The future of mental wellbeing services

A 60 minute Case Study by:

Jennifer Bagehorn


Gene Libow


About this Case Study

London has poorer levels of wellbeing than anywhere else in the UK. Many Londoners do not get treatment for their common mental health difficulties, straining public and private resources. In this session we will show how Londoners' stories helped us engage with stakeholders to envision a new service model built on small, experimental interventions. Join us as we share our vision of a service ecosystem that distributes services into the digital communities that Londoners already inhabit.

Public Health England (PHE) and the London Clinical Commissioning Groups (CCGs) identified the opportunity to meet Londoners' unmet mental wellbeing needs through a 24/7 digital mental wellbeing service at scale (914,300 working age adults). The brief called for an online service to promote mental wellbeing by encouraging self-care and peer support via online communities, providing signposting to quality information and services and ensuring that there are safe online spaces for discussion and support.

PHE and Tower Hamlets (the lead CCG) selected Livework to lead a discovery phase to inform the design of the service. We fundamentally reinterpreted the brief and imagined a future service ecosystem that challenged the existing approach to designing and implementing services.

To begin, we spoke with Londoners who were experiencing low-level mental health difficulties, including stress, anxiety, low mood, sleeplessness, loneliness and depression. We travelled to their homes and listened to their stories. In doing this, we began to understand their experiences and needs.

We built on the insights from these personal stories by engaging health experts and diverse stakeholder organisations in identifying key challenges to providing mental wellbeing services. We unpacked these challenges and defined opportunity areas collaboratively in an initial workshop.

In a subsequent workshop, we collaborated with an even broader group of stakeholders including commissioners, third sector organisations and designers, to co-create service solutions for the main opportunity areas. We developed concepts by mapping how Londoners might interact with the key touch points, both online and offline. We created a new vision for a service ecosystem that distributes service elements into the digital environments that Londoners already inhabit, giving them the option of entering a more centralised environment when it makes the most sense for them.

To implement the service, we introduced an experimental approach based on small digital interventions that can grow over time. This enables users to digitally co-produce the service elements that meet their needs. For our client, this strategy avoids the risk of specifying a single large, untested service for implementation. In order to ensure sustainability, we outlined a set of priority experiments. We detailed what it would take to implement each one, and what type of team would be required to sustain such an initiative over time.

Because this is a public sector project, we are happy to share detailed insights into the process, methods and deliverables. We will argue that Londoners' wellbeing needs are best met through a mix of centralised and distributed means. Furthermore, we'll explore how a project like this operates within the broader health system, and reflect on the challenges and opportunities of engaging a broad mix of critical stakeholders. Finally, we'll consider what this project means for the design and implementation of future wellbeing services.

About the Speakers

Jennifer Bagehorn

Jennifer is a service designer at Livework with a particular expertise in designing services and systems that have a positive impact on people's health. She is passionate about building radically improved services for population health, increasing capability for change in organisations and joining up behavioural science with service delivery. Jennifer is also a certified yoga teacher and meditator who advocates for living and working in ways that promote good health.


Gene Libow

Gene is a senior service designer at Livework, where he leads the development of the agency's healthcare offer. He has worked in both the public and private sectors. Projects include designing services to support mental health, hospice care, cardiovascular health, student finance, childcare and travel. Gene studied philosophy at Boston College and before joining Livework, spent a year researching and co-creating healthcare service solutions that promote quality of life, care co-ordination and effectiveness.