The Research

Co-designing a wearable emotion monitoring tool with people living with anxiety disorders, their carers and mental health clinicians

MEMoPAD was not designed for people living with anxiety disorders; it was designed with them. Over seven phases, patients, unpaid carers and mental health clinicians have shaped what the tool does, how it looks and how it speaks to the person wearing it. This page explains how we did it, what came out of it, and what we learned about co-design with this population.

This page accompanies our talk and poster at the Mental Health Platform Research Summit (Sheffield, 8 October 2026).

Why co-design?

Digital mental health tools often show promise in trials but lose their users in daily life: attrition has been called the “Achilles heel” of digital therapeutics [1]. Anxiety disorders add their own barriers. Avoidance, cognitive overload and fear of judgement are among the symptoms these tools aim to address, and they may also work against sustained use of the tool itself [3].

Co-design is one response: the people who will live with a technology help decide what it should be. We adapted the co-design framework of Noorbergen and colleagues [2], from understanding the problem to testing in daily life, and ran it with three groups:

• Patients: people living with anxiety disorders. We use “patients” because it was the term our participants preferred in a terminology survey.
• Unpaid carers: the family members and friends who support them.
• Mental health clinicians, from the NHS and private practice.

How each phase worked

• A format for each group. In Phases I–IV, held online as most participants preferred, patients met in focus groups of up to six people, lasting about two hours. Carers and clinicians took part in separate one-to-one online interviews of around 30 minutes, to limit power imbalances and fit busy diaries.
• Building on the last phase. Every phase opened by presenting what the previous one had found, so all three groups worked from the same evidence.
• Tools matched to the question. A survey to map needs, storyboards to generate ideas, mock-ups to shape the interface, a click-through demo to test it, then the working prototype in the lab and in daily life.
• Analysis. Thematic analysis (Phases I–II) and affinity diagrams (Phases III–V), compared across the three groups, then a roundtable with the interdisciplinary supervisory team.
• Staying in touch. A monthly newsletter and this website kept participants informed between phases.

Four lessons for co-design with people living with anxiety disorders

1. Real-time group tools can backfire. Collaborative digital whiteboards added pressure and risked raising anxiety in the session itself. Lower-pressure, asynchronous and analogue options, such as sending a photo of a hand-annotated mock-up over WhatsApp, were more inclusive.
2. Invite carers from the start. Patients asked for it in our first consultations. Anxiety disorders are lived within a network of family, friends and services, and designing for an isolated user misses how they are managed day to day.
3. Build low-touch routes for clinicians. Clinician involvement fell over the phases. Short online interviews and asynchronous feedback suit time-poor experts better than long focus groups.
4. Frame around emotions, not disorders. Tracking the full emotional spectrum, rather than monitoring pathology, may matter for sustained engagement as much as any single feature.

Where we are now

Phase VI is under way: 10 participants in Bristol are using the working watch and phone app in their daily lives for up to five weeks. Its results will be reported in the PhD thesis and in forthcoming papers. To read what a smartwatch can and cannot tell us about emotions, see What can a smartwatch tell us about emotions?

Our papers on co-design

• Co-Designing MEMoPAD: Multimodal Emotion Monitoring in Clinical Pathways for Anxiety Disorders (BCS HCI 2025 workshop, 2025)
• Designing for Sustained Engagement in Anxiety Disorders: Lessons from MEMoPAD's Co-Design Journey (CHI 2026 workshop, 2026)
• MEMoPAD: Multimodal Emotion Monitoring in Clinical Pathways for Anxiety Disorders (ACM Interactive Health 2026 (IH '26), 2026)

References

1. Nwosu, A., Boardman, S., Husain, M. M., & Doraiswamy, P. M. (2022). Digital therapeutics for mental health: Is attrition the Achilles heel? Frontiers in Psychiatry, 13, 900615. doi:10.3389/fpsyt.2022.900615
2. Noorbergen, T. J., Adam, M. T. P., Teubner, T., & Collins, C. E. (2021). Using co-design in mobile health system development: A qualitative study with experts in co-design and mobile health system development. JMIR mHealth and uHealth, 9(11), e27896. doi:10.2196/27896
3. Moretti, L. A., Thompson, M., Matthews, P., Loizou, M., & Western, D. (2026). Designing for sustained engagement in anxiety disorders: Lessons from MEMoPAD’s co-design journey. Engagement in Digital Health Interventions Workshop, CHI 2026. Paper page