Presents for Christmas

Since it is Christmas and since gift giving is “top of mind” (regardless of your religion – this is a time of year that gift giving is celebrated – OK, not the retail kind, the REAL kind), I thought about what gift I as a mental health professional would like to receive. And guess what – a number came to mind.

First, I would like to see a Canada and the global society be a place in which people living with mental illness had exactly the same rights, equalities and access to care as people with illnesses that are not disorders of the brain have. When we can speak of diabetes and colitis and arthritis and schizophrenia all in the same breath and with the same considered and supportive perspective then we will have gone a long way to decreasing stigma and barriers to mental health care.

Second, I would like to see us beginning to talk about finding a cure for various mental illnesses, much as we speak about finding a cure for breast cancer or finding a cure for prostate cancer. We have finally developed and are rapidly developing our understanding of the brain and its functions – in health and in disease. And we are getting closer to understanding the social and environmental impacts that effect brain function and how those may contribute to the development or perpetuation of mental disorders. So its time we set our sights on a cure for schizophrenia, a cure for major depressive disorder, a cure for bipolar disorder and so on. We may not find a cure in the next five or ten years, but by gosh the search will take us a long way forward.

Third, I would like to see our mental health community supported and enhanced by coming together of various components instead of those components pulling us apart. Sometimes I think that if we spent one half of the time and effort that we seem to put into supporting pet ideologies or convincing others of our “truths” in common purpose, we would be so much further ahead. One foundation that we really need to build our community on is scientific literacy. We need to use science to advance our cause. We need to use the best scientific methods and the knowledge that they bring to us to inform our directions. We need to embrace the science and not rail against it. Building on this foundation we can work together to ensure that all the interests and different voices of individuals and groups are expressed, heard and included. A house has many rooms, but if its foundation is not strong it will collapse, regardless of how pretty it may look.

So those are my three Christmas gift wishes. The best of this gift reminding season to you and yours. Regardless of your religious beliefs or other defining features. Be well.

--Stan

Doing better with Depression

It's hardly a day goes by that we don’t read about depression and its impact on people and the economy and the toll it takes with suicide. We also read about how wonderful treatments are and how it is important to get help as soon as possible. All the above is true and for sure if I, or one of my loved ones, or one of my friends, was depressed I would certainly opt for immediate treatment with an antidepressant medication and an evidence based psychotherapy, delivered by competent health care providers.

But, and this is a big but – the evidence shows that good as our treatments are, they are not as good as they should be. The medications really help a lot but they do not help everyone. The psychotherapies help a lot but they do not help everyone. Combining the treatments helps more people but even this does not help everyone. So what do we need to do?

Well, it's all well and good to make our systems of care more accessible and to train more health care providers to be able to treat depression but wait a minute. Shouldn’t we be spending a whole lot of time and effort on making our treatments better? Shouldn’t we be making sure that when we offer a treatment to someone the chances of it working the first time are as close to 100 percent as we can get? What would you prefer – a one day wait time for a treatment that works 50 percent of the time or a one week wait time for treatment that works 90 percent of the time? And while we are at it – why not a one day wait time for a treatment that works 100 percent of the time.

So we need to invest in treatment research. We can have all the health care providers and all the clinics and all the nice posters on the walls of schools and neat anti-stigma ads on the television and radio and on and on and on – but, if we do not get better at treatment, how much further are we really ahead? Do you know how many high powered (meaning really good scientific studies) have been done in Canada in the last five years on the treatment of some of the most common mental disorders that begin in adolescence. One? Five? Nine? Maybe none? Do you have any idea how much money is being spent on finding out how to better treat young people that have psychosis or depression or obsessive compulsive disorder compared to treatments for other medical illnesses or even compared how much is spent on posters that tell youth about problems? Don’t you think you should have some idea?

We need to invest in a major way in learning better ways to treat mental disorders in this country. We are not doing that in Canada. It is time we started to. Improving access to care is a good idea. Improving access to care that actually works is an even better idea.

--Stan

Suicide attempt or self-harm: does it matter?

Some of us think we have a problem in our suicide research and in our suicide prevention approaches. Actually there may be many problems with those (stay tuned for future blogs) but one of the concerns is the meaning of the statistics when it comes to the definition of “suicide attempt”.

A suicide attempt can be defined as a purposeful self-injury with the intent to die. A self-harm attempt on the other hand can be defined as a purposeful self-injury without the intent to die. Self-harm can be the result of many different factors, including but not limited to: difficulties with problem solving, difficulties with impulse control, copycat phenomenon, social or situational control, etc. Increasingly, research is showing that young people who self-injure may be substantially different from those who attempt suicide. So what does this mean?

Hospitals that use the ICD system (and that is all of them) tend to code self-injury as a suicide attempt. Even DSM at the time of this writing, does not allow for differentiation of self-injury from suicide attempt. Could it be that many of our statistics about suicide attempts are incorrect? Could it be that “truths” that we think we know – such as more females attempt suicide than males – may not be accurate but may be an artifact of not separating out self-harm attempts from suicide attempts?

And what about suicide prevention programs? Does a decrease in reported incidents of self-harm equal a decrease in real suicidal behaviour – that is suicide attempts? That does not mean that we should not try to bring down self-harm attempts, but it may mean that the methods useful for one outcome may not be useful at all for another outcome.

Actually, I think its time that we started to think more critically about what we mean when we use the words “suicide attempt”. Is it really a suicide attempt or is it a self-harm event? It is an important distinction. Both are important targets for interventions – public health type and clinical type. We need to separate them out in our statistics and we need to separate them out in our programs. Then we can get a better handle on what is actually happening and what we can do about it.

-Stan

Sleep – A Teenagers Best Friend

So what is this with sleep anyway?

Given what we know at this time, sleep is necessary for brain growth and development. It is also fundamentally necessary for academic success. For example, when we sleep, we learn. Important memories from the previous days are consolidated and the capacity to learn for the next day is refreshed. And, during the teen years, with the accelerated brain growth and re-organization that occurs during those years – youth actually need more sleep than when they were children.

During the teenage years the child pattern of getting up early and going to bed early shifts to going to bed later and getting up later. And at the same time, the brain’s need for total sleep time increases – as much as an hour or more per night. When accentuated by the digital and light enhanced evening environment, staying up later and later becomes the norm for many teens. And, because the school day usually starts fairly early, students (as the research has shown us) are frequently sleep deprived, sleepy and not at their optimal learning capacity – especially in the first hour or two of classes. This pattern leads to not enough sleep during the week and this leads to sleep debt – time that needs to be repaid – you guessed it – on the weekend! This results in a pattern of about 2 hours difference between usual sleep/wake patterns between school days and weekend days for many teenagers. This is equivalent to a jet lag of 2 hours. And that happens mostly every week!

One obvious solution to this problem is starting the school day later for high school students. Indeed, some studies have reported that this results in improved academic performance and one study in Kentucky also found fewer automobile accidents during the later school start trial. However, this accomodation to the changing teen brain has not proved to be popular with education officials and across most of Canada and the USA, schools still start early and teenagers still come to class tired and not ready to learn. And guess what? In many places, exams (including those that take an enormous amount of concentration – such as mathematics) are frequently scheduled for early in the morning!

So what can be done about this? Well, changing the school day is not likely to happen, but that would be a really good idea. Just think, setting up a school protocol to meet the needs of the students – what a novel idea! For the individual student, trying to get to sleep a little earlier (even one hour earlier) would pay big dividends. And if that is just as hard as changing the school start time – at least get a good nights sleep before your exam. Staying up all night and cramming is not helpful. Getting your beauty rest is. Isn’t science grand? Did your grandmother tell you this at some time?

Understanding Youth Suicide

Today’s Los Angeles Times carried a front page local story regarding youth suicide in Palo Alto: "Palo Alto campus searches for healing after suicides”. Although details are sketchy and of course incomplete, the story points out that there has been a cluster of suicides involving students from the same school campus over a short period of time, occurring in the same place and under similar circumstances. As expected, such tragic events have caused substantive community consternation.

Youth suicide is a very emotional issue. It cuts to the very core of our families and our communities. It leaves scars in parents, siblings, grandparents, other family members, friends and many others. It elicits strong responses from individuals or from communities. Some of those responses are of grief – private and shared with only a few. Some of those responses are very public – it is not clear what motivates them or how these differ from the private responses. Some of these responses may be helpful – such as support and counseling from family and friends. Some of these responses may be harmful – such as bringing in grief counselors and creating community emotional contagion in the wake of a suicide. Some of these responses may be neither helpful nor harmful – but may be costly. So, what can be done?

Here the evidence is not fully in yet and each situation begs careful assessment and considered planning before anything is started. What is not helpful is putting into place those things we know do not work. What is likely not helpful is grief contagion. This can be created by mass grief counseling and enthusiastic and well meaning initiatives to “do something”. What may be useful is identifying young people who know the victims and addressing their mental health needs and emotional concerns. What may be useful is for the newspapers and television and radio stations to stop running front page stories and prime time news about youth suicide. This does not mean that we do not talk about it. This does not mean that we avoid the topic. Not at all! This means that we address this tragic and emotionally issue rationally and responsibly.

-Stan

Mental Illness can impact anyone

Recent events in the National Basketball Association (NBA) involving two high profile players, Delonte West and Michael Beasley have highlighted the issue of mental health in the NBA. And, this is an important step forward, not only for the NBA in specific but for professional sports in general.

Professional athletes are no less likely to suffer from mental disorders than the general population. We can expect that approximately 10 to 15 percent of professional athletes will have significant and substantial mental health problems, including mental disorders. The most common mental disorders will be: depression, anxiety disorders and substance abuse. A few may have bipolar illness or other psychotic conditions.

These disorders will affect them in both their personal and professional lives. Athletes living with mental disorders can expect to have the same challenges that people who are not athletes but who are living with mental disorders have. These include but are not limited to personal problems and decreased job performance. One important difference however is that professional athletes are very high profile. Their lives are often lived in a public arena. When they have problems these are difficulties are known to the many, not only to the few.

When mental disorders in professional athletes lead them to experience personal and professional difficulties these can be publicly addressed in positive or in negative ways. One positive way may be for their employers (professional sports teams) or their associations (players associations, professional leagues such as the NBA , the NHL and others) to publicly acknowledge these difficulties – much as they now do with physical illnesses or injuries. Another way may be for the players themselves to be open about their problems and to discuss them much as they discuss any physical injuries or other similar issues. Another way may be for the sports media to become more knowledgeable about mental health problems and mental illnesses and to write their stories from a position of understanding.

Mental disorders affect everyone – including professional athletes. How they, their employers and the media handle these issues may have an important impact on how society in general and youth in particular understand mental illness. Its time for professional sports to get “on side” – so to speak.

-Stan

Suicide Prevention – Time to Get On With What We Know Works

Another World Suicide Prevention Day (September 10, 2009) has passed and in many locations a variety of activities were underway across Canada, for example, community suicide awareness walks such as the one that has been initiated in New Minas/Kentville Nova Scotia and one that will be occurring in Halifax on the weekend following. The Canadian Broadcasting Corporation has presented a number of stories on the topic and the London Free Press newspaper has announced that it will publish obituaries in which suicide can be identified as a cause of death. The president of the Canadian Association for the Prevention of Suicide is quoted as saying that a national suicide prevention strategy is needed. All in all, there is increasing awareness of the importance of this issue nationwide.

Unfortunately, in all the media reports I have seen or heard on this issue there has been not one mention of what I consider to be the most important item that needs to be addressed. That is, based on solid scientific evidence we already know what to do to decrease suicide rates, so why are we not doing those things? Marches are good for raising awareness but do we need to march to put effective programs into place?

So what do we know helps bring down suicide rates? First of all is the identification and effective treatment of people who are living with a mental illness – especially depression, bipolar disorder and schizophrenia. Second is the reduction of access to lethal means – be that through control of handguns or barriers on bridges. Third is the creation of “gatekeeper” programs in organizations such as schools or similar institutions. In this way those individuals at highest risk can be identified and interventions provided to them. None of these are difficult to do. None of these are costly to develop and implement. So why are they not universally in place?

Health care systems are notoriously inert – change comes very slowly and often inefficiently. Stigma against the mentally ill pervades the health care system and providers are not immune from its insidious effects. Could this be a reason why those relatively simple and proven effective approaches are not already in place everywhere? Where are our legislators - provincial/territorial and federal? Why are they not demanding that these approaches are in place and properly supported? Perhaps it is because they feel no pressure to do so. Perhaps the scientific evidence and moral imperatives are not enough.Perhaps they need a push from the people.

So, what do I have to say about this? Walk on. Speak out. Demand change. Demand that what we already know works be implemented. Demand that we learn more. Crush the stigma and let the science lead us to do what works best!

Dr. Stan Kutcher

Sun Life Chair in Adolescent Mental Health

IWK and Dalhousie University

Mental health in schools: How teachers have the power to make a difference

We've had a lot of great feedback from our post on schools as the next frontier for mental health education.

We all know the problem. Mental disorders represent the most common and disabling condition affecting young people and therefore have major implications for students and for schools. In short, mental health problems affect a student’s emotional well-being, their ability to learn, are a factor in why some students drop out of school.

But too often we focus on the problems instead of the solutions. In a recent article entitled "Mental health in schools: how teachers have the power to make a difference" for Health and Learning Magazine, Dr. Kutcher, Leigh Meldrum and I outlined a three-pronged approach to address mental health problems in schools. 

Schools can be an important location for mental health promotion, early identification and intervention, combating stigma associated with mental illness and possibly providing interventions and ongoing care. But as a teacher, what can you do to make a difference in the mental well being of your students? The answer is not always easy, and requires cooperation at all levels of the education system and a positive collaboration with health care providers.

Using the classroom for stigma reduction

One of the largest obstacles facing youth with mental illness is the associated social stigma against people living with a mental disorder. While the scientific understanding and treatment of mental disorders, as well as the awareness of the importance of mental health in all aspects of life, has advanced considerably in the past decade, the public’s perception about people with mental illness has been much slower to change.

In the classroom, stigma associated with mental illness can affect how teachers, classmates, and peers treat the student living with a mental disorder. School-based anti-stigma activities present an opportunity to enhance understanding of mental illness and improve attitudes towards people living with mental illness. Furthermore, school-based anti-stigma activities reach people on all social levels, from teachers, principals and administrators to parents and community members to most importantly, the students themselves.

Identify and intervene!

Early identification and effective intervention for youth with mental disorders is critical. If left untreated, the symptoms of a mental illness may increase in severity, and its effects may become more serious and potentially life threatening. Educators and school personnel are in an ideal position to recognize behavioural or emotional changes, which may be symptomatic of the onset of mental illness.

By providing training related to youth mental health and mental disorders in young people that is specific to educators we will be better equipped to protect and promote the mental health of our youth. Educator-specific programs, such as Understanding Adolescent Depression and Suicide Education Training Program, addresses the signs and symptoms of depression, as well as risk factors for suicide, methods of identification and appropriate referral of high-risk youth. The basis of this innovative Canadian program is supported by documented evidence of effectiveness and has been demonstrated to improve mental health literacy in educators and health professionals.

School curriculum meets mental health promotion

A potential starting point for the integration of mental health care into existing school health systems is through the implementation of a gatekeeper model. A gatekeeper model provides training to teachers and student services personnel (such as social workers, guidance counseling, school psychologists) in the identification and support of young people at risk for or living with a mental disorder. It also links education professionals with health providers to allow for more detailed assessment and intervention when needed.

Schools can also address students’ mental health through the implementation of mental health promotion strategies through innovative curriculum initiatives. Improving mental health literacy through curriculum development and application could enhance knowledge and change attitudes in students and teachers alike, and embedding mental health as a component of health promoting activities could enhance mental health while decreasing stigma associated with mental disorders. Two examples of recently developed Canadian mental health curriculum for schools are: Healthy Minds, Healthy Body (Province of Nova Scotia) and the Secondary School Mental Health Curriculum (Canadian Mental Health Association).

~ David Venn

Stigma associated with mental illness runs deep

Try playing this little game with a friend, parent or co-worker. Ask them to list three adjectives that describe a person with mental illness. Then ask them to list three adjectives that describe a person with breast cancer. Finally, ask them to list three adjectives that describe a friend.

More than likely the person will use words like "crazy", "sad", "depressed", "lonely", "patient", "consumer or victim", "scared", "down", "violent", etc. to describe someone with a mental illness. In describing someone with breast cancer they will likely use words such as "strong", "confident", "undeserving", "survivor", "thriving", "family connection", etc.

And in describing a friend the person will likely use words like "fun", "caring", "happy", "smart", "loyal", "honest", "responsible", etc. See the difference?

Whether you play this game with youth, parents, educators or even health professionals you get the same result - positive words to describe a friend or a physical health problem like breast cancer and negative words to describe a mental illness like Depression.

And what if the your friend had Anxiety Disorder or Depression? Would that change your perception of them as a fun, smart, caring, loyal person? Would they suddenly be relegated to being a crazy, lonely, scared patient? The stigma surrounding mental illness runs deep. It is embedded in our actions, our culture and our language. Imagine a time when we describe and perceive people living with mental illnesses the same way we describe and perceive our friends or people living with physical health problems!

Teens aware of marijuana harm and impact on mental health

According to a BBC article, a survey of of 27,000 teenagers found that "nearly one in two teenagers knows someone who has suffered from a mental health problem like paranoia after using cannabis."

The research, which was carried out on networking website Habbo Hotel, found 64% of young people were aware cannabis could cause panic attacks, 41% knew it could bring on paranoia and 38% thought it could result in memory loss.

Over 50% of teenagers associated cannabis use with losing motivation and doing badly at school or college.

While the survey is far from scientific - it does point to some interesting trends among teens and their perception of marijuana use and how it affects mental health. Recent research suggests that heavy use of cannabis may increase the risk of psychosis in some young people The website Psychosis Sucks maintains that:

Psychosis can be induced by drugs or can be "drug assisted". Some stimulating drugs, like amphetamines, can cause psychosis, while other drugs, including marijuana, can trigger the onset of psychosis in someone who is already at increased risk because they have "vulnerability". The risks associated with drug use for a person with psychosis include an increased risk of relapse, the development of more secondary problems (including depression, anxiety or memory problems), a slower recovery and more persistent psychotic symptoms.

The good news is that with early identification, treatment and support, people living with psychosis, substance abuse or a combination of these mental health problems can recover. Because people with psychosis may have interlinked problems with substance use problems, treatment that combines both mental health and addiction services into one program is best. ALSO - integrating treatment for psychosis and substance abuse into one program is an effective way to help both problems at the same time. Treatment programs include:

• Improving quality of life including belief in the possibility of recovery.
• Going beyond just eliminating symptoms of psychosis and substance use and emphasizing social and other supports.
• Motivation support to help you set and accomplish your goals.
• Taking medications as prescribed

Kutcher Adolescent Depression Scale for the iPhone

Recently I wrote a post on mental health in the palm of your hand - exploring how technology and iPhone applications were being used to share medical and mental health information. Following that post I contacted Dr. Harvey Castro at Deep Pocket Series to ask him about Sad Scale - a self screening Depression test and iPhone application tool. Understanding the need for a Depression scale for children, Dr. Castro worked with our team to adapt the Kutcher Adolescent Depression Scale (KADS) for use on the Sad Scale application. 

The KADS, along with the Center for Epidemiological Studies Depression Scale for Children (CES-DC), are now available on the Sad Scale. These applications will give you a graph on your progress and will also allow you to email your health care provider the results of the test. The iPhone application is available now and can be downloaded for $0.99 from iTunes. We are now adapting the Kutcher Generalized Social Anxiety Disorder Scale for Adolescents (K-GSADS-A) ... stay tuned! (literally)

 ~ David Venn

School Mental Health: The Next Frontier

Promoting student health and well-being in school has long been a component of education. Traditionally, varsity athletics, school intramural sports programs and gym classes have stressed the importance of staying physically healthy through exercise. More recently, school-based sexual education programs have informed young people about the importance of sexual health, exposing students to issues of contraception use, gender identity, reproductive rights, and sexual behaviour. Nutrition has also made headway, with some schools banning high-caffeine/energy drinks and introducing healthier eating options into school cafeterias. But despite these advances, mental health – a fundamental part of student health and well-being – still remains largely absent from the education agenda.

According to the World Health Organization, mental disorders are the single largest health problem affecting young people. In Canada, approximately 15 to 20 percent of children and adolescents suffer from some form of mental disorder; which translates to one in five students in the “average” classroom. Furthermore, most major mental disorders onset prior to the age of twenty-five, making adolescence a critical time for the prevention and treatment of mental health problems.

Mental disorders can lead to serious consequences if untreated. They may impede a student’s emotional well-being and social development, leaving young people feeling socially isolated, stigmatized and unhappy. Mental disorders may also present significant barriers to learning. For example, students with mental disorders may have difficulty meeting academic standards or reaching their academic potential. These barriers can be so difficult to overcome that they may lead to chronic absenteeism or even school drop-out.

Early and effective treatment of mental health problems can substantially improve emotional and behavioural difficulties, thus reducing the number of days of school missed and reducing instances of contact with law enforcement. Treatment can also lead to improved social and behavioural adjustment, school performance, and enhanced learning outcomes. The earlier that mental health problems are addressed through appropriate effective interventions, the more likely that beneficial effects will be achieved in both the short and long term.

For all of these reasons, addressing the mental health of young people should be a priority for schools. (Excerpt from "Mental Health: The Next Frontier of Health Education",Education Canada, Spring 2009- by Dr. Stan Kutcher, David Venn, Magdalena Szumila

Young Minds launches youth mental health video and manifesto

Great video on youth mental health produced by YoungMinds in the UK. But good advice for any country and its leadership. "YoungMinds Very Important Kids (VIK), our national panel of young people with mental health problems, have launched a manifesto and accompanying film to highlight to politicians the changes that need to be made to improve young people’s mental health." 

http://www.youtube.com/watch?v=NzPdo00pPrY

You download the YoungMinds children andyoung people's manifesto here "Written in their words and including their own stories it covers 11 areas where they believe things must change so that all young people with mental health problems get the support they often so desperately need." Manifesto main points

1. Stigma still affects us; its about time we were able to talk about how we feel.
2. Dealing with problems when we are young; train primary school staff
3. Growing up is difficult; support us when changes happen in our lives
4. Getting what we need at secondary school; train everyone to understand teenagers problems.
5. Waiting lists and assessments just make it harder; make them shorter and provide us with one worker for all our care.
6. Some doctors don’t listen to us; they need to understand and support us
7. Going to Accident and Emergency can be traumatic; treat us with respect, see beyond our labels
8. Some psychiatric units feel like prisons; learn from the best ones
9. Someone to speak up for us; we all need advocates
10. Lost in the system; don’t forget about us when we are 16 plus
11. We’re the experts; start listening to us

Nova Scotia Releases Report on Suicide, Attempted Suicide

Official press release

A new report will better position government and its partners to help Nova Scotians at risk of attempting suicide.

The report, Suicide and Attempted Suicide in Nova Scotia, was released today, July 15. Its purpose is to help those who work in the areas of suicide prevention, intervention and support.

"Suicide is a very complex and sensitive public health issue," said Dr. Robert Strang, Nova Scotia's chief public health officer. "We need to talk about it more and better understand it to ensure the right programs and supports are in place to help Nova Scotians."

The report describes the conditions surrounding suicide and attempted suicide in Nova Scotia. The data is based on hospital and vital statistics records of suicides and suicide attempts from 1995 to 2004. It examines demographic factors, how people attempt suicide and complete suicide, and the types of health-care services used by Nova Scotians at risk.

"This report is a baseline we can use to evaluate future efforts on this important issue, and we've made good progress since 2004," said Dr. Strang. "We've developed a suicide prevention framework to reduce suicides and attempted suicides, we're doing additional research with the medical examiner's office, and we fund our community partners who work with Nova Scotians."

Dr. Stan Kutcher, Sun Life Financial Chair in Adolescent Mental Health, a partnership with the IWK Health Centre and Dalhousie University, said that even though suicide and suicide attempt rates are decreasing, and Nova Scotia is experiencing lower suicide rates than most Canadian provinces, there is more to be done. "Improving care for people with mental disorders, enhancing the capability of health care and education professionals to identify people at risk, promoting overall good health and resiliency, and improving access to good mental health care, can all help further reduce Nova Scotia's suicide rates.

" Highlights of the report include:

• The rate of hospitalizations for suicide attempts declined by 30 per cent over the 10-year period
• 55 per cent of those hospitalized were female
• Lower income was associated with higher rates of both hospitalizations for suicide attempts and suicide deaths
• The rate of suicide death declined from 11 to nine individuals per 100,000
• Nova Scotia's suicide rate was lower than the national average, nine out of 100,000 individuals compared to 11 out of 100,000
• 84 per cent of suicide deaths were male
• 55 per cent of suicide deaths were previously diagnosed with a mental disorder

The report is available online at www.gov.ns.ca/hpp.

Mental illness ad campaings: sexy, edgy or emotional?

In the past few weeks I've come across several advertising campaigns aimed at raising awareness about mental health problems. Two in particular focusing on Autism and Eating Disorders caught my attention (you can see why below). Advertisers know what "sticks" when it comes to marketing: sex, shock and emotion. These approaches can be effective ways to sell products or promote a brand identity - but how well do they transfer into the world social awareness? Or for that matter mental health? SEXY The people at Sociological Images alerted me to this Rethinking Autism ad campaign. The RA site maintains that:

"All too often in the world of autism, celebrity and sex appeal are used to promote pseudo-science that exploits autistic people, their family members and the public. We decided to put those very same factors to work in service of the truth."

This is a clever ad. It's information is scientifically-based and it captures your attention. But is it effective? While I get the tongue-in-cheek reference that Autism has become a "sexy" topic of discussion, I question whether the core message gets buried beneath a sea of lingerie. The Rethinking Autism website claims to want to "change the conversation one video at a time", but are we changing the conversation towards Autism and debunking pseudo-science or does the ad instead meander towards a debate about the objectification of women as sex objects. If the latter then the message is lost. 

EDGY Next up is a series of ads from the Looking GlassFoundation for Eating Disorders based in Vancouver BC. The ads are edgy alright - but their message is misleading. The tagline in the ads is "Not every note is a suicide note" - which falsely implies that eating disorders are a method of suicide. We know this is not true. So while the ads are effective in shocking us, they do little to advance discourse because of their false message - in fact they may even perpetuate the myth that eating disorders are motivated by suicidal intent. 

MOTIONAL Finally an anti-stigma ad campaign from the Mental Health Foundation of Nova Scotia (see video on their homepage). The ad uses personal narratives, emotional music and dream-like backgrounds to tell a story. In under a minute the video captures the pervasive stigma that accompanies mental illnesses, touches on the scientific basis of mental disorders as brain disorders, points to the need to improved resources to meet the needs of those living with mental illnesses and challenges the viewer to talk more openly about mental illness and mental health. Effective doesn't have to be flashy and this ad is a great example of the power of emotion and story to communicate an important message

David Venn

How to Spread your Cause: A Child and Youth Mental Health Case Study

How do you let people know about your cause? For big corporations and organizations this problem isn't so difficult. They throw money at national advertising campaigns, they hire creative PR firms, they design complex websites, etc. But as non-profits our capacity to engage in these expensive promotional techniques is often limited. Here are some useful, more cost-effective ways to share your message

Collaborate instead of communicate - when we work in a silo we don't accomplish as much as we could if we worked in partnership. Find other organizations either at home or around the world who have the same cause and vision as you and ask them to partner. Don't help yourself first. Bring something to the table that is of value to them, especially if you are the smaller organization. What do you have that they don't? Find a way to make the partnership mutually beneficial. (See our project with ViewFinders as an example)

Listen to what others are doing - yours is not the only voice in the room. Instead of trying to communicate your message, listen to how others are communicating theirs. Set up RSS feeds to track what other people are doing, read blogs (Beth Kanter's blog on how non-profits can use social media is excellent), follow people on Twitter and Facebook. Listening to others will give you great ideas about how to spread your cause.

Know your audience - a group of a few who care is often better than an army of many who don't. Communication is not always a numbers game. Find a core group of people who really care about what you are doing and ask them to help you spread your message. (Chris Guillibeau talks about this idea in his Brief Guide to WorldDomination). A few people in power positions and really connected to what you are doing may have a much greater impact on your cause than many people with minimal influence.

Use multiple mediums - diversify the mediums you use to communicate your message. The best approach encompases multiple streams of communication. Email and e-newsletters may be great for reaching some people, but blogs and social media may be useful for reaching others. Cross-link your communications for a comprehensive approach.To Write Love On Her Arms is doingthis really well.

A Child and Youth Mental Health Case Study On July 1st we are opening up a survey as part of the Evergreen project to ask Canadians to share thier values and ideas about child and youth mental health. We have been implementing the principles above to spread the word about this initiative.

Here's how we are using these principles:

Collaboration - we don't have many connections with parent groups so we found a publication that did and partnered with them. Today's Parent has been supportive of our project from day one and have even helped us by asking their audience to take a survey about mental health and take part in this cool online flower garden for children's mental health.

Listen - we have been using google RSS feeds and a del.icio.us account to track news and blogs about mental health. It's been a great way to listen to what others are doing and to join the conversation.

Know your Audience - our key audiences, in addition to youth and parents, are health professionals and educators. By using promotional networks specific to these audiences (ie: HPClearinghouse) we can target our communications efforts.

Multiple Mediums - our blog and website are strong tools for reaching our audience. Recently we have expanded to Facebook and are using e-newsletters (sign up on left hand side) to engage people who are interested in what we are doing. Another great tool is interactive media like Slideshare. Have you found a particular technique helpful or useful? What other ways are you are promoting your cause and voicing your message? Share your ideas in the comments section!

~ David Venn (image credit: omacaco)