Entry Category
Program Entry – Overall Social Marketing
Name of Intervention/ Program
988. Anywhere, Anytime.
Background and Situation Analysis
Rates of suicide have been on the rise in the United States for more than two decades. Over the same period, suicide rates in Washington state have remained higher than the national rate, with more than 1,000 Washington residents dying by suicide every year. To address this important public health issue, the 988 Suicide & Crisis Lifeline launched in July 2022. This new three-digit number replaced the National Suicide Prevention Lifeline to improve ease of access (as opposed to the lengthier 1-800 number) to mental health resources and to decrease the burden on emergency services as it allows callers to connect to a network of local call centers specialized in mental health crises. In 2023, the Washington state health officials contracted our agency to develop a statewide suicide prevention campaign with the goal of increasing awareness, understanding and usage of the 988 Suicide & Crisis Lifeline in Washington. The process for creating the 988 Suicide & Crisis Lifeline awareness campaign was organized around the 10 planning steps used in social marketing. Using a combination of secondary and primary research and social marketing planning principles, the team arrived at the final campaign messaging and marketing strategy. In addition to creating this new awareness campaign, the client also partnered with Volunteers America and communications agency and partner of the client DH to incorporating the existing Native & Strong 988 campaign assets into advertising and community engagement efforts to effectively reach the American Indian and Alaska Native priority audience. To inform campaign development, three phases of research were conducted. Phase One included secondary research and community partner listening sessions; Phase Two included a quantitative survey evaluating understanding, awareness, barriers and motivators for contacting 988 in English and Spanish; Phase Three included concept testing in English and Spanish. Key learnings and applications included: •Data showed higher rates of suicide among some populations and regions. Spanish-speakers, Veterans, Black/African American people, American Indian/Alaska Native people, males and people living in 11 WA counties were chosen as priority audiences. •The campaign would be more successful if it instilled hope but didn’t promise it – “You are not alone” resonated better than, “There is hope.” Message strategy focused on communicating that you are not alone and that 988 can help. •Knowledge that you can call 988 on behalf of others was low. Campaign established that 988 included the ability to call on behalf of a family or friends. •A top barrier and potential motivator was knowing that 988 counselors are properly trained. The fact that 988 counselors are trained was a key campaign message. •Confidentiality and police involvement were top barriers. The campaign homepage included “confidential” as key message and police involvement was addressed in FAQs. •Some audiences prefer the new option to text 988 rather than call. “Call-Text-Chat” sign-off on all materials. •The highest-ranking concept tested was “Anywhere, Anytime.” This concept which evoked hopeful, optimistic and courageous emotions and communicated that 988 is available anytime, anywhere and is for everyone, was chosen.
Priority Audiences(s)
Based on the research findings, priority audiences for the campaign included people experiencing emotional pain or distress, feeling a lack of connection, feeling isolated, and/or are experiencing mental health or substance use challenges. We also focused on populations with higher rates of suicide: •Spanish-speakers •Veterans •Black/African American people •American Indian/Alaska Native people •Male identifying individuals (age 26-54) •People living in 11 Washington counties with higher suicide rates Secondary audiences included people concerned about someone who might need support (e.g. friends, family, caregivers).
Behavioral Objectives
The team defined the following framework for the campaign. Purpose: Provide resources to people in crisis in the state of Washington. Goal: Build awareness and drive action to prevent suicide. Campaign Objectives: Increase awareness, understanding and usage of the 988 Suicide & Crisis Lifeline in Washington, while reducing disparities within priority populations. Specifically: •Increase familiarity with 988 among populations disproportionately impacted by suicide (Spanish-speakers, Veterans, Black African American people, American Indian/Alaska Native people, Males) •Increase overall awareness of 988 (people that had heard of it) •Increase contacts to 988 (calls, texts and chats) •Increase understanding that 988 is available anywhere, anytime
Description of Strategy/Intervention
Primary research with members of the priority audiences and partner listening sessions uncovered barriers, benefits, and motivators for using the 988 Suicide & Crisis Lifeline. Barriers: •Lack of awareness of 988 overall •Lack of awareness that 988 is also for support networks •Concerns about training of 988 staff Privacy concerns •Worry about wait times Unsure about cost •Unaware that service is offered in multiple languages •Concerns about law enforcement involvement Benefits/Motivators: •Get help – 24/7/365 •Get help for loved one in crisis Saves lives •Talk to trained mental health professionals •Confidential – no personal information or insurance requested •Free •Separate from law enforcement – understand importance of privacy The social marketing strategy focused on using communication to raise awareness of 988 supported by social diffusion and convenience strategies to spur behavior change. Communication: The cornerstone of the campaign was statewide advertising. The campaign sought to raise awareness, shift audience thinking, overcome barriers with motivators and highlight benefits of using the 988 Suicide & Crisis Lifeline. Disseminated through channels that reached priority audiences, the campaign included bolstering ads in key counties with higher rates of suicide. A campaign website was created in both English (WA988.org) and Spanish (WA988.org/es) to help further explain how the 988 Lifeline works, share resources about tools/skills for coping and support people who are experiencing emotional distress, substance use challenges and mental health crises. Social Diffusion: Peer and referent groups can help spread behavior change through conversations, interactions and observation. A partner toolkit of campaign assets was created to support the important crisis and suicide prevention work already being done by many community organizations and partners throughout the state. Key partners were engaged during the campaign planning process to determine which additional assets, messaging and resources would be most helpful for them in their work with community members in crisis. The resulting toolkit included material in 14 languages: English, Spanish, Simplified Chinese, Traditional Chinese, Hindi, Khmer, Korean, Punjabi, Russian, Ukrainin, Somali, Tagalog, Telugu and Vietnamese. Toolkit materials included handouts, wallet cards, signage, social media posts, print ads, radio ads and scripts, videos, and banner ads. In addition, the campaign placed 988 Lifeline messaging in more than 400 venues throughout the state such as Next Door Gastropub in Port Angeles and Shamrock Tavern in Longview via bar coasters and mirror clings. Convenience: One of the key features of the 988 Suicide & Crisis Lifeline is that people have the ability to reach trained counselors in a variety of ways – by calling, texting or chatting. This convenience feature was integrated into the key campaign messaging, ensuring people understood how easy it was to connect with a trained counselor anywhere and anytime.
Implementation
An audience-focused strategic framework was used to identify the campaign insight used to guide the creative development and message strategy for the cmapaign: •The problem (how the audience is currently feeling): Don’t see a way forward, feeling alone and a burden to others •The advantage (what makes 988 unique to the audience): 988 provides 24/7, confidential, and free connection to trained professionals •The strategy (how to approach the problem): Show people that with 988 they have compassionate and trained counselors ready to listen to whatever they are going through •The insight (the unspoken human truth that sheds new light on the problem): Compassionate connections help people see a way forward Main Message: A compassionate person is ready to listen. Call, text, or chat 988 to connect with someone in a caring environment, if you’re thinking about suicide, concerned about substance use, are worried about a loved one, or need emotional support. Campaign Dissemination Strategy: Campaign materials and messaging were distributed using three main pillars: •Paid and earned communications through channels that reach priority audience groups •Partnerships with community groups and Tribal Nations to support them with disseminating messages through their channels and events •Message placement and signage in places where people may be in crisis to act as reminders that 988 is a resource Tactics: The tactics that supported deployment included: A campaign website was created in both English (WA988.org) and Spanish (WA988.org/es) to help further explain how 988 works, who should contact 988, and who answers the contacts. The websites also shared resources about tools/skills for coping and how to support people who are experiencing mental health crises. A partner toolkit was created and posted on the campaign website to provide resources to community organizations. Key partners were engaged during the campaign planning process to determine which assets, messaging and resources would be most helpful. The resulting toolkit (in 14 languages) included handouts, wallet cards, signage, social media posts, print ads, radio ads and scripts, videos, and banner ads. Tribal outreach was conducted by the client’s partner, DH, who provided tribes with customized materials for tabling at relevant community events (such as conferences, wellness gatherings and powwows). The team hosted 25 meetings with tribes and provided materials to 15 tribes and staffed 13 events. Coasters & window clings were created and distributed to bars and other venues in 11 counties that had higher suicide rates. Media relations was conducted with the client’s Public Information Officer supporting the launch of the campaign with a press release and the agency team placing interviews on Spanish radio stations. Paid media materials were produced in English, Spanish and 12 additional languages, reaching priority audience groups through these channels: •Males 25-64: Facebook/Instagram, pre-roll and digital TV, TV/cable, radio, digital audio, banner ads, paid search •Veterans: Facebook/Instagram, Pre-roll and digital TV •American Indian/Alaska Native People: Facebook/Instagram, Snapchat, TikTok, TV, pre-roll and digital TV, Native radio, digital audio, banner ads, tribal print and paid search •Hispanic/Latino People: Facebook/Instagram, pre-roll and digital TV, digital audio, banner ads, paid search, community-owned print •Black/African American People: Community-owned print, banner, radio and social ads •11 counties with higher suicide rates: Higher levels of paid media in these counties
Evaluation Methods and Results
The campaign was evaluated through a pre and post campaign statewide quantitative survey that measured changes in familiarity, awareness and campaign recall among the general public and priority audiences. 988 center call volume was tracked to measure changes in contacts to 988. All four campaign objectives were achieved: Goal: Increase familiarity with 988 among populations disproportionately impacted by suicide Result: All priority populations had increases in 988 familiarity after the campaign (as compared to the general public at 17%): •Black/African American people: 19% increase (7% before and 26% after campaign) •American Indian/Alaska Native people: 19% increase (5% before and 24% after campaign) •Spanish-speakers: 15% increase (21% before and 36% after campaign) •Veterans: 12% increase (23% before and 35% after campaign) •Males: 2% increase (19% before and 21% after campaign) Goal: Increase overall awareness of 988 (people that have heard of 988) Result: Awareness of 988 increased 8% for the general population (37% before the campaign, 45% after the campaign) Goal: Increase contacts to 988 (calls, texts and chats) Result: 988 contacts were up 39% during the three-month campaign period. Texting was up 75%. Goal: Increase understanding that 988 is available anywhere, anytime Result: Among those with unaided recall of the campaign, 61% identified the correct main message: “Help is available any time, any place, anywhere”. The general public had 14% campaign recall and all priority audiences had higher campaign recall than the general public: •Veterans: 26% recall •American Indian/Alaska Native People: 24% recall •Spanish-speakers: 22% recall •Black/African American People: 17% recall •Males: 16% recall In addition, campaign outcome metrics were also strong including: •129,000 engagements on social media •51,000 unique visits to the campaign website
Entry Letter: F