COLORADO CRISIS AND SUPPORT SERVICES STRATEGIC … · • ‘Family first, me later’ mantra ... • Marriage and Divorce • Moving • Children • Aging parents Barriers to Services:

JULY 2014

COLORADO CRISIS AND SUPPORT SERVICES / STRATEGIC PLANNING /

CACTUS © 2012 ALL RIGHTS RESERVED

Objectives

Methodology

The Mental Health Crisis Experience

Audiences

Crisis Counselor Insights

Motivator Comparisons

Key Insights

Positioning Statement

Key Message

Reasons to Believe

AGENDA /

OBJECTIVES/

ACCOUNT PLANNING OBJECTIVES/

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Understand the behavioral health (mental health and substance abuse) attitudes, influencers and behaviors for

all key audiences and the general public.

Outline barriers and drivers for utilizing behavioral health resources for key audiences and the general public.

Develop insights to drive messaging development, including: hierarchy, call to action, tag line, and messaging

for awareness vs. engagement/advocacy.

Profile key audiences and include relevant details like: lifestyle, health behavior, mental health/substance

abuse behaviors and attitudes, influencers, and basic media consumption.

Develop insights to drive communications planning (when, where, how engage audience?)

THE METHODOLOGY /

FRONT LINERS SURVEY

N=315 The survey will help to gather insights from a

large-sample of people that provide mental health services in Colorado, including: Medical

Providers, Behavioral Health Providers, Substance Use Providers, and Substance

Counselors

IN-DEPTH INTERVIEWS

N=8, Crisis Counselors N=7, Important Stakeholders

N=10, Front Liners The In-Depth Interviews will help us dig deeper into the needs and barriers to

receiving mental health services in CO. The interviews will also provide insights that

lead directly into the messaging strategy.

SECONDARY RESEARCH AND EXPLORATION

Secondary Research is crucial in understanding the overall background of the mental health space regionally, and nationally. We must understand the

landscape to continue the process as an informed, and educated organization.

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THE PATH TO MENTAL HEALTH SERVICES/ The path leading to the utilization or under-utilization of mental health services vary significantly depending on the personal experiences of an individual.

Life Change A life change may play a direct role on the mental health of an individual due to the potential stressors including (but not limited to):

Need State Individuals experience various levels of need states before, during, and after a life change + unique trigger:

• Prevention • Intervention • Retention

Unique Trigger A life change may set off a unique trigger, resulting in a need for mental health services:

Experiences Personal & cultural experiences dictate the way people move from stage to stage

• A fender bender • Misplace your keys • A fight with your boyfriend • Stuck in traffic • Drug usage

• Having a baby • Moving • Divorce • Losing a job • Death in the family • Trauma

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NEED STATES / In order to reach individuals before a crisis, during a crisis, and after a crisis we must strategically think about the touch points within each stage.

Before a Crisis During a Crisis After a Crisis

Education & Prevention: How can we encourage people to reach out at the earliest stage of a crisis?

Intervention: How can we reach an individual at the, “I don’t know what to do” stage of a crisis?

Retention: How can we support the individual at the “What do I do next?” stage?

TV Radio Social

Strategic Partnerships

Follow up

Partnerships: Health Care Providers

WOMSearch Online Create a Plan

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Advocacy Post-crisis advocacy group

Before a Crisis During a Crisis After a Crisis

Uncertain Hesitant Unaware Confused Uninformed

Scared Overwhelmed Confused Angry Distrust

Assured Calm Control Engaged Forward looking Ongoing need

THE MENTAL HEALTH CRISIS EXPERIENCE /

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AUDIENCES/

Survey Respondents, which consist of Front Liners within the Health industry, believe that there are needs and barriers when it comes to utilizing mental health services across all populations. Nevertheless, they believe that the Underinsured and Young Adults have higher barriers than other audiences.

AUDIENCE NEEDS & CHALLENGES/

41% The General Public

37% Men

46% Young Adults (18-24)

36% Hispanics

41% Moms

70% Underinsured

36% Older Adults (65+)

Audiences with the Most Barriers to MH Services

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1. Stigma associated with “getting help” 2. Accessibility of services 3. Treatment options are limited 4. Cultural barriers 5. Transportation to services 6. Unaware of resources available 7. Denial that they need help 8. Inability to pay for services (cost) 9. Wait time to access services 10. Distrust of the system

10 BARRIERS TO MENTAL HEALTH SERVICES/ Answers are ranked from 1-10 based on Survey Respondent feedback:

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Mental health services in CO have been considered the ‘elephant in the room‘ within the past decade. Why? Because CO has a higher demand for MH services than supply, equating in a larger discussion: what are the needs of the General Public, and how do we meet those needs?

GENERAL PUBLIC/

Key Takeaway: The General Public in CO turn to Community Mental Health Centers, their doctors, hospitals, faith based communities, and loved ones for counseling and support.

Barriers to Services: • Finding Mental Health Care providers • Getting & setting appointments • Transportation • Co-pays (cost) • Often those with mental illness do not have the capacity to pursue a system that is difficult to navigate

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UNDERINSURED/

Life Changes: • Loss or gain of employment • Marriage • Having children • Access to health insurance due to the ACA

Barriers to Services: • Unaware of their Mental Health care coverage • Incorrect perception of cost • Unaware of services available • Transportation to appointments • Wait times to access services • Employers do not offer coverage • Cost-sharing requirements

Key Takeaway: Historically, the underinsured audience has not had access to health insurance. Now however, due to the ACA, they have access but still do not understand how to utilize health services, let alone mental health services.

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YOUNG ADULTS/

Life Changes: • Graduation from High School or College • Moving away from home • Financially independent • New job or unemployment • Relationship changes (breakup, marriage)

Barriers to Services: • Transitional-aged youth; not quite on their own and responsible for their own care, but too old to be a 'kid' • Transition into adult services at age 18 • Young adults generally do not seek treatment unless mandated • Denial of Mental Health needs

Key Takeaway: Young Adults do not identify themselves as mentally ill because of their perception of mental illness. Mental illness in their minds = Bipolar Disorder & Schizophrenia.

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Key Takeaway: Mental Health needs often go undiagnosed because Older Adults do not seek help on their own. Therefore, we are more likely to reach this audience via their personal support system.

Barriers to Services: • Mental Illnesses have been incorrectly diagnosed and gone

untreated • Pushed into receiving mental health services by loved ones • Unable to pay (often unemployed) • Difficulty finding services due to inexperience with technology

Life Changes: • A move from home, such as to a retirement facility • Chronic illness or pain • Children moving away • Spouse or close friends passing away • Loss of an ability to pursue your passions • Loss of independence (for example, problems getting around

or caring for oneself)

OLDER ADULTS (65+) /

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MOMS /

Life Changes: • Having a child • Marriage and Divorce • Moving • Change of employment/loss of employment • Financial hardship • Loss of independence

Barriers to Services: • Arranging childcare for personal appointments • Stigma • Fear of the system (kids taken away) • Cost of services • ‘Family first, me later’ mantra • Wait time to access services

Key Takeaway: Family is her #1 priority, so she often down plays her own needs based on what she feels is best for her kids. She is the healthcare decision maker for her children, spouse, parents, and in-laws.

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MEN /

Life Changes: • Loss of employment • Marriage and Divorce • Moving • Children • Aging parents

Barriers to Services: • ‘Men don’t cry’ manta • Denial of problem • View it as an individual issue, unlikely to turn to personal support system • Cost of services

Key Takeaway: Due to stigma, men are less likely to seek help than women. This is because men are reluctant to address their issues, preventing them from seeking the help they need. However, the privacy of a crisis line encourages help seeking behavior.

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HISPANICS /

Life Changes: • Relocation of family • Marriage • Children • Loss of employment

Barriers to Services: • Culture • Language • Fear of system • Undocumentation • Stigma • Cost of services • Transportation • Uninsured

Key Takeaway: The Hispanic audience has a prevalent ‘keep it family’ mentality and fear the consequences of seeking mental health services.

PERSONAL SUPPORT GROUP /

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Parents Friends Children Spouses Teachers Faith Communities

Barriers to Services: • Limited capacity to help loved ones • Lack of awareness of resources • Fear of consequences if they reach out for services on behalf of a loved one

Key Takeaways: • Personal Support Groups play a crucial role in the crisis experience because they are often the ones to push people to seek help. People turn to influencers they know and trust, and more likely to heed their advice to get help. • Personal Support Groups feel a high degree of personal responsibility to their loved ones, and often reach out before their loved one reaches a point of crisis.

INFLUENCERS (FRONT LINERS) /

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Nurses Firefighters Primary Care Physicians School Counselors Therapists Medical Health Professionals

Barriers to Services: • Lack of Mental Health training • Unaware of resources available/how to access resources • Concerned about career implications

Key Takeaway: • Influencers often struggle to understand the Mental Health needs of an individual because they feel like they do not have the skill set to de-escalate a situation.

Crisis counselors are not a target audience, but they are a source of insight because they talk to our audiences every single day. Understanding them helps us understand the greater calling experience.

MINDFUL INFORMATION/

INSIDE THE MIND OF A CRISIS COUNSELOR/

“Every call coming in is it’s own mini event, you never really know what’s going to happen when you pick up the phone.”

“You don’t have to be suicidal to call. You will always get someone on the call that will listen.”

Summary: Kali has a Masters in social work, and has been at MCS for a year. She is trained, experienced, and dedicated to her job. For her, being a crisis counselor is about getting people the help they need. The phone calls she gets on a daily basis range in stress levels, so she must be able to think quickly in crisis situations.

Kali, Metro Crisis Counselor 29 years old

Insights:

Because we’re a crisis line you can be sitting in the bathroom by yourself and no one will know, they would be really hesitant to see

a counselor face to face but they don’t have to do that with us.

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INSIDE THE MIND OF A CRISIS LINE CALLER /

Summary: Crisis line callers (clients) vary significantly in age, background, and need level. Many callers turn to the line simply to have someone to talk to, while others turn to the line to seek help for a loved one. The crisis level of a caller is in the eye of the beholder. A crisis to one individual may be a recent breakup, while another caller may be on the verge of suicide.

Insights About Callers from Crisis Counselors:

“I think they have no one else to talk to, they feel lost and want to talk to someone who is going to listen and be more

“Sometimes it surprises people that we answer right away and it’s a person that’s kind and listens.”

Metro Crisis Caller

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MOTIVATOR COMPARISON / Net Motivator Definition

Support SystemThe influence your family and friends have over getting you to take action (make a call to us!).

Physician InfluenceThe influence your Physician has over getting you to take action (make a call to us!).

Mental Health AcumenBasic understanding of mental health issues, treatment (treat mind like body).

LanguageThe language used (Spanish vs. English), the reading level and the relevancy of message.

CultureThe core collective beliefs, customs, mental health experience, knowledge, etc., of a particular group.

AccessAbility to access mental health services. Includes proximity, availability, transportation and coverage.

Cost The monetary cost of services (perceived and actual).

Trust The belief that the service is reliable, good, honest, effective, etc.

Relevancy Services are applicable and suitable for their unique needs.

Self AwarenessConscious knowledge of one's own character, mental health needs, feelings, motives, and desires.

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MOTIVATOR COMPARISON /

UnderinsuredYoung Adults (18-24)

Older Adults

Men Moms Hispanics

Support System

Physician Influence

Mental Health Acumen

Language

Culture

Access

Cost

Trust

Relevancy

Self Awareness

MOTIVATOR COMPARISON /

UnderinsuredYoung Adults (18-24)

Older Adults

Men Moms Hispanics

Support System

Physician Influence

Mental Health Acumen

Language

Culture

Access

Cost

Trust

Relevancy

Self Awareness

DRIVER The most universally motivating factor is your Support System -- the influence your family and friends have over getting you to take action. This is more universally important for our key audiences than the influence of physicians.

BARRIER The most universal barriers for utilizing services are Mental Health Acumen, Culture and Self Awareness.

Mental Health Literacy will help overcome these barriers.

BARRIER + DRIVER INSIGHT /

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You don’t know what to ask for if you don’t know what you need. Therefore, no matter where you are emotionally, a plan is reassuring. The system is so complex that people do not know where to start. People need to feel like this is a relatable, simple solution.

KEY INSIGHTS /

THE RIGHT FRAME OF MIND

POWER OF A PLAN

Often the first question an individual is asked when being treated by a medical professional is, “what’s wrong with you?” Instead, the first question should be, “what happened to you?” because this puts the individual in the right frame of mind.

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In year one, we will focus on driving awareness and utilization of our services: WHAT we offer, WHO we are, and HOW to access services

In year two, we will begin to overcome barriers for service utilization (Mental Health Acumen, Culture and Self-Awareness) by building stronger mental health literacy, after a baseline awareness and understanding are established.

WHAT we offerWHO we are

HOW to access services

WHYAccess

Services +MH Literacy

[ ]YEAR 1

YEAR 2

MESSAGING HIERARCHY /

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Front liners, partners and influencers ALSO require this baseline level of information -- WHAT we offer, WHO we are and WHEN/HOW to access services. Marketing is an effective way to get the word out.

We do not believe marketing should be used to provide audience-specific education on how to address unique barriers of our audiences. Instead, traditional education is a more effective and efficient approach (like Mental Health First Aid training). In year two, our messaging will help front liners, partners and influencers inspire action among audiences that present more barriers for calling via mental health literacy.

WHAT we offer

WHO we are

HOW to access services

WHYAccess

Services +MH Literacy

[ ]YEAR 1

YEAR 2

NON-CONSUMER AUDIENCES /

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POSITIONING STATEMENT/

Crisis is in the eye of the beholder. No matter where you stand, even if you’re not sure what you need - start here, we will provide guidance. Think of it as an entry point to support. Every day, any time, you’ll talk to a real person who will not only listen, but who will help you create a plan and connect you to the resources that you need.

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It’s more than a call, it’s a plan - start here.

KEY MESSAGE & CTA/

• “You don’t know what to ask for if you don’t know what you need”

• “I don’t even know where to start”

• “No matter where you are emotionally, a plan is reassuring”

• We are softening the siren of ‘Crisis’

• The line is the hub & will direct the caller to various resources

• A plan = an answer, is simple, and helpful

REASONS TO BELIEVE /

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THX :) /