate Me Equip Me Support Me

Psychographics Psychographic:

The cruisy youngster: The cruisy youngster likes to think they are old but still enjoys childish things. They are mostly content but have moments when they feel down but nothing major. They also don’t understand the concept of wellbeing. Psychological Distress Level: Minimal to Mild

The moody teenager: The moody teen has a fluctuating mood. They have good days and bad days, and they have been taught about the concept wellbeing in health class but still do not understand how to apply it in everyday life. Psychological Distress Level: Mild to Moderate

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Process

Solution

ora

Your personal guide to help you thrive! 1. (verb) to be alive, well, safe, cured, recovered, healthy, fit, healed. 2. (modifier) healthy, fit, well, alive - in a state of wellbeing or just being alive. 3. (noun) life, health, vitality. MÄ ori dictionary, (2018)

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A proactive, evidence-based system that contributes to improving young New Zealanders mental health.

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Process

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What is Ora?

Ora is a proactive platform that supports young people throughout their journey. It helps to make the concept of wellbeing applicable to everyday life. It builds self-awareness using evidencebased therapies as well as helping to equip our audience with tools they need to be resilient and supported. Our visual style and tone of voice was informed through many iterations and finding the balance between the tension of being youthful but not childish. Another tension was making Ora relatable and credible but not clinical. Our illustration style is informed by an insight from the Auckland District Health Board that smooth lined illustrations are calming.

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Solution

Ora’s

The Ora’s act as the audiences personal guide throughout their journey to thriving. Using artificial intelligence, they can notify the user of trends and offer recommended daily habits based on the areas of wellbeing that need improvement. These are abstracted characters so that no matter what culture or background the user comes from, they can relate to them.

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Quiz

The quiz is a series of simply worded statements using relatable language that the user answers on a scale, this then measures their level of wellbeing to be reflected in a garden analogy. There are five questions based on each area of wellbeing which are body, mind, social and self-worth. The wording has been adapted slightly from the Te Whare Tapa WhÄ model in order to be more inclusive.

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Solution

Healthy Habits

In order to create behavioural change and reach specific health outcomes, Foggs (2012) suggests creating “tiny habits”. Since our audience would fall under the low motivation category, the evidence-based healthy habits Ora facilitates are “tiny”. These habits are really simple to do and can be easily incorporated into a daily routine. Therefore habits are more likely to be sustained. Ora also allows users to create their own personalised habits to increase ease and motivation.

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NZ Plants

After evaluating current resources, we identified that surprisingly many did not include a New Zealand context making it hard for young Kiwis to see it as a resource for them. By using familiar New Zealand plants and scenes throughout our solution, our target audience would find it more relatable and engaging. Using a plant analogy is a great way to re-frame the concept of well being into something more easily understood, as like plants, our wellbeing needs to be nurtured and maintained.

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Solution

Notifications

Customisable push notifications are used to ease the inputting of data. The feedback from our users was that time and effort were large barriers for them. The language used in the notifications is therefore direct and clear so they don’t need to go into the app to get the information they need. In turn, by using notifications we are minimising those barriers. These could be further developed to incorporate location notifications to increase ease.

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Collective Wellbeing

As the New Zealand Guidelines Group (2008) point out, the concept of mental health can be viewed and constructed in different ways according to your cultural perspective. For example, in traditional MÄ ori and Pacific cultures, the construct of mental health and wellbeing emphasise collectivity vs the Western focus on individualism. Therefore, one feature of Ora is collective wellbeing and this can be with whÄ nau, friends or their community.

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Progress & Tracking

A key aspect of CBT is an awareness of one’s thoughts, feelings and actions (“cognitive behavioural therapy - Mayo Clinic” 2018). The progress and tracking feature allows the user to reflect on what healthy habits they have completed and whether or not they affected their feelings or improved their mood, therefore, building that self-awareness. By also adding the gamification aspect of the ability to grow and level up plants, this helps to build the incentive to keep progressing. Through artificial intelligence, Ora can help young New Zealanders pick up on trends over time, such as mind habits improve their mood more.

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Toolkit

The toolkit works as a collection of external resources such as videos, podcasts, websites and images that can be used in times of distress and can be accessed at any time to support the user.

Our audience can add external resources by clicking this icon.

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Ora Chat

Ora chat utilises artificial intelligence to facilitate structured problem solving. This is a strategy based on the principles of cognitive behavioural therapy. Ora helps young New Zealanders define the problem and then reframe it into possible solutions in order to help them work through it in a supportive way, instead of letting the problem become overwhelming (“How it works�, 2018).

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Ora chat also help to facilitate our audience to further help resources, so they are always supported, validated and informed on what helplines and primary care health professionals they can go to for the help they need. When young New Zealanders go forward with further help, they can take with them the understanding of the concept of wellbeing from Ora.


Stickers

According to Fogg (2012), “prompts” or “triggers” are the third element in creating effective behavioural change. Our stickers can be placed throughout the individuals daily routine to act as prompts to assist with healthy habit building. They can also be used as personalised incentives as the user can customise what habit they want to achieve and upon completion, scratch off the surface of the relevant day to reveal the corresponding plant. Then using augmented reality technology, they can watch their plant come to life and grow in front of them thus giving them that reward and building incentive. 41


Before

Ideal ‘Ora’ system & how it fits into the mental health system

Preventive & Proactive Psychological Distress Level: Minimal to Mild

Normal day to day Common varying mood with both good days and bad days.

Increased understanding Has a better understanding of the concept of wellbeing and how small actions can effect it

Connectedness Feels connected and in-tune with those around them.

Increased self awareness Has an understanding of what sort of activities have a positive effect on their mood.

Situation Feeling: great, content

Feeling: surprised, informed

Feeling: supported, supportive

Feeling: surprised, informed

Malakai is able to check in on his Whānau and friends wellbeing as well. He notices he’s more aware of other people’s feelings and situations.

The more Malakai uses Ora, the more he learns about what works for him and is more aware of what activites improve his mood.

Think, Feel, Do

Meet Malakai: He’s 14, has a few close friends and enjoys playing videogames

Malakai is happy with where he is at, he’s doing well at school and has just made the under 16 boys rugby team. A friend recommends Ora to Malakai “Things are pretty good right now I guess”

Using the app, he better understands what wellbeing is and what small everyday habits he can do to improve it. “Wow I didnt realise how helpful it is to just take some deep breathes sometimes!

“I reckon Mum’s been pretty down lately, I should take her to lunch and have a chat”

“I notice when I play basketball with my friends I feel real good afterwards!”

Ora NZ Plant Analogy Helps young people apply the Hauora wellbeing model in an interactive and engaging way using relatable language. This helps improve understanding around wellbeing.

Health System Some students learn the Hauora model in school. Posters of the model are placed in the classroom.

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Individuals aren’t sure how to apply it to everyday life.

Healthy Habits Everyday easy and attainable healthy habits that are based off the Hauora Model and evidenced-based therapies.

Collective Wellbeing Not just about individual wellbeing framework. Everyone helps to keep others on track and can check up on each other.

Progress & Tracking Helps individuals pick up on trends on what helps them thrive. A part of Cognitive Behavioural Therapy is learning what activities work for you to help improve your mood and building self awareness.


After

During

Event that causes distress This effects individuals thoughts, feelings and behaviours.

Sustain & Support

Facilitate to Further Help

Psychological Distress Level: Mild to Moderate

Psychological Distress Level: Mild to Severe Depression

Equipped with tools/resources Can utilise their collection of habits / resources they know work well for them.

Feeling: stressed, upset

Feeling: calmer, equipped

Malakai finds out his mum and dad are splitting up. He has trouble concentrating at school so his grades are dropping.

Being more aware of his mental state and overall welbeing, he does the everyday habits he knows improves his mood and uses helpful resources from his toolkit.

“What am I going to do?! Who will I live with?

“Everything’s going to be okay”

What works for me habits & The Toolkit Collection of tools and resources that individuals know help them whenever they need them.

Anonymous support available Ora chat uses AI to facilitate complex conversations. Due to it’s form, it helps remove barriers young people have to seek help.

Feeling: supported, reassured

Malakai has days where he feels really down. He uses Ora chat which reminds him its okay to not be okay - thats normal! His Ora helps him work through his feelings in a healthy way, using language he understands. “So it’s not the end of the world...”

Ora Chat Uses Structured Problem Solving which is based off of Cognitive Behavioural Therapy.

Does mood improve?

YES

NO

Facilitated to further help Ora does not replace medical professionals and will always facilitate users to further help if needed.

Feeling: hopeful, supported

By using Ora Chat, Malakai understands he’s in a state where he does need a bit more help so Ora directs him to other resources that can help him. When he gets further help he has some understanding of what wellbeing is as well as knowledge of some healthy habits that make him feel better. “Alright, I’ll give these a try”

Need help now? Uses relative language and validates the individual “Sometimes you just feel like you can’t take any more and feel stuck. There’s no shame in that – but you do need to get help. Everyone needs a bit of help at some point :)”

First point of contact resources: • • • • • •

Helplines Health Professionals General Practitioner (GP) Counsellor Youth Worker Psychologist

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Solution

Conclusion Challenges & Future Opportunities

Throughout our process, we were faced with many challenges. One challenge we faced was being able to test with our users, and if we had more time, we would have liked to have worked with a lot more young people from different cultures and backgrounds. Working more closely with our audience would have helped to balance the tension of being relatable yet credible and youthful but not childish. At the start of our project we were trying to be inclusive of all 13-15 year olds, however, we discovered that it is impossible to create a design solution that is going to suit everyone. If we had more time, we would have explored being able to personalise the analogy to suit the individual. Because there is a need to engage, we would have liked to have ramped up the gamification aspect, for example, their points earned from completing habits could also be redeemed to customise their Ora.

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We acknowledge that we are not psychologists and would have liked to have worked more alongside health professionals with incorporating evidence-based therapies such as CBT and to inform the healthy habits aspect. Therefore, working more with health professionals is a future opportunity to develop Ora further. We chose a digital platform due to accessibility. However, not all young New Zealanders have access to a smartphone. We tried to balance this tension by incorporating the features into the website, but going forward we would create more physical touchpoints to increase inclusivity. Having more hands on touchpoints would cater to more kinesthetic learners as well. Regarding whakatinana, we see an opportunity for Ora to be introduced into schools as a resource used alongside the Te Whare Tapa WhÄ model. However, this would need further exploration and testing as we do not want Ora to be seen as a teachers resource as this could be seen as telling young people what’s good for them, and they may not respond well to this.


Summary

By offering a preventive and proactive solution that facilitates increased self-awareness as well as a better understanding of wellbeing, when young New Zealanders are faced with challenges, they are equipped with the tools they need to be resilient. In turn, Ora will contribute to improving our mental health system.

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Solution

Reference Lists Adern, J. (2018). Jacinda Ardern delivers passionate speech on mental health, opening up about losing someone to suicide. [online] 1 NEWS NOW. Available at: https://www. tvnz.co.nz/one-news/new-zealand/jacinda-ardern-deliverspassionate-speech-mental-health-opening-up-losingsomeone-suicide [Accessed 20 Oct. 2018]. Fogg, BJ. (2012, December 05). Forget big change, start with a tiny habit: BJ Fogg at TEDxFremont. Retrieved from https://www.youtube.com/watch?v=AdKUJxjn-R8&t=736s Gordon, R. (2018). How severe is New Zealand’s mental health crisis?. [online] Thebigq.org. Available at:http:// www.thebigq.org/2018/08/09/how-severe-is-new-zealandsmental-health-crisis/#.W2udYIMJZvg [Accessed 22 Oct. 2018]. Maoridictionary.co.nz. (n.d.). ora - MÄ ori Dictionary. [online] Available at: http://maoridictionary.co.nz/word/4791 [Accessed 20 Oct. 2018]. Mayoclinic.org. (n.d.). Cognitive behavioral therapy - Mayo Clinic. [online] Available at: https://www.mayoclinic.org/ tests-procedures/cognitive-behavioral-therapy/about/pac20384610 [Accessed 20 Oct. 2018]. Mentalhealth.org.nz. (2017). [online] Available at: https:// www.mentalhealth.org.nz/assets/Suicide/Suicide-statisticsmedia-release-Embargoed-midday-28-August-2017.pdf [Accessed 22 Oct. 2018].

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New Zealand Guidelines Group, (2008) Identification of common mental disorders and management of depression in primary care. Wellington, N.Z. : New Zealand Guidelines Group, 2008. Nordqvist, C. and Legg, T. (2017). [online] Medicalnewstoday.com. Available at: https://www. medicalnewstoday.com/articles/154543.php. [Accessed 20 Oct. 2018]. PHQ-9 Depression Test Questionnaire. Retrieved from https://patient.info/doctor/patient-health-questionnairephq-9 Stats NZ (2015/16) Proportions of people with high levels of psychological distress. [Graph] Retrieved From:http:// archive.stats.govt.nz/browse_for_stats/snapshots-of-nz/nzsocial-indicators/Home/Health/prevalence-psych-distress. aspx Synthesis Report. (2011). In P. Gluckman, & H. Hayne (Co-chairs), Improving the transition. Reducing social and psychological morbidity during adolescence (pp. 1-16). Retrieved from http://www.pmcsa.org.nz/wp-content/ uploads/Improving-the-Transition-report.pdf


Image List

Ethics Forms

Figure 1: Stats NZ (2015/16) Proportions of people with high levels of psychological distress. [Graph] Retrieved From:http://archive.stats.govt.nz/browse_for_stats/ snapshots-of-nz/nz-social-indicators/Home/Health/ prevalence-psych-distress.asp

Please find our ethics forms on our blog: katieandrachelhonours.tumblr.com

Figure 2. Collection of Mental Health Resources. 2018 Figure 3. Bolt, R. (2018) Proposal. Own work. Figure 4. McKenzie, K. (2018) Proposal. Own work. Figure 5. Bolt, R. (2018) Brainstorm. Own work. Figure 6. McKenzie, K.(2018) Brainstorm. Own work. Figure 7. McKenzie, K. Bolt, R. (2018) Personas. Own work. Figure 8. McKenzie, K. Bolt, R. (2018) Features. Own work. Figure 9. McKenzie, K. Bolt, R. (2018) Formative Assessment. Own work. Figure 10. McKenzie, K. Bolt, R. (2018) Formative Assessment. Own work. Figure 11. New Zealand School Kids, n.d.

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