Authors
Christopher E. Bianco, Elio G. Daci, Nicolas Vayas Tobar
Sponsor
Victorian Counselling and Psychological Services
Advisors
Stephen M. McCauley, William R. Michalson
Term
March – May 2017
Abstract
The goal of this project was to create a web-based campaign to normalize mental health care in Australia. We surveyed university students in Melbourne and interviewed mental health professionals to inform our campaign’s content and approach. The project resulted in an extensive mental health website which strengthens VCPS’s web platform and centers on our campaign, named ‘I See A Psychologist,’ with videos, quizzes, and other resources to encourage people to seek mental health care as part of their regular routine.
Executive Summary
Almost half of Australians have or will experience a mental illness in their life; about 20% of Australians are experiencing a 12-month mental illness at any given time and only 35% of these people will seek help (Australian Bureau of Statistics, 2007). According to the National Survey on Emotional and Mental Health, young adults, ages 16 to 24, are the group of people who have the greatest prevalence of mental health disorders, and are the group that use mental health services the least (Australian Bureau of Statistics, 2007). The Australian government has tried to combat issues that are preventing people from seeking mental health care with Medicare, the universal health care system, and the National Mental Health Strategy. However, stigmatization of mental health is still present. This consists of public stigma, which is prejudice derived from media and social standards, and institutional discrimination, which is the systematic discrimination by corporations against those with mental illnesses. These lead to self-stigma and shame which inhibit individuals from seeking mental health care.
Through the years, organizations like Mental Health Australia, beyondblue, Headspace, SANE Australia, Lifeline, and Australian Psychological Society (APS) have emerged to offer resources and guidance to people who could benefit from mental health care. All of these promote mental health care, and several of them have campaigns to promote the use of mental health care. For example, the “Man Therapy” campaign by beyondblue was very successful in reaching its audience, which was the middle-age Caucasian population, by creating a fictional character that used humor to educate them. Lifeline specifically targets suicide prevention and intervention, and Headspace focuses primarily on young adults. The issue with these campaigns is that they all focus on some specific mental health illness or condition, like depression, anxiety, or suicide, and they target specific people or groups, like young adults, aboriginals, pregnant women, and others. There is a need for a campaign that is centered around normalizing mental health care, which means promoting the regular and common use of mental health care as a form of preventative care.
Project Goals
The goal of this project was to develop a web-based campaign with Victorian Counselling and Psychological Services (VCPS) that emphasizes normalizing mental health care. The campaign, called ‘I See a Psychologist’ includes a website with a series of videos, selfassessment quizzes, connections to mental health practitioners, and general information on mental health. The project assessed public perceptions of mental health and mental health care among different cultural groups in Victoria through public surveys. Additionally, the project evaluated mental health outreach strategies by interviewing other health-related organizations in Melbourne to inspire the campaign. The campaign makes it easier for Australians to receive necessary care to recognize early symptoms of mental illness, thus reducing the severity of those illnesses, while providing educational resources to maintain a good well-being.
Learning from Key Stakeholders
Victorian Counselling and Psychological Services
To understand the role of the web-based campaign in VCPS’s broader goal of normalizing mental health care, we built relationships with several of the staff at VCPS to learn about the practice and the methods they have been using to attract clients. In a focus group with VCPS staff, psychologists suggested that people from lower socioeconomic classes were less likely to seek care because they could not access mental health services; even among those who started treatment, the limit of 10 sessions imposed by Medicare meant that they could not complete necessary treatments. White collar workers were also found to be not very willing to seek mental health care, which is probably due to their time commitments. We found that most people thought that mental health care was only useful to directly prevent or treat a serious mental disorder. Respondents did not think of mental health care as a way to maintain one’s general well-being. Some practitioners commented that the issue of few people seeking mental health care is related to not having a sense of community approach to emotional struggles. Historically, mental health care was dealt with by religious leaders, family or other trusted individuals; however, it has become more of an individual problem. It was suggested that it is necessary to “re-normalize” mental health care so that people feel comfortable seeking help as preventative care.
Public Perceptions
We assessed public perceptions of mental health and mental health care among different demographics in Melbourne. Research suggests the utilization of mental health care is particularly lower in some minority cultural groups (Minas et al, 2013), and in young adults, from 16 to 25 years of age (Australian Bureau of Statistics, 2007). To understand the perceptions of these groups and to better target our campaign, we had conversations with some stakeholders in the mental health industry that could give us insight on the use of mental health care by different cultural groups. Mr. Yonas Mihtsuntu, a social worker in Victoria, gave a general overview of the social worker practice and how he tries to engage with people as efficiently as possible to be able to offer mental health services. He discussed how difficult it can be interacting with different cultural groups because of their hesitation to discuss mental health. Additionally, he discussed how the differences between perception are vastly different among different cultural groups and even individuals within the cultural groups that there are no “one size fits all” solutions.
We also performed a survey of 55 students at Melbourne University to understand the views on mental health care of the young adult demographic. Responses suggest that very few people have a diagnosed mental disorder, even if the Australian Bureau of Statistics has previously shown that in a 12-month period about one fourth of the population will experience a mental health disorder. The number of people seeking mental health care significantly improved from the National Mental Health Survey of 2007, which suggests that there might be better access and promotion of mental health care now, a decade later. The survey also suggests that people mostly consider mental health care during difficult moments in life, and that even if they identify that it is important to maintain mental well-being, people are not willing to go to a mental health practitioner for preventative care.
Mental Health Organizations
To gain unique insight into the design process of mental health campaigns, we interviewed experts who have worked closely with other campaigns. With the help of our project liaison at VCPS, we fostered relationships with beyondblue, one of the major mental health organizations in Australia. Through the snowball sampling method, we were able to connect with a representative from a mental health and disability support non-profit organization. Through phone and email we were able to contact several of the other mental health organizations. Most of the organizations could not share information on their campaigns, except for SANE Australia and beyondblue. In these interviews, we learned about the importance of target audience, relatability to the campaign, word choice and phrasing of the message and the importance of ensuring that our campaign is not offensive to any potential users.
The Campaign
With a more informed understanding of issues surrounding mental health and the communication challenges with such a sensitive topic, we developed the ‘I See a Psychologist’ campaign. The campaign is centered on a website with a series of videos, self-assessment quizzes, connection to mental health practitioners, and general information on mental health. It is aimed at the general public, to encourage all people to utilize the available mental health care resources for preventative care. This focus complements the goal of VCPS to provide care to all people who could benefit from it.
We designed the campaign website as an interactive journey that visitors will complete. The site begins with an introductory video that is engaging and interests the user in continuing in the campaign while conveying the concept of the overwhelming aspects of life and how we are able to manage those overwhelming aspects by looking after our mental health. The campaign then prompts the user to enter some information about themselves to begin their journey and to provide information to VCPS that will allow them to improve the campaign. The user can select an avatar to follow their daily journey and learn about how they integrate mental health care into their lives. There are three avatar videos that were created for the campaign: a student, a bluecollar worker, and a businesswoman. Each of the videos is approximately 90 seconds long and details the daily routine of one of the avatars, including how he or she incorporates seeing a psychologist into their lifestyle.
After watching one of the avatar videos, the user is led through a modified Kessler 10 emotional distress questionnaire which will assess the emotional distress levels of the user. Based on the result of the questionnaire, different recommendations may be displayed for the user. The users also see videos of psychologists explaining what seeing a psychologist is like, what they should expect, and what they will get out of the experience. These educational videos answer any questions the users may have about seeing a psychologist so that they can make an informed decision on whether to seek care. The combination of many different health professionals all reinforcing the same point shows the diversity of mental health care available while reinforcing the point of using care preventatively. Finally, users will get routed to a resources page that will contain resources such as explaining Medicare coverage or specific mental illnesses. It will also contain information how to maintain their mental well-being. The website also has a link to connect a person directly to a member of the VCPS team. After visiting the website, visitors will have an understanding of the benefits of using mental health care as a preventative measure, knowledge on what to expect from the experience and what they can expect to get out of the experience as well as knowledge on a variety of mental health related topics they might find helpful.
In the future, this campaign can be grown or improved upon to attain a greater influence. The integration of the campaign into the wider network of VCPS’s other resources will increase traffic to the campaign and make all resources among all platforms available to all visitors, increasing the knowledge base available. The expansion of the campaign will also be important. This can include additional avatar videos that individuals can relate to, as well as potentially adding videos of real people telling their real stories with mental well-being. In addition to this, additional focus testing will be vital to ensuring the effectiveness of the campaign. preliminary focus groups have suggested areas of improvement already, but, larger and more diverse focus groups will only help further refine the campaign. VCPS can also improve their social outreach using their presence to reach more individuals with the campaign and learn more about other cultures to incorporate them into the campaign. Finally, the expansion of the campaign through social media will be useful for reaching a broader audience and more efficiently maintaining a constant reminder of the campaign for those who see it.
Conclusion
The ‘I See A Psychologist’ campaign will cause more people to seek mental health care for minor concerns and as preventative care against developing mental illness, which can potentially reduce the number and severity of mental illnesses in Victoria. More generally, the campaign could either stand alone or serve as the foundation for future projects to further normalize mental health care and extend the reach to other parts of Australia or even other countries. Just by elevating the position of mental health in the public view, the existence of this campaign invites more work on this important subject in the future, which can have wide-reaching implications beyond Victoria or even Australia.
Final Report
I See a Psychologist: Reducing Stigma Through Normalizing Mental Health Care in Australia