Sunday, May 1, 2011

Top 10 Programming Tips for Mental Health Advocates

For the past twenty years I have worked with mental health advocates on campuses and in communities to help them create positive change. Here are the top ten programming tips I have learned along the way:

1. Normalize struggle safely

Photo by Foxtongue
 One goal for many mental health advocates is to let people know they are not alone. When mental illnesses and suicidal crises strike, people often suffer in silence. Letter people know what others have lived through similar challenges often provides comfort. One of the most successful programs using this strategy of “normalizing struggle” is Frank Warren’s Post Secret project. Frank encouraged strangers to send him their secrets written on postcards which he subsequently posted to a blog. The honesty of these pieces is very compelling and the program has been replicated on many college campuses and has started many positive conversations about despair and help-seeking. It’s the idea that pain shared is pain lessened. The trap that some mental health advocates fall into, however, is overemphasizing the prevalence of extreme behaviors as an “epidemic.” This type of messaging can make people feel hopeless about change. Worse, when it comes to suicide, this type of exaggeration might even create a cultural script that inadvertently influences people to engage in suicidal behavior, because it is the ‘norm’ of what people do to cope with pain. Following the safe messaging guidelines can help mental health advocates make sure what the messages they are sending are promoting health and not creating additional risk.

2. Offer screening tools that lead to action

Screening is a great example of a low cost, high impact tool for mental health advocates. Like with other health issues, screening for mental health conditions increases the likelihood that we can identify emerging symptoms and alter their course with early intervention. Screening offers people a way to anonymously self-assess, which is often an attractive first step for those who are ambivalent about help-seeking. A screening that just gives participant a label, however, will fall short. Effective screening tools give participants a call to action and link them to additional local and on-line resources. Many on-line and paper screening options exist (e.g., Screening for Mental Health), and nationally recognized days can make screening a part of a community’s regular health programming:

National Depression Screening (October)

National Eating Disorders Screening Day (February)

National Alcohol Screening Day (April)

National Anxiety Disorders Screening Day (May)

3. Know your resources on a first-person basis

Effective mental health advocates do their homework. If you want to be a trusted referral source, you need to walk your talk. Get to know your local mental health providers. Visit your local psychiatric hospital. Invite local counselors to a “meet and greet” event. Call your local crisis line to get a better sense of how it works. Ask the questions you need to have answered so you can confidentially refer. Your referral will be so much stronger if you can say, “Oh, I know Dr. So-n-so, she’s really approachable and competent. I’ll take you there to meet her if you’d like.”

4. Share stories of hope and recovery

A main goal of many mental health advocates is to reduce the stigma of mental illness; however, the more we talk about stigma, the more we actually reinforce it. Instead, we can fight stigma by sharing stories of hope and recovery. When we can demonstrate how others transform their wounds into sources of power, we create hope. When respected people come forward and say, “I suffered, and I got better” others feel they can get better too and the issues become less marginalized. When you do programs that highlight the experience of mental illness, be sure that they don’t end with despair; share the healing practices and positive outcomes as well.

5. Make programs attractive and fun

It’s human nature to turn away from things that are scary, confusing, and depressing. The challenge for mental health advocates is to make programs uplifting, engaging and cool without becoming so superficial they miss the point. One of my favorite examples of this outcome came from a student group I worked with a few years ago. One student was a musician, one worked at the radio station, and one was a community organizer. The musician came up with the idea to have friends write songs with themes of overcoming emotional struggles. These songs were then recorded in the campus radio station and turned into CDs. The community organizer then sold them to students, faculty and staff around campus to raise money for future mental health programs. The student musicians were excited to be recorded and helped spread the mental health messages much wider than the small group could do alone.

6. Tell people what you want them to remember

Sometimes, in our attempt to get attention to our cause, we play up tragic outcomes and overlook important calls to action and messages of hope. We need to tell people what we want them to remember: treatment works, prevention is possible, and people recover. Let people know what to do if they are struggling or if they are worried about a friend or loved one. Tell people exactly how to get involved in suicide prevention in their communities.

7. Engage leadership

Often mental health advocacy work gains momentum at the grassroots level – passionate families, students, or faith community members come together and apply their collective energy to make changes. “Grass-top” approaches should also be considered to augment this strategy. People in position of influence can often move things along more quickly and usually just need to know that people care about an issue. So, start the conversation. Write to your legislators. Set up a meeting with your university administrators. Have coffee with professional association and business leaders. Speak the language that is meaningful to them (voters needs, cost savings, student retention), and give them concrete and simple ways to help.

8. Provide opportunities for deep learning

Many mental health promotion efforts seek to promote awareness, but education alone will not move the needle. We call it the “State Trooper Effect.” We pay attention to educational or awareness raising efforts when they are done well and right in front of us, but once they are in our rear view mirror, we tend to go back to what we were doing before. Deep learning goes beyond passive input of knowledge. Deep learning engages people in a knowing-being-doing process. Yes, education is part of that equation – a necessary, but not sufficient piece. We also need to get people “doing” – physically, emotionally, and even spiritually involved in the work, and in order really make it stick, personal reflection on the experience is key.

9. Create a symbol of solidarity

We’ve seen the pink ribbons and the Livestrong bracelets. Symbols of solidarity work, but they need to be unique. When these symbols work well, people can see at a glance the community that is being built. Symbols used to promote suicide prevention can let people who are struggling know who might be a safe person to approach with questions. When the symbol of solidarity starts to spread to large groups of people it is a powerful testament to a person secretly in despair. Some examples of symbols of solidarity include:
Photo by Joits

• Mardi gras beaded necklaces often worn at the American Foundation for Suicide Prevention’s Out of Darkness Walk. Participants choose to wear different colors to symbolize their experience – one color represents “I have lost a loved one to suicide,” another color might mean “I have struggled myself,” while another “I support the cause of suicide prevention.”

• Stickers that show hands reaching out to one another hung on the room doors of Residence Hall Assistants who have been trained as suicide prevention gatekeepers.

• Stars displayed on the stage of a community forum – one star symbolizing each person who received help that year.

10. Promote belonging and purpose

Thomas Joiner’s model of suicide risk tells us that thwarted belongingness and perceived burdensomeness and two critical factors that increase a desire for suicide; the opposites of these states are belonging and purpose. When we create meaningful communities and let people know they are needed, we are doing suicide prevention.


What are your top tips for effective mental health programming?

1 comment:

  1. I think this is a really good article. You make this information interesting and engaging. You give readers a lot to think about and I appreciate that kind of writing.