A Trojan horse approach to changing mental health care for young people through service design

This case study describes 'First Line', a multi-year service design project focused on changing mental healthcare for young people that was conducted through collaboration between Experio Lab and Första linjen in Karlstad, Sweden. The project reflects a 'Trojan Horse' approach to changing healthcare in that service design was brought in by the clinical team based on the explicit agenda of developing new digital mental health services for young people. However, bringing in service design also came with the somewhat hidden agenda of supporting new ways of working within the context of mental healthcare. This case study tells the story of the overall project, how this 'Trojan Horse' approach to change through service design unravels and the benefits and tensions amid the complexity.

"[T]he project effectively supported the development of a new digital service for young people, which included involving staff, young people and other stakeholders in the service design process. This involvement helped to create, at least temporarily, new ways of working related to patient engagement, prototyping and experimentation.... [On the other hand, t]he Trojan Horse approach [brought] with it feeling of imposition and unwanted activity.... [T]he Trojan Horse was the promise of new digital services, but the process of realizing this change was not fully communicated with all stakeholders involved. This case study suggests that there may be value in being more deliberate, explicit and collaborative in the process establishing, questioning and working toward related goals of service design projects in healthcare contexts." (Authors, 253-254)