The Metro Denver Partnership for Health (MDPH) is a regional public health collaboration previously recognized as a NACCHO Model Practice which is led by the six Local Health Departments (LHDs) serving the seven-county Denver Metro area, including Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas and Jefferson counties. Participants include Boulder County Public Health, Broomfield County Department of Health and Human Services, Denver Department of Public Health and Environment, Denver Public Health, Jefferson County Public Health, and Tri-County Health Department. The region includes nearly 3 million Coloradans, 60% of the state's population, with substantial diversity: 52% White, 22% Hispanic, 10% Black and 3% Asian (2015 census). The Partnership collaborates regionally on a range of shared public health priorities, one of which is addressing mental health stigma.
Research indicates that stigma is a significant barrier to early intervention and treatment for mental health concerns. Even when services are available, they may not be accessed due to fear and stigma. According to the Colorado Health Access Survey, talking with a health professional about mental health concerns has consistently remained a barrier for about a third or more of Coloradans living in the seven county metro region (2015: 39.3%; 2017: 30.8%; 2019: 37.4%). Coloradans living in the Metro area reporting concern about someone finding out they had a mental health problem has increased since 2015 (2015: 24. 3%; 2017: 21.1%; 2019: 31.6%), illustrating growing discomfort talking about mental health concerns. Research conducted by the Frameworks Institute found that while participants agree it is wrong to stigmatize people with mental health issues, they nevertheless engaged in patterns of talk that othered” people, such as defining people with mental health challenges as abnormal” and blaming individuals for their own mental health issues.
MDPH's overarching goal for our practice was to improve mental health by reducing stigma and fear associated with mental health and seeking care for behavioral health issues. The objectives of the project were 1) To develop a messaging campaign , 2) To collaborate with partners to disseminate, and 3) To modify the campaign over time to keep the message novel and timely.
Initiated in 2017, the campaign, Let's Talk Colorado”, is focused on beginning the conversation to reduce stigma of behavioral health issues and increase openness to help-seeking attitudes and behaviors in low-income populations in the Metro region. MDPH convened a Message Action Team representing multiple regional partners to develop messaging and strategies to promote a mental-health conversation. The team began with Minnesota's Make It Ok” campaign and focus-group tested it with a Colorado adult audience. Focus group data guided the development of Let's Talk Colorado.” The materials and website were then trans-created into Spanish (Hablemos Colorado”) and tested with Spanish-speaking audiences. TCHD also engaged the FrameWorks Institute to study perceptions around mental health in Colorado adults, and messages were reframed based on findings. Additionally, due to limited existing work targeting boys and men, additional messages were framed and tested with men-only focus groups.
A communication agency assisted with creation and testing of messages and development of collateral materials. The partners included LHDs, community mental health, FQHCs, healthcare organizations, caregiver organizations, etc. About 400 partners helped share the message using resources from https://letstalkco.org/toolkit/. Paid media was purchased using grant funds, and many partners shared the message through a variety of paid and free channels. Additionally, Colorado Community Media committed to publishing 6 segments in local newspapers on mental health, with attention to getting the messages in frame”.
All objectives were met, including a successful campaign, broad dissemination by a large number of partners, and continual testing and updating of the messaging over time. The combination of the marketing and grassroots efforts resulted in the following media impressions: year 1 - 45,617,882; year 2 55,729,056; year 3 48,303,603. Over the three years, there were over 23,000 website visits.
Key to success was the wide variety of partners participating, including local public health, healthcare systems/hospitals, schools, and local media partners. By creating a non-branded resource open to all, more partners were willing to share. For example, hospitals shared messaging because it was not branded with a competing health system's logo. The use of sound research to develop the message also improved message uptake and campaign success.
Let's Talk Colorado” continues to be utilized and promoted even after grant funding ended. Partners are continuing to utilize all materials, MDPH has committed to maintaining the website, and several stakeholders have committed funds to promote throughout the year, especially during Mental Health Month in May.
Websites: https://www.coloradohealthinstitute.org/research/metro-denver-partnership-health, letstalkco.org, and hablemosco.org.