Below is a guest blog I wrote for the Society For Participatory Medicine (SPM) and their newly released manifesto…
Navigating youth and their families through what is often a complex mental health system is a job that is frustrating but also an honor. As a licensed social worker, my compass through the journey is guided by a group of core values. The National Association of Social Workers defines our core values as service, social justice, dignity and worth of the person, importance of human relationships, integrity, and competence. When feeling frustrated about the work, grounding ourselves in these core values is a good place to start.
However, these values often lack an operational definition. In mental health or healthcare practice, how do these values play out? How do you measure them? Enter the Society For Participatory Medicine, Manifesto….
To read the rest of the post and learning more about Society for Participatory Medicine follow the link here.
Last you heard from me, a little over a year ago, I made the not so bold prediction that COVID-19 would shine the light on disparities and access to care. Not shockingly that came to fruition. From initial access to telemedicine services to the ongoing launch of vaccines, outcomes have demonstrated a lack of equity and equality. From a larger community perspective, COVID-19 has demonstrated what many of us have known. The playing field is not level and it will continue to the case. Unless we do something about it.
As virtual systems of care continue to be built and maintained. Questions still remain about have and have nots. Who gets access harkens back to the origins of their design. Enter in the concept of Design Justice.
Design Justice is a field of theory and practice that is concerned with how the design of objects and systems influences the distribution of risks, harms, and benefits among various groups of people. Design justice focuses on the ways that design reproduces, is reproduced by, and/or challenges the matrix of domination (white supremacy, heteropatriarchy, capitalism, and settler colonialism)”
It was my assertion several years ago was designers needed social workers. Learning basic design theory embedded in the book, shifted my thinking. Not only does design need social work theory, social workers need to understand design theory. The book takes you on journey of some of the important design theory and where it omits considerations of social justice. What was most striking to me was the difference between participatory design and design justice. Participatory design as it is the idea that end users are active participants are part of design. Being such a democratic process, I was surprised to learn it’s criticism of omitting social justice issues. Design Justice takes this a step further and talking about how users also have continued ownership and accountability in ongoing design. The end user involvement in design is not the only outcome, it yields a completely new system with users playing an active role in it’s continued development.
The author makes it clear that Design Justice was the developed by not just one person but it is a community of practice. The Design Justice Network have developed 10 core principles Design Justice practitioners are guided by:
We use design to sustain, heal, and empower our communities, as well as to seek liberation from exploitative and oppressive systems.
We center the voices of those who are directly impacted by the outcomes of the design process.
We prioritize design’s impact on the community over the intentions of the designer.
We view change as emergent from an accountable, accessible, and collaborative process, rather than as a point at the end of a process.
We see the role of the designer as a facilitator rather than an expert.
We believe that everyone is an expert based on their own lived experience, and that we all have unique and brilliant contributions to bring to a design process.
We share design knowledge and tools with our communities.
We work towards sustainable, community-led and controlled outcomes.
We work towards non-exploitative solutions that reconnect us to the earth and to each other.
Before seeking new design solutions, we look for what is already working at the community level. We honor and uplift traditional, indigenous, and local knowledge and practices.
In reading these principles and watching them come to life I couldn’t help but think how much they align the core values of social work practice. For those of you reading this from the design side of the shop, those core values are service, social justice, dignity and worth of the person, importance of human relationships, integrity, and competence. I was also struck by how much these principles could help better operationalize these core values.
These social work core values and Design Justice principles collide in our work; from facilitating community organizing to design of digital health technologies. Examining social work practice from the Design Justice framework can add a lot of value. In our individual work we do well with principles but then as we expand out to more mezzo and macro work, it becomes more challenging. This is especially true of the work we are doing around anti-racist practices. The elevation of decolonization of social work and abolitionist practices has forced us to think differently about systems design. Who holds the power and makes decisions in our systems design directly impacts the outcomes.
For example thinking about design of our mental health services. Where do we “truly center the voices of those directly effected”? Is our systems design more influenced by billing and reimbursement or are they designed with the services for the client? In light of recent news much has been talked about what social work’s role should be with police departments. When thinking about police reform that includes social workers we need to consider the impact this will the community? Who defines “success” and how it is carried out matters.
One of the principles that is in line with social work values is being a facilitator rather than and expert. Treatment modalities such as motivational interviewing, challenge clinicians to mind our “expert stance”. Our ability (our inability) to do this in community level of practice is key.
Much like the author of the book, I am interested in technology design practices. Using these principles, we can question what we have missed and continue to miss when building health information technology design. The work in this space often lacks the above principles. It often ignores what is already working in communities. It often owned by companies disconnected from the communities they serve. Not only that sometimes disconnected from the clinicians that utilize the technology. The author takes us through examples that are easily applied to your area of practice.
Design Justice has been a powerful exploration for me in a lot of ways. If you are interested in a how we can design more just systems of care that align with social work values, I highly recommend this book. As mentioned earlier, Design Justice is not just one person, it is a community of practice. Learn more about this also visit the Design Justice website.
