Accessibility online: juggling or plate spinning?

Zoe Limbert

It may be a case of never ending plate spinning or juggling to manage competing demands within tight budgets, but we are definitely building our skills in the arena of online accessibility.

At mHabitat we have been working to develop an NHS commissioned adult mental health information website in Leeds over the last two years, and we have been able to get up close and personal to users from a wide range of communities in the city.

MindWell LogoOne of the key user requirements for MindWell Leeds since day one has been to make it accessible to as many people as possible. This has become a passion for the mHabitat/MindWell team but comes at a cost – in frustrations as well as budgets.

The site was developed with a wide range of people who have diverse needs so we built it with them in mind. However, when we began user testing different aspects of the site, it quickly became clear that we have to learn to live with limitations….at least for now.

Accessibility for us is about enabling people with sensory, cognitive and/or physical requirements to access websites and web services. We also consider the impact of digital exclusion and of mental health stigma which can both affect access to online services

Here are some of the things we have learnt along the way:

  •  Share learningSoftware frustrations – people with all kinds of sensory impairments can experience challenges getting the right software and setting it up on their devices. We heard stories about people buying and setting up software for multiple devices and having to re-upload it with every software update. You may know a workaround for this but if we don’t make it simple and easy for people to access it then the software might as well not exist. Share what you know widely.
  • Voice engine limitations – we have not been able to find a voice engine for Urdu. There are no words to describe how stunned I was about this. We’d love to hear from you if you know differently.
  • Mapping online and offline offers – accessibility is not just about the technology being accessible but also how we can provide offline alternatives. MindWell is an online resource. It gives far more accessibility than paper and is open to personalisation in ways paper cannot. For people who are not online we  provide resources that can be downloaded by others on their behalf. We are also exploring how we can work with libraries, support staff and volunteers to improve access for people who want to but are not yet online. Using the site as a means to enable conversations is a core message.
  • PunctuationLanguage is not the same as words – we want to create a connection with everyone coming to the site, even when they are stressed and anxious, or in a frightening situation. Accessibility means reaching out to people with words they are able to relate to and a tone of voice that they feel comfortable with. For those using the speak function we need to ensure it is not relayed at high speed. Add punctuation as this helps slow the speech software.
  • Reading accessibility – there are lots of people who may not able to read their preferred language very well, and I don’t just mean non-native English speakers, it also applies to those in our community who have been profoundly Deaf since birth and who use British Sign Language (BSL) as their first language. This means that subtitles on audio visual materials may not be enough, so make sure to ask.
  • British Sign Language (BSL) – we have been working with some of our BSL community to try and work out what we have, what we need and what approach we can use to embed BSL on our site. We are using a stepped approach to balance user needs with the resources available to us. We have focused on prioritising the most important content to people who use BSL.
  • Make it easy for everyone – we have created an icon for the site to make it easy to identify and add more information to the ‘Accessibility’ page. Users told us the standard approach to accessibility pages on sites is not helpful to them so we started to design a MindWell version here.
  • Tackle difficult subjects upfront – or is this just a Yorkshire thing? People helping us build MindWell took time and energy to share stories of their experiences and ambitions for the site. They took the project to their hearts and challenged us to find solutions to meet their needs. Sometimes we have managed it and sometimes we haven’t. We try to be upfront with people and have relayed unmet needs back to our commissioners. At events we speak with anyone who might help us find a solution. We have found that once people understand that the site is a constantly developing tool, they are generous with their ideas, energy and focus on finding answers. Never stop listening and engaging the audience and embed ways people can get in touch. We may not have an answer but we can probably find someone who does. Model accessibility yourselves.
  • ConversationsReducing stigma – trying to support a reduction in mental health stigma was a challenge set by our commissioners. Creating a site accessible to the public and professionals, service users and potential service users meant that we needed to balance generic quality psycho-educational materials with everything from referral information for GPs and support for those using services, or in a serious situation requiring fairly immediate help. Was this a classic 80:20 rule? Our approach to MindWell three user journeys, came from participants. It aims to gradually reveal information to website visitors as we know they might be struggling to concentrate and be feeling overwhelmed. We listened to stories and pleas for straight talking about difficult conversations. We are making short, animated films based on real conversations that happen every day. Here is one example that responded to fears of being referred to a community mental health team by a GP: CMHT. Talk about it.
  • Build it in at the startThere are budget impacts for all this work and we have to make a little go a long way, so being crystal clear about  what will be improved and its impact on accessibility for different groups (including those using blended on/offline approaches) is really important. Don’t rush it! Build it in at the start.
  • Colours and visual noise – we developed a range of design features for MindWell but of course for some users it may add to the stress of using an online tool. We worked with those needing a more stripped back approach from our initial design workshops and included this in our personas. We integrated features from a software tool, Browse Aloud, and are considering what else we can do to manage the look and feel. Pop-ups were a ‘no’ from everyone! Keep focus on user needs not swanky features!

Focus on the user needsOur experience tells us to keep listening to those who are actually using or trying to use the website and to help diverse groups understand each other’s needs. The latter been effective in triggering new solutions we may not have thought of ourselves.

Software and device manufacturers need to develop more cost effective, integrated tools so users can set it up once and use it across devices. We shouldn’t assume people have onesensory impairment and no other requirements. We found extensive frustrations for people who can feeling stigmatised, excluded, spoken down to and put in one diagnostic box, when it came to their accessibility needs.

mHabitat are passionate about people driven digital solutions and are learning about how hard accessibility can be to achieve in reality. We endeavour to share our learning as widely as possible and are always keen to work with partners to surface new ideas.

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