Promotional Campaign Case Study: Man Therapy

Introduction

Man Therapy was launched in Australia coinciding with Men’s Health Week in June 2013. As part of a multiagency effort, Man Therapy gives men resources to help them cope up with the realities of life problems and its possible implications to mental health. Man Therapy provides the tool for men to stop increasing suicide deaths in Australia (Beyondblue, 2015). Thus, Man Therapy is targets men aged 18 to 54. In particular, the campaign aims to influence young men aged 18 to 24, men of aged 25 to 54, men living and working in the city, men living and working in remote areas, unemployed men and who are misusing alcohols and drugs.

Project Partners

In July 2012, Man Therapy (mantherapy.org) was launched in the US by the Colorado partnership and beyondblue. Beyondblue is a non-profit and non-government Australian organization that aims to promote good mental health to improve the lives of people affected by depression, anxiety and suicide (Beyondblue, 2015).

The Colorado partnership was established in 2007, which includes the Colorado Office for Suicide Prevention, Carson J Spencer Foundation, and Cactus Marketing Communications. The group collaborated to devise a new method to prevent working age men from committing suicide (Colorado Office for Suicide Prevention, 2012). The Colorado partnership identified eight strategies to reach men, which is the same as the findings of beyondblue, upon conducting its own research.

Hall and Partners/Open Mind led by Dr. Vicki Arbes, conducted the qualitative research to determine the help-seeking behavior of men during the conceptualization of Man Therapy and the testing of Man Therapy a year after it was launched (Beyondblue, 2015).

Marmalade Melbourne is an advertising firm that offers fresh and effective communications to its clients. Marmalade has recreated Man Therapy from the US version to pursue the Australian market (Beyondblue, 2015).

Man Therapy Rationale

The Challenge

Throughout the world, across many borders and languages, it is common to working-aged men not to seek help despite facing mental issues whether in its early or late stage. This has led to increasing suicides among men.

According to the Australian Bureau of Statistics (2011), “Suicide is the number one killer of men aged 15 to 44.” Almost 33 men die every week in Australia due to suicide. Apparently, for each person dying from suicide, at least six people are impacted from the event for the rest of their lives. Investigations suggest that mental illness is common among people committing suicide, which is left untreated at the time of death (Australian Bureau of Statistics, 2013). Men have greater predisposition to know or respond to their own bad emotions or distress, due to the social norms or stigma associated with ‘mental health’, which may lead to clinical depression (Beaton & Forster, 2012).

Beyond blue commissioned Hall and Partners/Open Mind to conduct a research to determine men’s help-seeking behavior. The research further explores the known barriers and motivators that affects men’s help-seeking behavior (Hall & Partners/Open Mind, 2012).

Research Findings

In the last 10-15 years, the attitude to men’s mental health has shifted significantly in the Australian setting. Despite that the society are openly discussing mental health issues and seeking health, there is a lag observed on the personal attitude of people towards it. Most men are still tentative discussing about their anxieties and depression partly due to the lack of information about the topic. It is unclear to most people the difference between ‘feeling depressed’, ‘being depressed’, and ‘clinically depressed’.

Admitting anxiety and depression for men equates to a major image change from the people around them. Having anxiety or depression typically means being not good and strong enough and incapable of going through the daily life. Many men are afraid of what other people might think particularly in the work place which affects their identity. Being cast as the provider and the head of the family, there is a strong need for men to control their world. Men feared that the treatment such as medications may result into loss of control. The idea of psychological therapy is perceived as “feminine”, which employs all talk and no action form of treatment (Beyondblue, 2015).

“Partners of men with depression often spoke of their experience of speaking to a brick wall” (Beyondblue, 2015).

“The research found that men often spoke of being ill-equipped or not having the tools to enable them to discuss their experiences” (Beyondblue, 2015).

Lack of social support especially to those who are in a broken relationship or socially isolated hinders the person from taking actions early. If the person has no experience in taking action before, it will be hard for them to seek for health and support, especially when there are uncertainties on the knowledge about how to seek help or whom to seek help and the kinds of available support.

For many men, the point of action to deal with anxiety and depression is uncertain. Aside from that, seeking help to overcome anxiety and depression means failing to ‘handle the problem’. Without knowing the signs and symptoms of anxiety and depression, men reach a crisis point unknowingly.

The Colorado partnership identified the following eight approaches to reach men:

1. Remove the mental health language from the context of the communication, and start to introduce the mental health topic as the communication progresses.
2. Show success stories of recovery.
3. Show the connection between the emotional health and its physical symptoms.
4. Reach men on their current state by using humor as conversation starter or use of internet and technology as a medium.
5. Consider men who are less likely to seek intervention, but have a range of risk factor as the primary target.
6. Recognizing that having opportunities to give back is an important factor in suicide prevention.
7. Coach the men, and the people around them, on what to do and what to look for.
8. Provide self-help strategies for men to self-assess and fix themselves.

The Colorado partnership and beyondblue uses these key findings to launch the Australian version of Man Therapy which has been a success in the United States of America.

The Insight

To be successful, it was desired to go upstream and engage men before reaching a point of crisis. The first goal is to normalize the idea of male mental health maintenance. To reach men, the campaign use the cultural stigma around seeking help as a leverage for the program’s advantage.

The Campaign

The Man Therapy campaign primarily aims to improve the man’s wellbeing as an individual which affects the people around him, and to reduce the high rate of men’s suicide in Australia. It was launched initially at the Parliament House in Canberra on June 5 2013. The components of Man Therapy campaign is shown in Appendix A.

The campaign is centered on the use of a website, the mantherapy.org.au, that provides guidelines to its audience on how to assess their wellbeing, answers to common questions about mental health and provides advice to overcome anxiety and depression. To introduce the website, the launch includes TV and radio advertisements, printed materials and online or digital advertising means.

The target audience of the website is the 5.5 million men in Australia, of the age 18 to 54. “The target, in particular includes young men aged 18 to 24 years, fathers who are aged 25 to 54, men living and working in urban growth areas, men living and working in regional and remote areas, men who are unemployed and men using alcohol and drugs as coping mechanisms” (Beyondblue, 2015).

Man Therapy campaign features a fictional doctor, Dr. Brian Ironwood and a straight talking tradesman named as Davo. The characters are using humor as they guide the audience through the website and provide instructions and tools to overcome depression and anxiety.

The website includes presentation of people who surround the men at risk, through a section called “worried about someone”. This section offers advices on how to give back by volunteering and helping others in need. The website also shows a testimonial library where men from many walks of life overcome significant life challenges (Spencer-Thomas, et al., 2014).

A mobile version of the website which can be downloaded and installed like any mobile application makes it more accessible to its audience at any place or time of the day. However, major challenges include high bandwidth requirement of the site and the app.

Man Therapy provides the following key learnings:

1. Know the signs
2. Know the range of treatment options
3. Develop and action plan

Man Therapy includes the following overarching goals (Spencer-Thomas, et al., 2014):

1. To improve social norms around mental health among men andthe general population.
2. 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).
3. Long-term: to reduce rates of suicidal ideation and deaths among men.

For each of the overarching goals, Man Therapy aims to change the following men’s attitudes and behavior:

Attitudes

1. 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).
2. Men will express a greater willingness to try self-help tools.
3. Men will express a greater willingness to seek professional help when needed.

Behavior

1. Increased numbers of men will self-screen for mental health conditions.
2. Increased numbers of men will use on-line self-help tools.
3. Increased numbers of men will interact with peer, professional and crisis resources.
4. Increased numbers of men and women will reach out to distressed men in their lives, expressing concern and support.

To provide the connection between the worlds of stereotypical manliness and mental health, the character of Dr. Brian Ironwood embodies Man Therapy’s approach of using humor to engage men and aid in tackling tough subjects like anxiety, anger, depression, substance abuse and suicidal thoughts, a first of its kind.

According to beyondblue, Man Therapy “Uses a combination of manly humor and a disarmingly blunt approach to these otherwise taboo subjects within the male subculture.” In turn, “Man Therapy successfully engaged the audience and built their trust, while simultaneously removing barriers between men and their need to address their mental health issues.”

Outcomes

In 2013, beyondblue tapped Ipsos Social Research Institute (SRI) to evaluate the effectiveness of Man Therapy in Australia. The final report was delivered in May 2014.

Post campaign results show that Man Therapy exceeded the expectations in terms of campaign reach. 43% of men in Australia or about 3,500,000 of the men’s population of the aged 18 and above saw one or more of the Man Therapy’s advertisements. It is highest among men who have experienced the signs and symptoms of anxiety. Most men who have seen the ads thought positively of the campaign, and has positive feedback regarding Dr. Ironwood, the guy appearing in the ads. The advertisement also increases the viewership of the website from 2% to 22%. Most of the website users appreciate its content and state that the website is useful. 80% of the website’s users state that the website has provided useful information, while 55% of the users indicate that the information is new to them. The impact of the website to its visitors are shown based on their actions after viewing the site’s contents. Major findings include:

• 36% had spoken to family or mates
• 29% had visited a GP
• 23% had visited a psychologist or psychiatrist
• 21% had looked for further information.

It is evident that the campaign has been successful upon its release in 2013. Beyondblue conducted a comprehensive evaluation of the campaign using various resources and measurements to fully understand its effect on men as the target audience and on the general population.

According to the Google Analytics to 2 Jan 2014, the website mantherapy.org.au obtained the following data:

• over 350,000 visits
• over 280,000 unique visitors
• over 40% of visits have been via a mobile device
• average time on site has been almost 4 minutes

The advertisement was also successful in increasing awareness about the campaign:

• 35% males aged 18 and over recognize the Man Therapy campaign
• 5% of those aware of the campaign had visited the website

Campaign Effect

According to beyondblue, men who have seen the website are more likely to develop the following knowledge and attitudes compared to those who were not.

Men who have seen the website will:

• agree that anxiety is a medical condition (67% vs 60%)
• disagree “men can generally live with depression without any serious impact on their lives” (56% vs 51%)
• agree “I am well informed about the signs and symptoms of depression” (51% vs 42%)
• agree “I am well informed about the signs and symptoms of anxiety” (40% vs 34%)

Among the attitudes developed after seeing the website are:

• Men aged 40 to 54 who have seen the campaign were more likely to agree “I feel confident I have the ability to take action” (78% vs 66%)
• Men located in capital cities who have seen the campaign were more likely to agree “I have the strength to take action” (73% vs 63%)
• It does not appear that exposure to the campaign has impacted either self-stigma or social stigma
• However, men who have seen the campaign and who have psychological distress (K6 measure) appear more willing to confirm they have been a recipient of stigma

The website aims to change the behavior of men at risk or suffering from anxiety and depression to promote a better life with the people around them. Among the behavioral effects are:

• Men who have seen the campaign were more likely to agree “I am comfortable talking to my mates about this” (42% vs 34%)
• Men who have seen the campaign were more likely to identify lifestyle changes as a positive step in treatment (19% vs 14%)
• Men aged 18 to 40 who have seen the campaign and who have psychological distress (K6 measure) were more likely to identify they used alcohol/drugs to cope (27% vs 21%)
• Men aged 18 to 40 who have seen the campaign and who have some level of psychological distress (K6 measure) were more likely to have taken positive action (88% vs 75%)
• Men aged 18 to 40 who have seen the campaign were more likely to identify online discussion forums as a positive step (61% vs 45%)
• Men aged 18 to 40 who have seen the campaign were more likely to identify telephone support as a positive step (81% vs 72%)

Some of the testimonials about Man Therapy is shown below:

“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. You took the guilt away from asking for help.” – Man Therapy visitor

“Your website saved my life a couple of nights ago,” – Man Therapy visitor

Evaluation Design

Ipsos SRI uses a stratified sampling approach and demographic information from panelists to represent the Australian male population in terms of age, location and employment status. 1,000 surveys were completed for the pre-campaign benchmark. The evaluation includes comparison between those who have accessed the website and those who are not aware of the campaign, through 31 December 2013.

The Impact of Social Media

The internet is the most accessible resource about all aspects in life, which provides anonymous means for gathering information. However, most information is gathered through search engine’s outcomes and not through a particular site.

Social Media provides the best platform not only for advertising the campaign, but to deliver the campaign effectively as well to its target audience. Among the benefits of using social media is being interactive where multiple users can participate, ease of sharing, it is conversational and dynamic and able to provide many-to-many connections. Through social media, the audience can be utilized as part of the marketing team.

The Man Health campaign took the advantage of the popularity of social media in Australia. Facebook is the leading social media brand in Australia, followed by LinkedIn, Twitter and Instagram. In Australia, there are over 10.4 M Facebook users, 9.8 M unique Youtube visitor and 2.0 M and 1.9 M unique visitors for LinkedIn and Twitter respectively (Australian Communicaitons Consumer Action Network, 2012). On the average, Australians spend about 5.9 hours per week on Facebook alone.

The main reason of using social media mainly includes catching up with family and friends and sharing photos and videos. A large percentage of social media users aims to know more about a certain brand or business or to research about some products or services. By gaining popularity in social media, Man Health reduces the negativity associated with men seeking help for mental health. Social media has re-launched a new life perspective and social norms that the millennials are enjoying today.

References:

Australian Bureau of Statistics, 2013. Causes of Death Australia 2011, preliminary data, s.l.: Catalogue Number 3303.0.

Australian Communicaitons Consumer Action Network, 2012. Sociability: social media for people with a disability, s.l.: Media Access Australia.

Beaton, S. & Forster, P., 2012. ‘Insights into men’s suicide’. Australian Psychological Society, Volume www.psychology.org.au/insych/2012/.

Beyondblue, 2015. A place for men to deal with manly issues in manly way. [Online]
Available at: https://www.mantherapy.org.au
[Accessed 25 March 2017].

Colorado Office for Suicide Prevention, 2012. Man Therapy: An innovative approach to suicide prevention: White Paper, s.l.: s.n.

Hall & Partners/Open Mind, 2012. Men’s Health-Seeking Behavior Report of Research Findings, s.l.: s.n.

Spencer-Thomas, S., Hindman, J. & Conrad, J., 2014. Man Therapy: Outreach and Impact on Men’s Mental Health Program 18 Months After Launch. [Online]
Available at: https://mantherapy.org
[Accessed 25 March 2017].

Appendix A: Man Therapy Components

1. Website
   1. Interactive website gives users:
      1. Information about substance abuse, depression, anxiety                and anger
      2. An 18-point head inspection (self-screening tool)

• A blueprint for how to “fix” the problems

1. Guidelines on how to help someone they are worried about
2. Access to crisis services
3. Access to the Suicide Prevention Therapist Finder

• Access to online support groups for men
• Rich’s List of mental health and support resources

1. Mobile Version allows website to be used on mobile devices and in areas that have low bandwidth

2. Out of Home Campaign
   1. Billboards and bus shelters displayed Man Therapy promotions
3. Posters/Coasters/Business Cards/T-shirts – this collateral material was distributed to bars and restaurants that men tend to frequent
4. Videos – on website and on YouTube
5. Social Media (Twitter/Facebook/YouTube)
   1. Twitter Followers
   2. Facebook Likes

• YouTube Views

1. eCards – in partnership with the National Suicide Prevention Lifeline these eCards allow people to send supportive messages to men they are worried about.

6. Town Hall Meetings
7. Conference Presentations