Design Thinking Process: e3  

Discovery Phase-Checklist
Parts 1, 2, 3
Due:

Work with your design thinking team to take notes about each part of the Design Thinking
Process that you complete together. After you feel that you have fully explored each step of
the three parts listed, change the checkbox to a check mark. Return to and revise each part as
needed.

Prepare for Research – Discovery Part 1

❏ Identify/define the topic

We are looking at how schools are correlated with poor mental health, and how we can change the
way classes are structured to help improve mental health both in e3 and in other schools.

❏ Identify/define the audience (end users) -- Who will benefit from solving our problem
statement? These are the end users:

Going from narrow to broad, our end users are as follows:

- E3 Scholars
- E3 LF’s
- E3 Families
- Middle/High School students

❏ Share what you think you know about each end user (needs, challenges, background, etc.):

Scholars are under tremendous pressure to perform in schools, and I have firsthand experience
with how this can induce anxiety. Additionally, when students get behind they can start to feel a
sense of hopelessness that prevents them from reaching out for academic and emotional support
from the people around them, and this can lead to depression. Although I am less intimately familiar
with them, pre-existing conditions are particularly hard on students; ADHS, PTSD, anger issues and
any other mental stresses exerted by student’s surroundings can be massively exacerbated by the
high standards of performance in school.
I am even less familiar with how student mental health affects teachers, but I do know that it can
lead to poor working relationships between scholars and teachers; I’ve been on the receiving end of
more than one lecture from a misunderstanding teacher who didn’t realize that the reason my
homework wasn’t complete wasn’t because of my laziness or academic inability but rather my
emotional inability to process the additional stress the work placed on my shoulders.

❏ Identify what you don’t know:

So far, my greatest concern is that I’m not sure where to start looking. A cursory internet search
produced a moderate list of organizations I can start pestering to in order to find where I need to
look. A key data set we still need to more fully understand is that of demographics; intuition tells us
that there will be a demographic disparity regarding mental health, but we need to know to where
and to what extent this occurs.
I am familiar with the student counselor system from the point of an end user; I’m particularly aware
of its limitations. One of the greatest concerns I have is that the ratio of emotional counselors to
students can exceed 500:1 in fortunate cases; my former school had a ratio closer to 3,000:1. It’s
also concerning how little time they have available, even for students with acute mental disorders; it
can be difficult to get a hold of them for more than a half hour per week, depending on their case
load. I need to do more research to understand why they’re so overworked and how we can reduce
this.

❏ Make a plan for your research: How will we complete our research over the course of the
next two weeks?:
I’m gonna start pestering the people on the email list, see if anything turns up. I’ll also poke a little
deeper into the websites I found, see if I can start developing some stronger research questions.
 ❏ Revisit: Identify the end users, experts and other sources of information:

For end users, we talked to some of the scholars at New Dawn High School, all of whom were
personally connected to mental health in some way. We also contacted the staff from the high
school and interview them. Additionally, we have put together a google form with which we hope to
reach some of the scholars here at e3; this is pending approval. Lastly, I have been sending out
emails to different organizations with some success; hopefully, we will hear back from them soon.

❏ Users (sometimes called the audience) - who can we contact and how?:

As far as users, we are still in the process of brainstorming who we will contact. Current possible
groups include: Local elementary/junior high schools, e3 Scholars, a more intensive interview
session with the New Dawn team.

❏ Build questions to ask the end users (think of as MANY relevant questions to ask as
possible):

- Do you currently or have you ever experience(d) any symptoms of anxiety, ADHD,
depression, PTSD or another mental health complication that has ever impaired your ability
to perform in or out of school? If so, how?
- What do you think schools do well with regards to student mental health?
- What do you think schools do poorly when addressing mental health?
- (KIPP specific) Does your school experience an uncommon proportion of students with
poor/excellent mental health? Why do you think this is?
- What effect does school have on your mental health, personally?

❏ Build questions to ask the experts:

- What do you think the school system does well/poorly with regards to student mental health?
 - How can parents/teachers better work to help student mental health?
- What causes poor mental health in schools?
- What can be done to improve mental health in schools?
- How do academic and social pressures contribute to poor mental health in schools?
- What traits and circumstances are common in students with poor mental health?

❏ Make a plan for conducting the fieldwork:

We will contact experts through email, telephone and in-person interviews in order to better
understand the nature of our problem. We will also engage in research by exploring articles online
and in the library.

❏ Set the schedule for your work on the discovery phase:

Although we don’t have enough information to craft a hard schedule yet, we are all currently
engaged in various forms of research and plan to be able to draft more concrete questions by early
November.
- Complete disc. Phase checklist part 1 (Oct 23)
- Complete 5 articles research (Oct 23)
- Interview New Dawn High (Oct 16)
- Email organizations (MHS, CMI, SDBoE, ERMHS, NAMI) => review Oct 23

❏ Determine who will do what by when:

Kimberly: Talk to Mr. Smith, contact experts (Due Oct 25)

Rile:
Cayton: Interview New Dawn staff, email organizations (Due Oct 25)
Fernanda: Contact Sociology professor (Due Oct 25)
All: Develop research questions, review articles (Ongoing)

❏ What do you plan to report back?:

Kimberly: Report a list of possible sources to follow up with

Cayton: Report a list of possible contacts, deliver results of interview w/ ND Staff, provide questions
and resources to review
Fernanda: Provide questions, update on contact w/ Sociology professor

❏ When do you plan to report back?:

- Oct 21: Primary debriefing, plan next steps

- Oct 23-25: Followup debriefing

❏ Did you dig deep enough?:

We have more questions than answers, but for where we are at right now this is a very good thing.
So far we have struggled because we don’t know what to ask or to whom; over the past few weeks,
we have done a fair job of making connections with people who know about the subject. The next
phase of our research is to develop more specific questions and interview our experts further to get
a better idea of the nature of the problem we are trying to solve.

Conduct the Research (Gathering Inspiration) – Discovery Phase Part 2

 ❏ Immerse yourself in context

❏ Learn from groups

❏ Learn from experts

❏ Learn from peers observing peers

❏ Learn from people’s self documentation

❏ Seek inspiration in new places

❏ KEEP AN OPEN MIND!!

Research Findings:

Findings:
Cayton
1. In the article, the author (Mental Health America) discusses the high incidence of mental health disorders
in the adolescent population
● 11% of people age 2-17 currently have 1 or more emotional, behavioral or developmental issues
● 50% of adolescents will experience a mental health disorder in their lifetime
● ⅓ of adolescents will experience an anxiety disorder in their lifetime
● 12% of adolescents have had at least 1 major depressive episode in the past year
● 80% of teens who took the MHA screening survey scored positive for moderate or worse depression
● 31% of adolescents have an anxiety disorder
2. The article discusses how poor mental health can lead to poor academic and social performance; this in
turn can fuel anxiety and depression, which in turn leads to worse academic/social performance, etc.
3. Suicide is a major problem, but it is preventable
● Suicide is the #2 killer of adolescents in America
● 17% of students seriously considered killing themselves in the last year
4. There are steps that can be taken to help reduce anxious symptoms
● Recognition and prevention is the best way to stop anxious symptoms
● Physical sensation (e.g. “grounding”) is particularly helpful to arrest anxiety
5. Major Depressive Episodes (MDE, defined as a 2-week or greater period when a person experienced a
significantly depressed mood or loss of interest or pleasure in daily activities. See DSM5 for more info.) and
MDE w/ severe impairment (Defined as causing severe problems to do chores, school work, family or social
interaction)
● Current estimates: 14.4% of adolescents scored positive for MDE, 10% scored pos for MDE
 w/ SI
● Especially harsh spike from 2012-13 and 2017-18
● Note: The statistics for adolescent and adult MDE and MDE w/ SI aren’t directly comparable;
the diagnostic questions were slightly different. This being said, both scores are significantly
higher (>5%) for adolescents ranged 12-17 than 18+
6. An estimated 1.5% of adolescents scored positive for both Substance Use Disorder (SUD) and MDE;
1.2% for MDE w/ SI (Comes out to ~1 in 9 students diagnosed with MDE)
● This correlation has held fairly constant over the past 3 years
7. MDE and general substance use ​are​ strongly positively correlated; the % of adolescents that used illicit
drugs, marijuana, alcohol or cigarettes was ​>2x ​higher for adolescents who had a MDE within the past year.
● This means that 32.7% of youth with a MDE in the past year had used illicit drugs, marijuana,
etc. as opposed to only 14% without one.
8. Only about 41.4% of adolescents with an MDE in the past year received treatment for said MDE; most of
these (1.1m/1.4m) were MDE w/ SI. This percentage has remained relatively unchanged for the past
decade.
● Notable (~2%) drop in treatment percentage during the years 2009 and 2012; why?
9. The percentage of adolescents receiving treatment for any mental health issue has increased at a steady
mean rate of ~½% per year every year since 2009; notable jumps in clinical treatment in 2015 and 2017
Interview:
- Significant % of mental health issues are family based or exacerbated by familial conflict/lack of
support
- High % correlation between mental health disturbance and drug use/abuse
- Several roots (motivation/focus, anxiety, avoidance, lack of personal growth)
- Often poor mental health found in students performing below their grade level
- No Child Left Behind -> students moving on who shouldn’t ​(More research)
- Kids don’t know when/how to ask for help
- High student:teacher ratio; makes it more difficult
- Few/no available therapists on campus; often inaccessible (overworked)
- Peer pressure, academic pressure & home pressure all lead to anxiety/depression
- Drug use and self harm v. high among students w/ mental health disorder (MHD)
- Not taught coping skills
- Culture not conducive to mental health (always “push, push, push, go go go”)
- Teachers don’t have a lot of time w/ students
- Parenting style shift?
- Schools don’t teach coping techniques
- Current advancement system pushes students to levels they aren’t ready for
- Competency based learning good/bad?
- Kids = dependent
- Teachers burn out? Don’t care?
- Teachers not always great?
- Students never evaluated; alarms never go off
- Students not engaged; can’t learn about what they don’t care about
- No social/emotional education
- Stronger student-teacher interaction => Better bond = better learning
- Cross-trained staff to know more about mental health
- Mental health issues that don’t manifest as behavioral issues don’t get detected

FERNANDA
Article 1
1. In the article “Low Socioeconomic Status and Mental Health Care Use Among Respondents With
Anxiety and Depression in the NCS-R”, the author states that low socioeconomic status is associated with
premature mortality and poor physical health. Studies have also shown that low socioeconomic status is
related to an increased point prevalence of psychological distress and depression and a more chronic course
of depression.
2. The article states that results from the National Comorbidity Survey Replication (NCS-R) indicated
that unmet need for treatment among respondents who had a mental disorder in the past 12 months was
greater among those with low incomes than among other respondents.
3. The article also tells us that not all studies have shown a strong and definitive relationship between
low socioeconomic status and lower probability of receiving mental health care.
4.In the article, we also learn although one study showed that the quality of care among patients in
treatment for depression and anxiety disorders was poorer among those with less education, other analyses
have not found evidence that quality of care among patients in treatment was significantly related to any
measure of socioeconomic status.
5. Finally, we learn from the article that previous studies have shown that persons in ethno racial
minority groups are more likely to receive lower-quality mental health care for depression and anxiety.

Article 2
1. In the article “Education and Socioeconomic Status”, the author claims that encompasses more
than just income. The author claims that educational attainment, financial security, and subjective
perceptions of social class and status are affected as well.
2. The article states that the overall society is affected by SES. Including physical and mental health,
educational achievement, overall human functioning, poor health and poverty. Inequities are increasing; for
example, in health distribution, resource distribution and quality of life.
3. The article also tells us children in low-SES households and communities develop academic skills
slower than children in higher SES groups. In childhood, Low-SES is related to poor cognitive development,
language, memory, socioemotional processing, and poor income and health in adulthood.
4.In the article, we also learn that school systems in low-SES communities are often under
resourced, which negatively affects students’ academic progress and outcomes. Insufficient education and
increased dropout rates affect children’s academic achievement, continuing the low-SES status of the
community.
5. Finally, we learn from the article that a child’s initial reading competency is correlated with the
home literacy environment; like the number of books owned and parent distress. Poor households have less
access to learning materials and experiences. (books, computers, stimulating toys, skill-building lessons, or
tutors)

Article 3
1. In the article “Low Socioeconomic Status Is a Risk Factor for Mental Illness, According to a
Statewide Examination of Psychiatric Hospitalizations”, the author mentions that a study examined a
database of 34,000 patients with 2 or more psychiatric hospitalizations during 1994-2000 and found that
unemployment, poverty and housing unaffordability were correlated with risk of mental illness.
2. The article states "The poorer one's socioeconomic conditions are, the higher one's risk is for
mental disability and psychiatric hospitalization," said author Christopher G. Hudson, Ph.D., of Salem State
College. Also, this is found regardless of what economic hardship or type of mental illness the person
suffered.
3. The article also tells us the study considered economic stress as one of the possible explanations
for the correlation between SES and mental illness.
4.In the article, we also learn that the study provides strong evidence that SES impacts the
development of mental illness directly as well as indirectly, through its association with adverse economic
stressful conditions among lower income groups.
5. Finally, we learn from the article that the study explains the need for the continued development of
preventive and early intervention strategies that pay particular attention to the devastating impacts of
unemployment, economic displacement, and housing dislocation, including homelessness.
Article 4
1. In the article “How Poverty Affects Behavior and Academic Performance”, the author states that
children raised in low-SES or in poverty rarely choose to behave differently. But they are faced with
overwhelming challenges on the daily that affluent children never have to confront. Their brains have
adapted to suboptimal conditions in ways that undermine good school performance.
2. The article states emotional and social challenges, acute chronic stressors, cognitive lags, health
and safety issues are the most significant risk factors affecting children raised in poverty.
3. The article also tells us that, typically, the weak and anxious attachments formed by infants in
poverty become the basis for full-blown insecurity during the early childhood years. Very young children
require healthy learning and exploration for optimal brain development. And unfortunately in impoverished
families there tends to be a higher prevalence of such adverse factors as teen motherhood, depression, and
inadequate health care; which leads to decreased sensitivity toward infants and later poor school
performance and behavior on the child’s part.
4.In the article, we also learn that children raised in poverty are much less likely to have crucial needs
met than their more affluent peers and are subject to some grave consequences.
5. Finally, we learn from the article that deficits in

● A strong, reliable primary caregiver who provides consistent and unconditional love, guidance, and
support.
● Safe, predictable, stable environments.
● Ten to 20 hours each week of harmonious, reciprocal interactions. This process, known as
attunement​, is most crucial during the first 6–24 months of infants' lives and helps them develop a
wider range of healthy emotions, including gratitude, forgiveness, and empathy.
● Enrichment through personalized, increasingly complex activities.

inhibit the production of new brain cells, alter the path of maturation and rework the healthy neural circuitry in
children’s brains, therefore undermining emotional and social development and predisposing them to
emotional dysfunction.

Article 5
1. In the article “Educational attainment differences by students’ socioeconomic status”, the author
demonstrates how obtaining higher education can be an important step towards better occupational and
economic outcomes.
2. The article states that lower levels of educational attainment are associated with higher
unemployment rates and lower earnings.
3. The article also tells us that although there’s an increasing number of students who have enrolled
in postsecondary institutions over the last several decades, there are still differences in the characteristics of
students who complete various levels of postsecondary education.
4.In the article, we also learn that one particularly important issue to explore is the differences in
educational attainment by SES to investigate the opportunities for social mobility that education can provide.
5. Finally, we learn from the article that there was a report which surveyed students at different points
during their secondary and postsecondary years. It was found that low-SES students were more likely to not
complete high school. Also, were less likely to earn a bachelor’s or higher degree.

Kimberly
Article 1
1. In the article, the author claims that, culture has an influence on mental health.

2. The article states culture affects the way people describe their symptoms.
- “​For instance, culture affects the way in which people describe their symptoms, such as whether
they choose to describe emotional or physical symptoms. Essentially, it dictates whether people
selectively present symptoms in a “culturally appropriate” way that won’t reflect badly on them.”
3. The article also tells us that every culture has their own way of thinking when it comes to mental health.
Each has a different opinion, and level of stigma surrounding it.
- “​Every culture has its own way of making sense of the highly subjective experience that is an
understanding of one’s mental health. Each has its opinion on whether mental illness is real or
imagined, an illness of the mind or the body or both, who is at risk for it, what might cause it, and
perhaps most importantly, the level of stigma surrounding it. “

4.In the article, we also learn that based on how the cultural influence, that is how people go about deciding
how they will cope with mental illnesses.
- “​Based on these cultural influences and ideals, people decide how they are going to cope with mental
illness and seek treatment (whether that be by seeing a psychiatrist, psychologist, social worker,
primary care practitioner, clergy member, or traditional healer, etc).”

5. Finally, we learn from the article that minorities that have been affected with some sort of mental health
experience have been greatly affected by their culture.
- “​Furthermore, research has shown that the mental health experience of minorities has been greatly
affected by culture and how society at large views that culture. Racial and ethnic minorities in the
U.S. are less likely than white people to seek mental health treatment, or to delay treatment until
symptoms are severe. This finding has been largely attributed to mistrust due to the history of
discrimination and racism and a fear of being mistreated due to assumptions about their
background.”

Article 2
1. In the article, the author states that in retrospect, children raised in a broken home are more likely to
struggle with mental health.

2. The article states trouble in family structure can lead to several events which would lead to impacting the
parents and child's mental health.
- “​Disruption in family structure can lead to several adverse events impacting both the mental health of
children and their parents.”

3. The article also tells us ​that single parenthood becomes a risk factor for mental health problems for
children (and adults). This can lead to bigger psychological distress, depression, and more mental health
problems.

4.In the article, we also learn “​The interest in family structure and its effects on children's mental health
gained momentum in the 1960s and 1970s when there was a spike in divorce rates and single-parent
families.”

5. Finally, we learn from the article that many factors pile on top of making a childs mental health decrease.
- “​Factors which increase the likelihood that children will show disturbance over time include marital
conflict, being raised in poverty, teen and single parenthood, parental depression, and hostile/angry
parenting. Dysfunctional family backgrounds and socioeconomic adversity have also been attributed
to suicide in young people. Childhood adversity including divorce and impaired parenting seems to
cause both short- and long-term problems, various childhood disorders, and subsequently depression
in adulthood.”

Article 3
1. In the article, the author demonstrates that mental health is a big issue in the latino community.

2. The article states a few common mental health conditions among the latino community.
 - “Common mental health conditions among Latinos are generalized anxiety disorder, major
depression, posttraumatic stress disorder (PTSD) and excessive use of alcohol and drugs.
Additionally, ​suicide​ is a concern for Latino youth.”

3. The article also tells us how Latinos are discriminated. Latinos don't get equal/quality treatment.
- “Latinos experience disparities in access to treatment and in the quality of treatment we receive. This
inequality puts us at a higher risk for more severe and persistent forms of mental health conditions.”

4.In the article, we also learn different issues that get in the way of Latinos getting help.
- Lack of info/understanding, privacy concerns, language barriers, lack of health insurance, cultural
difference, legal status, faith/spirituality and much more.

5. Finally, we learn from the article that “​approximately 33% of Latino adults with mental illness receive
treatment each year compared to the U.S. average of 43%. Without treatment, certain mental health
conditions can worsen and become disabling.”

Article 4
1. In the article, the author states that, “​Up to one in five kids living in the U.S. shows signs or symptoms of a
mental health disorder in a given year.”

2. The article states “Experts say schools could play a role in identifying students with problems and helping
them succeed. Yet it's a role many schools are not prepared for.”

3. The article also tells us that “ in a school classroom of 25 students, five of them may be struggling with the
same issues many adults deal with: depression, anxiety, substance abuse. And yet most children ( nearly 80
percent) who need mental health services won't get them.

4.In the article, we also learn mental health in schools is a hidden crisis and it needs to be fixed.

5. Finally, we learn from the article that schools, families, counselors and many more adults should be able
to recognize when a child/young adult may be suffering mental health illnesses, but the truth is, most of the
time they're all busy with too much on their plate already, and they simply don't know what signs to look out
for.

Article 5
1. In the article, the author states that, “​one in five children and adolescents will face a significant mental
health condition during their school years.”

2. The article states “​Students suffering from these conditions face significant barriers to learning and are
less likely to graduate from high school.”

3. The article also tells us “​Key responsibilities of school leaders regarding this issue include creating a safe
and nurturing school environment, supporting the physical and mental health of children, fostering their
social and emotional well-being, and being prepared to address teen suicide through effective
communication and support. “

4.In the article, we also learn “​according to the Coalition to Support Grieving Students, death by suicide is
the third leading cause of death in children ages 10–14 and the second leading cause of death in children
ages 15–19. Close to one in five high school students has considered suicide, and 2 to 6 percent of children
attempt suicide.”

5. Finally, we learn from the article that “​within a district, numerous schools must share school psychologists,
 school social workers, school nurses, and other specialized support personnel. This increases the caseload
of these mental health professionals and limits access to their services for students in need of support and
assistance.”

Define the mission for the design thinking process - Discovery Phase Part 3

❏ Identify/define the challenge - Restate your problem statement:

How can we help improve the existing school system to provide more support for student mental
health?
- Home life/culture
- Poor mental health education in schools (students and teachers), poor classroom structure
(allows students to be marginalized), poor support system (1 therapist for >300 students)
- Poor existing school culture; overemphasis on performance, poor monitoring of social
interaction.

Checklist Evaluation Rubric

Exemplary Evidence Good evidence Some evidence Little or no evidence
✔ x
✖ ⁄