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1 Effec&ve Messaging for Suicide Preven&on: Anara Guard Lessons from a statewide campaign and from a na&onal framework

2 This morning The Know the Signs statewide social marke&ng campaign How we did it, what we did, outcomes Cultural adapta&ons New direc&ons in messaging for suicide preven&on

3 California s Statewide Preven&on and Early Interven&on (PEI) Projects: Are funded by Prop. 63, the Mental Health Services Act, a voter ini&a&ve CalMHSA implements 3 PEI ini&a&ves as part of a comprehensive preven&on strategy: Student Mental Health S&gma & Discrimina&on Reduc&on Suicide Preven&on

4 Suicide Preven&on Ini&a&ve Overview Created regional networks Partner with crisis centers to develop capacity Develop a social marke0ng campaign: inform Californians to iden&fy suicide risk and refer for help Train Californians to respond to suicidal crises

5 Social Marke&ng A systema(c approach to understand and modify behavior by reducing barriers and increasing facilitators to behaviors that improve the quality of life for individuals and society. It uses concepts and planning processes from commercial marke6ng, but goes beyond communica(on, public service announcements, and educa(on to take a 360- degree approach to poten(al causes and solu(ons. All survey instruments and reports can be downloaded in the resource center at

6 Framework

7 Research Mee&ngs with nearly all 58 coun&es to learn about exis&ng ac&vi&es and needed resources Literature review and review of exis&ng suicide preven&on campaigns KAB Study (random digit dial phone survey) Analysis of media adherence to recommenda&ons for repor&ng All survey instruments and reports can be downloaded in the resource center at

8 KAB Study Confidence in the ability to discuss suicide significantly increased with knowledge about resources and of warning signs for suicide. Those who know where they could seek help for someone were 7.8 0mes more likely to agree that they felt confident. Those repor&ng knowledge of at least one warning sign were significantly more likely to agree that they felt confident that they could discuss suicide with someone they care about and less likely to agree that it was none of their business.

9 Target Audience: Helpers Contempla0on People acknowledge there is a problem and think about how to solve it. Awake, but haven t moved. What do we know about each of them? What do they need to know and believe? Contempla&on Stage- already concerned about someone but don t think it is as serious as suicide. General Public (across the lifespan) With an emphasis on poten&al helpers of middle aged white men of young La&nas

10 Messaging Logic Model

11 Safe Messaging.

12 Statewide mass media campaign to drive people to the websites Tool kits with campaign materials to each of the 58 coun&es Technical assistance Culturally competent outreach tools to reach targeted popula&ons Smartphone app High school video contest Tac&cs

13 suicideispreventable.org 13

14 Campaign Materials 14

15 Reaching helpers of men

16 Local Customizing

17

18 High school video contest 18

19 Toolkits

20 MY3 safety planning app Add 3 primary contacts Pre- loaded with bubons to call Na&onal Suicide Preven&on Lifeline and 911 Free to download Also in Spanish Google Play and App Store Best to use with guidance 20

21 Outcomes - Media Buy November February 2013 Media Outlets: TV, cable, print ads, outdoor and digital ads Engagement 471,925 website hits within California in the 4- month period 25% of traffic via mobile Coverage 720, 378, 821 impressions served in California Reached 52,468,000 people 23.5 million total completed views for online video ads

22 Outcomes - Coun&es 89% used at least one of the campaign materials U0liza0on of Campaign Materials Tent Card 7% Radio 7% TV 7% Print Ads 11% Outdoor 12% Outreach Poster & Brochure 88%

23 Outcomes - Evalua&on 35% of survey par&cipants reported being exposed to Know the Signs campaign material Individuals exposed to the campaign had higher overall confidence to intervene with those at risk for suicide, compared to those not exposed Also agreed more with statements related to knowledge of suicide risk and knowing what to do if someone seems at risk: I feel comfortable discussing suicide with my friends, colleagues and family I am aware of the warning signs of suicide I can iden&fy places or people where I should refer somebody

24 How did California do it? Big budget Skilled professionals (adver&sing, social marke&ng, suicide preven&on) Rapid &meframe Lots of input from the intended audiences Building on the work of others

25 Cultural adapta&ons

26 Nothing about us without us!

27 Reaching families of young La&nas

28 Spanish TV & Radio

29 elsuicidioesprevenible.org

30 Cultural Adapta&on Projects at a Glance Strategies, materials and distribu&on plans are guided by workgroups African American - Print Ads, Billboard, Outreach Poster and Brochure API Youth - Online Ad LGBTQ Youth - Online Ad Na&ve American Materials Catalog Cantonese/Mandarin, Hmong, Khmer, Korean, Lao, Tagalog, Vietnamese - Outreach materials ANY DAY NOW

31 Workgroup Process 1. Iden&fy areas with highest popula&on concentra&on 2. Recruit par&cipants 3. Provide s&pend and clear par&cipa&on parameters and expecta&ons Ci0es with highest AA popula0ons: Los Angeles Long Beach 347,380 59,925 Oakland Sacramento 106,637 64,967 Inglewood San Diego 47,029 82,497 Compton San Francisco 30,992 46,781 Fresno Moreno Valley 37,885 33,195 Stockton Lancaster 33,507 30,859 San Bernardino 29,897

32 1. All discussions housed on Your Voice Counts 2. Introductory Webinar 3. Engagement through different formats Phone Online discussions and vo&ng Webinars 4. Other engagement as needed Focus groups In language copywriters Addi&onal members

33 Workgroup Discussion Ques&ons Who is at risk in this community and who are poten&al helpers? How is the topic of suicide discussed (or not discussed) in this community? What exis&ng suicide preven&on materials exist to reach this group? What types of materials would resonate or work most effec&vely for the helper? In what sepngs/format can we reach the helper? What resources should be listed? What kind of image/sepng would be most appropriate? (e.g., Photo or Illustra&on?) Discuss strategies for distribu&on of outreach materials.

34 African American materials

35 Digital Ad Campaign for LGBTQ Youth

36 Digital Ad Campaign for API Youth

37 Spanish (low literacy) Suicide Preven&on Outreach Materials Purpose: To develop low literacy suicide preven&on outreach materials in Spanish for Promotores and other individuals involved in outreach.

38 Culture and Community - Suicide Preven&on Resources for Na&ve Americans

39

40 New Direc&ons in Suicide Preven&on Messaging

41 Na&onal Ac&on Alliance for Suicide Preven&on priority: Change the public conversa6on around suicide & suicide preven6on: change the na0onal narra0ves.to ones that promote hope, connectedness, social support, resilience, treatment and recovery. Media/Entertainment Outreach (Journalists, Writers) Public Messaging (Suicide Preven0on & Mental Health Professionals & Other Messengers) 41

42 NEED FOR A CHANGE IN SUICIDE PREVENTION MESSAGING Data Sources Char(ng the Future progress review of 2001 NSSP Public opinion surveys Research literature Expert Panel, January, 2013 Dialogues with diverse stakeholders 42

43 Common Messaging Problems Violate safety guidelines I. May encourage imita&on II. Normalizing III. Nega&ve narra&ve IV. No preven&on info 43

44 Emphasis on problem severity II. Normalizing III. Nega&ve narra&ve IV. No preven&on info But.a majority already agree it s a problem In the U.S. 4 people die by suicide every hour. 44

45 Challenges in Crea&ng Guidance Diversity in Messengers Goals Mul&ple considera&ons for messages Safety Effec&vely designed; tailored to context Contribu&on to overall narra&ve Uses applicable guidance 45

46 Consulta&on with Stakeholders Many individuals & groups, mul&ple &me points Helped to understand & address What the audience thought was needed, e.g. Turn up the volume: get EVERYONE talking about suicide One campaign that everyone pushes out Create approved messages Nothing is needed; we have no idea what works. S&cking points/touchy issues, e.g., It s the media, not us Confla&ng all types of communica&ons Those with lived experience: you re silencing us Reluctance to let go of problem focus Biggest benefit: Ul&mate product wasn t a surprise, has broad support 46

47 Na&onal Ac&on Alliance for Suicide Preven&on Framework For Successful Messaging Four considera0ons when developing messages: Strategy Safety Posi0ve narra0ve Guidelines 47

48 Applies to Public Messaging Defined Broadly Any public- facing informa&on Campaigns & ALSO social media, newslebers, websites, event publicity, fundraising, public talks, etc. Does not include Private conversa&ons 1- on- 1 with individuals in crisis Doctor- pa&ent interac&ons Sharing in support groups 48

49 For More Successful Messages: Use all Four Lenses Strategy: Define goals, audiences & ac&ons, integrate with other efforts, etc. Safety: Avoid don ts Posi0ve narra0ve: e.g. stories of coping & resiliency; programma&c successes; ac&ons audience can take; available resources & services, etc. Guidelines: Use message- specific best prac&ces 49

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