Working and Mental health have usually been focused on in many research areas. But in this research paper, the time period of travelling from place to place for work or some other reasons has been implemented in regards to the mental health of the people. With the help of an artistic approach, an open platform is aimed to be formed for the people to interact, share and listen to each other's stories concerning mental health challenges by ignoring the stigmatised notion of the same. The methodology used comprised extensive secondary and primary research. The study was conducted mainly in Indian metropolitan cities. Distribution of surveys was conducted remotely on ‌mental health and the various perceptions of it, continuing with one-on-one interviews with a total of 16 volunteers from the three major target audience groups - artists, mental health professionals and mental health challengers. After receiving the results from the methodology tools, a device was created for interaction among the people who commute by metro trains. Through this device, tasks were given out for the users/travellers for them to perform during their commute with an end incentive attached to it.

Keywords: mental health, metros, artists, therapy, interactive platform

The mental health of a human being consists of their psychological, emotional and social well-being. This means that it affects one’s feelings, thinking and behaviour throughout the day.¹ Mental health is an essential and integral component of health. The World Health Organisation (WHO) constitution states: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." This definition has implicated the importance of mental health and that it is more than just the absence of mental disabilities or disorders.²

Yet there are one too many people out there facing several challenges mentally, and some are not even aware of them. Mental health conditions are considered being indiscriminate and hence can affect anyone. Mental health issues seem to be like a spectrum where everyone finds a place to sit somewhere along the continuum. Some groups are more likely to be affected than others.³ The National Mental health Survey 2016 found that almost around 14% of Indians requisite active mental health interventions, making India one of the highest prevalence of mental health globally.⁴

Awareness of mental health

There’s a very important reason to make a concerted effort to spread mental health awareness. That is simply for the fact of de-stigmatizing how mental health issues are thought upon, approached, and even identified in society. Having those tough conversations and admitting there’s a problem means that a solution can be dug up. The work to remove the shame and fear that’s often associated with topics surrounding mental health can be implemented. Doing so will increase the probability of somebody reaching out after they want to help. Posing for assistance is an indication of strength. Working together permits human beings to begin building a foundation focusing to respect and honour the importance of good mental health. Another profit in aiming the awareness of mental health is that it will build signs and symptoms of conditions even more known. Predictions of early interventions are of how flourishing the treatment of mental health is going to be for several conditions. The earlier someone is diagnosed and begins treatment, the more likely it is that they’ll be able to manage their condition and improve their mental health.⁵

Given a large amount of people in need of therapy and immediate solutions, it is pharmacological treatments taken as a first choice. Through these treatments, major symptoms are eased for mental disorders, but the antipsychotics lead to poor life qualities. Hence, professionals have begun to consider complementary therapies like expressive art therapies.⁶

Art and artists

Health and art go positively hand in hand. Art can bring tremendous benefits to the mental health of oneself and contribute to overall well-being. According to Alban,⁷ the average person has roughly 70,000 thoughts per day and 90% of them seem to be the same thought. And doing artistic activities helps them to immerse in creative endeavours and find themselves in “the zone” or a state of “flow”. These activities are known to lower stress levels and promote calmness. The mental flow received by the brain when creating art relaxes and distracts one from their day-to-day life worries.  The details and creativity from the art skills bring imagination and creative thinking in kids and adults along with problem-solving abilities. The dopamine produced when working with art makes people feel good, increases drive and improves concentration.

Art therapy

Art therapy is a type of therapy that amalgamates mental health and human services by using “active art-making, human experience, applied psychological theory, and creative process.” Art therapy is a relatively new development as compared to art, which has been an important part of human civilization for thousands of years. The term art therapy came from the artist Margaret Numburg who lived in the United Kingdom in the 1940s. She believed that while going through the creative procedure, the individuals might bring up their unconscious feelings and thoughts that were repressed before.⁸

One of the most important things to know about art therapy is that the person need not be an awesome artist. All that person needs to do is let down their guards and let the creativity take over. If the person becomes honest with oneself and feels the emotions within, the inner artist will come to the surface automatically. It is verified and agreed upon by the Mental Health professionals and experts on the benefits of art therapy. It helps boost confidence, and self-esteem and provides you with a safe outlet to relieve your emotions, giving you a sense of control over your life and helping you to get to know and understand yourself better.⁹

Daily commute in metros

According to the Centre for Urban Design and Mental Health, most people dealing with mental health challenges have higher rates compared to rural areas. It can be seen that there is more than 40% risk of depression, anxiety crossing over 20% more and the risk of schizophrenia is double than its regular rate. There are high possibilities of loneliness, stress, and isolation.¹⁰

With the given statistics it is also observed that travelling in the metros can cause issues related to mental health. There is a high possibility for a drop in serotonin levels meaning a chemical in the brain that manages a person’s moods can be affected while travelling in the metro for their daily commute. This results in feelings like being worried and low and scouring into one’s deep thoughts. Travelling in daily commutes can lead to ‘Cattle Struck Syndrome’, this mainly points to the stress of a tiresome day which crowded more similarly to a cattle truck. This can lead to anxiety symptoms as well.¹¹

All the research was mainly focused on aspects such as art therapy, stigma on seeking mental health and also lack of platforms for people to express themselves. These led to the formation of the objective which was to create a platform that will help destigmatize and help people express freely their worries and experiences. The problem statement curated was, ‘Mental illness challengers need a place/platform to comfortably look for reliable and accurate solutions without the need to pay for expensive therapy because even if provided for free, they wouldn’t opt for therapy due to the social stigma and are ultimately more drawn towards false information fed to them through unreliable online/social media content.’

The dive into a more detailed study on the selected topic under mental health led to various research materials, tools, and methodology implemented for the study. The division of the methodology was into two major stages which had several sub-sections in it. Each stage of the study was aimed at achieving development in the study’s objective through the bifurcation into their features.

Design research

The groundwork for the research was at this stage. In this section extensive research was performed on the topic. Thorough research was conducted using the Primary and Secondary research tools. Through this phase, sufficient data was accumulated which helped in understanding the basis of the problems like stigma towards mental health and inadequate amount of money leading to the inability to have therapy and the current solution that was being implemented in the hope to reduce the existing issues.

1. Secondary research

The orientation of the study began with in-depth research on the topic itself. A vast topic like Mental Health is required to be precisely broken down into the various categories it comprises. The secondary research conducted was to understand the basis of the target population along with the streams under mental health that the target audience was in relation to. Literature review was undertaken to analyse the vastness of the topic and the major problem sections in today’s world regarding the study. After the literature review, mind maps were drawn out to understand the connections on the topic, which further help in establishing the key findings. Through these tools, a better perspective was cultivated on the study and clarity on the problem areas was highlighted along the way. This helped in the compilation of existing qualitative data.

2. User groups

The classification in the target audiences was achieved with the help of tools like mind mapping and secondary research. The age range of the audience was selected between 18 - 50+ years. They were precisely categorised into three groups, namely, the artists, the mental health professionals - therapists and doctors, and the people who were then currently dealing with mental health challenges. The study was conducted mainly focusing on Indians living in metropolitan cities. Following was the procedure followed in the process of finding final end-users and outcomes of the surveys and interviews conducted.

1. Online Survey

Online surveys were conducted to reach a wider group of the targeted audience which helped in the collection of quantitative data. Google Forms were used to create the surveys, which consisted mainly of multiple-choice questions and a few reasoning questions to understand the users’ selections. Each survey was conducted remotely and was spread across with the help of social networking sites. The questionnaire was precisely made in context with the major problems that are yet to be dealt with, especially in India, regarding Mental health and it also included the perspective opinions on the existing solutions in the same study.

2. Empathy interviews and personas

After the results were gathered from the surveys, empathy interviews were conducted with people representing the target audience. An open-end questionnaire was curated for the interview. Each targeted audience group had representative users. A total of 6 artists comprising no particular art forms and 6 mental health challengers were interviewed along with 4 therapists and counsellors. The interviews conducted for the mental health challengers were kept anonymous for the interviewees' comfort. The users were interviewed to mark out their understanding of their experiences, reasoning, motivations, and pain points. Through the interviews, a more direct and comparatively clear motive came to understanding the intent of the study. The questions put forth in the interview aided in the creating the personas of each group of the target audience.

The following personas were created:

1. Artists
2. Professionals (Therapists and Counsellors)
3. Mental Health Challenger

Each persona consisted of users’ specialisations, users’ task flow and expectations for the ultimate solution regarding the field of concern.

3. Data evaluation

The evaluation of the data collected from the secondary and primary research began from this stage. The users’ insights were studied to look into their feelings and understand their actions and subconscious behaviour.

1. Empathy mapping

The user personas were broken down into four categories to understand their behaviour more intensely and were recorded on Empathy Map including the gains and pains in their user journeys. Through this mapping system, each user’s conscious and subconscious behaviour were brought to light by bifurcating what they saw and heard around them and what reactions did that have they said and did as their own actions. The users’ thoughts and feelings were also looked into so as to get a more in-depth perspective of the study.

2. Saturated wall

In the saturated walls, the data gathered from the empathy map for all three users individually was summarised into one. This helped in discovering different patterns in the data which helped in aiming in a specific direction of the topic and identifying the major problem areas in the study.

3. Problem statements

The problem statement was curated with the help of the saturated walls as it narrowed down the categories the study was directed in. The major problems were then grouped into one main problem statement. As mentioned earlier the problem statement formulated was, ‘‘Mental illness challengers need a place/platform to comfortably look for reliable and accurate solutions without the need to pay for expensive therapy because even if provided for free, they wouldn’t opt for therapy due to the social stigma and are ultimately more drawn towards false information fed to them through unreliable online/social media content.’

Ideation & prototyping

This stage of methodology was aimed at building different concepts which ultimately led to making the final product prototype. That product would represent the solution and its viability in real-world scenarios.

1. Conceptualisation and product vision

Through the problem statement, three major themes were identified. Theme 1 being ‘Stigma’ for the taboo and stigma that is still engraved in society towards mental health issues. Theme 2 was ‘Platform’ which symbolised a creative outlook for the final envisions of the product. The last theme being Theme 3 was ‘Expensive Solutions’ which was denoted as another barrier that prevented people from getting the treatment they deserve and more importantly required. For each of the three themes ideations were conducted which led to three ‘How might we?’ statements. These statements then led to various concepts for the final design of the product/interaction forming under each statement.

The conceptualization helped in curating a product vision by eliminating unnecessary and weak products. The vision for the prospective outcome was aimed at "Interactions aren't limited only with the known". This product vision helped in giving a concrete outline of the desired outcome.

2. Minimum viable product

After the selection of the one concept of the lot, the process of prototyping had begun by discovering the concept’s Minimum Viable Product (MVP), meaning its most elementary form of the final product.

3. Analysis tools

1. SWOT analysis

The swot analysis was performed to brief out the final product’s strengths, weaknesses, opportunities it would bring in the future, and the threats it may possess if faced with any backlash.

4. Prototyping and iterations

The commencement of the final product being formed had begun at this stage. Before the final product would be released, in this step various design-related and technical changes appear that help in iterating a better version of the final product.

After the finalisation of the product’s forms and interactions, a low fidelity prototype was created following a 3D Computer-Aided Design (CAD) model formatted in fusion 360 application along with its interface being prepared in Adobe applications like Illustrator and Photoshop.

Based on the user problems identified, the mentioned stages followed in the methodology procedure were key in gathering and deriving insights into the data efficiently. Identification of pain points and challenges faced by the users enabled an empathetic relationship. The final design solution was a result of all the executing various design tools and processes. The formulation of the final concept made a step forward in the refinement of the problem procured earlier.

The motive of the study is to focus on the reduction of mental health stigma with the help of creative outlooks and discovering new methods inspired by therapies like art and music which ultimately help in identifying solutions for the said problems.

The purpose of this segment is to present the key findings and accumulation of the data gathered in order to aim at procuring an outcome to improve the Mental Health status in India.

Through the desk research, various problems and trends followed by the people were highlighted when it comes to mental health precautions and stigmas. Along with the data gathered through desk research, mind mapping provided further insight by narrowing down the extensive data and information collected. Through these tools, further research was conducted to get to terms with the help of surveys and interviews which ultimately led to the formation of the final concept.

Mental health in India has yet to be given the importance it deserves. It is agreed upon that the conditions have improved yet it supposedly has a long way to reach the comfort level of the people, especially those who live in India. Mental Health is a topic that is extremely talked about by almost everyone these days, although it is unclear whether that is actually educating people about its seriousness or if people are just pretending to be understanding as it seems to be trending.

Similar questions were asked in the surveys conducted for this study. Through the questionnaire, a jist of knowledge was achieved in gathering insights into people’s mindsets and beliefs. Each survey was bifurcated into specific age groups and one of the surveys focused mainly on art and its influence on mental health.

However evident the need to have a healthy mind is encouraged, it is seen that out of a total of 37 respondents, 78.4% respond in a firm ‘yes’ when asked a question about seeking a counsellor. 8.1% have considered opting for one and only 13.5% have confirmed not required to see a counsellor (Figure 1). In the same survey, a total of 51.9% out of the total count are still insecure about their dealings with the mental health issues they are facing. Through these responses, the research conducted earlier confirmed how the stigma is overpowering the need to seek help. When asked about the individual opinions of the surveyees on the Mental Health progress, one main pattern was noticed. It is that mental health issues and seeking help should be normalised.

Figure 1 Survey question for the general audience on their need to see a counsellor.

The surveys were then asked questions in relation to therapy and how art is an upcoming way that helps in the field of therapy for dealing with mental health challenges. Out of the total responses, 82.4% were aware of the term ‘expressive art therapy’ but 17.6% were still not sure of any such therapy for the mental health challengers (Figure 2). This led to the understanding that expressive arts have reached a level where maximum people were aware of it and have tried different art forms themselves to cope with their issues and circumstances (Figure 3).

Figure 2 Survey response on the knowledge of expressive art as being on the therapy for mental health challenges.

Figure 3 Survey response on the different art forms used by the participants to cope with their mental issues and well being.

After receiving the responses from the survey questionnaire, specific target audience groups were created to do more in-depth interviews with an aim to collect a cluster of specifications and put them forth in a particular direction.

To dive into more details into specific research, one-on-one interviews were conducted. A total of 16 participants were selected for the interviews which were conducted virtually through platforms such as Zoom and Google Meet. Each interviewee had their consent and volunteered for the interview. As mentioned earlier, the three groups were Artists, Professionals and Mental Health Challengers.

1. Artists

A total of 6 interviews were conducted under the artists target group. These artists were not selected based on any particular art form, however, the hope to see a trend based on how they use their platforms to express their emotions and mental state was the aim. Since the topic had been narrowed down to only focusing on the “expression of mental health through creative media”, Artists became one of the best users to interview in terms of finding out whether art or creativity really does help one to be more expressive about their mental health and emotions (Figure 4).

Figure 4 Questions asked to the artist.

The procedure followed was to ask the interviewees about their mental health and if they had faced any low points in life that may have caused them to not be in a good place mentally. The conclusion achieved was that creativity and art can be a way or a platform to express or help one feel less burdened about their emotions. It was brought to light that artists had a more open mind and were more comfortable talking about their issues. Some common emotions among artists that were visible were frustration, insecurity, sadness, anger inflicted on themselves and uncertainty about whether they would have to go through this again. 

2. Professionals

The interviews conducted were for 4 different professionals in the field of mental health. The interviewees selected for this user group were mainly from the medical industry or had connections to expressive art therapy. The aim of these interviews was to achieve some insight from professionals in the industry and to see how mental health is perceived in reality (Figure 5).

Figure 5 Questions asked to the Professionals.

The reason to choose this persona was to understand what the medical industry or expressive art therapists were doing in order to help those with mental health issues cope. Many misconceptions about the study were revealed which were then cleared by the interviewees. When asked about the industry they were happy to share information and how they usually go about their procedures when they have a mentally unstable client. All of their first priority seemed to be the same, which was to make the client comfortable first.

3. Mental health challengers

The people who are going through and/or have been through some distress in their mental health were asked to give their interviews with their consent. Six volunteers agreed to do the interview on the condition that they remain anonymous. This user group was selected hoping to understand their state of mind and what they go through during that ‌period of time (Figure 6).

Figure 6 Questions asked to the Mental Health Challengers.

The interviewees that were currently or have been in the past suffered from mental illness were asked to share their experiences in order to understand and empathise with them. They were further asked about their daily challenges and what they had to go through during that period. Even though the questions asked at the beginning of the interview were mild and not that triggering along with the ice breakers, the common emotion felt by all was hesitance and insecurity. Not all were open about their experiences and even if they were it was easy to sense that they would rather not say this again to anyone else.

Then the interviewees were introduced to the topic of expressive arts therapy and creativity as a way to cope, and the majority agreed that they would opt for expressive arts therapy, for certain common reasons such as normal therapy being a taboo in society along with it being expensive and not being as accessible since they have to talk to a stranger. Some even mentioned that art helped them cope with some of their issues at that moment. Another issue that came into the conversation was COVID-19 and being locked inside the house with nothing to do to distract one from their thoughts. Quarantine and lockdown have made many lives difficult in terms of mental health. However, the conclusion came that creativity/arts help one, and people would want to opt for it if they haven't before or instead of therapy.

The intense analysis of the surveys and interviews rowed the study towards its endpoint, i.e. the ultimate solution for the said problems. The results achieved helped in creating a better outlook and a probable concept hoping it would come to help in the future.

Proposed solution

Various concepts and ideations were executed after the completion of the research procedure. After going through that procedure, it came to light that expressing mental health issues has still been a challenge that needed to be looked into urgently. Although the awareness on the same topic was known to almost all the people, yet the need to express it or even acknowledge it freely had not been accepted completely. The stigma around the study did not help in making it easier to come up with a solution that will affect people’s lives in a better way than it already was.

After brainstorming on the highlighted problem areas, the process of finding a final concept solution had begun. Through various themes that were established, several ideas were put down on the table and had been a notion to declutter and remove the repetitive or unnecessary possible solution ideas. With the help of the existing solutions and practices followed in the field of mental health, a number of concepts were influenced and improvised while narrowing them down as well. Finally, one single concept was adapted and aimed to work forward to improve the same. The solution focused on creating a platform where people could interact and do activities, in the hope that it might distract them from their daily lives and give a little sense of relaxation and/or happiness by doing the same. In deciding the area to conduct this interactive process, a conclusion was derived for doing it in a moving environment which is usually filled with haste and hustle. Hence, it was decided to go with people travelling in metros as their daily commute.

For the interaction, a device was required which would help in containing and managing the activities. To create the same a lot of ideation processes were followed where the rejection of many traits and adoption of particular forms were conducted.

Each concept was sketched out keeping in mind the mind state of the people travelling in the metro and how they will perceive it (Figure 7). After the ideations and iterations, a final form was selected which was created from the inspiration of a mason jar. The aim of the device was to get out that magical and happy feeling for whoever sees it and hence the product was formed. The main agenda of the device was to act as a dispenser that will be installed on the walls of the metros. From these devices, records of activities and tasks will be suspended for the user to perform.

Figure 7 Ideations of the Concepts.

Now coming to the second part of the solution concept, activities. Through the jar, tickets shaped papers were planned to be dispensed which had various activities and tasks written on it that were supposed to be performed by the travellers/users. These activities were short spanned and were curated with the aim of making the people interact with each other instead of them staying on their phones. It is said that the social interaction of just 10 minutes can boost intellectual performance.¹² Through these activities, the users were supposed to perform them and were given the opportunity to share it with the world as well by recording themselves and uploading on the said websites along with social media. This could also help in spreading the word about the initiative with the aim of getting popularity and people trying it out in various other places as well. Though the tasks and devices were ready, there was a major issue that came across which needed to be dealt with. When the consumption of paper is involved it is bound to be thrown off or left behind making a clutter of waste everywhere on the stations itself. To avoid this mishap, it was decided to create an incentive with the papers itself, in order to reduce and maybe even prevent littering. It was decided that the skill of origami will be used for the aftermath of the activities papers. The tickets will have a drawn-out step by step of easy origami characters which could be folded by literally anybody. This initiative would help in keeping the stations and metros clean along with giving the users a gift or prize like the thing to keep with them in remembrance of the activity they did there.

In the above image (Figure 8) the task mentioned is written in English along with its Hindi translation to make it human friendly for the people of India, keeping in mind that Hindi is the official language of India. Along with the task and origami activity, a donation QR code was also provided in the tickets for the users to spread the word and do a good cause for others too.

Figure 8 A demonstration of one of the tickets.

Prototype

The final prototype was created in the Fusion 360 of Autodesk. Condensing all the refinements and corrections, the device was made in hope of it reflecting a kind of magic that would attract the travellers to it (Figure 9).

The dimensions of the jar were formed with 4.5ft in height and 1ft in its width. It consisted of a mechanism which surfaced a pushed button at its bottom which when activated will dispense off a ticket from the flap right beside it (Figure 9). The lights and origami cut-outs hung on the glass reflection was to create a magical yet attractive outer look for the device. The symbolic meaning behind the jar having a transparent outer surface which is letting the users look into the inside of the jar was to let them know that when the inner self is seen with the outer look, it becomes even more beautiful and realistic (Figure 9). In the figure above (Figure 9), the black screen visible was created for the travellers to see the daily news in regards with the Mental Health topic along with the count of tickets precured on that particular day. The working mechanism of the jar was covered by a mirrored pole right in the middle of the device (Figure 10).

Figure 9 AutoCAD version of the final concept named, Magical Jar.

Figure 10 Live presentation of the Magical Jar installed in one of the metro’s compartments.

The importance of Mental Health is a vast topic with a number of sub-topics branching out. Through extensive research on the same, it has been realised that irrespective of the unlimited numbers of solutions and futuristic devices created for the betterment of mental health, it can be successful until and unless there is a positive involvement of the users themselves. In the hope of the same, the Magical Jar was created to provide an interactive platform for the daily commuters on the metro trains.

Through the research, surveys conducted and interviews performed, it was established that an artistic approach for the solution of the study of the betterment of mental health among the people of India would be something relatively new and attractive. Through the proposed solution it is aimed the interactions would lead to help the commuters neglect their stressful day and have time for leisurely fun. The ultimate aim achieved will not only focus on those dealing with mental health issues but also on those who might or might not be dealing with them knowingly.

The end result of the study can be procured as an attempt toward healthy and creative minds. The solution achieved from this study could be further used in enhancing the idea of using art with mental health or any such specific measures which could start as a small impact on a group of people but will ultimately spread like wildfire and expose it to the world. It is hoped that ‌mental health challenges eventually be discussed more freely and accepted even more easily in the societies that we live in.

We want to thank NMIMS School Of Design for giving us the opportunity to conduct research on such a relevant topic.

No conflict of interest.

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