Tag Archives: mental health

15 Top Apps for Mental Health

For many people, apps are a part of our everyday living – from Uber, to conference schedules, to how we find our restaurants. They can also be part of our resilience toolkit.

When we consider a comprehensive strategy to suicide prevention and mental health promotion, it’s helpful to segment approaches into “upstream” (preventing problems before they emerge through self-help), “midstream” (catching emerging problems early and linking people to least restrictive support) and “downstream” (helping people with more serious mental health challenges and suicidal thoughts) tactics.

Thus, for this article, I have organized some of the most popular, best-researched and most innovative apps into these three categories.

Upstream: Resilience Self-Help Apps

  • Positive Activity Jackpot

Developed by t2health, this app uses the phone’s GPS system to find nearby enjoyable distractions. It comes with a clinician’s guide:

  • Calm

Calm is designed for people new to meditation – starting with guided practices from three to 25 minutes in length and focused on a variety of topics from sleep to gratitude.

  • Breathe to Relax

Another t2health app, Breathe2Relax, offers portable stress management focused on diaphragmatic breathing skill-building that helps with anger management, mood stabilization and anxiety reduction.

  • MoodKit

Based in cognitive behavioral therapy, MoodKit helps people improve their mood by engaging them in over 200 mood-enhancement activities like thought checking and journaling.

  • Pacifica

Pacifica is designed to help people who live with anxiety through soothing meditation and other personalized self-help strategies. Check out the science behind this strategy.

See also: Impact on Mental Health in Work Comp  

Midstream: Early Detection and Peer Support/Life Coach Apps

  • Life Armor

Another t2health app, this brief assessment tool helps users manage emerging symptoms like depression, sleep deprivation and post-traumatic stress. Videos share personal stories from warriors and military family members.

  • DBT Diary Card and Skills Coach

Through this app, users can master the skills of dialectical behavior therapy (DBT), known for its effectiveness in regulating emotions and interpersonal relationships. Users remind themselves of skills they are trying to develop and track skill use.

  • TalkLife

Developed by folks at Harvard and MIT, TalkLife is a peer support platform that engages an online community when people just need someone who’s willing to listen. Posting can be done anonymously. Here is some research behind TalkLife.

  • Koko

Also developed by researchers at MIT, this app provides help for people in all states of distress from bullying and harassment, or even thoughts of suicide and self-harm. Koko provides evidence-based supportive interactions with users while referring users in crisis to international lifelines for immediate help.

  • Lantern

Lantern is a subscription service offering daily on-one-one coaching sessions and simple exercises combining cognitive behavioral therapy (CBT) and advice from real “professional coaches” trained in CBT. Recommended plans are personalized based on the user’s initial self-assessment.

See also: Top 10 Ways to Nurture Mental Health  

Downstream: On-Line Mental Health Services and Suicide Prevention Apps

  • Virtual Hope Box

The original non-app version of the Hope Box was developed as a tool to help therapists in clinical practice work with their suicidal clients so they can find reasons for living. Clients would find something like a shoe box and fill it with future goals, pictures of loved ones, bucket list experiences and the like. When clients felt their suicidal intensity increase, they would bring out the box to remind themselves of these things.

The Virtual Hope Box (VHB) does this and more. Still designed as something to augment treatment, the VHB helps people live through painful emotional experiences through distraction, inspiration, relaxation, coping, support and reasons for living.

  • BetterHelp

BetterHelp is a monthly subscription on-line counseling app that matches people with licensed mental health professionals and gives them unlimited access to these therapists.

  • My3App

My3app is a safety plan tool that helps people who are at high risk for suicide. It helps people develop a written list of coping strategies and sources of support. This app is based on content developed by B. Stanley & G. Brown (2008) and the Department of Veterans Affairs and is owned and maintained by Link2HealthSolutions, the administrator of the National Suicide Prevention Lifeline created in partnership with the California Mental Health Services Authority and was funded by the California Mental Health Services Act.

  • MyVAApps — Safety Plan for Veterans

Part of the MyVAApps suite of apps, the Safety Plan app helps users create or co-create with their therapist a safety plan that outlines specific steps to take when they face crises, including connecting to Veterans Crisis Line.

  • SAMHSA — Suicide Safe

This app is designed to help healthcare providers reduce patient suicide risk and is based on the SAFE-T Approach.

I am interested to hear about your experiences with these apps! What else have you used? What do you find to be most helpful in managing your resilience, mental health and emotional crises?

How to Help Veterans on Mental Health

Employers need to re-evaluate their relationship with the military and the profound disconnect that exists between the lip service of “Thank you for your service” and the tangible, material benefits we give to our armed forces and veterans. The reception and perception that veterans often receive by the civilian population is in need of a total overhaul.

A Veteran’s Perspective: The Frustrations of Being Valued by Civilian Workforce

Hearing gratitude for one’s service does make an impact and has been special to me personally, but I would have much more preferred the chance to show what I could do with my skills in the workplace. I remember when I first separated, I spent most of my days job searching and tailoring my resumes to fit each job description precisely. I had received a few calls back but nothing that led to an interview or job offer. After about three to four months of the same routine, I found myself questioning our decision to separate from the military. My experience helped me land a job, but I found it frustrating that my training in the Air Force was considered null at my new place of employment. Veterans with just four or five years of service are almost guaranteed to have some sort of management/supervisory role when they stay in the military, so starting out at entry level all over again in a civilian job is also somewhat difficult.

Some employers do not want to hire veterans for fear they might have PTSD or other performance-limiting conditions. This remarkable stigma exists and is actually a form of discrimination. The prejudice persists even though service members are expertly trained and capable of remarkable problem-solving, teamwork and leadership.

Part of the difficulty veterans face is that the civilian work culture is often far different than the one in which they thrived, and often the level of discipline and performance is below their expectations. Whether it’s the Marines, Navy, Army, Air Force or the Coast Guard, veterans count themselves as being part of something bigger than themselves. Assimilating to a new standard becomes all the more difficult when moving into a new field.

One veteran shared, “My co-worker showed up 20 minutes late with no consequence. If we were in the service, we would have beat his ass.” Veterans are accustomed to being pushed to excellence, to the boundaries of their abilities to serve an important calling. In the right motivating environment, veterans will bring this level of performance to the workplace. From the initial training and throughout their career, our service members are repeatedly tested to:

  • Work together as a team to complete a mission
  • Implement efficient procedures
  • Quickly overcome obstacles
  • Have one another’s back

These skills and many more and the mindset of service for the greater good can benefit an employer in countless ways.

Switching From One Battlefield to Another

When our warriors move out of military life, those who deployed are sometimes moving from one battlefield to another – that being the battlefield of the mind. For those who return with images and experiences of war, their minds may ruminate on these experiences as they try to process what they experienced. Post-traumatic stress is an understandable reaction to these extreme conditions, though civilians may not have knowledge or awareness of symptoms, and may unfortunately exercise bias against the veteran unknowingly.

For others, the battlefield of the mind comes from feeling isolated and misunderstood at home. One minute they are spending 24-7 in a tightly knit unit, the next minute they are surrounded by family and friends who now feel like strangers. Many don’t feel comfortable talking about their military experiences with civilians for fear of being judged.

While veterans were well-trained for one battlefield, the military does not adequately train them to battle the demons of depression, anxiety, addiction and trauma. From a mental health perspective, transition inoculation is critical to thwarting the potential negative outcomes of this life change.

See also: How to Help Veterans on Mental Health  

We provide the greatest military training to our armed services; they are the undisputed elite military fighting force in the world. But what kind of training do we provide for re-entry into to civilian life? The preparation and training they receive is in no way comparable to the pre-deployment preparation, especially in terms of mental health. .

A Veteran’s Perspective: Honoring the Warrior in Transition

The loss of identity is a big deal in transition, along with camaraderie and cohesion. We think about “Who I was, who I am now, who I am going to be.” We have all these warriors coming back, and we need to find ways to honor them because they are always going to be warriors.

The Transition Assistance Program does tremendously important work, and provides critical resources and access to post-service opportunities. However, many veterans have described the process as a one-size-fits-all, death-by-Powerpoint experience. They liken the process of moving out of service as something akin to being released from prison.

We can do better.

One veteran shared that when he received his benefits manual, it was hundreds of pages thick. He became so frustrated in trying to read through it that he literally burned it.

A Veteran’s Perspective: Help Us Translate Our Warrior Skills to the Workforce

What would be most helpful would be if organizations on the outside could assist veterans with translating the job skills and experience learned in the service to a language more consistent with that of the civilian workforce. One positive development is Google’s new “Jobs for Veterans” search capability where services members are able to enter their military job codes to identify civilian positions that matched their skills and abilities. This is a step in the right direction.

There are many pathways veterans can lead post-service; let’s create the means and conditions where their futures follow the pathway very best for them.

Often what is most helpful to veterans in transition is a peer who’s been there. Peers who’ve moved successfully in to new careers can help others behind them find their path. The continuing connection of these peers can offer troubleshooting and moral support when the job prospects are not forthcoming. Veterans can guide one another to employers who are veteran-friendly to help make sure the best and brightest job candidates are well taken care of.

A Veteran’s Perspective: Employee Support Group for Veterans

It would be so helpful to offer an employee veterans support group. Veterans isolate themselves because they feel others they work with do not understand their experience. Allowing veterans to meet at work will provide a safe environment for them to share current struggles in adapting as well as frustrations with communicating with their fellow civilian coworkers. Imagine being a new employee coming straight out of the military and being able to connect with other veterans at the workplace that have shared similar experiences in serving as well as the difficulties of moving into a new civilian job.

Preparing Employers for What to Expect

When veterans return home, some reintegrate quickly, putting their training and discipline toward becoming successful entrepreneurs or seamlessly moving to a parallel career path. Others need more help with converting their unique strengths into job opportunities best-suited for them. Often employers need coaching on what a veteran employee can do.

Here’s a brief narrative:

A good friend of mine, Charlie Shelby, a retired Army captain, shared his experience of trying to find post-service employment with a well-known technology company:
Talent rep: “So, Mr. Selby, what did you do while in the military?”
Charlie: “I worked in artillery.”
Talent rep: “What does one do when they work in artillery?”
Charlie: “Well, you blow stuff up.”
Talent rep: “Well, we here at [well-known technology company] don’t blow things up. Thank you for your service. Have a nice day.”
Charlie did not get the job.

Sadly, this experience is not uncommon. A colleague from a job-sourcing company shared that “recruiters see a veteran’s resume and say ‘Oh, you have experience using a firearm; your job opportunities are a security guard or a police officer.’”

This limited thinking needs to be turned on its head.

How are we going to sustain enrollment in the armed forces, if returning veterans are not treated properly? How are they going to justify encouraging their children to join if they themselves are not receiving the benefits, entitlements and compassion they deserve?

We grow accustomed and take for granted the benefits their continued sacrifice provides. All of us move through our day-to-day lives with relative ease and safety due to the efforts of armed service members. They protect our freedoms by facing threats to our safety abroad, and, yet, they face tremendous threats to their safety at home.

Work Is Good for Veterans

Meaningful work gives veterans a new mission to focus on. While the exact purpose may shift from protecting our country to something new, the discipline and teamwork needed to reach audacious goals is familiar. Veterans’ sense of duty to a larger cause can help them live through the challenges they may experience like post-traumatic stress or other mental health conditions.

Veterans need to be needed.

The structure of needing to get moving each day can also help veterans’ well-being. A routine in the day of exercising brain and body helps ward off emotional and physical pain. This ebb and flow of work and rest is the rhythm that humans are meant to exist within. Too much idleness is not good for the soul. When work challenges veterans in a good way, they experience “eustress” — the positive side of the stress continuum that helps us continue to grow and learn.

See also: New Approach to Mental Health 

Finally, working helps veterans establish a sense of community and can offer social support. Belonging is central to mental resilience. When veterans find workmates who help them evolve into their best selves, they thrive. A sense of camaraderie is formed that transcends the immediate task at hand. Building a new part of an identity post military service that extends the self into new self-descriptors beyond “former military” is a critical step in transition success. Together this enhanced self-concept combined with new, supportive tribe increases self-esteem and builds a safety net around veterans, so when times get tough, they have something to keep them standing strong.

What to Do if You Are Worried about a Veteran Employee

Treat them like any other employees. Don’t assume that because they served in the military they have PTSD, as many are not deployed and many do not see combat. Do assume that they come with a high level of resilience and self-reliance, so they may not readily disclose if they are experiencing hardship. You may need to ask, reassure, refer and follow up.

1. Ask: All employees should have regular mental health check-ups. Workplaces can participate in national screening days for depression, anxiety and alcohol abuse. If a supervisor or other employee is concerned they should ask directly, “Hey, you don’t seem like yourself lately. Are you okay?”

2. Reassure: Employers can create a culture of caring for all employees by reassuring them that “they have their back” if they ever are facing a mental health challenge.

3. Refer: Employers seeking to support veterans should be aware of both veteran and non-veteran mental health services, including:

  • Veteran Crisis Line — 24/7 crisis counseling for military, veterans and families.
  • Make the Connection — Make the Connection is a free resource with veterans, military families and clinicians who can connect veterans with care for fulfilling, healthy lives.
  • Real Warriors — The Real Warriors Campaign is a multimedia public education campaign designed to promote service members’ engagement with psychological health treatment. The campaign website offers access to 24/7 live chat, message boards and more.
  • Vets4Warriors 855-838-8255 is a 24/7 confidential peer support network for veteran and military communities.
  • Treatment Works for Vets — A new website that offers evidence-based treatment for sleep and mood issues that veterans often face.
  • Give an Hour — Give an Hour is dedicated to meeting the mental health needs of military personnel, veterans, their families and communities affected by the post-9/11 conflicts through counseling and public education.

Non-veteran mental health resources (like most employee assistance programs) are not usually familiar with military-specific stressers like moral injury, traumatic brain injury, military sexual trauma and parenting/relationships challenges during deployment. Employers might brief non-veteran-specific providers with information on these challenges to help ensure that veterans’ experiences are better understood.

4. Follow up: Once support has been offered, following up is advised. Sometimes referrals don’t work out. Sometimes it’s just nice to know that someone cares. You can say, “I am not sure what is happening for you right now. I just wanted to let you know that I hope I can be that person you feel like you can talk to when things get overwhelming. I know you’d do the same for me.”

While it can be challenging to look at issues of distress and despair among our veterans head-on, it is thrilling to consider a future world where our society recognizes and demonstrates our appreciation for their service in a meaningful and material way. A job and career tailored for veterans and their individual skills and abilities allows them every chance for a thriving post-military life.

This article was written by Sally Spencer-Thomas, David Maron and Jason Field.

Impact on Mental Health in Work Comp

According to the World Health Organization, mental health is described as: “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stress of life, can work productively and fruitfully and is able to make a contribution to his or her community.” But the World Health Organization’s definition applies only to part of the population.

At any given time, one in five American adults suffers with a mental health condition that affects their daily lives. Stress, anxiety and depression are among the most prevalent for injured workers. Left untreated, they can render a seemingly straightforward claim nearly unmanageable, resulting in poor outcomes and exorbitant costs.

Increasingly, many in our industry are recognizing the need to do all we can to address this critical issue. We must openly discuss and gain a deep understanding of a subject that, until now, has been taboo.

Four prominent workers’ compensation experts helped us advance the conversation on mental health in the workers’ compensation system during a recent webinar. They were:

  • Bryon Bass, Senior Vice President for Disability, Absence and Compliance at Sedgwick
  • Denise Zoe Algire, Director of Managed Care and Disability for Albertsons Companies
  • Maggie Alvarez-Miller, Director of Business and Product Development at Aptus Risk Solutions
  • Brian Downs, Vice President of Quality and Provider Relations at the Workers’ Compensation Trust

Why It Matters

Mental health conditions are the most expensive health challenges in the nation, behind cancer and heart disease. They are the leading cause of disabilities in high-income countries, accounting for one third of new disability claims in Western countries. These claims are growing 10% annually.

In addition to the direct costs to employers are indirect expenses, such as lost productivity, absenteeism and presenteeism. Combined with substance abuse, mental health disorders cost employers between $80 billion and $100 billion in these indirect costs.

In the workers’ compensation system, mental health conditions have a significant impact on claim duration. As we heard from our speakers, these workers typically have poor coping skills and rely on treating physicians to help them find the pain generator, leading to overuse of treatments and medications.

See also: Top 10 Ways to Nurture Mental Health 

More than 50% of injured workers experience clinically related depressive symptoms at some point, especially during the first month after the injury. In addition to the injured worker himself, family members are three times more likely to be hospitalized three months after the person’s injury. Many speculate that the distraction of a family member leads the injured worker to engage in unsafe behaviors.

Mental health problems can affect any employee at any time, and the reasons they develop are varied. Genetics, adverse childhood experiences and environmental stimuli may be the cause.

The stress of having an occupational injury can be a trigger for anxiety or depression. These issues can develop unexpectedly and typically result in a creeping catastrophic claim.

One of our speakers relayed the story of a claim that seemed on track for an easy resolution, only to go off the rails a year after the injury. The injured worker in this case was a counselor who had lost an eye after being stabbed with a pen by a client. Despite his physical recovery, the injured worker began to struggle emotionally when he finally realized that for the rest of his life he would be blind in one eye. Because his mental health concerns were raised one year after the injury, there were some questions about whether he might be trying to game the system.

Such stories are more commonplace than many realize. They point out the importance of staying in constant contact with the injured worker to detect risk factors for mental health challenges.

Challenges

Mental health conditions — also called biopsychosocial or behavioral health — often surprise the person himself. Depression can develop over time, and the person is not clued in until he finds himself struggling. As one speaker explained, the once clear and distinct lines of coping, confidence and perspective start to become blurred.

In a workers’ compensation claim, it can become the elephant in the room that nobody wants to touch, talk about or address. Organizations willing to look at and address these issues can see quicker recoveries. But there are several obstacles to be overcome.

Stigma is one of the biggest challenges. People who realize they have a problem are often hesitant to come forward, fearing negative reactions from their co-workers and others.

Depictions of people suffering from behavioral health issues in mass media are often negative, but are believed by the general public. Many people incorrectly think mental health conditions render a person incompetent and dangerous; that all such conditions are alike and severe; and that treatment causes more harm than good.

As we learned in the webinar, treatment does work, and many people with mental health conditions do recover and lead healthy, productive lives. Avoiding the use of negative words or actions can help erase the stigma.

Cultural differences also affect the ability to identify and address mental health challenges. The perception of pain varies among cultures, for example. In the Hispanic community, the culture mandates being stoic and often avoiding medications that could help.

Perceptions of medical providers or employers as authority figures can deter recovery. Family dynamics can play a role, as some cultures rely on all family members to participate when an injured worker is recovering. Claims professionals and nurses need training to understand the cultural issues that may be at play in a claim, so they do not miss the opportunity to help the injured worker.

Another hurdle to addressing psychosocial issues in the workers’ compensation system is the focus on compliance, regulations and legal management. We are concerned about timelines and documentation, sometimes to the extent that we don’t think about potential mental health challenges, even when there is clearly a non-medical problem.

Claims professionals are taught to get each claim to resolution as quickly and easily as possible. Medical providers — especially specialists — are accustomed to working from tests and images within their own worlds, not on feelings and emotional well-being. Mental health issues, when they are present, do not jump off the page. It takes understanding and processes, which have not been the norm in the industry.

Another challenge is that the number of behavioral health specialists in the country is low, especially in the workers’ compensation system. Projections suggest that the demand will exceed the supply of such providers in the next decade. Our speakers explained that, with time and commitment, organizations can persuade these specialists to become involved.

Jurisdictions vary in terms of how or whether they allow mental health-related claims to be covered by workers’ compensation. Some states allow for physical/mental claims, where the injury is said to cause a mental health condition — such as depression.

Less common are mental/physical claims, where a mental stimulus leads to an injury. An example is workplace stress related to a heart attack.

See also: New Approach to Mental Health  

“Mental/mental claims” mean a mental stimulus causes a mental injury. Even among states that allow for these claims, there is wide variation. The decision typically hinges on whether an “unusual and extraordinary” incident occurred that resulted in a mental disability. A number of states have or are considering coverage for post-traumatic stress among first responders. The issue is controversial, as some argue that the nature of the job is, itself, unusual and extraordinary and that these workers should not be given benefits. Others say extreme situations, such as a school shooting, are unusual enough to warrant coverage.

What Can Employers Do

Despite the challenges, there are actions employers and payers are successfully taking to identify and address psychosocial conditions.

For example, Albertsons has a pilot program to identify and intervene with injured workers at risk of mental health issues that is showing promise. The workers are told about a voluntary, confidential pain screening questionnaire. Those who score high (i.e., are more at risk for delayed recoveries) are asked to participate in a cognitive behavioral health coaching program.

A team approach is used, with the claims examiner, nurse, treating physician and treating psychologist involved. The focus is on recovery and skill acquisition. A letter and packet of information is given to the treating physician by a nurse who educates the physician about the program. The physician is then asked to refer the injured worker to the program, to reduce suspicion and demonstrate the physician’s support.

Training and educating claims professionals is a tactic some organizations are taking to better address psychosocial issues among injured workers. The Connecticut-based Workers’ Compensation Trust also holds educational sessions for its staff with nationally known experts as speakers. Articles and newsletters are sent to members to solicit their help in identifying at-risk injured workers.

Continuing communication injured workers is vital. Asking how they are doing, whether they have spoken to their employer, when they see themselves returning to work reveal underlying psychosocial issues. Nurse case managers can also be a great source of information and intervention with at-risk injured workers.

Changing the workplace culture is something many employers and other organizations can do. Our environments highly influence our mental health. With the increased stress to be more productive and do more with less, it is important for employers to make their workplaces as stress free as possible.

Providing the resources to allow employees to do their jobs and feel valued within the organization helps create a sense of control, empowerment and belonging. Helping workers balance their work loads and lives also creates a more supportive environment, as does providing a safe and appealing work space. And being willing to openly discuss and provide support for those with mental health conditions can ensure workers get the treatment they need as soon as possible.

As one speaker said, “By offering support from the employer, we can reduce the duration and severity of mental health issues and enhance recovery. Realize employees with good mental health will perform better.”

To listen to the full webinar on this topic, click here.

Top 10 Ways to Nurture Mental Health

May is Mental Health Month! Across the world, many companies are highlighting mental wellness, mental health condition awareness and recovery. Over the past 25 years, I have been helping organizations create effective mental health campaigns, and here are 10 tips I’ve learned and resources I’ve discovered to help your mental health awareness campaigns be most successful.

1. Normalize struggle safely

One goal for many mental health campaigns is to let people know they are not alone. When mental illnesses and suicidal crises strike, people often suffer in silence. By letting people know that others have lived through similar challenges, campaigns can offer hope and community. Pain shared is pain lessened. The trap that some mental health campaigns 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 helps ensure that 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 to highlight during mental health campaigns. As 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 seeking help. 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:

See also: New Approach to Mental Health  

3. Know your resources on a first-person basis

Effective mental health campaign leaders 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, text the Crisis Text Line or contact your EAP (employee assistance program) to get a better sense of how it works. Ask the questions you need to have answered so you can refer people confidently. 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.”

  • Need more information about EAPs? Here is a buyer’s guide:

4. Share stories of hope and recovery

A main goal of many mental health campaigns is to reduce the stigma of mental illness; however, paradoxically, 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 campaigns highlight the experience of living with a mental health condition, focus on the turning points, the coping and resilience and the interventions that worked. One powerful storytelling resource that models best practices in safe and effective testimonies is the photojournalism of Dese’Rae Stage. Her project “Live through This” is an anthology of portraits and interviews of people who have lived through their own suicide attempt. Dese’Rae’s story and project are highlighted in a new documentary just released in April 2017 called “The S Word.”

5. Make messaging attractive, compelling — and even fun

What attracts us to advertising? Messages that make us laugh, catch us off guard or inspire us. It’s human nature to turn away from things that are scary, confusing and depressing. The challenge for mental health campaigns is to make messaging uplifting, engaging and compelling without becoming so superficial they miss the point. Here are some examples of messages on the mark and one example of what not to do:

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.

  • More tips on creating an action-oriented, positive narrative

7. Engage leadership

Often, mental health campaigns gain 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 positions of influence can often move things along more quickly and usually just need to know that people care about an issue. So, engage your leaders to start the conversation. Ask them to speak publicly on why mental health matters to them, why it’s an important health and safety topic for your workplace and how mental health challenges have shown up in their own lives. If they have experienced a mental health condition including depression, addiction or overwhelming stress themselves and have received any form of support that was helpful, their “lived experience” is often the most important driving force in changing culture within a company. By sharing their vulnerability and positioning their story as overcoming hardship by reaching out, they model for the rest that “we are all touched by this, and we can get through it together. I’ve got your back and will persist with you to get you the help you deserve.”

See also: Language and Mental Health (Part 3)  

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, to really make it stick, personal reflection on the experience is key.
One example of “learning, being, doing” is Project Helping – a corporate, positive psychology engagement program that gets people engaged in actions that create a caring culture at work.

9. Create a symbol of solidarity

We’ve seen how the color pink has symbolized breast cancer awareness. 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

  • “Honor bead” necklaces 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 says that “I support the cause of suicide prevention.”

10. Promote belonging and purpose

Thomas Joiner’s model of suicide risk tells us that a thwarted feeling of belonging and a perception of being a burden are 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.

How can your mental health campaign help people connect to one another and find a new or renewed sense of purpose? How can people “pay kindness forward” and develop trusting relationships with one another?

Conclusion

Mental health awareness campaigns need to go beyond “awareness raising.” They need to do more than just share statistics and the local resources’ contact information. Promising campaigns model hope, inspire creatively, practice safe messaging and call us to action. The campaigns that are most effective go well beyond any awareness day, week or month and are “baked in” to a company’s health and safety culture. The ones that are truly culture-changing are “by, about and for” the people within the company; real employees telling real stories of hope and recovery. When we realize we have a secret we all share, the walls come down and we heal together.

Can Apps Manage Mental Health?

Improved awareness and recognition of mental health problems and their complexity puts pressure on health systems to increase care. In turn, this stimulates exploration of the potential value of software applications (apps) run on mobile devices. The ubiquity of smartphones makes them an ideal tool for apps that can help individuals manage mental health.

Apps create long-term patient health data in a way episodic clinic consultations cannot and generate a personal health record fundamentally different from a clinical patient record. Doctors have much to gain from the gaps in information being filled by continuous monitoring in this way. Insurers also can benefit from the potential of this technology, especially for claims.

Health apps used on mobile devices can monitor physiological cues associated with sleep disturbance, anxiety, depression, phobias and psychosis. For example, depression is associated with a fall in activity levels – less exercise, movement and fewer social interactions. Sensors in smartphones can help spot patterns of altered behavior that may represent the early warning signs of lowered mood.

See also: New Approach to Mental Health  

Some apps help diagnose problems. Others help people track and manage mood using self-assessment techniques augmented by coaching functionality. Online environments are a gateway to support from more specialist clinical resources. The resources allow patients more control of their mental health management while enabling clinicians to monitor and support them remotely. (Read my blog, “The Growing Impact of Wearables on Digital Health and Insurance.”)

Apps can also help with treatment by sending reminders about medication or appointments, regardless of the person’s location. And they can provide distraction from cravings or link with social networks at times of stress. This “nudging” is effective at altering behavior; for example, integrating text messaging in smoking cessation programs improved six-month cessation rates by 71% compared with the regular treatment.

However, work remains to be done before apps can integrate with insurers’ processes. The confidentiality and use of personal data generated and stored by apps is complicated and needs clarification. The accuracy and sufficiency of information is a potential concern, and hardware constraints may limit potential. More evaluation of the impact of digital technology is needed in research and clinical practice.

See also: Not Your Mama’s Recipe for Healthcare  

Meanwhile, insurers could engage with emerging providers of software solutions. Services like these will, over a relatively short time, become highly influential in the lives of people living with mental health problems. Pilot schemes that compare current insurance methods while evaluating new ones would take us one big step forward.