Building a National Mental Health Platform Through User Research and Behavioral Design

It goes without saying that the COVID-19 pandemic has taken a serious toll on our collective mental health, but it’s still worth taking a second to consider the numbers. A year into the pandemic, in March 2021, 35% of Canadians said they were dealing with anxiety, and 17% said they felt depressed all or most of the time.¹ With this massive spike in demand straining the capacity of mental health systems across the country, many have struggled to access the services they need, at the moment they need them.

Wellness Together Canada was launched in response to this crisis, with funding from the Government of Canada. Developed by a consortium of Canada’s leading mental health and substance use organizations, Wellness Together Canada is an online platform that connects users to important sources of support. These include everything from phone calls with a trained counsellor, to online communities of support, to articles and self-guided courses, to emergency crisis response services. 

For the many Canadians who were overwhelmed and struggling to find support during the early days of the pandemic, Wellness Together Canada became an invaluable lifeline, connecting users to a counsellor after an average wait time of just 12 seconds. In its first year alone, Wellness Together Canada was used by more than 1.2 million people, across 3.6 million web sessions. If the platform hadn’t been available, almost a quarter say that wouldn’t have accessed help elsewhere. That means an extra 300,000 people who were able to get the help they need.² 

Digital mental health services like Wellness Together Canada represent a promising new frontier for delivering scalable resources at a low cost. But in order for this kind of platform to be truly accessible and impactful, behavioral design is key. Users may be coming to the website from different cultural and linguistic backgrounds, mental health histories, and levels of readiness to engage with certain resources. They all face different barriers when accessing digital mental health care, and it’s only through rigorous testing and behavioral research that we can design a product that balances such a vast array of interlocking concerns. 

Complicating things even more, individuals who are going through mental health difficulties may be more susceptible to information overload and other cognitive biases. That makes it harder to navigate available options and make informed decisions, increasing the risk that users will give up and click away if they don’t find what they’re looking for quickly. Platforms like Wellness Together Canada have to be designed with the science of human decision-making in mind, to ensure that users in crisis are still able to find the support they need.

TDL partnered with leading mental health organizations from across Canada to redesign the Wellness Together Canada platform, bringing an evidence-based behavioral perspective to the website’s development. 

Our work with Wellness Together Canada has been an ongoing collaboration, with TDL serving as the project’s Behavioral Science Team since 2020. We’re proud to have played a key role in the platform’s development, empowering people in Canada (and Canadians abroad) to take an active role in shaping their own journeys through digital mental health.

Since coming onboard the project, we’ve conducted research with thousands of people from across Canada. We’ve taken a mixed methods approach, combining quantitative and qualitative tools such as surveys, focus groups, 1-1 interviews, revealed preference experiments, and data analytics.

Our research

With everything going on in the world today, the mental health needs of people in Canada are constantly evolving. But those needs also vary between groups. Some communities, such as people of color or newcomers to Canada, face substantially more barriers in accessing mental health care.  

We wanted to ensure that the Wellness Together Canada platform was representative of all of these experiences. With that goal in mind, we recruited an co-design research pool of more than 2500 people, with a focus on representing communities traditionally underserved by the healthcare system. We’ve engaged our research pool to participate in one-on-one interviews, focus groups, usability tests, surveys, and more. 

Getting the chance to talk to so many people about such an important topic was a hugely meaningful experience for us. Our participants have gotten vulnerable with us, sharing their personal stories — their experiences with mental health and substance use, what they think needs to change in the healthcare system, and what they think about digital mental health services. 

It’s because of our participants’ courage that we’ve been able to get such a rich understanding of who is using Wellness Together Canada (and who isn’t yet). Through this work, we were able to develop user personas and the shapes their user journeys take, what barriers they face when seeking care, and more.

Through all our surveys and conversations, one clearly theme has emerged very early on: privacy. A majority of our research participants were concerned about sharing information related to their mental health online. It’s not hard to understand why: there is still a lot of stigma surrounding mental health and substance use, and users are understandably worried about the consequences they might face if their information were to be leaked. 

Users need to feel safe when accessing digital mental health care. Before they can feel secure in sharing personal information, they need to understand why they’re being asked to do so, how it will benefit them, and how their data will be stored. And above all else, they need to know that the platform they’re sharing this information with actually has their best interests at heart.

The updated platform is structured to emphasize user autonomy and transparency at every turn. Through changes such as minimizing the amount of personal information users need to share and highlighting the platform’s Privacy Commitment highly visible across the platform, we made sure that visitors to Wellness Together Canada knew they were always in control of their own journeys. 

People come to Wellness Together Canada for support with all kinds of concerns. They also arrive at different points in their mental health journeys, different preferences for the types of care they receive, different cultural backgrounds, and more. In redesigning the platform, we had to make sure that everyone visiting the site saw themselves represented there — and that no matter what they were looking for, Wellness Together Canada would help them find it. 

Our work was grounded in the Stepped Care 2.0 model, which is focused on ensuring that individuals are always able to access the type of care that’s best for them (rather than funnelling everybody through the same starting point). We wanted to make it as easy as possible users to “step up” to more intensive forms of support, or “step down” to more hands-off resources that they could complete on their own. 

Implementing Stepped Care meant building out all the different levels of support for users to access, from low-touch options like educational articles all the way up to immediate crisis support. TDL worked with more than a dozen of Canada’s leading mental health and substance use health organizations to integrate a diverse suite of wellness resources into the platform, and facilitate users’ journey to the resources that are likely to be most helpful for them. 

Users can now access dozens of evidence-backed tools, educational articles, and self-guided exercises without needing to log in or create an account. For any visitors who are feeling hesitant about reaching out for counselling, or who are just starting to learn about mental health, this resource library is there for them 24/7. 

COVID-19 was the impetus for creating Wellness Together Canada. But even as the world opens back up, the platform is still helping millions of Canadians who are struggling with mental health and substance use concerns. TDL is continuing to support the platform’s development as behavioral research leads, working to make sure that diverse communities across the country have access to evidence-based mental health support. 

1. Third poll in CMHA Ontario series indicates mental health impact of COVID-19 at all-time high. (2021, March 15). CMHA Ontario. https://ontario.cmha.ca/news/third-poll-in-cmha-ontario-series-indicates-mental-health-impact-of-covid-19-at-all-time-high/ 
2. Yousif, N. (2021, May 8). A national online mental health Portal had 1.2 million users in its first year. Is wellness together Canada here to stay? The Toronto Star. https://www.thestar.com/news/canada/2021/05/08/a-national-online-mental-health-portal-had-12-million-users-in-its-first-year-is-wellness-together-canada-here-to-stay.html