Josh Lavra (he/they) began his career in chemical engineering but quickly realized that his dreams were bent on design.

As a result, he shifted his career and is now a creative lead at Hopelab, a social innovation lab and impact investor focused on supporting the mental health of young people — particularly those who are BIPOC and/or queer.

For the last few years, Josh has been working on imi, a free, virtual resource focused on supporting the mental health and well-being of young queer people. Here, he shares how that project came to be and how its human-centered design approach included the input and contributions of the real queer teenagers it sought to support.

In Full Health (IFH): What unique challenges do queer teenagers face related to mental health, and how does imi address them?

Josh Lavra: If you were to search on Google “LGBTQ+ teens,” some of the first things that are going to come up are statistics related to suicide, self-harm, and some of the mental health challenges that young queer people face. There’s no shortage of commentary or resources for young people who are in crisis. Certainly, they make up a portion of the population conducting those searches, but there really wasn’t much out there that was celebrating the identity and existence of young queer people — and supporting their mental health. We wanted to create something rooted in joy and hope for the future that these younger people want to build and will have.

IFH: Can you share a little bit about imi’s development process, and how were teenagers included?

Josh Lavra: I was formerly a queer teen, but the perspective that I have now is so different than the ones that young queer people are holding today. Before COVID, we were able to travel to LGBT centers across the country to just go and talk to young queer people. Over time, this shifted to online spaces where we could connect with queer teens from all over the country.

Hearing their stories, hearing the things they’re worried about, hearing the things they’re excited about, hearing the ways they’re already trying to manage their mental health — it started opening up a lot of ideas. We then started to prototype and got into this cycle of getting feedback from and co-creating with young queer people, as we got closer to an idea that might work for them.

Community Connections

We work with so many LGBT centers across the country. Beyond CenterLink and the It Gets Better Project who are our core partners and truly the reason why this was able to get out there, it’s the people who are working at the LGBT centers day in and day out with young queer people face to face in their communities that I think, have not only been an important part of this work being successful but have been such an incredible inspiration to what’s possible with advancing the power of queerness. They are in the community, helping support the people who might not feel like they have any support.

Josh Lavra
Creative Lead, Hopelab

IFH: How do you think that this mental health resource would have been different without the explicit perspective of those teenagers that you talked to?

Josh Lavra: It would have sucked, to put it bluntly. We started with an idea that was basically a queer chatbot. If we would have stopped there without any input from queer teenagers, we probably would have built this queer chatbot. Luckily, we took it and got more feedback and more input from young queer folks. And across the board, the response was, “This isn’t going to help me.”

Their feedback and reasoning pushed us to keep shaping and changing the thing that we wanted to build with them. As we created more and more space for input, we actually had young people create some of the things that are in imi today. With their guidance, we got to a much better place that we never would have gotten to otherwise.

IFH: How are you measuring impact — and what have you seen so far?

Josh Lavra: In 2021, we ran a randomized control trial on imi as a way to understand outcomes and impact. We had 270 young queer people across the country who were randomized between using imi or using a control product – 78% of the sample identified as racial and/or ethnic minorities, and approximately 60% of the sample identified as transgender, gender non-conforming, or non-binary. And over a 4-week period, we got to test if and how it actually improved their mental health and well-being. The results were really promising to see that it helps reduce some of the stressors that a young queer person might feel.

 READ THE RESULTS OF THE 2021 STUDY

We’re also looking at the qualitative data too. One story that really stuck out in my mind was this young trans person who lives in the south, and does not live in an affirming household, does not go to an affirming school, and had a really hard time existing day to day. They came across imi through an Instagram ad and started using it when they would be sitting at lunch alone. They saw imi as this moment of connection where they could read the stories of other young people who were going through similar things that they were — and in a place like the lunch room where they were experiencing a significant lack of that connection.

On the flip side, I think some of the backlash that we’re starting to receive related to imi is, in my opinion, denoting a success. The fact that there are people who don’t believe in the existence of queer and trans people, who have very strong opinions about us creating a tool to support young queer and trans people — for them to speak out so vocally about this tool, I think, is showing that we’re doing something right. I don’t know that we’re changing any minds of those folks but just knowing that we’re providing a resource that the people who have such a closed

IFH: Do you have any advice for solution developers who might be bringing teenagers into their creative process or solution development?

Josh Lavra: I’ve spent a lot of time working with adults in the design space, and I think with teens, it shifts a little bit because there’s always a power dynamic. But when you have an interaction with a teen in which they’re viewing you as the expert, I think you have to view them as the expert too. You have to recognize that the experience that they’re coming with is truly as valuable as what expertise you might have as someone who’s lived through that already.

The biggest piece of advice I would give to solution developers is to listen. Truly listen. Give them the space and responsibility and freedom to voice their opinion, and actually listen to what they’re saying — even if it challenges the thought, bias, or opinion that you might have.

IFH: How do you hope that imi is utilized to advance equity in health innovation?

Josh Lavra: First, we hope that it’s utilized by people who might not have access to the mental health support that they deserve or need. imi is free, and we will never charge for it. There’s no account creation. There’s no barrier to access, and we designed it as a website so you can access it from a phone or a computer at home, school, or library. Truly any device with an internet connection and a web browser can be a point of access for imi. By building it in a way that was thinking about equity and access, we hope it will continue to inspire other developers to learn from or build upon.