Summary

· Challenge: 1-in-7 Singaporeans are experiencing mental health issues and yet 3-in-4 do not seek help out of shame leading to a 12-year long treatment gap and highest suicide rates among youths.

· Insight: Youths with mental health conditions don’t want to talk openly about needing help, and stigmatize themselves to “save face and fit in” due to the cultural taboo of the topic.

· Idea: Help youths confront their mental health self-stigma to seek and accept help, and a solution to help them find the right kind of help comfortably.

· Solution: Belle, a mental health chat-based helpbot aggregates hundreds of helplines and services in one interface so youths can find help easily and comfortably, driven by an omnichannel destigmatizing campaign.

· Results: Belle and Beyond the Label campaign delivered 2x attitudinal shifts about mental health, and routes hundreds of previously unreachable help-seeking queries to social services nationwide, even after the campaign ended.

Context

According to research by IMH, 1-in-7 Singaporeans will suffer from a mental health condition, up from 1-in-8 6 years ago.

To understand the quality of life for people with mental health conditions (PMHCs), the National Council of Social Service (NCSS) surveyed the nation to heartbreaking findings:

· 1-in-2 said PMHCs “should not be given responsibility.”

· 50% would not even work or live near a PMHC.

· PMHCs surveyed confided that they felt excluded from society.

As a result of this stigma and discrimination, we faced an alarming national mental health crisis –

· 3 of 4 Singaporeans with a mental health condition do not seek help, out of fear of being stigmatized.

· A treatment gap of as long as 12 years between when PMHCs first experienced symptoms to getting clinical help.

· 1-in-3 people in their 20s would not consider contacting others for help when emotionally overwhelmed.

· Suicides accounted for 1/3 of all reported deaths amongst Singaporean youths aged 10 to 29-year-olds.

NCSS launched “Beyond the Label’ – a campaign to raise awareness of mental health stigma. While first-year efforts were successful in destigmatizing discussion of the topic, we now had to grapple with getting PMHCs the help they needed.

· Search engine searches for mental health resources raised more questions than answers for a PMHC yet to understand their condition, help needed or comfortable with receiving.

· Many mental health social services required adult consent to book appointments for.

· NCSS’ existing mental health directory was a clunky 56-page long PDF hidden away in a corporate website and NCSS weren’t sufficiently staffed to address Facebook private messages requesting mental health aid.

Target Audience

Given the higher treatment gap incidences among younger Singaporeans, we focused on:

· Youth PMHCs aged 18 – 35 (by national definitions of youth)

· Their parents, caregivers, employers and partners as immediate social circles of influence.

To encourage help-seeking behaviours, we sought to provide youths with a means to find the right help saliently without the fear of being judged for it.

Strategy

Our research identified several behavioral biases affecting this issue:

· Choice overload: The paradox of overchoice prevents us from taking action, is associated with unhappiness, decision fatigue and choice deferral. Without a clear single channel for PMHCs to find help, most abandon the search.

· Avoidance coping: We typically change our behaviour to avoid thinking or feeling things that are uncomfortable or complex. Because of difficulty of understanding mental health conditions, PMHCs avoid addressing their condition.

To counteract these biases, we needed to make the search of mental health help & info cognitively easier (saliency behavioural nudge) via a familiar, single source of information (defaulting behavioural nudge).

Solution / Creative Idea

In response, we developed:

Belle, a mental health Helpbot that alleviates the daunting task of searching for help via traditional search engines or face-to-face queries.

● Aggregates Singapore counselling, clinical, helplines, employment, community & volunteering opportunities by geography, age and cultural/caregiving segments.

● Links users to various mental health related services from a national social service directory, segmented by type of support, level of intervention and condition via Natural Language Processing (NLP) of in-chat queries.

● Purposefully not trained to act as a virtual therapy device but to rapidly connect undiagnosed PMHCs to actual social service workers.

● Emergency queries escalated to a panel of social service agency volunteers to provide help.

● Developed for Facebook – as a social first, mobile-first, messaging-first resource for youths predominantly on mobile devices.

Rolled out in 3 key phases:

LAUNCH: Belle was first launched with an accompanying omnichannel paid media burst targeted at Singaporean youths aged 18 – 35 as well as parents, employers and caregivers aged 35 – 59 between 24th Sep 2019 - 5th Dec 2019.

SUSTAIN: Awareness of Belle was then sustained from Jan - Aug 2020 via scheduled social posts on the Beyond the Label FB/IG Pages, as well as earned amplification through national press mentions and promoted by other mental-health related public sector partners such as Institute of Mental Health.

SUPPORT: This was further supported by a 3rd paid media burst from 14 Sep 2020 - 11 Nov 2020 to respond to heightened calls for mental health support as Singaporeans coped with COVID-19 pandemic mental health stressors.

Amplification / Activity

LAUNCH Phase (24 Sep - 5 Dec 2019):

● Youth-centric testimonial videos and KVs to promote Belle.

● Programmatic/Social/Mobile optimized via lookalike interests and topics - youths, mental health, parenting and wellbeing.

● Retargeting lookalikes from Belle user search data with paid and partner assets.

● Promotion of Belle via Social content publishers and Influencers popular with youths and parents.

● A mental health festival with arts exhibits, workshops, products, music performances, escape rooms, and games for Singaporeans to “experience” the topic and try Belle out.

● Press pitching on mental health related channels.

SUSTENANCE Phase (2 Jan - End Aug 2020):

● Scheduled calendar of social postings on Beyond the Label Facebook / Instagram pages on mental health related matters, with Belle as hero platform for resource search.

● Earned mentions on partner social channels to promote Belle as well as mentions on national press.

SUPPORT Phase (14 Sep - 11 Nov 2020):

● Family-centric short film to promote importance of help-seeking via Belle skewed to rising mental health stressors during COVID-19.

● Programmatic/Social/Mobile optimized via lookalike interests and topics - youths, mental health, parenting and wellbeing

● SEM via mental health related keywords & phrases.

● Promotion of Belle via Influencers popular with youths and parents.

● A virtual mental health advocacy festival with performances and workshop activities for Singaporeans for mental health support during lockdown.

● Press pitching on mental health related channels.

Results / Impact

Since its launch, Belle has routed thousands of previously unreachable requests monthly to different helplines, centres, programmes and services.

● Belle saw a 4x increase in no. of users during Singapore’s COVID-19 circuit-breaker phases.

The 2020 Support Phase of the campaign also encouraged PMHCs to find and accept help for their conditions -

● Overall campaign awareness reached 56% of persons with mental health conditions vs 40% campaign KPI.

● Improved attitudes of Persons with Mental Health Conditions towards recognizing the importance of seeking help (vs. 3% uplift attitudinal KPI measured via pre- vs. post campaign surveys)

6% uplift in knowledge about mental health conditions

4% uplift in affective statements about PMHCs, indicating lowered self-stigma among PMHCs.

7% uplift in behavioural statements about finding help.

The 2020 Support Phase exceeded its paid media & PR KPIs, off a media budget of just under SGD562k (far lower than most government nationwide campaigns).

● Achieved 60% 1+ reach of P15+ (approximately 4,320,000 of the SG population) vs. yearly KPI of 40%

● Achieved offline ROI of 654% ($,1883,342.75 total offline media inventory value vs. offline media spend of $287,899.25)

● Achieved 22,170,622 online impressions, 1,943,067 CT/ER/ENs to Belle and 3,365,120 film views off online media spend of $206,251.37

● Attained media pitching value of $1,963,061.07 from 64 articles and 14 micro-influencers.

Belle has also enabled NCSS to better understand help-seeking patterns to inform our future communications – insights that we would not have been able to acquire via past touchpoints.

Belle - Mental Health First Responder

CREDITS

Preet Kaur

Adrian Loo

Alfred Wee

Fathrul Fazakir

Natalie Oh

Kester Poh

Local partners

Gold partners