Mental health care and mobile tech: How Mindstrong achieves the magical mix

Shot of a young woman using a smartphone while relaxing on the sofa at home

When it comes to mental health, most people agree on a couple things. First, we need accessible, impactful mental health treatment now more than ever. Second, we should be using smartphones to help with this.

The charge sounds easy. We have solid, science-backed treatments that are used by therapists all over the world. These treatments work. At the same time, most people have smartphones and many use them several hours per day. Mobile software development for healthcare (aka building apps for patients) has also taken off in recent years.

The reality? Two scenarios are common:

  1. offering treatment/therapy with little to no mobile technology; and
  2. offering content-dense, feature-rich apps with little to no therapy

We have the two ingredients. Yet like many recipes that have the potential to be great, the magic lies in how you combine them.

Merging apps and mental health treatment is harder than it looks

This work requires clinicians to collaborate with software development and design teams. Though this is how the magic happens, it also poses several challenges.

Challenge 1: different points of view about what we are building

Product teams are more likely to think we are providing an app assisted by therapy. Clinical teams are more likely to think we are providing therapy assisted by an app. These perspectives can be subtle or really pronounced. Either way, differing POVs result in very different approaches when building things for patients. If these approaches can’t be joined, problems develop.

Challenge 2: lack of knowledge of the other discipline

Clinicians know what works medically/psychologically and why. They aren’t as familiar with best practices in mobile software development. Product teams know how to design and build engaging products that people want to use. They aren’t as familiar with which treatments work best in a particular situation. Building technology-assisted mental health treatment requires knowledge of both. It also requires that some of this knowledge is shared across, not just within teams.

Challenge 3: large differences in experience

Digital health companies intentionally hire people with very different backgrounds. Because digital health tech is relatively new, many clinical people in these companies haven’t worked closely with product people and vice versa.

These challenges have impact

The challenges I just outlined matter. To build technology-based mental health treatments, clinical and product teams need to deeply collaborate. Different perspectives, knowledge, and experience can block this collaboration. This often happens in two ways.

Siloed work

We feel most comfortable with people like us. We are more likely to work with people who do what we do and know what we know. We seek them out, defer to them, and trust them. Also, when we lack basic knowledge of what the “other” team does, it is hard to see the value they bring.

This makes it very difficult to rely on the other team. So, each team does their work. Product teams create the app with little clinical input. Clinical teams design and implement treatments with few tech or UX inputs. The other team may get pulled in for advice or to fill a needed gap. Teams treat each other like consultants instead of partners.

Deep, step-by-step collaboration doesn’t happen. The offerings for patients don’t represent a strong clinical and user experience. The magic isn’t achieved.

Tradeoffs instead of compromise

A good UX in an app doesn’t necessarily translate into a clinically impactful experience. Many things that are clinically impactful are hard to translate into a good UX.

Teams that do work together often make tradeoffs. Instead of earnestly trying to combine clinically impactful tactics with an engaging tech UX, one is swapped out for the other. Or one is ignored for the other. The magic isn’t achieved.

How to build a healthy treatment/tech marriage

Teams CAN overcome the challenges above. Here’s how:

Change your lens

You can’t just gain a new perspective. You must work to build it. How? Learn about the basics of the other discipline. Take a class. Better yet — join the other team’s meetings and really listen. Ask questions. Be teachable. Admit what you don’t know and be okay with it.

When you start to see the work through the other team’s lens, you will come to trust and rely on them.

When I joined my first digital health company, I felt lost on the Product side. To me, the word agile applied to people and PM meant Project Manager. And what the heck is Jira? Prior to that, I spent 10 years building mental health treatment programs at a nonprofit. I didn’t understand the basics of how software was built and designed.

I committed to changing my lens. I immersed myself in Product work and took some Udemy courses. I asked lots of questions and leaned on my Product partners to share knowledge. I got a Figma account and started to make mocks.

Did I feel like doing this? Not really, especially at first. Was I willing to do it anyway? Yup. Did it result in a stronger collaboration with my Product partners and improve our ability to innovate for patients? You bet.

Be aggressive in cross-functional collaboration

Aggressive collaboration means a strong commitment to build things together — hand in hand — from beginning to end. It starts from the very first idea to implementation.

“Does someone from Product need to be in the room right now? Shouldn’t we have a clinician on the team?” If the answer is no, ask the question again. And reframe it. “How could a person from product design add value to this conversation right now?”

This kind of collaboration doesn’t happen organically or by accident. It requires dedication, focus, and intent. It requires that clinicians be willing to think more like product teams and product teams to think more like clinicians — and recognize what both bring to the table.

Always ask: Is this a “person as a patient” issue or a “person as a user of technology” issue?

People walk two paths when they seek help in the healthcare system: they are patients living with a medical condition and they are users of technology.

The answer to this question will help direct what to build in each situation. Sometimes clinical tactics and a great app experience can’t be perfectly merged. Teams need to compromise and deemphasize one thing (UX) in favor of the other (a clinical ingredient/tactic). “Person as patient” versus “person as tech user” will help teams prioritize.

Prioritizing doesn’t mean leaving out the other thing. If there is a clinical “ingredient” that must be a certain way, how can the UX support it? What is the next best thing to an ideal UX?

At Mindstrong, we give clinical surveys as part of care. They measure whether symptoms are improving in our members and inform ongoing care. Members receive these surveys in the app. The content of these surveys and how they are administered must be a certain way for several (clinical) reasons. These parameters can’t be changed for a better survey UX.

Instead, the team focused on other aspects of the survey experience in the app. How do members find and access surveys? How are they messaged to members in terms of their importance in care? How can the app better convey their value proposition? How are the results of the survey visualized and shown to the member in the app?

The team identified and pulled these UX levers, even though the survey content had to stay the same.

Own up to misunderstandings and disagreement — and walk past them — together

Life happens at work. People sometimes misunderstand each other and overstep. People may overlook others or not realize they need to be involved. These things happen when very different teams of people work together.

We need to be willing to work through hurt feelings and justified resentments. We need to walk through these experiences and come back to the table again.

The recipe…one more time

To build great things for patients, technology needs to incorporate treatment and treatment needs to incorporate technology. Some ways to do this are:

  1. Commit to changing your lens. And not just one time or a few times. Commit to changing it as part of your ongoing work.
  2. Build out knowledge that you don’t have, especially regarding the other discipline (this will naturally shift your lens).
  3. Collaborate aggressively. Clinical team and Product team collaboration doesn’t happen by accident or artifact. It requires constant commitment to the partnership.
  4. Keep “patient seeking care for a medical condition vs person as a user of technology” at the forefront of every design decision.
  5. Accept and own misunderstandings and disagreements, then move past them.

If teams commit to these things, the magical marriage of mental health treatment and mobile app development becomes possible. When this magic happens, people with mental health challenges can experience healthier, happier lives.

About the author
Audrey Klein
Audrey Klein

Audrey is a doctoral-level psychologist who has worked in the behavioral health treatment industry for 15 years. Before Mindstrong, she led the Butler Center for Research at the Hazelden Betty Ford Foundation, where she designed, implemented and evaluated new treatment programs for individuals with substance use and mental health disorders. She currently leads the Clinical Operations and Design team at Mindstrong.