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Healthcare Leader

For several years, digital transformation has been promised as a solution to the rising pressures on the UK’s health service. Digital as the default delivery method is believed to be the solution to speeding up access to care, freeing up physical access for those most in need, and meeting financial pressures. And it’s not just the UK; globally, health leaders are advocating and driving the digitisation of care.

Yet for digital transformation to be successful, research persistently shows that service users must be central to the development and roll-out of digital solutions. To include service users, novel techniques are required. That’s where Human-Centred Design comes in.

In our recent paper, published in JMIR Human Factors, we discuss the complex challenge of including service users in the design and delivery of digital transformation. We focus specifically on mental health.

Mental health services are an especially promising area for digital innovation. Digital diagnostics can speed up signposting to necessary services. Chatbots are promised as a cheap, scalable, and rapid solution for psychiatric treatment. Health promotion, education and prevention can be supported remotely through digital resources. As can rehabilitation.

However, in 2022, it was estimated that there were over 15,000 mobile mental health apps already, with more predicted now. The problem is making tools stick. Research on uptake of digital tools shows that only where these tools are developed alongside users are they effective. For example, platforms for peer mental health support, or parent-led therapy for children, have been developed with their stakeholders and led to improvements in care.

How can this be achieved? In our paper we outline the method of Human-Centred Design (HCD). HCD is a method developed from design and commercial user-experience. It requires iterating between problems and solutions along with relevant stakeholder groups, or ‘actors’. In mental health, these actors include service users, clinicians, caregivers, public officials, and many more. The process requires:

• empathising with the situation;
• a discovery phase to understand needs;
• defining the problem at hand;
• designing the correct solution;
• prototyping and testing the solution
• planning and implementing the best option.

To be even more specific, we have defined HCD for mental health services as:

A practical iterative approach to the design, development, and reform of mental health systems, services, and products, that is achieved through communication, iteration, and empathy with users’ needs, desires, experiences.

The UK government, a long-time global leader in digital transformation, showed this is viable. We write about how NHS Digital, under the guise of NHSX, led HCD discovery projects to support the reform of the Mental Health Act. The primary recommendation emerging from this was that there should be electronic ‘advance choice documents’ to set out future care preferences, especially in cases of detention. Such a suggestion does not require artificial intelligence, but could make significant improvements to the dignity people receive in severe cases. However, it does require ongoing resource and commitment for success.

Readers might note that at no point in the HCD process I outline above did I specify the solutions were digital. One key message, both from our stakeholder engagement and from reviewing state-of-the-art literature, is that ‘the solution may or may not be digital’. We call this ‘digital solutionism’: assuming that digital transformation is going to solve all our healthcare problems.

True service user involvement requires openly identifying the problems in service delivery. At times, certainly, digital transformation can lead to more efficient and even higher quality delivery. Yet those designing and delivering policy and services must recognise what is vital: we must choose the solution for the problem, not pick up a hammer and look for a nail.

For digital transformation of all health services to be successful, we must include the most important people in that design and delivery. As well, we must recognise its limits. Human-centred design offers us an approach for both.

William Fleming is a Research Fellow at the University of Oxford’s Wellbeing Research Centre

Wanying Zhou, Jose Marquez, Leoni Boyle and Laura Taylor

This study applied psychometric network analysis to examine the structure of adolescent wellbeing across 49 indicators of subjective and psychological wellbeing in a large international sample (N = 6,445; ages 11-18) from 38 schools across 24 countries. We estimated networks separately for early (11-14) and middle (15-18) adolescents to assess developmental change. The overall network was moderately dense and highly stable. Overall life satisfaction, satisfaction with student life, and optimism about the future emerged as central nodes. While the global network structure was similar across age groups, older adolescents showed increased centrality for negative affect (“bad”), relaxed mood, and future optimism, and decreased centrality for current life evaluation. These findings underscore the integrated and developmentally shifting nature of adolescent wellbeing, and offer practical insights for monitoring, intervention, and policy. Results highlight the value of developmentally sensitive strategies that support both present experience and future-oriented resilience across diverse youth populations.

Alexandra Kirienko, Kate Laffan, and Laura M. Giurge

Abstract

People spend between 21% and 40% of their waking hours at work, making it an important domain of life to consider when trying to improve wellbeing (Kantak et al., 1992; Thompson, 2016). In addition to its inherent value to workers themselves, wellbeing is key to organisational success (Nielsen et al., 2017), with research showing that happier employees are more productive (Oswald et al., 2015) and less likely to quit (Pelly, 2023). Employee wellbeing is also positively associated with company profitability and stock market performance (De Neve et al., 2023).

William Fleming, Adam Coutts, Diane Pochard, Daksha Trivedi, and Kristy Sanderson

Abstract

Mental health services face a multitude of challenges, such as increasing demand, underfunding, and limited workforce capacity. The accelerated digital transformation of public services is positioned by government, the private sector, and some academic researchers as the solution. Alongside this, human-centered design has emerged as a guiding paradigm for this transformation to ensure user needs are met. We define what digital transformation and human-centered design are, how they are implemented in the UK policy context, and their role within the evolving delivery of mental health services. The involvement of one of our coauthors (DP) in the design and delivery of these policies over the past 5 years provides unique insights into the decision-making process and policy story. We review the promises, pitfalls, and ongoing challenges identified across a multidisciplinary literature. Finally, we propose future research questions and policy options to ensure that services are designed and delivered to meet the mental health needs of the population.

Financial Times

One of the most striking but under-discussed insights from this year’s World Happiness Report was that the marked worsening in young adult mental health over the past decade is primarily, if not exclusively, an Anglosphere phenomenon.

The share of young adults regularly experiencing stress and anger has risen sharply over the past 15 years in the US, Canada, UK, Ireland, Australia and New Zealand. But it has been largely stable elsewhere in the west, according to detailed data from the Gallup World Poll used in the report.

McKinsey & Company

In this edition of Author Talks, McKinsey’s Vanessa Burke chats with Jan-Emmanuel De Neve, director of the Wellbeing Research Centre at the University of Oxford, about Why Workplace Wellbeing Matters: The Science Behind Employee Happiness and Organizational Performance (Harvard Business Review Press, Spring 2025), coauthored with INSEAD assistant professor George Ward. De Neve shares data analysis on the feelings and motivations of millions of job seekers and identifies key drivers that influence their workplace well-being. He explains why workplace well-being varies across companies and provides evidence-based ideas for business leaders who seek to improve productivity, recruitment, and retention.