Objectives: We aimed to examine existing and emerging master narratives on mental health and to capture the changing emphasis in these narratives over time. Making these shifts explicit can facilitate alignment of actors and practices that must collaborate to support those seeking help. Design: We gathered data via a scoping review, semistructured interviews and podcast episodes. Data analysis consisted of a thematic analysis to identify narratives and a content analysis to map shifts in emphasis over time. Setting: Semistructured interviews and included podcast episodes were all Dutch. The scoping review included Dutch and English publications. Participants: Semistructured interviews were performed with 11 participants working in medical education and mental health provision. The selected podcast featured interviews with 15 people who aim to change the Dutch mental healthcare system. Results: We extracted four master narratives and observed a shift in emphasis as well as a coexistence of narratives. The narratives we found were: (1) treating a classification, (2) understanding the patient’s problem, (3) recovering life-balance and (4) building collective resilience. We found increasing emphasis on ‘building collective resilience’ when discussing the future of mental health. Conclusions: Our concretisation of narrative patterns underlying the perspectives and approaches in mental health is a first step in creating a collective understanding of the shifting master narratives, which enables working with it in practice. The shift has implications for mental health professionals, educators, policymakers and those seeking help. Future research should further examine these implications and explore the perspectives of individuals seeking mental health support and their network, both of which remain insufficiently addressed. ... Read more

To prepare medical students for their future role addressing complex health problems, medical education should pay attention to students’ Personal and Professional Development (PPD). Meaningful reflection plays an essential role in such education. We aimed to explore how to facilitate PPD-related reflections, periodic retrospection and collation by medical students. Methods We performed an intervention study with fourth-year medical students at the University Medical Centre Utrecht in 2024. The interventions consisted of workshops and individual assignments addressing PPD with three different formats for reflection (note to self, core value or representative item), retrospection (compilation, value mapping or self-scoring), and collection (online or analogue). These were analyzed using a convergent mixed methods design with data from Likert scales and open questions in a survey, focus groups and analysis of the submitted reflection materials. Results Thirty-four students completed the intervention (participation rate 100%), 33 students completed the survey (response rate 97%). The format of a making a note to oneself using text/video/audio/image was experienced as the most suitable form of reflection. Students experienced the retrospection systems as useful, fun, and/or actionable and most appreciated the opportunity to trace their personal development. An online medium was preferred for the collection of reflections, but ease-of-use and an overview display option of the collected materials were deemed crucial requirements.
Conclusions
Students found the reflection, retrospection and collation methods useful and desirable. Most important for the future design is the freedom to choose and adapt, as well as a balance in time investment and perceived added value. Further research should focus on development of a suitable online medium and test this in a longitudinal setting to address retrospection suitability. ... Read more

eHealth solutions at home are gaining interest and relevance in healthcare; however, they face challenges in sustaining motivation for therapy due to difficulties in creating meaningful connections between technology and people receiving care. In this article, we explore how embodied agents in eHealth interventions could be designed to establish a motivating relationship with people in the context of home-based stroke rehabilitation. We studied this potential by referring to the need for social relatedness in Self-Determination-Theory (SDT) and how this translates to the design of embodied agents’ characters, the collaborations they afford and the partnerships they establish over time. In co-creative ideation sessions with stroke survivors, this potential was explored, resulting in an interactive prototype of ‘Edo the Coach’, i.e. an embodied agent for home-based upper extremity stroke rehabilitation that was evaluated by stroke survivors in their home contexts. Based on the insights gained, we reflect on the potential of using SDT for designing embodied agents that foster motivational relationships between patient and agent as an answer to the growing demand for eHealth-supported self-care within an increasingly digitized healthcare context. ... Read more

Designers are increasingly collaborating with various stakeholders to address complex societal challenges. These challenges often require a codesign approach, where different actors with diverse perspectives and experiences unite to explore innovative avenues for change. Such collaboration requires empathy between the actors to understand each other’s perspective better in their interactions. This paper aims to assist social designers in orchestrating such empathic codesign processes by introducing an Empathic Journey framework. This conceptual and practical framework is based on empathic design theory and three design cases which used Virtual Reality for perspective exchange between actors. The framework addresses the importance of integrating an emotional spark through immersion and the necessity of embedding immersive experiences in a larger journey. ... Read more