The Scottish Government

« Previous | Contents | Next »

Listen

CHAPTER SIX THE CAMPAIGN IN PRACTICE

Introduction

6.1 As indicated in Chapter 1, 'see me' has broadly drawn on social marketing approaches to realise the campaign's objectives. To understand the development of the campaign's activities, this chapter explores in more detail how this approach has been interpreted in practice together with an analysis of the application of these principles in relation to one campaign strand.

Applying the Social Marketing model

6.2 Social marketing describes the use of commercial marketing techniques to influence behavioural change for a social good (Stead et al, 2007; National Social Marketing Centre, www.nsms.org.uk). The communications agency commissioned by 'see me' described it as marketing an issue, as opposed to a product, with the potential to impact on individuals, communities and society as a whole.

6.3 The 'see me' campaign was not originally conceptualised in social marketing terms. Evidence from interviews with key 'see me' personnel and the communications agency indicates that it was the previous experience of IAS Smarts in implementing social marketing approaches that encouraged 'see me' to adopt this model. It was, however, an adapted form of social marketing, combining the creative development, implementation and evaluation processes of social marketing, with what 'see me' personnel described as community development approaches to encourage local level engagement. This drew on evidence from other countries, such as New Zealand, that suggested the effectiveness of 'bottom up' approaches.

6.4 Across the range of evaluation participants there was broad agreement on the need for the campaign to draw on both social marketing and community development approaches. However, there was some disagreement on whether the right balance had been achieved. While some felt that 'see me' had got the mix of approaches right, others felt that there had perhaps been too much emphasis on social marketing at the expense of supporting local activity. The perception among the latter was that while there were pockets of good practice in local areas, the picture was patchy across Scotland as a whole. It was felt that there was more potential for sustainability through building local anti-stigma activity and support.

The 'see me' campaign approach

Behavioural goals

6.5 As discussed in Chapter 1, 'see me' adopted a developmental and linear approach to tackling stigma and discrimination: beginning by making "a non issue an issue" and capturing the attention of the public; before moving on to attitudinal shift followed by behavioural change. This directional change from awareness to attitude to behaviour was repeatedly articulated by the management group and communications agency as the goal of 'see me'. The campaign has always worked on the premise that it takes a generation to effect attitude and behavioural change (to complete the whole cycle from beginning to end), although the process of generational change was not mapped out more fully, reflecting perhaps, the difficulties in identifying effective agents for change.

Consumer orientation

6.6 The overall tone of the campaign has been set with the agreed change process in mind. Initially, three different types of 'argument' were developed and tested by the communications agency:

• Informative and educational
• Engaging
• Hard hitting.

6.7 According to documentary evidence, professionals within the mental health sphere preferred the first approach, whereas the last was preferred by mental health service users. Focus group research undertaken by 'see me', indicated that adopting an informative approach could risk weakening the overall message, whereas implementing a hard hitting accusatory approach could risk alienating the public. Consequently, the middle 'see me…I'm a person like you' approach was adopted to try to encourage and bring the public on side. Working with where the public and the media were "at" was viewed as a key feature of 'see me''s approach.

6.8 In this way, the views of the general public, who 'see me' perceived as the target audience, have been taken as paramount to 'see me' and to how the campaign is developed. Professionals and service users and carers have had opportunities to present their views, but since these were not perceived by the campaign as being the target audience, in the sense of not the population group among whom it was hoped to effect change, it was felt that they were not necessarily best placed to comment on campaign materials. This had led to some frustrations being expressed by users and professionals, some of whom felt that consultation processes were a mere tick box exercise.

Stages of 'see me' campaign development process

6.9 The 'see me' campaign development process consisted of a number of stages, which utilised research and consultation methods to develop and refine the campaign messages and materials.

Pre-development research

6.10 In the pre-development stage, 'see me' and the communication agency IAS Smarts gathered information and statistics relating to stigma in the context of the theme of the campaign strand together with examples of other relevant approaches or models.

6.11 The pre-development research also included consultation with users, carers, professionals and target groups to understand the nature of stigma, the issues that affect them, and what, if anything, they would like to see done to address these issues. Consultations at this stage took the form of surveys, focus groups and round-table discussions. These consultation exercises were also used to gather views and perspectives on previous 'see me' campaigns, to understand some of the perceived strengths and weaknesses of previous approaches.

Creative testing

6.12 A first attempt at possible campaign materials was designed and tested with samples of the target audience, for example employers and employees for the workplace campaign, or young people for the young people's campaign. Approaches were also sometimes tested on a sample of service users and carers. A number of different approaches were tested in focus group formats, with attention paid to the applicability of the materials, likely effectiveness, and the tone and style of the messages and visuals. Materials were also discussed with the management group at this stage, to ensure that they were true to the agreed brief or campaign proposition. Materials were developed or rejected following this stage.

6.13 The team then refined the detail of the campaign materials through further discussions with focus groups.

Public consultation

6.14 The third stage of the campaign development process involved a number of public consultation and information gathering exercises, which aimed to provide a further check on whether the messages developed were appropriate and to provide further evidence of stigma as it affects individuals. This evidence was utilised to provide the public and media with further information alongside the campaign materials and to shape any launches or case-study input.

Campaign launch and ongoing dissemination activities

6.15 A co-ordinated campaign launch was arranged by 'see me' and IAS Smarts, comprising a number of different approaches and interventions. These have included:

• A pre-launch 'warm up' in which previous 'see me' campaigns are re-run to "re-awaken" the public to 'see me' and the anti-stigma message
• TV, radio and cinema adverts
• Posters, leaflets and dedicated websites
• A centralised media launch, with relevant media volunteers and stories available
• Work with local organisations and agencies to develop related local campaign activities.

6.16 Activities relating to individual campaigns sometimes took place over a protracted timeframe. For example, 'see me' recognised a need to keep drip-feeding the campaign messages through articles, interviews etc., to keep the issue on the public's "radar".

Evaluation and review

6.17 Following the campaign launch, data about the effectiveness, reach and impact of the campaigns were collated by 'see me' and IAS Smarts through:

• Monitoring information, such as material orders, website hits etc.
• Omnibus and street surveys designed to test recall and understanding of the key messages
• Focus groups and questionnaires.

6.18 The campaign development process was intended to be a cyclical one, with information from the evaluation phase feeding in to further development phases.

The 'see me' brand

6.19 The name 'see me' came from a focus group, and the four dots after the name in the 'see me….' logo represent the 1 in 4 statistic indicating that one person in four will experience a mental health problem at some point in their lives. The 'see me' team and the communications agency have created a well-recognised brand. This brand is held by SAMH rather than the Scottish Government; giving SAMH the potential to continue 'see me' branded activities even if government funding were to end.

6.20 This brand is used for all 'see me' developed and sponsored activities, both at a national level, and locally with its partners as well as on a range of marketing materials which can be provided and used by organisations in the context of their anti-stigma activities.

6.21 Quality control over usage of the 'see me' brand was identified as an important issue by 'see me'. It was also argued by a number of evaluation participants that maintaining a strong and consistent anti-stigma brand across Scotland was crucial for maximising the impact of the campaign and its messages. Having a range of different anti-stigma brands in existence risked diluting the messages and the quality of those messages.

6.22 However, at the same time, it was argued that 'see me' should not be too heavy handed in its approach to brand control, or seek to "monopolise" all anti-stigma activity. As illustrated by local anti-stigma activities such as Positive Mental Attitudes in Glasgow, and HUG in the Highlands, there has been no obligation placed on local or national organisations to employ the 'see me' identity when developing activities to tackle the stigma experienced by people with mental health problems.

Perceived strengths of 'see me''s social marketing approach

6.23 Among the evaluation participants, the perceived strengths of 'see me''s social marketing approach include:

Inclusiveness

6.24 Through combining social marketing with community development approaches, it was felt by 'see me' that their campaign maximised inclusiveness. It was argued that a wide range of individuals could participate in the campaign, whether at the product testing or implementation phases. At the same time, the campaign also benefited from having one organisation to drive it forward.

Systematic and evidence based

6.25 'see me''s campaign development process was felt to be systematic, with clearly defined stages. Because of the perceived transparency of this process, and the evidence informing campaign material development, individuals and organisations could have faith in the campaign outputs and messages. The process was also something in which the 'see me' team members were confident, and which they could use to justify their decisions if challenged.

Perceived limitations to 'see me''s social marketing approach

6.26 At the same time, evaluation participants highlight what they perceived could be the limitations to the approach adopted by 'see me':

Limited scope for impact

6.27 Some participants questioned the extent to which a social marketing campaign aimed at the general public can effect change. It was felt that the focus of the 'see me' campaign had been too broad based to have any real impact on attitudes or behaviours. It that also suggested that any impact on public perceptions of mental health problems achieved through 'see me' were likely to be fragile, and that one negative media story could undo all the previous good.

6.28 Further, although evaluation participants felt that the 'see me' brand was well known, some did question the extent to which this awareness lay mostly within the mental health community rather than among the general public at large. Data from the most recent 'Well? What do you think?' survey (Braunholtz et al, 2007) do indicate that 37% of all those questioned had heard of 'see me'. Amongst those without a direct or indirect experience of mental health problems, however, this awareness does decline to 21%. The implications of this will be returned to in Chapter 10.

6.29 Although related more to the campaign remit than its approach per se, it was also suggested by some participants that, in an ideal scenario, actions aimed at tackling the stigma experienced by people with mental health problems should encompass not only campaigning but also mental health awareness and anti-discrimination activity. There had been some discussions between 'see me' and the Scottish Executive about where the boundaries of 'see me''s role lay, but it had been agreed that mental health education was not within their remit. Mental health education was being pursued through Scottish Mental Health First Aid, led by NHS Health Scotland.

Exclusiveness

6.30 While 'see me' was recognised to be inclusive, evaluation participants (from outwith 'see me') were unclear about how individuals were selected for focus groups, and a concern was raised that certain groups, including those who were socially excluded, may be at risk of also being excluded from the campaign development process.

6.31 Although there were opportunities for service users, carers and professionals to express their views, as described earlier there was also a view among some that their perspectives were not given as much as weight as those from the population groups which 'see me' had identified as target groups for effecting change. It was felt that this might be one reason why suggestions for targeting the NHS, for example, were perceived not to have been progressed by 'see me' to the extent that had been hoped. This was not the viewpoint of all participants, however, and others felt that there was scope for them to be involved in campaign development with 'see me'

6.32 Another dimension to exclusiveness may be the concern expressed that the campaign could come to view self-promotion as an end in itself, rather than the first step in a process of attitude and behaviour change that extended beyond brand awareness.

Developing the employment and workplace campaign strand

6.33 As previously outlined, since the inception of the 'see me' campaign in 2002, there have been a number of campaign strands tailored towards specific audiences. These strands of the national 'see me' campaign all broadly followed the social marketing model described above.

6.34 To provide an in-depth examination of the issues involved in developing a campaign, the following draws on documentary material to describe the development and implementation of the Employment and Workplace campaign strand ( EWP) launched in 2004.

The development of the idea

6.35 As outlined in the [ people too] draft project proposal, the NHS was considered a key target area on which to focus anti-stigma activities. This was identified through discussions and consultations with users of mental health services who had consistently argued for the need for the NHS to be more aware of the stigma of mental health problems both in terms of attitudes of NHS staff and in service provision. In the final [ people too] project proposal agreed by 'see me' and the Scottish Executive, the focus had been broadened to a commitment to targeting employers and those who work in public services.

6.36 Following a subsequent process of focus groups and discussions with the field in the course of 2002, the campaign director advised the management group that one of the emerging target groups for the campaign was the workplace.

6.37 The National Programme Action Plan 2003-2006 also anticipated linking 'see me' with the Scottish Executive Equalities Unit to address stigma and discrimination in employment and the workplace.

6.38 Because the NHS is the largest single employer in Scotland, and because it employs people at every level and location, it was again initially considered as the focus of the EWP campaign. However, following concerns from within the Scottish Executive and the 'see me' management group that by focussing on the NHS it would pigeonhole the issue of stigma to one of health, when in fact stigma affects everyone and all services, the decision was made to focus on public services as a whole. It was therefore agreed to target the NHS from a different angle - as an employer. It was hoped that this would produce positive outcomes on two levels:

• In terms of service provision: it would encourage more people to seek help for mental health problems: and ensure appropriate physical health care for people with mental health problems
• As an employer the NHS would become better at supporting people with mental health problems in the workplace.

Aims and objectives of the EWP campaign strand

6.39 In line with the campaign's remit, it was emphasised early on in the development of the EWP campaign strand that 'see me' would not be actively involved in supporting people with mental health problems in the workplace. Instead, its main aim was to create a starting point from which to tackle stigma in the workplace, but highlighting the impact of stigma on employees and organisations and promoting better practice in supporting employees to take up posts, remain at or return to work where appropriate. Box 6.1 summarises the aims and objectives of the EWP campaign strand.

Box 6.1 Summary of aims and objectives of the Employment and Workplace Campaign strand

Development of the EWP campaign strand

6.40 The EWP strand development process is outlined in diagram 6.1. In planning the campaign, 'see me' considered three factors:

• That the campaign strand was fit for purpose and that resources were committed to projects that would achieve maximum effect

• Consideration of other work being done in the field and to link in with this work to ensure effective collaboration
• That the development of this strand could present an opportunity to cement the links the campaign had made with local areas.

Diagram 6.1 Employment and the workplace strand campaign development timeline

6.41 The process of campaign development can broadly be divided into three main stages:

• Research and audit
• Creative development and testing (focus groups)
• Obtaining contextual information.

Stage 1 Research and audit

6.42 To determine the nature of stigma in relation to employment and the workplace and to inform the focus of the employment and the workplace campaign, available statistical data, literature and current practice were reviewed.

Stage 2 Creative development and testing

6.43 Preparatory to the creative development and testing, the 'see me' campaign team made contact with Scotland's Health at Work ( SHAW) ⁷ to advise them that they were going to be developing a campaign specifically aimed at employers and the workplace. Members of the 'see me' team attended a SHAW conference and asked employers present if they would like to be involved in the campaign development process. In addition to this, SHAW circulated all their advisors asking them if they were aware of any companies or employers willing to participate in the development of the EWP campaign strand. Volunteers for the creative testing process came from this structured approach through SHAW, contacts from conferences, contacts from previous campaign activities and other campaign contacts.

6.44 A three-step creative development process followed this pre-development phase. This involved focus groups with an emphasis on local area involvement and including service users, employers, employees and professionals. They took place in urban, rural and island communities

• Step 1: Eight focus groups in two areas with the aim of obtaining views on the 'see me' campaign and obtain ideas for possible campaign materials for the EWP campaign strand
• Step 2: Ten focus groups across Scotland to test campaign materials developed following the Step 1 focus groups
• Step 3: Four focus groups with four employers to refine the campaign materials.

Obtaining contextual material

6.45 Running in parallel was a process of collecting contextual material to support the campaign messages. This comprised a web-based survey of people with lived experience of mental health problems, who were currently engaged or had been recently engaged in the workplace, and a bespoke survey of public attitudes in the workplace. The two surveys were conducted in parallel in April and May 2004.

6.46 The purpose of the web-based survey of people with lived experience was to measure the perceptions of the extent of stigma and discrimination in the workplace. The survey generated a total of 195 responses.

6.47 The bespoke survey of the general public was conducted with 502 adults. The purpose was to gauge the likely relevance of the 'see me' campaign to the workplace and to explore public attitudes to mental health in the workplace.

Launching the EWP campaign strand

Publicity material

6.48 Following the creative development process four images were produced for the EWP strand of the 'see me' campaign. These were developed from the process but also mirrored media volunteer employment and mental health profiles, ensuring that the materials used in the campaign were backed up by personal stories which could provide context and ensure validity when the campaign was launched to the media and the wider public.

6.49 It was agreed that there needed to be an even gender split with two women and two men and one of the male characters would be Asian. The creative focus would be on the name badges of the individuals in each image, which would contain their job title but with their mental health problem where a name should be (the Manic Depressive Data Analyst, the Depressive Nurse, the Schizophrenic Storeman, and the Depressive Mechanic). The images were made available as A4 posters and A6 postcards. The postcards had the images above on one side, with printed information on the reverse (see Annex 4).

6.50 In addition to the national publicity campaign, a range of materials were developed for use by employers, made available for download from the 'see me' website. Materials included a screensaver, desktop wallpapers (see Annex 4), factsheets and information on how to support someone with mental health problems in the workplace. The website also included links to information produced by other relevant organisations.

6.51 In addition to the visual publicity materials, 'see me' produced radio advertisements that were intended to be more detailed and personal to sit alongside and complement the visual images.

6.52 It was agreed that one of the most effective mediums for accessing people in the workplace was radio, for a number of reasons:

• Many workplaces listen to radio throughout the day
• A large number of employees and employers listen to the radio on their daily commute to and from their place of work
• Through using local stations, the 'see me' message could be given a local emphasis.

The launch

6.53 Prior to the official launch, 'see me' received an additional £50,000 grant income from the National Programme to enable the campaign to rerun the 'Goalie' advertisement, used in the year one 'see me' campaign, during Euro 2004 (between the 10 ^th and 20 ^th June 2004). The purpose was to access a young male target audience, but also to reacquaint the public with 'see me' prior to the launch.

6.54 A strategic mailing was also sent to key figures in Scotland about the campaign and a wider mailing was sent to all 'see me' and management group contacts.

6.55 A series of activities throughout the week of the 28 ^th June 2004 culminated with the launch on the 1 ^st July 2004. The radio advertisements for the campaign strand were aired on local and national radio stations between the 5 ^th and 24 ^th July 2004.

Media activities

6.56 Media volunteers who had experienced stigma and/or discrimination in the workplace, recruited prior to the launch of the campaign strand featured in a range of media coverage. During the launch, all six core media volunteers and one anonymous case study were used to support the PR activity.

6.57 Following the launch, the EWP campaign strand message featured in 13 national and regional press titles, two national television programmes, nine national and local radio programmes and on BBC online and a number of smaller websites. This included coverage in the Sunday Herald, the Press and Journal, the Big Issue Scotland and on BBC Good Morning Scotland.

6.58 In addition to the mainstream media, the IAS Smarts team targeted media relevant to employment and the workplace including, for example, journals and periodicals associated with trade unions or with specific industries.

Local networks and campaign activities

Local networks

6.59 It was agreed early in the development of the EWP campaign that a network of local 'champions' would help to guide 'see me' whilst the campaign itself would also engage with the major decision-makers. The EWP campaign drew on local networks by involving them not just in the delivery of activities, but also in shaping the campaign through the creative development process.

6.60 'see me' worked with SHAW teams, including supporting the development of the SHAW mental health commendation award launched in October 2004 and with local SHAW-registered companies locally. The campaign also drew on existing links in areas such as NHS Ayrshire & Arran and NHS Grampian to champion the EWP campaign strand locally. Activities were also planned in Lanarkshire, Shetland, Tayside, Argyll & Clyde and Orkney, again building on existing links with local networks.

6.61 The reach of the campaign is suggested by documentary data on the pattern of orders for the workplace materials: Local authorities and Higher Education/Further Education establishments ordered over 10,000 items each. Local SHAW coordinators ordered over 7,000 items, and trade unions, individual employers and supported employment initiatives ordered between 4,000 and 5,000 items.

Key points

• The campaign draws on the creative development, implementation and evaluation processes of social marketing, combined with what it describes as community development approaches to encourage local uptake.
• The perceived strengths of this are its inclusiveness in involving people in the design development and implementation and its systematic and evidence based approach. Some of those outwith the campaign suggested that, as a model, it may be limited in its scope to effect change. There was also a perception that some groups might be at risk of being excluded from the campaign development process.
• The Employment and Workplace campaign strand provides an example of the social marketing process in practice. Initially intended to focus on the NHS as an area identified through focus groups as a source of stigma and discrimination, this was subsequently expanded to the 'workplace' as a whole.
• The campaign strand, launched in July 2004, went through a detailed pre-testing and
  development process.

« Previous | Contents | Next »