Psychiatry - Research Publications

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    Influencing the Conversation About Masculinity and Suicide: Evaluation of the Man Up Multimedia Campaign Using Twitter Data
    Schlichthorst, M ; King, K ; Turnure, J ; Sukunesan, S ; Phelps, A ; Pirkis, J (JMIR Publications, 2017-10-09)
    Background: It has been suggested that some dominant aspects of traditional masculinity are contributing to the high suicide rates among Australian men. We developed a three-episode documentary called Man Up, which explores the complex relationship between masculinity and suicide and encourages men to question socially imposed rules about what it means to be a man and asks them to open up, express difficult emotions, and seek help if and when needed. We ran a three-phase social media campaign alongside the documentary using 5 channels (Twitter, Facebook, Instagram, YouTube, and Tumblr). Objective: This study aimed to examine the extent to which the Man Up Twitter campaign influenced the social media conversation about masculinity and suicide. Methods: We used Twitter insights data to assess the reach of and engagement with the campaign (using metrics on followers, likes, retweets, and impressions) and to determine the highest and lowest performing tweets in the campaign (using an aggregated performance measure of reactions). We used original content tweets to determine whether the campaign increased the volume of relevant Twitter conversations (aggregating the number of tweets for selected campaign hashtags over time), and we used a subset of these data to gain insight into the main content themes with respect to audience engagement. Results: The campaign generated a strong following that was engaged with the content of the campaign; over its whole duration, the campaign earned approximately 5000 likes and 2500 retweets and gained around 1,022,000 impressions. The highest performing tweets posted by the host included video footage and occurred during the most active period of the campaign (around the screening of the documentary). The volume of conversations in relation to commonly used hashtags (#MANUP, #ABCMANUP, #LISTENUP, and #SPEAKUP) grew in direct relation to the campaign activities, achieving strongest growth during the 3 weeks when the documentary was aired. Strongest engagement was found with content related to help-seeking, masculinity, and expressing emotions. A number of followers tweeted personal stories that revealed overwhelmingly positive perceptions of the content of the documentary and strongly endorsed its messages. Conclusions: The Man Up Twitter campaign triggered conversations about masculinity and suicide that otherwise may not have happened. For some, this may have been game-changing in terms of shifting attitudes toward expressing emotions and reaching out to others for help. The campaign was particularly effective in disseminating information and promoting conversations in real time, an advantage that it had over more traditional health promotion campaigns. This sort of approach could well be adapted to other areas of mental (and physical) health promotion campaigns to increase their reach and effectiveness.
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    Evaluating the effectiveness of a website about masculinity and suicide to prompt help-seeking.
    King, K ; Schlichthorst, M ; Turnure, J ; Phelps, A ; Spittal, MJ ; Pirkis, J (Wiley - John Wiley & Sons, 2019-02-25)
    ISSUE ADDRESSED: A website was designed to form the core of a multimedia strategy surrounding the Man Up documentary - a three-part documentary that aimed to address the problem of male suicide in Australia. Together these formed a media-based, public health intervention that explored the link between masculinity and suicide and promoted help-seeking. This is of great importance given the demonstrated link between masculine norms, men's reduced help-seeking and suicidal thinking. This study assesses the website's effectiveness in facilitating help-seeking and fostering conversations about suicide, mental health and help-seeking. Help-seeking indicators included website clicks to helping organisations, downloads of health information from the website and request for help received via emails. METHODS: Google Analytics data, emails to the Man Up team received through the website and open-ended responses to an online survey were analysed. RESULTS: The website reached 43 140 users. Indictors of help-seeking activity on the website included 307 outbound clicks to helping organisations and 802 downloads of health information. Qualitative analysis of emails received and responses to the survey demonstrated that Man Up's messages resonated with viewers and provided further evidence of help-seeking. CONCLUSION: The findings demonstrate that the website provided an important opportunity for people to engage with Man Up and seek help. SO WHAT?: Media-based public health interventions offer enormous potential to provide suicide prevention interventions and promote help-seeking. The website evaluation findings provide insight into the ways in which websites can be used as part of a multimedia strategy to address the problem of male suicide.
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    Using Social Media Networks to Engage Men in Conversations on Masculinity and Suicide: Content Analysis of Man Up Facebook Campaign Data
    Schlichthorst, M ; King, K ; Reifels, L ; Phelps, A ; Pirkis, J (SAGE Publications (UK and US), 2019-10-01)
    We analyzed comments published on the Man Up Facebook page (manuptvseries) during the roll-out of the Man Up digital campaign. The aim was to gain insight into how the public perceived the Man Up campaign and the conversation topics that the campaign instigated. We downloaded Facebook threads (posts and comments) from the manuptvseries page using NCapture and performed conventional content analysis on a random set of comments (n = 2,236) to identify how the campaign was perceived and what were the popular conversations. Overall, the campaign was perceived extremely positively by the Facebook audience showing many comments endorsing the content of the campaign by sharing among their Facebook community. The strongest themes were expressing emotions, help and support, and masculinity/gender roles which related to the higher level theme of expressions of masculinity. Another strong theme was suicide and topics related to suicide. Comments acknowledged the importance of discussing the issues of male suicide and masculinity publicly. Men were less engaged with topics on masculinity and expressing emotions compared with women and recognized stigma around help-seeking for mental health issues. The Man Up Facebook campaign did foster a public discussion on masculinity and suicide. A gendered approach in mental health promotion is needed with stigma still present for men when seeking help for mental health problems. Social media holds considerable potential for the use of health promotion campaigns aiming to increase interpersonal communication on challenging health topics. Yet, these campaigns need to carefully manage the risk of reinforcing stereotypes.
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    Engaging Australian men in masculinity and suicide - A concept test of social media materials and a website
    Schlichthorst, M ; King, K ; Turnure, J ; Phelps, A ; Pirkis, J (WILEY, 2019-09)
    ISSUE ADDRESSED: Men dominate the suicide statistics and are less likely than women to seek help for emotional problems, and this has been linked to aspects of stoic masculinity. Promoting help-seeking and challenging stoic thinking may help to address this problem, but it is unclear what works in engaging men in these topics. METHODS: We developed a multimedia intervention called Man Up - including a documentary and digital campaign. We tested promotional materials and the website by interviewing 17 men from different ages and backgrounds about their perceptions, and asked them whether the materials generated interest in the topics of the documentary. RESULTS: Participants preferred visual materials that were relatable to them and included active and direct language. This helped them to understand and identify with the messages being imparted. Participants had mixed views on talking about masculinity and the use of the term "man up," with some expressing interest and others being deterred by it. Sharing content about mental health and suicide was seen by some as a risk to personal reputation and their relationships with others. CONCLUSIONS: Our findings informed the design of targeted materials for the national Man Up campaign and website which were then used in a multilevel national health promotion intervention in Australia. SO WHAT?: Our study provided valuable insights beyond Man Up for those seeking to design and deliver health promotion interventions targeting Australian men and engage in sensitive and stigmatised male health issues. Using active and empowering language was especially important when addressing men which contrasts with many promotional materials currently available.
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    Using a television documentary to prevent suicide in men and boys
    Schlichthorst, M ; King, K ; Spittal, M ; Reifels, L ; Phelps, A ; Pirkis, J (SAGE PUBLICATIONS LTD, 2018-04)
    OBJECTIVES: We investigated whether a documentary about masculinity and suicidality ( Man Up) could raise males' awareness of societal pressures to conform to masculine norms and influence their likelihood of connecting with their male friends and seeking help. METHODS: We conducted a repeat cross-sectional survey, posting versions of the survey online before and after Man Up was screened. RESULTS: 1287 male respondents completed the survey; 476 completed the pre-screening survey, 811 the post-screening survey (192 had not viewed Man Up, 619 had). Those who had viewed Man Up were more likely to desire closer relationships with their male friends than those who had not, and had greater awareness of societal pressures on males, but were no more likely to seek help. Almost all respondents who saw Man Up indicated they would recommend it to others, and most said it changed the way they thought about the term 'man up'. They indicated they would be likely to undertake a number of adaptive actions following the show, and provided overwhelmingly positive feedback. CONCLUSIONS: Man Up appeared to effectively address factors that place males at heightened risk of suicide.
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    Influencing the Conversation About Masculinity and Suicide: Evaluation of the Man Up Multimedia Campaign Using Twitter Data
    Schlichthorst, M ; King, K ; Turnure, J ; Sukunesan, S ; Phelps, A ; Pirkis, J (JMIR PUBLICATIONS, INC, 2018-02-15)
    BACKGROUND: It has been suggested that some dominant aspects of traditional masculinity are contributing to the high suicide rates among Australian men. We developed a three-episode documentary called Man Up, which explores the complex relationship between masculinity and suicide and encourages men to question socially imposed rules about what it means to be a man and asks them to open up, express difficult emotions, and seek help if and when needed. We ran a three-phase social media campaign alongside the documentary using 5 channels (Twitter, Facebook, Instagram, YouTube, and Tumblr). OBJECTIVE: This study aimed to examine the extent to which the Man Up Twitter campaign influenced the social media conversation about masculinity and suicide. METHODS: We used Twitter insights data to assess the reach of and engagement with the campaign (using metrics on followers, likes, retweets, and impressions) and to determine the highest and lowest performing tweets in the campaign (using an aggregated performance measure of reactions). We used original content tweets to determine whether the campaign increased the volume of relevant Twitter conversations (aggregating the number of tweets for selected campaign hashtags over time), and we used a subset of these data to gain insight into the main content themes with respect to audience engagement. RESULTS: The campaign generated a strong following that was engaged with the content of the campaign; over its whole duration, the campaign earned approximately 5000 likes and 2500 retweets and gained around 1,022,000 impressions. The highest performing tweets posted by the host included video footage and occurred during the most active period of the campaign (around the screening of the documentary). The volume of conversations in relation to commonly used hashtags (#MANUP, #ABCMANUP, #LISTENUP, and #SPEAKUP) grew in direct relation to the campaign activities, achieving strongest growth during the 3 weeks when the documentary was aired. Strongest engagement was found with content related to help-seeking, masculinity, and expressing emotions. A number of followers tweeted personal stories that revealed overwhelmingly positive perceptions of the content of the documentary and strongly endorsed its messages. CONCLUSIONS: The Man Up Twitter campaign triggered conversations about masculinity and suicide that otherwise may not have happened. For some, this may have been game-changing in terms of shifting attitudes toward expressing emotions and reaching out to others for help. The campaign was particularly effective in disseminating information and promoting conversations in real time, an advantage that it had over more traditional health promotion campaigns. This sort of approach could well be adapted to other areas of mental (and physical) health promotion campaigns to increase their reach and effectiveness.
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    Impacts of a Documentary about Masculinity and Men's Health
    King, K ; Schlichthorst, M ; Reifels, L ; Keogh, L ; Spittal, MJ ; Phelps, A ; Pirkis, J (SAGE PUBLICATIONS INC, 2018-09)
    As part of a larger study, we developed a three-part documentary called Man Up that explored the relationship between masculinity, mental health, and suicide. In this study, we examine in detail the qualitative feedback provided by those who viewed Man Up, in order to gain a more in-depth understanding of its impact on them. A total of 169 participants provided qualitative feedback via an online survey 4 weeks after viewing Man Up. We examined their opinions about the show and whether they reported any changes in their attitudes and/or behaviors as a result of watching it. All the men who provided feedback on Man Up were overwhelmingly positive about it. The majority reported significant and profound impacts of viewing the documentary. They reported being more aware of others, more willing to help others, and more open about their emotions and problems, as well as demonstrating associated behavioral changes related to helping others and being more emotionally expressive. The data presented here demonstrate the potential for men's health outcomes to be positively impacted by novel, media-based public health interventions.
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    Can a documentary increase help-seeking intentions in men? A randomised controlled
    King, KE ; Schlichthorst, M ; Spittal, MJ ; Phelps, A ; Pirkis, J (BMJ PUBLISHING GROUP, 2018-01)
    BACKGROUND: We investigated whether a public health intervention-a three-part documentary called Man Up which explored the relationship between masculinity and mental health, well-being and suicidality-could increase men's intentions to seek help for personal and emotional problems. METHODS: We recruited men aged 18 years or over who were not at risk of suicide to participate in a double-blind randomised controlled trial. Participants were randomly assigned (1:1) via computer randomisation to view Man Up (the intervention) or a control documentary. We hypothesised that 4 weeks after viewing Man Up participants would report higher levels of intention to seek help than those who viewed the control documentary. Our primary outcome was assessed using the General Help Seeking Questionnaire, and was analysed for all participants. The trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12616001169437, Universal Trial Number: U1111-1186-1459) and was funded by the Movember Foundation. RESULTS: Three hundred and fifty-four men were assessed for eligibility for the trial and randomised to view Man Up or the control documentary. Of these, 337 completed all stages (nine participants were lost to follow-up in the intervention group and eight in the control group). Linear regression analysis showed a significant increase in intentions to seek help in the intervention group, but not in the control group (coef.=2.06, 95% CI 0.48 to 3.63, P=0.01). CONCLUSIONS: Our trial demonstrates the potential for men's health outcomes to be positively impacted by novel, media-based public health interventions that focus on traditional masculinity. TRIAL REGISTRATION NUMBER: ACTRN12616001169437, Results.