Time for Action: A Case for Mental Health Advocacy in Kerala, India

Mental health continues to be one of the most neglected areas of public service in India, even in its most developed states like Kerala. Advocacy services in mental health are also inadequate in availability to those in need. This call to action paper argues for a collaborative advocacy-through-action model of mental health advocacy for Kerala, with people’s participation as an important component. Kerala is chosen as the candidate for such a model because of its successful experience in implementing participatory development programmes. The proposed advocacy model can be extended to the whole country based on the feedback received from its initial implementation

#UsapTayo: Utilizing Tweetchat for Mental Health Advocacy in the Philippines

Mental health remains a public health concern across countries. It is estimated that 1 in 4 people will be affected by mental or neurological disorders at some point in their lives. In the Philippines, about 3 million Filipinos live with depression. Mortality rate for suicide is 3.2 per 100,000 population. Meanwhile, social media use remains high in the country with 76 million users in 2019. It is thus important to explore potential ways in maximizing social media for mental health advocacy. From January 1 to December 31, 2019, a mental health tweetchat “#UsapTayo” (direct Filipino translation of WHO's #LetsTalk) was observed every 10th, 20th, 30th of the month from 7:00 to 8:00 PM. #UsapTayo aimed to answer how effective social media platforms like Twitter in promoting mental health awareness and education among Filipino Twitter users. Engagements and impressions from users were measured using Symplur, a healthcare hashtag analytics platform. From January to December 2019, a total of 4,626 users participated in the tweetchat. Impressions for the year reached 52 million with an average of 4.75 million impressions per month. Engagements and impressions were recorded highest in the month of September with 1,169 users and 8.74 million, respectively. Overall, the tweetchat #UsapTayo was able to generate 14,385 tweets for the complete calendar year with suicide prevention identified as the most discussed topic among Filipino Twitter users. Given the country's high social media penetration rate at 71% with Twitter ranking as the second most frequently used social media, leveraging this platform improves access to information and helps in normalizing conversations on mental health. #UsapTayo then partnered with #ThereIsHelp, a project initiated by Twitter to create safer spaces online through integration of suicide prevention measures. It was also recommended convening a multistakeholder consultation to develop a national mental health promotion and communication plan. Key messages Innovative platforms in social media like tweetchat can be leveraged to promote safer digital space for mental health and to strengthen online effort for suicide prevention especially among youth. It is important to maximize the use of social media platforms for mental health advocacy particularly suicide prevention given the Philippines’ high penetration rate and access to social media.

The Public Psychiatrist as Advocate

Given the credibility many physicians possess with legislators, political leaders, and other policymakers, along with people of influence such as thought leaders and activists, community psychiatrists play an important role in patient advocacy. Contemporary professional advocacy is rooted in mental health advocacy generally, beginning with Dorothea Dix’s asylum movement in the 19th century. This chapter reviews the historical significance of mental illness and the underpinnings of modern-day mental health advocacy. It then discusses the community psychiatrist’s role in advocating for mental health care, primary prevention, community awareness, and social justice. It includes examples of the community psychiatrist effectively serving in the advocate role, and it explains the how and where to learn about public policy and advocacy skills. It concludes with a summary of key learning points.

Online mental health advocacy groups social support, stigma management and advocacy messaging, and audience reactions to this messaging

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] Mental health concerns continue to be stigmatized in traditional media, in spite of -- or perhaps contributing to --high prevalence rates of mental health diagnoses globally. This has led to the World Health Organization (WHO) declaring a public health crisis. Given stigmatization in traditional media, mental health communication scholars are investigating how mental health concerns are depicted and discussed in digital and social media spaces, but this area remains underexplored. The WHO has also outlined the importance of grassroots mental health advocacy groups in addressing the public health crisis, and an understanding of such groups' social media content is imperative. Through the theoretical lenses of information and resources, social support, advocacy, and stigma management communication, case studies of two grassroots mental health advocacy groups were conducted. Analysis of 200 social media posts, interviews with 5 content creators, and interviews with 15 users of the groups' social media feeds identified five major themes: providing information and resources through peer support, using stories, encouragement and connection to provide peer support, using peer support to foster advocacy work amongst users, progressing through stigma management communication strategies from accepting to challenging, and the importance of what is left unsaid. The theoretical and practical implications of these themes are discussed in the final chapter.

Mental health advocacy outcomes from service user perspectives

Purpose The purpose of this paper is to address a knowledge gap on advocacy outcomes from mental health service users’ perspective, and the implications for evaluating advocacy impact. The studies discussed highlight challenges for measuring the outcomes of advocacy, but underline the importance of doing so, and of involving service users alongside other stakeholders in co-designing evaluation systems. Design/methodology/approach The paper uses findings from three qualitative studies of independent advocacy involving focus groups and interviews with: 30 African and African Caribbean men who were mental health service users; 90 “qualifying patients” in a study of Independent Mental Health Advocate services; and nine young women in children and adolescent mental health services (CAMHS). Findings A comparative analysis and synthesis of findings from three studies identifies four common dimensions: how mental health advocacy is conceptualised and understood; how service users define advocacy outcomes; wider impacts; and, user involvement in evaluating advocacy outcomes. Advocacy outcomes were conceptualised as increasing involvement, changing care and treatment and supporting personal development. There was evidence of advocacy acting to empower mental health service users, and of broader impacts on service regimes and policies. However, there was limited evidence of transformational impact. Evaluating advocacy outcomes is increasingly seen as important. Originality/value Few researchers have focused primarily on the perspectives of people using independent mental health advocacy, or on the experience of “advocacy as empowerment”, and none have done so across diverse groups. This analysis adds insight into the impact of independent advocacy. Data from empirical studies attest to the important role independent advocacy plays in modern mental health systems.