The Health Promotion Campaigns: Purpose and Importance

Health promotion is promoting health in the hope that people will listen and change their health for the better. It is important because the people which listen to adverts for example, are impacted by the advert and it will affect them and so their behaviour is likely to change due to the advert. In this report I will review a campaign which I will use to explain models of behaviour change, I will also assess how socioeconomic factors may affect the ability of health education campaigns to change behaviour in relation to health. The campaign I am going to review is the Campaign Against Living Miserably (CALM) which is a mental health campaign for men. This campaign aims to encourage males to communicate about their feelings, because the stereotype is that females communicate their feelings more than men do. Males are typically told to 'man up' but females are given sympathy when they feel low. But actually "male suicide is the biggest killer in the UK" according to CALM.

Social marketing

Social marketing uses techniques which are used to sell items, except in social marketing the campaigns are trying to sell people a better lifestyle. For example, in CALM they try to encourage men to speak out about how they are feeling to prevent male suicide. There are clear goals set out when planning using social marketing. CALM's clear goals are to reduce the number of male suicides and to do this they are trying to make them feel comfortable to speak out.

CALM used social media to advertise their campaign. There is a YouTube video on their YouTube channel which is effective in order to make males speak out about their problems. They use language which males will typically use, instead of saying 'feeling depressed' or 'feeling down', CALM say 'feeling crap'. This is informal which will make men feel comfortable talking to the charity, and it will also make them feel like they are not 'being stupid' or 'weak' because there is a stigma around men speaking out about how they feel. The men watching the video may believe this stigma and therefore the language used in the video is important to make them feel like their feelings do matter and they are not being 'weak', as well as feeling comfortable to talk about it. CALM used social media because it is used frequently at this current time, males may watch gaming videos on YouTube and they may see the CALM video as an advertisement on a video or it may be recommended after watching a typically 'male' video. The target audience is predominantly male because the issue is surrounding males but there are other powerful influences in a males life. Females also use YouTube, they could be influencers in a male's life and therefore could see this video and inform males about it if they recognise the problem and want to make the male in their life recognise it too. Females in a male's life could be their mother, sisters, girlfriends or friends which will be important people to the male and so he would consider their opinion. This will influence change. The video is also interactive, it has sound but the words which are being said are on the screen. This makes the male focus on the message of the video because they are hearing it and reading it.

CALM use statistics in their video to emphasise their point about men struggling. The idea of the campaign is that if more males communicate about their problems, the less males will commit suicide. The exchange in the campaign is the male talking about his feelings to CALM, and therefore less males will commit suicide. The statistics in the video are worrying for a male to read, such as 'out of the 6109 people to commit suicide in the UK, 4623 were men'. A male may read this statistic and think that he wants to make a change. They may start thinking about their friends and family members who are suffering with mental disorders and encourage them to speak out. They may think about themselves and realise that they should talk about their problems in order to break the stigma around men and mental health. These statistics sell the idea of a better lifestyle to males which is having a life where they can talk about their issues regarding their mental health.

The charity encourages males to talk about their mental health using helplines, online web chat and to subscribe to the magazine to be a part of the charity and to break the stigma around mental health. CALM offer their helpline and online chat every day from 5pm until midnight so that males can segment this change into their life at this time. It would be simple for the male to use ten minutes in their day to speak with CALM, which would improve their mental health.

Mass media

Mass media includes advertising using television, radio, billboards, newspapers and leaflets. It is effective depending on where it is placed, for example if a radio advertisement was on the radio in the morning concerning a mother relaxing, it would be effective because most mothers would be taking their children to school and so it would be useful to get the message across.

Posters are another example of mass media. They are present most in schools, colleges, GP surgeries and hospitals. These posters have to be changed often to ensure that the audience are reading them and taking notice of them. If posters have been on a wall for a long time, a person may know that they are there but will not know what they include because they do not pay attention to them. Having posters there for a short amount of time means that people will notice when they are changed and therefore they are more effective. The message of the posters is more likely to come across to the audience if they are on the wall for a short amount of time because they will not go unnoticed as they would if they were there for a long period of time.

Bright colours will also attract people's attention. A person is more likely to look at a brightly coloured leaflet when waiting for a doctor's appointment than a black and white leaflet, simply because the black and white leaflet looks dull. On the CALM website, they use bright colours to highlight details which will draw the reader's attention to them, such as the phone numbers to call for help. Photographs are useful in campaigns. They are used in most campaigns to show issues which can arise from not taking action. Photographs such as body parts looking unpleasant are used on packets of cigarettes to make people stop smoking. The CALM website contains brightly coloured photographs in order to catch the reader's attention. Photographs surrounding the concern of the CALM charity may be triggering for people which are looking for help. For example, if a person was looking at the website to talk to someone and they saw a photograph of a man committing suicide or contemplating it, it may trigger the person that needs help and contribute to their low mood. These photographs are not on the CALM website for this reason, it would not be appropriate for the motive of the charity. However, they use bright colours to catch the attention of their audience and raise awareness of the rate of the suicide through text rather than photographs. The text is still effective because suicide is such a sensitive topic, the fact that male suicide is the biggest killer in the UK is effective enough, a picture may make the issue worse for a person viewing the website.

There is a deeper motivation for most men who contact CALM. These men may have problems which they are facing are have faced have driven them to contact the charity. These men may feel like they want to die but nobody wants to struggle. Their motivation is that they can feel reassured knowing that CALM is confidential and helpful support. Knowing that it is a confidential service means that these males will feel comfortable talking to the people at CALM because they will not be judged for how they are feeling by others, and that they can speak to someone who will understand how they are feeling and will support them.

Their recent campaign used Love Island's Chris Hughes which was called '#Dontbottleitup'. This campaign focused on encouraging men to speak about their problems, specifically to CALM because it is confidential so nobody has to know that they are speaking about their problems but it helps the male talk about whatever is bothering them. CALM used Chris Hughes because he is an attractive and young male which makes him a person which people aspire to be. He also suffers with anxiety himself, so he can talk about his first-hand experience to help others talk about theirs. It is effective to use famous people in mass media because they are people that an audience aspire to be because of their status or their appearance.

Two-way communication

Two-way communication is centred to the person and makes that person feel empowered. CALM offers a web chat in which the male and the people at CALM send messages back and forth centred around the male's mental health. This will make the male feel like they are cared about, making them feel worthy. They will feel empowered because the person at CALM will ask questions and offer advice. However, they may not want to be honest about their feeling due to the stereotype around men being 'gay' or 'stupid' if they speak about their feelings. CALM's motive is to break this stereotype and make the person feel comfortable, and so it may take a while for the male to speak about their feelings to the person at CALM because they do not want to be considered as the stereotype.

A relationship can be built when using two-way communication because trust can be built upon every time two people speak to one another. But with CALM, different people could appear to answer the phone or be available on the web chat which may not be effective for the male because they are not building a relationship. The male could ask if they could speak to the person that they last spoke to or ask when they work so that they know when to call or when to use the web chat so that a relationship is built between the two people. A relationship is important in two-way communication because the male looking for help will open up to someone that they know that they can trust rather than someone that they have never spoken to before. Nevertheless, building a relationship is time consuming and some people may want a quick fix to their problem, but this is not always the case, especially with psychological disorders. Some of the males may find it refreshing that the people that they speak to at CALM are different people every time, because if the male has depression for example and does not find leaving the house pleasant, they will enjoy talking to different people because they will not interact with many people anyway.

CALM's way of offering support is through two-way communication. It is effective because the male which is seeking help will feel like their problems will be kept with one person only which is reassuring if they are embarrassed, which is most likely the case. They use helplines to call for people who are suffering, they have a national helpline and a London helpline. They have their web chat and they also have a search tool for organisations which may be able to help for certain issues in certain areas, as well as nationally. Their support is effective which is delivered through two-way communication. They will offer advice and ask questions to the male about their feelings and thoughts.

Health belief model of behaviour change

The health belief model was developed in 1950's in America by social psychologists who wanted to know why people were not being immunised when it was offered to them. A persons behaviour is influenced by their susceptibility. If a male watches the CALM campaign video, they may realise that they are likely to be affected because of the statistics used such as 'most of the suicides in the UK are men'. This will make the male feel susceptible to the issue if he ever feels low or has contemplated suicide. He is likely to be affected by the issue and therefore is likely to make a change, which is communicating with CALM about his disorder. Another factor in the health belief model is the severity of illness. Suicide is very severe and so a male’s behaviour will be influenced by this fact. They will want to change their behaviour and communicate to CALM to avoid suicide because it is such a serious issue. The benefits of taking action is the next factor in the health belief model. The benefits of communicating to CALM are that male suicide should decline, resolving such a severe cause of death. There is a huge benefit if more males do talk to CALM because the stigma around men and mental health will be broken and less suicides will occur. The barriers of taking action is that males may feel embarrassed about their mental health because of the stigma around it, and therefore they may not want to talk to CALM about their disorder, making it worse. The male has to be ready to take action. They may feel ready after they have watched the video of the campaign or they may think about it for a while and realise that they want to make a change. When they are ready to change their behaviour, they can contact CALM using their helplines or their web chat. Their behaviour will change once they are ready and the stigma around males and mental health will be broken, reducing the number of suicide in males.

Transtheoretical model of behaviour change

The transtheoretical model was developed in 1982 by Prochaska and DiClemente with the aim to stop smoking.

The first stage of the model is precontemplation. This is the stage where the person does not consider any change. This may be when a male is suffering with a mental health disorder but does not think it is a problem and does not consider change. CALM then move the male into contemplation by their advertising because the male will then recognise their problem. For example, if the male sees an advertisement on social media of CALM and it asks questions such as, 'do you ever feel low?' Or 'have you ever contemplated suicide?' Then the male is likely to recognise the problem and contemplate change. The male then prepares for change after contemplating the idea. The next stage from preparation is action which is where change is initiated. CALM move the male into action by offering support via the web chat and the helplines available on their website. The male has to keep talking to the people at CALM for almost a year until they are maintaining their disorder. Maintenance means that the male is actively performing the change so that they overcome their disorder. After maintenance, the male either relapses and is prone to committing suicide or self-harming or changes their behaviour completely and their disorder would no longer be prominent. If the male relapses, they will have to go through the whole cycle again until they maintain their disorder, or they may never maintain it and will keep going through the cycle. After relapsing, the male will go into the stage of pre-contemplation again and begin the cycle.

Socioeconomic factors

Education is a socioeconomic factor which may affect an individual's ability to change their behaviour. If an individual is not educated, they may not know how to seek help. For example, if a male is illiterate, they will not be able to use the online web chat provided by CALM. They would not be able to use the web chat because they could not tell CALM their problem or read the advice that CALM suggests to guide them into recovering from their disorder. The web chat is an effective resource for people which are suffering but it becomes ineffective when the people cannot read or write. The male may be embarrassed because they cannot read or write and most individuals in society can. 15% of adults in the UK are illiterate, and this could be a problem for people at organisations such as CALM because it could make it difficult for them to understand the illiterate people. However, CALM has helplines which the male could use so that they do not have to struggle when communicating via the web chat. The helplines are available for people who may not use the internet or are uneducated and illiterate. CALM may struggle to understand the male's dialect if he is uneducated. It is likely that a person who is uneducated will not speak sophisticatedly, and they may have a dialect which they have gathered from the people in their community. CALM may struggle to understand this dialect and therefore there could be a breakdown in communication. If the male could read and write, they would feel comfortable when communicating with others. People that are illiterate will struggle to communicate because they cannot reiterate their points in a conversation. A person with a high level of education will notice their problem and are more likely to know how to change it. A male who is highly educated will know that there are services online to use if they are in need. They are more likely to change their behaviour because they know that there are services such as CALM which will help. Whereas males with none or little education will struggle to find these services as they may not be aware of them or may not have money to suffice a device to access the internet because of their little education means they have little income. CALM encourages males to communicate about their thoughts and feelings but they cannot do this if they are illiterate and uneducated.

Occupation is another socioeconomic factor. A person with an occupation which is considered high in society is more likely not to feel depressed because of their quality of life. They are likely to seek help if they are struggling because they will have devices which can be used to access the internet. Whereas a person with no occupation is likely to be depressed because they do not have money to afford devices such as mobile phones or computers to access services such as CALM. Also, if the male which is depressed does not have access to social media platforms such as YouTube, they will not see the campaign in the first place because that is where it is advertised. If they do not see the campaign advertised then they will not be aware of it, therefore they will not know where to seek help from. The individual may seek help from his GP if he is suffering with mental health issues who may recommend CALM, but if the individual has no access to a computer or a mobile phone, they will not be able to seek help from CALM. This means that their disorder could become progressively worse if they cannot communicate about it. CALM encourages males to communicate via phone or web chat, but if they cannot afford these items then they cannot communicate. They do offer their telephone line for free as well as a magazine, but this cannot be delivered to a person who does not have a fixed address, a person that is homeless is likely to be depressed but they would not be able to read CALM's magazine because they have no fixed address to send it to. A person with no occupation can result in being homeless and CALM may not be able to help because of this barrier in communication.

Culture is an example of a socioeconomic factor which may stop a male from using CALM. The culture is Catholicism is that they do not communicate about their feelings and will not seek help when they are struggling. Catholic people will struggle rather than admitting that they need help. Reverend Patrick Moloney said that "there's an ancient stigma in our country that there is something wrong with mental illness". People that are Catholic will not communicate about their problems, they may have a high level of education and an occupation which is considered good in society, but their beliefs may stop them from communicating about their feelings. Their education and occupation will mean that they have the devices to seek help and the knowledge of how to do this, but their beliefs will interfere with this and will stop them from communicating about how they feel. CALM encourages males to speak out about how they feel to stop mental illness, but Catholic males will not do this because of their beliefs that there is an issue with mental illness. Catholic males will not seek help for this reason and therefore CALM will not be able to guide Catholic males out of a mental illness. Whereas in women culture, it is stereotyped that they talk about their feelings openly. This is why there is a stereotype of men being 'weak' or 'gay' or 'ladylike' if they express their feelings. Women being open about their feelings does not make men this stereotype. Most females will communicate their feelings to their friends and family members and so they are more likely to seek help for a mental disorder. Men do not want to be considered female, they want to be masculine which is why they are not likely to communicate their feelings. CALM emphasise that it is normal to feel low for males and that they should speak about it to break the stigma around males and mental health disorders. The more that the stigma is broken, the more males will communicate about their feelings. CALM suggests males to communicate their feelings but they will not if they feel that they are being judged for not being 'masculine' due to the stereotype because of the culture of women.

There are many techniques used by campaigns such as social marketing, mass media and two-way communication which make up a campaign. Models of behaviour change are also used by CALM to target their audience and to change their behaviour surrounding behaviour. Socioeconomic factors can affect the way a person changes their behaviour, and in some cases the person may not change their behaviour.