Accessibility and Friction: Making Technology Work for Mental Illness
Mental Health Awareness Week coincides with Global Accessibility Awareness Day on Thursday. And while I get as weary of awareness days as the next disabled person, this does provide an opportunity to talk about an aspect of life living with poor mental health that gets too little attention.
Friction, in particular the microfrictions we encounter in everyday life, are the big problem I spend much of my time trying to help solve.
For the past two years, much of the practical outworking of that desire to contribute part of an actual solution has been working on Support Hub, the new platform run by Experian that allows disabled consumers to tell multiple organizations about their support needs from one place, and then have the reassurance that the next time they deal with those organizations they will be met, without them needing to take any further steps. It launched a few weeks ago, and I would encourage anyone to sign up whose support needs mean that using essential services takes precious resources that other people are able to spend doing the things that give life richness and meaning.
I want to use this piece to explain why micro frictions are so damaging for (among others) those of us with poor mental health, leading to widening inequality over time.
I want to explain why solutions to micro frictions have to be shared across different groups, institutions, and parts of society, and how they benefit from “network effects” to create vastly more benefits to individuals and wider society the more groups participate in them.
And I want to look briefly at a structural difficulty that poses for anyone who wants to solve the problem.
I have written in more detail about what micro fiactions are here, but let me recap quickly, focusing on technology as we’re thinking about GAAD, which spotlights accessible technology. Micro frictions are things that most people experience as a minor inconvenience if they notice at all, things that make life ever so slightly harder. That might be having to use a password to use an account. Or it might be having to buy food from 2 online stores rather than 1. It’s tech that wants regular updates. Screens you have to scroll down. Pop-ups that get in the way of typing or reading. Digital tools you can only access via the Cloud. Only being given one way of communicating.
The problem when you’re disabled is that you start each day with fewer resources than everyone else. So you run out much, much quicker. A small inconvenience can reduce your resources to zero on some days. Couple that with the fact that many aspects of mental illness (and neurodivergence — as well as chronic pain, dexterity difficulties, sight loss, hearing loss and many other conditions) mean that for us many of these are not just small inconveniences. Anxiety can make anything the last straw. Depression can make any additional steps in a process more than we can possibly manage, and even if we can manage them may leave us exhausted and unable to function.
And the problem is not that it happens once. It’s that it happens over and over every day. Which means we reach our resource limit constantly. And at that point we can’t engage with essential services, let alone the relationships, friendships, hobbies, interests, training, careers, passions that make life human.
Our lives shrink. Horizons close in on us. Dreams are a luxury we can’t imagine let alone afford. We see the lives of others spin out of our orbit as we are left with nothing to do but watch. And we can’t pursue training or volunteering or the other things that make people’s CVs stand out. Which contributes to the income gap. Which adds to the fact that life costs more when you are disabled (our financial resources function just like our mental resources that way — we start with fewer and expend more and bingo, lives take very different paths).
I could tell so many stories to illustrate how friction has impacted my own life, stolen meaning and opportunity, separated my life and my future from those of the people I thought were my peers — until their lives disappeared into the distance while mine sank under the weight of friction.
I often tell the story of how I spent 10 hours telling 11 people intimate medical details in the process of failing to order a washing machine. But as I really want to put a spotlight on tech, let me give an example from my day to day life — the software packages we use at work, and how we are required to access them before we can work.
Most of the issues I face illustrate a further crucial point that makes my work around friction so hard. Another group that sees friction as an enemy is the tech start-up industry that loves to move fast and break things and enable their would-be customers to spend fast and adopt easily. This creates its own problems. It is too easy to part with money and with data. And this can cause huge problems. Especially for those of us whose mental illness causes impulsivity problems — something my “term of 23 bibles” and many other incidents taught me too well.
So the introduction of friction has become a way of supporting people in and of itself. Gambling blocks, time window restrictions on and double confirmation of spending are great supports. And making people pause and think by building friction into systems comes at a cost.
I would argue that friction is sometimes necessary, occasionally essential, but that it is always fundamentally negative. Sometimes a negative that can be justified. But always one we should try to mitigate even if we can’t avoid. I fear that advocates of “helpful friction” can lose sight of that.
The prime example of the clash of “helpful friction” with accessibility comes with security. The interposition of friction into processes in order to protect consumer security is even backed up by legislation and regulation, whether that is data protection law or consumer protection. In my experience working with the financial sector, security always trumps accessibility in practice.
And now, the Consumer Duty is reinforcing that in firs’ minds. It requires firms to prevent or mitigate “foreseeable harm.” And this is taken to mean, among other things, the direct financial harm that comes from insecurity. The indirect but equally tangible harm caused by friction, which lies at the root of so many inequalities, financial, and other detriments, barely gets a thought — and certainly not an action. When I mention it, the issue is acknowledged in words but subsequent conversation shows there is no ability to do anything in action — but beyond that, it becomes clear that because the people in the room have no direct experience, they don’t really see how making my data more secure could cause me actual, tangible harm.
So let me explain with two examples from my work life. First is the way passwords are used. I accept the need for passwords. I would also point out that I have a very secure pass key that I will never forget because I carry it with me everywhere I go, and it would require zero memory on my part — it’s right there on the end of my finger. Not providing the option to use that is a choice that has been made at various stages of a process. And people need to own their choices more.
That said, typing in passwords is an example of executive function hell. And more so as passwords are required to become longer and more complex. The issue is not remembering the password. Not for me, anyway. It will be for some. It is actually typing the password in. Several parts of the process require steps that to many seem obvious, but which are precisely the steps that become hard when you struggle with executive function (when people ask “what is executive dysfunction?”, it’s easier to give a list like this and say “not being able to do these things.”
Not being able to see a long password means I forget where I have got to. I sometimes have to type one character every 4 or 5 seconds in order to remember properly (heaven preserve us from the banks’ AI that tries to predict our “usual” typing). I often have to restart again 4 or 5 times, getting more frustrated each time. And I am never sure I have made the right keystroke. Especially if it’s a capital or control shift. Which is more restarts. All the time aware that too many mistakes lock me out. And the fact I have to do this hammers home every time as though flashing in caps the message (whether or not it’s true)“you are living in a world that doesn’t work for you. You are working for an employer who doesn’t give enough of a **** to provide things you can use.” I forget how many figures I have typed and spend minutes counting dots.
Opening a document, typing out and then pasting in the password is what I usually end up doing — if the password field will allow something to be pasted in, which it won’t always. But this is far from simple. It means opening a new document. If this is MS Word, there might be “product activation” or “document not responding” issues — and where there aren’t there’s still the worry that it will be. Crucially, it is a task switch. And a literal opening of a new tab. A common aspect of executive dysfunction is “object impermanence.” Put simply this means if you can’t actually see something your brain forgets it’s there — I think it’s an essential protection mechanism for limited working memory — in order to work on what’s in front of us, we need to marshal all resources away from everything else. That’s why we can find mugs with teabags still in, lying around, or toast cold in the toaster on a regular basis. It means I can sometimes look at an open Word doc and wonder why there’s a random string of characters there, and then wander off to fetch the internal mail by which time I’ve timed out of everything.
It’s this which is at the root of the other seemingly tiny problem. We use the Cisco VPN to enable us to access central files and some central software remotely. Without going through the VPN we can’t use the tools we need. To connect the VPN it used to be the case that I would go to the bottom of screen control arrow, click to see the icons, click the Cisco icon, and my account username was prepopulated. I added the password and clicked. Now, the process starts the same. But the username is not prepopulated. Instead a pop-up appears and I have to type my username in, and then click, and then it asks for my password. That extra complexity means there is a significant proportion of the time when I cannot begin to think about activating the VPN (as mentioned before, I can’t just do it at the start of the day because there is an inactivity timeout). So I can’t do the work that requires I go through it. Not because I can’t do the work But because the friction of getting there strips me of that ability.
I would say that each programme that uses a password I can’t see as I type or which requires a multiple step login means I have a 50% chance of following the process through and ending up where I need to be with my head still in the right place to be able to manage what I set out to do. Every step involved in the process decreases that percentage. That has a huge impact on my work. That only arises because I am provided with tools that come with micro frictions. And which is compounded and becomes problematic because there are so many of them.
The thing about executive function is that it comes and goes randomly. And is task specific. If I am able to “do purchase orders” or “do HR” I need to be able to click a single button and be there, in the software. The interposition of a login takes me out of that zone and requires the activation of another area of my brain entirely. One I may not have. One the activation of which might take me out of readiness for the task I was OK to undertake, so by the time I’ve logged in, I end up staring at a screen of spaghetti.
Several things would each mitigate this. Not having passwords/keys is one I accept is not possible. Not logging me out once I have logged in would be the most helpful. When I start the day, I have to login to my machine. I am in login mode. If I could login to everything at once, or everything from that single action, and then not be logged out, I could move seamlessly from task to task. That is, apparently, impossible. It is not even possible to configure my machine to do that as a reasonable adjustment it seems, even though I work on my own in an office that’s always locked when I am not in it.
Letting me see what I am typing would be the next best option. In addition to meaning I don’t have to hold “what I’ve already typed” in my head and wonder if the shift or caps key has worked, it takes away the added anxiety of knowing that a certain number of mistypes will result in being locked out and having to initiate another inaccessible process to engage with IT.
And this is where “executive function” is so hard for people to understand. Because if you don’t experience it, every sentence you will say to me in response to what I typed begins with the word “just” and if I dare to respond with “I can’t” the follow-up will be a sigh, an eye roll, and writing me off as difficult and lazy. I know because it happens every time. Just last week it happened to me from another member of a disability group who was talking up the benefits of accessibility and got perceivably short with me for saying that a physical token wouldn’t solve the problem of executive function because (not because I’m lazy or careless but because my brain can’t cope with remembering AND doing anything else) I will lose it. Which is why I stop asking. Which is why my work suffers even more.
And this brings me to my second point. Which is that because the impact of friction is cumulative, across many platforms (on a daily basis at work I use a Microsoft client login, a Cisco VPN, Oracle financial software, SAP Concur expenses software, People XD HR software, Microsoft travel insurance software, Microsoft Teams, Zoom, as well as budgeting and student record software whose provenance I’m not sure of), the answer that will solve my problem best is not for EACH system to do accessibility well, but for EVERY system to do accessibility the same way, or better still at the same time.
This is how I express that part of the problem when I address financial services firms:
No single firm can solve this problem, because the problem isn’t what any one firm can do — it’s that I deal with so many firms that I can’t tell them all individually what I need. As I put it when I speak to firms: if every company I dealt with solved its accessibility issues for every single one of their disabled customers, they would not have solved accessibility for any single one of those disabled customers — because no customer deals with just one firm.
The biggest effect of micro friction on our lives is not the one that comes from this or that accessibility issue but the fact that we encounter so many of them every day, and yet more by having to ask for help every single time.
It’s an incredibly powerful message, because the instant response of every organization when you start talking accessibility and friction is “we’re working on it.” And when you ask for a common solution, the answer is, “we’re building our own.” To have someone who experiences the impact directly be able to turn round and say, in essence, “that’s great. But you could build the best possible accessibility solution of your own and it would do less for me than doing something way way less good together” provides one of those “penny drop” moments for firms.
Solutions to this problem benefit from the so-called network effect. That is, the more people who use them the more useful they are. In this case, the size of the network that matters is, unlike social media, the supply-side one. It’s a similar digital issue to one that is already recognised with hardware and the importance of interoperability. The more firms that are able to meet my support needs from a single request on my part, the more benefit I feel from that single click.
This is why, although Support Hub has launched with financial services, discussions are already at very advanced stages with utilities (water and electricity), retailers, and telecoms firms. The percentage of our daily interactions that would be covered by those categories is potentially life-changing for millions of us.
It might not be the organizations that are part of this solution that feel all of the benefit. Yes, I will find it easier to interact with them. And I will choose them over a competitor when my resources are running low. But the real benefit to me is the time it gives me to lead a more fulfilled life, and one where I am able to thrive, to explore my passions and push my limits, not held inside a tiny box of possibility.
And that might not seem to offer these companies any direct benefit. But that word “direct” does a lot of lifting. If I am more fulfilled, more content, more refreshed that will create a positive spiral in all areas of my life — which will eventually result in me being a better customer, possibly with more to spend, certainly with fewer administrative difficulties for them to manage.
And that brings me to the structural issue.
Just as no one organization’s attempt to be accessible will solve their customer’s problems with friction, so no organization’s participation in a common solution will provide them with a simple metric to demonstrate the value of their participation. Instead the benefit to all organizations comes to the overall network of which those organizations are a part. The exponential way this works makes it very hard for institutions to see why they should be part of such a solution — while we can see that if they were to do so anyway the benefits would suddenly break the surface dramatically at a certain point. This is a very particular problem facing a solution like Support Hub, which will work better and bring more benefits to all participating organizations as more of them take part. But it’s a wider problem measuring benefits whose impact occurs within a network. We saw this as public and politicians wrestled with public health policy during Covid, persuading people that direct cost in terms of restriction on their lives would come back to them in some kind of karmic terms if and only if they were part of a group in which many people paid the same cost.
Once a project reaches that critical mass, the proof of concept will follow. This is why the firms who have committed up front to be part of Support Hub have done something so valuable.
I hope many more firms follow. And I hope many more projects follow. I will be doing everything I can to facilitate those projects, and to study and attempt to solve the impact of friction, and campaign to raise awareness of the importance of funding and prioritising research on friction elimination. It’s a key part of what I do at Rogue Interrobang, where I help institutions to empower innovation and impact in their teams. It’s central to the open source support lists at the heart of WhatWeNeed.support, which exists to provide a platform for people who want to build solutions. And I am always available for motivational talks on the subject. Get in touch if you are interested in any of this at rogueinterrobang@gmail.com
