This work examinEd why people disengage from mental healthcare systems despite services being available. ALL INSIGHTS ACROSS Multiple stakeholder and client engagements were anchored in the same insight: People were not failing to access mental healthcare because services did not exist. They were failing to access it because the system did not make its own logic understandable.
At the outset, the work was framed as an effort to improve access.
Through extended listening with community members, caregivers, providers, and administrators, the pattern became clearer. Individuals seeking care were not simply navigating multiple systems. They were attempting to understand their role within a system that felt opaque and inconsistent. It became difficult to locate themselves inside of it. Each handoff introduced uncertainty. Each unanswered question felt like a risk as they moved through the system.
The research surfaced four recurring breakdowns of this navigation: unclear sources of authority, fragmented communication, invisible safety nets, and a client relationship that placed responsibility on individuals without adequate orientation. These were not isolated pain points. Together, they formed a system in which people were expected to persist without ever being grounded in what to expect next.
The internal readout translated these findings into a shared understanding for stakeholders inside the organization. By naming where trust was being unintentionally disrupted, it reframed access as a relational challenge rather than an operational one. This created space for different departments to recognize their interdependence within the client experience.
The subsequent workshop moved the work from insight into practice. Rather than prescribing solutions, it guided participants through how to apply the findings in their own contexts. The focus was on helping teams learn how to recognize moments where people either gain or lose confidence in the system.
The executive summary served to preserve the core insights while stripping away institutional language so that others could understand the problem without needing to be present for the full process. In doing so, it ensured that meaning did not collapse as the work moved outward.
Across all three forms, the work resisted the common temptation of treating clarity as an informational problem. Instead, it treated clarity as something people feel when a system acknowledges their position, explains itself honestly, and signals what support exists beyond the visible surface.
The contribution of this work wasn’t a redesigned service or a finalized solution; it worked to enhance a system that already showed a willing commitment to its population. The work established a shared understanding that trust must be designed end to end, and with clients, especially in systems where people are already carrying vulnerability.
This insight extends well beyond mental healthcare. In any public-facing system, when responsibility is placed on individuals without orientation, confusion will be mistaken for failure. The system will appear functional but people will quietly fall away.
In this context, designing for access meant designing for clarity, continuity, and care across every layer of the system.
Context
This work was conducted in partnership with the Los Angeles County Department of Mental Health and Wondros. Details are summarized across an internal findings report, an implementation workshop, and a public-facing executive summary.