Improving help seeking behaviour in 16-24 year olds with mental health disorders using social marketing

Only 10-15% of 16-24 year olds with mental health disorders will seek help from other people, compared to 40% of adults (Biddle et al 2004), how can social marketing be used to increase help seeking behaviour in this age group?

Identification of Relevant Social Marketing Issue

Background to the issue (Kotlers Step 1) The World Health Organisation defines mental health as a state of wellbeing which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community (WHO, 2010). It is cited by various organisations such as The World Health Organisation (2010) and The BBC (2010), that mental health is famously underfunded however it costs the UK 77 billion in care, lost employment, reduced quality of life or loss of life (Forster, 2011). There is therefore the opportunity to better the wellbeing of those directly affected by mental health issues through social marketing in order to make a positive impact on society. Targeting (Kotlers Step 3) Young people? because as Appelqvist-Schmedlecher & Stengrad (2010) highlight only 10-15% of 16-24 year olds will seek help if in mental distress, Biddle et al (2004) go further suggesting as few as one in six young adults with mental distress seek professional care. Specific mental health disorders? Based on the classifications in benchmark report; The ICD-10 Classification of Mental and Behavioural

Disorders (WHO, 1992),. Mood [affective] disorders including depression can be defined by its major symptoms; a disturbance in mood, inappropriate, exaggerated or limited range of feelings (WHO, 1992). Neurotic stress related (anxiety) disorders including panic disorders can be defined by abnormal anxiety.
Fig 1. Prevelance of Common Mental Health Disorders in the UK

Objectives/Goals (Kotlers Step 4) The aim of this research is to gain insight into the barriers and facilitators of help seeking behaviour in 16-24 year old with mental health disorders and make recommendations on how to increase this behaviour using social marketing and behavioural theory. Further aims of research are set out below in Proposed Further Research

Social marketing Concepts A study of the social marketing literature (e.g. Kotler and Zaltman, 1971; Lefebvre and Flora,1988) reveals a number of important ideas. These are integrated into my planning process: Consumer orientation Voluntary and mutually beneficial exchange (part 3) Internal and external environments; Objective setting; Market segmentation and target market(s); The formulation, implementation, monitoring (recommendations) and evaluation of the marketing mix i.e. the product, its price, promotion and , distribution.
Fig 2. Exchange Theory, Adapted for Social Marketing

Social Marketing Theory

The first 6 steps of Kotler & Lee (2011) 10 Step planning process provides the overall framework for this research project, the relevance of which is highlighted in this poster. Kotler & Lee (2011): Step 1: Describe background purpose/focus of plan Step 2: Conduct a situational analysis Step 3: Select target audiences Step 4: Set objectives and target goals and behaviour objective Step 5: Identify Target audience barriers, benefits, & competition

Source: Mind (2011)

Source: Gerald & Hastings

Background Purpose & Focus

Analysis of Research
Secondary Research:

Situational Analysis

Select Target Audience

Set Objective & Target Goals

Identify Barriers, Benefits & Competition

6. 7. 8. 9. 10.

Write a Positioning Statement Develop a Strategic Marketing Mix (The 4 Ps) Determine an Evaluation Plan Establish a Campaign Budget Outline an Implementation Plan

Identify target audiences barriers, benefits, the competition and influential others (Kotlers Step 5) Barriers (Internal/External): Internal Lay diagnosis incorrect (Biddle et al 2007) normalisation, denial and delay
Fig 4. Perception of mental illness, being a mitigator of help-seeking

Literature: Conducted secondary research through scholarly sources such as Journal for the Advancement of Mental Health British Journal of Mental Health Sociology of Health & Illness Case studies: National Centre of Social Marketing- Time for Change Perfect Circle Campaign- IAPT NHS- Improving Access to Psychological Therapies Primary research Interview with Deputy Manager of a Floating Support Service, Support worker and key worker in various mental health services

-Perceptions of help seeking -Perceptions of mental health -What creates these perceptions around them is the relevant level on The Social Ecology Framework (Collins, Pressley & Tapp 2010) Facilitators Rock Bottom a term used in substance abuse but has its place in mental health (Primary research) Making it acceptable to seek help (Primary research) Emotional intelligence (Ciarrochi et al 2005) Environment accepting of this

Proposed Further Research

There is literature on help seeking behaviour, on young people with mental health disorder. However there has not yet been a campaign to specifically carry the same behavioural goal which is to increase help seeking behaviour in this target audience. The aims of the further primary research are to: Understand how the target age group define and perceive help seeking behaviour Understand what their comfort zone is in terms of sharing feelings their illness Identification of which social ecological level (Collins, Pressley & Tapp,2010) is the most influential? If stigma was removed, would this immediately lead to more disclosure? Research Methodology Questionnaires will be used to collect qualitative and quantitative data as it is most appropriate for the sensitive nature of the research (Kumar, 2011) providing anonymity as well as allowing a greater sample and therefore greater accuracy (Kumar, 2011).

Findings and Analysis

Source: Biddle et al (2007)

Quota sampling will be used as it is the most convenient and cost effective way of targeting 16-24 years olds. The disadvantage of quota sampling is the lack of probability, therefore not making it representative over the general population. However the study can be made more representative by administering from more than one locati on which is what i will do, eg. The Social Zone Cockroft, Churchill Square and Survey Monkey. Therefore existing research will be applied with social marketing frameworks and once the insight is gathered recommendations using further social marketing theory and behavioural economics.

Fig 3. Influencing Access to Psychological Theory by Perfect Circle

Exploring Help Seeking What is help seeking? There is a lack of unified theory, tend to focus on macro-level factors (socio-economic factors influencing service provision) as opposed to micro-economic which makes the crux of the research Initial primary research indicated that the terminology of help seeking behaviour and that the wording may confuse respondents with the term attention seeking behaviours or other help seeking behaviours such as self-harm (primary source) Also what do we want the eventual outcome of help seeking to be?

Source: Perfect Circle (2011)

Trying to find yourself, dont know who you are Embarrassed (primary source) *insert image of the continuum framework* -You should be able to cope, or if not you are mad polarised continuum Knowledge values beliefs, behaviours Help negation (Ciarorrochi et al 2005) not utilising help that is available to you, intention to seek help decreases as need to seek help increases External - Massively influenced my peers 1,000% increase in smoking in teenagers if 2 of their peers smoke, a 26% increase if a parent does -Stigma- relating to lay diagnosis

References Ciarrochi, J.,Deana, F, P.,Rickwood, D. & Wilson, C, J. (2005) Young peoples help-seeking for mental health problems. Australian eJournal for the Advancement of Mental HealthVol 4, Issue 3 Pages 1-33 Collins, K., Pressley, A. & Tapp, A. (2010) Social Marketing and social influencers: Using social ecology as a theoretical framework. Journal of Marketing Management Vol 26: 13, 1181-1200 Collins, Pressley & Tapp 2010 Ciarrochi, J.,Deana, F, P.,Rickwood, D. & Wilson, C, J. (2005) Young peoples help-seeking for mental health problems. Australian eJournal for the Advancement of Mental Health Vol 4, Issue 3 Pages 1-33 Kotler, P. & Zaltman, G. (1971) Social Marketing: An approach to planned social change. Journal of Marketing Vol 35. p-p 3-12 Kumar, K. (2011) Research Methodology: A Step-by-Step Guide for Beginners. 3rd Ed London: Sage Publications Kotler, P. Lee, N. R. (2011) Social Marketing: Influencing Behaviour for Good 4th Ed California: Sage Publications