Research & design for mental health access
Case study by:
Elle Dixit, MSIS
Date:
March 2025
The problem
In Texas, a psychiatric advance directive (PAD) allows someone to document their treatment preferences in case of a mental health crisis. But the form—taken directly from Texas statute—is dense and difficult to navigate. People living with serious mental illness need a resource to help them understand and assert their rights under the law.
That’s where we came in. An academic client specializing in social justice and population health reached out to us for help creating a how-to guide for the Texas PAD. While the effort was designed with people living with serious mental illness in mind, it has relevance for anyone who could benefit from an advance directive for mental health care.
The goal was clear: make a complex, jargon-filled document more understandable, more human, and ultimately more usable—without altering the legal form itself. Our team combined design and research to create a guide that empowers people with mental illness to advocate for the care they need and deserve.
The goal
The client wanted to give Texans with mental illness a chance to understand a legal document that could be lifesaving in difficult situations. Sentier, with the ability to leverage researchers to test cutting-edge digital designs with real users, was an ideal partner for the project. The project would focus on producing an accessible how-to guide to better serve the PAD’s target population and empower people with mental illness to advocate for the care they need and deserve.
Our approach
We took a two-phase approach:
Our designers created a user-friendly layout for the guide, grounded in usability heuristics.
Our researchers validated the design through interviews with medical and legal professionals, as well as people with lived experience of mental illness.
Design process
We designed the PAD guide with empathy and clarity at its core. To understand the challenge, we first dissected the document’s phrasing and mapped its communication intent. Then we charted a path to make it easier for users to follow.
Here’s how we brought the guide to life:
We broke up the text to make it more readable and digestible.
We added icons for links, definitions, and reminders to draw attention and aid recall.
We embedded screenshots from the official PAD form to help users orient themselves visually.
We included a glossary of medical and legal terms, offering both inline definitions and a reference section at the end.
We also chose colors and typography carefully—favoring calm backgrounds, muted accent colors like burnt orange and navy, and a pairing of rounded serif and sans serif fonts that created a tone that felt both professional and approachable.
Research process
Once we had a strong prototype, we put it to the test. We conducted ten in-depth interviews across three key audiences: legal professionals, medical professionals, and individuals with a history of mental illness.
Each participant reviewed the guide and offered feedback, including impressions of an introductory video referenced within the guide. We asked what worked, what could be improved, and what would make the document easier to understand and use.
Key insights included:
The visual design made a positive impact—participants described it as “soothing” and “inviting.”
Some terms needed simplified definitions to improve accessibility for readers at varying literacy levels.
Adding QR codes to key links would improve usability, especially for printed versions available in clinical settings.
We took this feedback seriously and heavily revised the guide before release.
The impact
With these data-backed refinements, we delivered a new and improved resource that’s now helping Texans with mental illness—and their care teams—navigate a complex but essential legal process.
The guide launched in January 2024 and has been in use for over a year. It’s available online for public access and continues to be a meaningful tool for individuals and medical professionals alike.
This project is a testament to what happens when user-centered design meets ethical, intentional research. We’re proud of the result—and even more proud of the lives it may help.
Working in healthcare, civic services, or another complex space?
We help organizations design ethical, accessible experiences for the people who need them most. Whether you’re supporting vulnerable users, simplifying legal content, or navigating systemic constraints—let’s make it work, together.
A note from our collaborator
If you’re using or sharing the PAD How-To Guide, Dr. Virginia Brown, PhD, MA, who led this initiative, would love to hear from you.
Your feedback helps shape future improvements and supports ongoing efforts to expand access and understanding. We’re always looking for opportunities to take this guide to the next level to continue helping those living with mental illness.
Explore the Public Common License for further details, and feel free to connect with her directly: