Exploring Conditions for Community Care in one Neighborhood

How might peer support and community engagement enable a new approach to increasing low-cost and accessible mental health
services in Estonia? 

This was the central question of a 10-month research project supported by the Estonian Health Insurance Fund and Estonian Academy of Arts (EKA) as a joint development grant, which identified gaps in the existing mental health services for young adults aged 16–26 in partnership with a local family clinic in one neighborhood in Tallinn, Estonia.

Throughout the project, the research team created a deliberatecollaborative process to better understand a variety of stakeholder needs within the Estonian public sector and to uncover shared beliefs and values that function as the foundation for collaboration on a new service. The process and resulting service concept stems from the belief that all stakeholders, especially patients, can take responsibility and play a meaningful role within a mental healthcare service. We call this approach community care, in which stakeholders use the existing assets, talents and capital to create a service that represents and reflects their community. The service concept is a peer support group for young adults transitioning out of individual therapy that is mentored by a mental health specialist over six months. The small scale test of the peer support group with six young adult participants resulted in them feeling a sense of belonging and positivity after the sessions. This approach blends aspects of group therapy with peer-to-peer type services. The concept stemmed from the need to address the long queues for therapy services combined with the short supply of available therapists. It was critical this project resulted in a service concept that was both low-cost and resource-efficient.

This project is an example of where and how a design process can facilitate intersectoral collaboration, as it explores the specific practicalities required to do so, including funding, service structure, and activities within the service. For mental health services to become
sustainable in Estonia, lived experience has to be considered as an untapped resource that could help ease the burden of the current healthcare system. Unfortunately, this project and the resulting service concept does not address the larger systemic challenge of the drastic shortage of mental healthcare professionals in Estonia.

Eva Liisa Kubinyi (Guest lecturer, Department of Product Design, Estonian Academy of Arts)
Meghan Lazier (Guest lecturer, Department of Product Design, Estonian Academy of Arts)
Maarja Mõtus (Head of Department of Product Design, Estonian Academy of Arts)
Josina Vink (Design Researcher, Oslo School of Architecture and Design)
Ruth-Helene Melioranski (Dean of the Design Faculty, Estonian Academy of Arts)

Financed by Tervisekassa and European Regional Development Fund

Graphic design: Patrick Erik Zavadskis, Michael Ashley Fowler

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Posted by Mari Maiste