A White Paper by:
Sally Spencer-Thomas,
Psy.D.
CEO & Co-Founder,
Carson J Spencer Foundation
Jarrod Hindman, MS
Director, Office of
Suicide Prevention
Colorado Department of
Public Health and Environment
Joe Conrad
CEO & Founder
Cactus Marketing and
Communications
www.ManTherapy.org
February 25, 2014
|
Innovation in Men’s Mental Health:
Man Therapy
Difficult problems require bold
solutions. This stance is the guiding philosophy of the Man Therapy program.
The project is the result of a unique public/private/nonprofit partnership
established in 2007 between Cactus, a Denver-based advertising agency, the
Office of Suicide Prevention at the Colorado Department of Public Health and
Environment and the Carson J Spencer Foundation, a Colorado-based suicide
prevention nonprofit organization. Since its launch with an article in the New York Times on July 9th, 2012, the
project has drawn national attention and international awards for its creative
use of media in health literacy. Now 18 months later, the program continues
grow and receive feedback about its effectiveness and provocative approach.
This paper will review achievements and outcomes to date and outline a plan for
future directions.
From the outset, the co-founders of
the campaign made an intentional decision to unapologetically find a way to
reach “double jeopardy” men – those most at risk for suicide and least likely
to seek care on their own. Previous mental health campaigns targeting men have
often been ineffective with this subpopulation of men, so an audacious new
approach was needed. Thus, Dr. Rich Mahogany was born. Dr. Mahogany (a “fake
therapist”) is the focal point of Man Therapy. He strategically uses
maladaptive ideas of masculinity to bridge to new ideas that help men reshape
the conversation of mental health, often using dark humor to cut through stigma
and tackle issues like depression, divorce and suicidal thoughts head on. The
creators’ decision on this approach was steadfast, despite some initial
pushback from some in the mental health community who were concerned we were
making light of a serious topic or those supporting the men’s movement who were
discouraged that we chose to bring stereotypes of masculinity into the project.
As you will see from the results outlined below, our target demographic told us
that using humor and “manspeak” resonated with them and helped them think about
their mental health in a different way.
History and Strategic
Plan
The first
five years of the project (2007-Spring 2011) were dedicated to research and
development through multiple focus groups and in-depth interviews (read first
White Paper Man Therapy™: An Innovative Approach
to Suicide Prevention for Working Aged Men, July 17th, 2012 for the results). In June
of 2011, the Anschutz Foundation funded the initiative to develop and implement
the concepts developed during the research and development phase. Over the next year (June 2011-June 2012), the
creative team created and tested campaign assets. On July 9th, 2012,
Man Therapy rolled out its initial version of the campaign with an article in
the New York Times. 18 months later,
the program continues to evolve and provide an even broader scope of resources
for men’s mental health.
The purpose of Man Therapy is to
provide men, and their loved ones, a place to learn more about men’s mental
health, to examine their own wellness and to consider a wide array of actions designed
to put them on the path to treatment and recovery. The message is that all men
should be aware of their mental health, treat it like they would a broken leg,
and strive to get better. Because of this “upstream” approach to suicide
prevention, the program was quickly rebranded from a suicide prevention
initiative to a broader and more robust men’s mental health campaign.
Overarching
goals for Man Therapy include:
- To improve social norms around mental health among men and the general population.
- To increase help-seeking behavior among men for a variety of health and mental health issues, leading to an increase in men seeking available resources (including those provided on the site).
- Long-term: to reduce rates of suicidal ideation and deaths among men.
Attitudes
- Men’s attitudes toward mental health conditions like depression, anxiety/stress, substance abuse, anger and suicidal thoughts will become less stigmatized (e.g., they will endorse fewer myths).
- Men will express a greater willingness to try self-help tools.
- Men will express a greater willingness to seek professional help when needed.
Behaviors
- Increased numbers of men will self-screen for mental health conditions.
- Increased numbers of men will use on-line self-help tools.
- Increased numbers of men will interact with peer, professional and crisis resources.
- Increased numbers of men and women will reach out to distressed men in their lives, expressing concern and support.
Since the initial
launch, several changes were made to expand the scope of the program:
- A mobile version of the website makes it accessible on many more devices and improved downloading challenges facing users with limited bandwidth.
- A suicide prevention therapist finder now helps men find qualified care locally.
- Rich’s List compiles vetted mental health and other support resources for men.
- The Mind Master offers men time-limited, skills mastery programs to help relieve stress and conquer many other behavioral and health challenges.
- Support Group Central provides on-line support groups for men.
- Man Therapy eCards (a partnership with the National Suicide Prevention Lifeline) offer words of compassion in the tone of Dr. Rich Mahogany (e.g., “everyone needs a pork shoulder to cry on.”) and are sent to men who are having a hard time from someone who is worried about them.
Knowing that
we are reaching men (and the people who are “worried about a man in their
life”) at various points on the continuum from prevention to intervention to
crisis response, the project team is very intentional of developing strategies
to address needs across the continuum. For example, on the “upstream” end of
the continuum Man Therapy enhances connectedness by giving participants
opportunities to send caring eCards to others who are struggling. In addition,
Man Therapy augments intervention by linking results from the 18-point head
inspection to qualified referral resources. Finally, Man Therapy assists with
crisis response by connecting those in need to the National Suicide Prevention
Lifeline.
When a man
engages with Man Therapy, the intent is that the program first changes his
attitude toward mental health concerns and suicidal behavior and then his
behavior changes in ways that decrease these problems. While “raising
awareness” is an important goal, it is a necessary but not sufficient condition
for preventing suicide and promoting mental health. We must also see behavioral
changes. Thus, as the program evolved over the 18 months, additional mental
health tools were added to the website including a suicide prevention therapist
finder and access to an online support group.
Outcomes
The
Man Therapy program is evaluated by three different strategies: 1) Website
analytics (where do users go, how long do they stay, how many return), 2)
Pop-up survey questions (when users complete a significant experience on the
website, a pop-up question asks them about their opinion about it), and 3)
In-Depth survey (a longer survey asks participants demographic data and more
questions about their experiences)
Website
Analytics as of January 10, 2014
- Visits: 356,090 (95,807 are
mobile)
- Unique Visits: 285,960
- Return Visits: 20%
- Average Time on Site: 6 minutes
- 18-point head inspection
completions: 59,894
- Number of people who accessed
crisis information: 19,586
- Number of people who accessed
“Worried About Someone” link: 19,747
Pop-up
Survey Questions (n=7,933)
A
four key junctures of the website experience, pop-up questions are presented to
participants to get their initial impression of the Man Therapy program. Participant
satisfaction ratings for these experiences are high:
- 83% would recommend to a friend
in need
- 51% agreed or strongly agreed
they were more likely to seek help after visiting the site
- 73% said the 18-pt Head
Inspection helped direct them to the appropriate resources on the web
- 78% satisfied or very satisfied
with the quality of the Man Therapies
- 67% were satisfied or very
satisfied with the quality of Tales of Triumph
In-Depth
Survey (n=508)
In
addition to the pop-up questions mentioned above a more in-depth survey asks
participants demographic information and allows for qualitative responses (e.g.,
“What was one thing you liked?” “What didn’t you like?” Here are some results
from this survey:
Who is coming to the site?
- 79% male
- 79% between the ages of 25-64
- 10% are Military (1% Active Duty, 9% Veterans)
- 39% there “because of me”; 8% “for a friend or family member”; 49% “just curious”
Voices of Support and Concern
The qualitative responses were
analyzed for patterns and then the frequency of the major themes was tallied.
Most frequent responses to the
question “What is one thing that you liked about the website?”
- 43% Humor (light-hearted, fun, hilarious)
- 37%: Quality of Website and its features (fresh, creative, accessible, helpful, honest, trustworthy, testimonials, interactive, branding, design, authentic, engaging, illuminating)
- 17%: Manly (not too touchy feeling, blunt, not feel like a wus)
- 10% Identification with Character
- 2% Reassuring/relieving During Experience
Most frequent responses to the
question “Was there anything you didn't like about the website?”
- 22%: No (“nope” “nada” “absolutely not!”)
- 21%: Technology problems (bandwidth buffering, navigation, inability to print handouts, captioning needed, typos). Many of these problems were fixed over the 18-month period.
- 9%: More material needed (“Women Therapy”, more resources than Colorado, more topics covered: PTSD, spousal abuse, sexuality, prescription drug abuse, grief, chronic illness)
- 7%: Offensive, Too many stereotypes, Not funny
- 1%: Lack of Diversity
- 1% Too spiritual
Through the online survey and emails
we have received, we have captured some of the qualitative experiences users
are having with Man Therapy.
What did you like about the website?
Humor
At first I thought the site was
nothing more than a joke due to the light and humorous nature. I was almost
expecting it to be an Old Spice ad. However I am glad I decided to look around
anyway, since the information inside is relevant, useful, and put forth in a
way that is comfortable to read and easy to understand. I think it may have
been that very feeling of humor and lightness which relaxed me and made me more
open to the information.
The use of humor with this topic is
incredibly important. The last place that a person struggling wants to go to is
a 'sterile' site that sucks out that last bit of dignity.
Accessible and Engaging
Many men suffer from attention
deficits which can create the need for the visual stimulation provided by the
video on the homepage. This really helps to get the message across without
requiring someone who may not have the patience to read, the opportunity to
learn.
The relaxed, non-confrontational
nature of the site, like a friend saying hey, c'mon over, we'll shoot some pool
and chill out, the sense of acceptance and camaraderie
Related to Character of Dr. Rich Mahogany
The gentleman talking me through the
site was a very welcoming addition. After the survey, his calm yet concerned
voice was very reassuring, even if it was a prerecorded speech. In a sense, it
helped me calm down long enough to think straight.
The only thing greater than Dr. Rich
Mahogany's dry wit and wonderful sense of humor was his response to my Head
Inspection results. I received a pretty awful 'score,' and the warm,
comforting, and concerned response I got was perfect.
Weirdly, I feel as though the
"virtual" counselor actually cares about me and that makes me much
more comfortable addressing my mental health issues.
The way it is like sitting with a
person in a real room. It's not like a list of rows and columns. Very nicely
done!
Reassuring/Relieving
You took the guilt away from asking
for help.
Your site is the first one I've found
that helped with the loneliness of depression. Sure, the jokes were a cheesy
and the stereotypes abundant, but tonight, I needed to talk to someone more
than anything. Dr. Mahogany helped in that regard, even if I was already too
educated for my own good going into it. It made me feel better seeing an
empathetic face, even if it was pre-generated.
Manly. Was upset about recent stressful problems,
got a laugh out of this and helped gain perspective.
What didn’t you like?
Reinforcing Stereotypes
There's a lot of reinforcing
stereotypes in the tips and the verbal segments, and I think we're sidestepping
some important problems by not acknowledging that a man can be French, or like
spandex and still be a man with problems... But I DO understand why these
stereotypes are drawn up. It's a quick way to let men know that this kinda
stuff is socially acceptable, and does NOT conflict with being a man.
At first I thought the use of
stereotypes may be harmful, but that it is meant to be ironic and to appeal to
the men who are most likely to avoid treatment. Keep up the good work!
Conclusion and Next Steps
Eighteen months after the launch of
the Man Therapy program, Dr. Rich Mahogany has reached people all over the
world, has made many laugh and has made mental health accessible for many men.
Many of the technological issues have been fixed and the feedback received
gives the developers plenty of room to grow. Immediate next steps include
efforts to expand program outcome evaluation, to further expand the on-line
mental health tools (e.g., on-line cognitive behavioral therapy) and to enhance
our reach by licensing the campaign to organizations, counties, states and
countries. With additional funding, the Man Therapy program hopes to continue
to improve the website, testimonial library and media assets and exposure.
About the Man Therapy Partners
Cactus
Cactus is a full-service brand communications agency providing business solutions for companies and causes through brand strategy, advertising, design, interactive and media services. Cactus has been nationally recognized for its breakthrough creative executions by The One Show, Communication Arts, The Webby Awards, South by Southwest, Favourite Website Awards, Advertising Age, Creativity and Print’s Regional Design Annual. To learn more about Cactus, visit cactusdenver.com.
Cactus is a full-service brand communications agency providing business solutions for companies and causes through brand strategy, advertising, design, interactive and media services. Cactus has been nationally recognized for its breakthrough creative executions by The One Show, Communication Arts, The Webby Awards, South by Southwest, Favourite Website Awards, Advertising Age, Creativity and Print’s Regional Design Annual. To learn more about Cactus, visit cactusdenver.com.
Carson J Spencer Foundation -
Sustaining a Passion for Living
The Carson J
Spencer Foundation (www.CarsonJSpencer.org) is a Colorado nonprofit,
established in 2005. We envision a world
where leaders and communities are committed to sustaining a passion for living.
We sustain a passion for living by:
- Delivering innovative and effective suicide prevention programs for working-aged people
- Coaching young leaders to develop social enterprises for mental health promotion and suicide prevention
- Supporting people bereaved by suicide
Colorado’s Office of Suicide Prevention –– Colorado Department of Public
Health and Environment
The Office of Suicide Prevention, a legislatively mandated entity of the Colorado Department
of Public Health and Environment, serves as the lead entity for statewide
suicide prevention and intervention efforts, collaborating with Colorado
communities to reduce the number of suicide deaths and attempts in the state.
To learn more about the Office, visit www.coosp.org.
APPENDIX A:
Man Therapy Components, Outcomes and Accomplishments
July 2012-January 2013
Man Therapy Components Established
- Website
- Interactive website gives
users:
- Information about substance
abuse, depression, anxiety and anger
- An 18-point head inspection
(self-screening tool)
- A blueprint for how to “fix”
the problems
- Guidelines on how to help
someone they are worried about
- Access to crisis services
- Access to the Suicide
Prevention Therapist Finder
- Access to online support groups
for men
- Rich’s List of mental health
and support resources
- Mobile Version allows website
to be used on mobile devices and in areas that have low bandwidth
- Out of Home Campaign
- During August and September
2012, billboards and bus shelters displayed Man Therapy promotions
- Posters/Coasters/Business Cards/T-shirts – this
collateral material was distributed to bars and restaurants that men tend
to frequent
- 7 different posters
- 3 coaster versions
- 1 business card version
- 3 t-shirt designs
- Videos – housed on website and on YouTube
- 9 testimonial videos depicting
diverse stories of men who had struggled with a suicide crisis and were
not thriving
- Three “viral” videos (content
is mostly compelling and less educational with the goal to drive people
to the website)
- 30 second PSA
- Case study videos
- Social Media (Twitter/Facebook/YouTube)
- Twitter Followers - 286
- Facebook Likes – 868 “Likes”
for Man Therapy page
- YouTube Views – 28 videos with
a total of 52,410 views
- eCards – in partnership with
the National Suicide Prevention Lifeline these eCards allow people to
send supportive messages to men they are worried about
· Town Hall Meetings – Twelve Man Therapy town hall meetings were held throughout Colorado
between July 2012 and June 2013 attended by approximately 300 local elected
officials, business leaders, community members and media.
· Conference Presentations -- The Man Therapy partners presented on the program at over a
dozen Colorado, national and international conferences on behavioral health,
public health and suicide prevention, including several keynote addresses
impacting over 2,000 people.
APPENDIX
B: Media,
Awards and Expansion Earned
Major Media
New York Times - Launch (print and online)
National Council for Behavioral Health (magazine)
9News Interview (TV and online)
Colorado Public Radio Interview (radio)
American Public Health Association
Psychology Today (blog)
Huffington Post (Online /
Email)
Globe and Mail (Canada
print and online)
Partial
List of Awards Won
Colorado Healthcare Communicators Gold Leaf Award
- Grand Gold Leaf Award
- Gold within Advertising for Multimedia campaign
Suicide Prevention Coalition of Colorado Media Award
Safe States Alliance Innovative Initiative of the Year Award
Expansion Achieved:
Australia and Wisconsin
- On
June 5th, 2013, the Australian mental health organization
beyondblue launched their own version of Man Therapy with a new character
called Dr. Brian Ironwood. www.ManTherapy.org.au
- Wisconsin
became the first state to license Man Therapy and launched the program
roll out in the Fall of 2013.
[SS1]When
formatting this for the final publication, would the geniuses at Cactus please
make this continuum graphic more attractive?
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