From 90 Interviews to Two Programs: Designing Bohoka

The context

Mental health literacy among young people in Rwanda was low, and the reasons weren't simple. Roughly 13% of Rwandans aged 12 to 17 had reported suicidal ideation or behavior in the prior six months, and around one in four young people met the diagnostic criteria for depression. Seeking help carried real social cost. A generation shaped by the aftermath of the genocide often saw its own trauma as the only trauma worth taking seriously, which left little room for a teenager's anxiety or a break-up to register as something real. The program's job wasn't to build an app. It was to find a way into a problem that most young people had been taught not to talk about at all.

What the research found

In September 2021, I took part in design research across two youth centers in Kigali, speaking with 45 people: 37 young people aged 10 to 19, and 8 parents, teachers and healthcare providers. What came back shaped everything after it. Young people mostly defined mental health by its most extreme, visible symptoms, shouting, self-harm, addiction, which meant quieter struggles like anxiety or low mood didn't register as something worth mentioning to anyone. Confidentiality mattered more than the channel it came through. And who a young person would actually turn to depended entirely on how stigmatized they judged their own problem to be: something like sadness went to a parent or friend, but shame around HIV status or self-harm was more likely to go to a stranger, precisely because a stranger didn't know them and couldn't judge them by it later.

We built three personas from this research to keep the work grounded in specific people rather than an abstract "youth" user: a 13-year-old whose new anxiety is going unnoticed because his aunt believes staying strong is the only response to hard feelings, an 18-year-old numbing a breakup with alcohol because he doesn't want to burden his parents, and a 15-year-old hiding auditory hallucinations from her family for fear of being labeled mad.

What I ran

I helped facilitate two co-design workshops with 12 participants aged 15 to 19 across the two youth centers, working directly from those personas. The brief we gave participants was open on purpose: how could they help other young people identify, learn about and talk about mental health. We weren't looking for validation of an idea we already had, we were looking for what they'd actually build if it were up to them. The sessions produced five original concepts, ranging from a YouTube page where trained young people interviewed experts, to a peer program pairing trained "Wellness Warriors" with youth needing support, to a comic book following a young person's mental health journey.