Comparing Social Media and Community Outreach Efforts in Implementing an Online Public Health Education Program Focused on Mental Health
Abstract
The rising mental crisis in the United States has been exacerbated as a result of various factors, including psychosocial disconnection, increasing throughout the years. Although psychotherapy aims to utilize methods such as coregulation to dimmish the mental health crisis, it is evident that there is the need for a more extensive and affordable solution that can be utilized all throughout the United States. This study aims to investigate the efficacy of utilizing social media outreach efforts in comparison to community outreach efforts in implementing an online public health education program. Through data collection of partnerships and referral link engagement, data was analyzed to determine which outreach effort is the most effective. Community outreach efforts proved to be the most effective means of outreach. Meanwhile there is no guarantee that community outreach will always be effective, it is the form of outreach which could result in greater engagement and aid in diminishing the mental health crisis.
Keywords: Mental Health, Psychosocial Disconnection, Psychotherapy, Public Health Education, Health Coregulation, Social Media Outreach, Community Outreach
1. Introduction
With the mental health crisis in the United States growing at an alarming rate, the need for a solution that encompasses all aspects of the mental health crisis is urgently required. The mental health crisis can be attributed to a wide variety of factors such as social and environmental factors known as the social determinants of health (Pinals et al., 2021). Another factor that can be contributed to the mental health crisis is known as Psychosocial disconnection. Psychosocial disconnection is the psychological and social problem that arises when a person becomes disconnected socially and mentally (Metcalf, n.d.). Psychosocial disconnection can arise from a variety of factors such as the increased dependence on technology and social media, shortage of qualified health care professionals and the recent COVID-19 pandemic (Metcalf, n.d.). Given that many of the factors which can lead to Psychosocial disconnection continue to rise in prevalence, it is anticipated that this may lead to even more mental health conditions rising in the years to come.
1.1 Site and Program Introduction
Coregulation Health Institute, a small non-profit organization, has centered their research and development on solutions to this dilemma. Through the creation of various programs aimed to target different mental and social health problems, Coregulation Health Institute is utilizing methods backed by psychology in conjunction with public health efforts to lower the rates of mental health conditions. Healing Mental Circles, a division of Coregulation Health Institute, specifically focuses on targeting psychosocial disconnection and mental health through the implementation of a free online public health education program. Additionally, this online public health education program aimed to provide information on services that are being provided by Healing Mental Circles and Coregulation Health Institute. The main mental health conditions that are being addressed via this program are anxiety and loneliness. However, other various mental and social health conditions such as depression, trauma, and bipolar disorder that could benefit from Health Coregulation practices were included.
1.2 Health Coregulation
Health Coregulation is based around the foundational practices of “coregulation”. Coregulation is an interactive practice that is heavily utilized in psychotherapy where emotions are regulated via the bidirectional emotional linkage between therapist and client (Soma et al., 2019). Health Coregulation focuses on the regulation of the mental and social health of an individual through the practice of coregulation with another individual or a therapist (Metcalf, n.d.). Health Coregulation can be viewed as an affordable alternative to therapy given that it can be taught and learned at a relatively fast rate. Therefore, its distribution to various individuals would be expected to contribute to the amelioration of various mental and social health problems given its potential for rapid spread and low cost to teach and learn its practices.
1.3 Access and Limitations to Mental Health Care in America
With recent studies indicating that the weighted mean mental health treatment gap in the United States is over 64%, we are currently experiencing a mental health crisis that is not being addressed to its full potential (Kohn et al., 2018). As previously stated, many factors contribute to the mental health crisis that is continuing to develop in the United States. Many of these factors such as the social determinants of health, the stigma surrounding mental health care and the scarcity of practitioners are creating barriers for many Americans to seek help (Coombs et al., 2021). These factors especially impact the marginalized communities within the United States and the creation of an accessible and affordable solution for all is necessary (Stringer, 2024). When we look at the solutions that are being offered within the United States to address the mental health crisis, there is a lean towards digital interventions for mental health care given the widespread access and usage of technology (Stringer, 2024). With rising costs of treatment and inaccessibility to services, creating services such as a free online public health education program on mental health interventions can therefore be a solution that may provide positive long-term effects.
1.4 Incorporation of Public Health Practices
A key aspect of the implementation of this program is utilizing public health practices in conjunction with psychologically backed practices. Several public health practices such as public health education, promotion, and outreach, were utilized in this study to be able to aid in the distribution and uptake of these services (ACPM, 2024). With the primary focus being implementing a public health education program that will aid in diminishing the mental health crisis, this research study aimed to determine which means of outreach would be the most effective at achieving this goal. Given that studies have shown that outreach programs are an effective strategy to reduce health disparities, provide services and education to underprivileged communities, this aided in determining the outreach practices that would be utilized in this study (Park & Park, 2021).
1.5 Aim of Study
This study took place over the course of 6 months and was conducted online and within the Chicagoland area. There are two different forms of outreach that are explored in this study, social media outreach and community outreach. This study was conducted in order to determine if community outreach or social media outreach is more effective at implementing an online public health education program centered around mental health and Health Coregulation. Community outreach is known to be an established and effective method of public health practice and could be beneficial in the implementation of an online public health education program (The University of Kansas, 2023). However, with the rise of technology and social media usage, social media is expected to be a more effective outreach method for implementing a public health education program on mental health and Health Coregulation.
2. Methods
2.1 Data Collection
Overview In order to understand whether social media or community outreach efforts are the most effective at implementing an online public health education program, public health efforts were utilized in conjunction with psychology-based practices. As stated previously, public health education, promotion, and outreach methods were utilized in each form of outreach. In order to measure which form of outreach is the most effective, there were two different measurements analyzed: establishment of partnerships and referral link engagement. Additionally, analytics from social media and referral link usage were utilized for further information.
2.2 Mental Health Education and Promotion
This public health education program is centered around the education and awareness of topics such as Health Coregulation, psychosocial disconnection, mental health, and the stigma surrounding mental health. Both community and social media outreach efforts provided education on these topics utilizing public health education practices such as: identifying the mental health needs of the community, developing educational material that increases the public’s knowledge on mental health, and developing content and materials that reflects the learning style of the intended audience (Rural Health Information Hub, 2024). Community outreach focused on education and awareness of mental health and Health Coregulation practices through flyers posted on bulletin boards. These flyers contained QR codes which led to the link to sign up for the free online public health education program being offered by Healing Mental Circles. The free online public health education program would involve sending out weekly emails on information regarding Health Coregulation, mental health, and social health topics. These flyers also contained information on Healing Mental Circles social media accounts. Whereas social media outreach focused on the direct promotion of the services through “Linktree” and educational social media posts. These social media posts were tailored to according to the target demographic that would benefit most from the free online public health education program. Content of the social media posts featured topics such as psychosocial disconnection, health coregulation, mental health, social health, and public health related topics.
2.3 Measuring Formed Partnerships
The first measurement came from the number of “partnerships” that were created via each mode of outreach. “Partnerships” were defined as the established relationship between two entities (Healing Mental Circles and the other individual/institution or business) to promote and educate the public on mental health and Health Coregulation practices. First, potential partners were identified in each respective mode of outreach. For social media outreach, this meant identifying social media pages on each respective platform who promoted mental health, public health, or psychology-based content. Social media outreach in this study was done through two social media accounts on two platforms, Instagram and TikTok. For community outreach, potential partners were determined based on their likelihood to promote mental health related content and have bulletin boards in their establishment. Next, potential partners were contacted either via social media, email or in person to identify their willingness to partner with Healing Mental Circles in the promotion of the free online public health education program and the distribution of mental health educational material. All potential partners were provided with an overview of Coregulation Health Institute, Healing Mental Circles, and the purpose of the public health educational program that was being offered. It is important to note that all partnerships were done without the use of any exchange of money. If a collaborative partnership were to be established, it would result in the free promotion of other mental health related services being offered that would be beneficial to people with mental health conditions. Each location or individual who was considered for this portion of the study was entered into an excel sheet along with their information such as social media handle, business address, and their response as to their willingness to partner. An established partnership was defined as the stated willingness to promote the public health education program being established at Healing Mental Circles. Rejection of a partnership was defined according to the outreach type. Social media rejections often came from a lack of response from a social media account after either initial contact or stated disinterest in further engagement. Whereas community outreach rejections were delivered directly by a verbal rejection to post flyers related to the mental health education program.
2.4 Measuring Referral Link Engagement
The second measurement that was taken was engagement through the usage of a personalized referral link to the mental health services being provided. Two distinct referral links were used, one solely for social media and the other for community outreach. Link number 1 was utilized in community outreach efforts through flyers. This link was converted into a QR code and posted on flyers for easier access on phone and led to Coregulation Health Institute’s website where people could sign up for free mental health services. The second link was solely for social media and was posted on both Instagram and TikTok through a “Linktree” which led to the link where people could sign up for free mental health services. Additionally, the “Linktree” led to other beneficial links such as Coregulation Health’s main website and our other social media accounts. Engagement of these links were measured through the number of visitors and subscribers of the links in addition to other online analytics that were provided by sites such as “Linktree”. The referral link also measured engagement in two different ways, through visitors and subscribers. “Visitors” are defined as individuals who visit the referral link and do not sign up for the free online public health educational program. Whereas “subscribers” are defined as individuals who visit the referral link and choose to subscribe to the free online public health education program.
3. Results
3.1 Success of Outreach Methods on Establishing Partnerships
Findings showed that utilizing community outreach was more effective than utilizing social media outreach at establishing a partnership. Table 1 shows how community outreach had a larger success rate at 65% over social media outreach at 3.5%. Success rate was calculated utilizing the following equation below:
Social media rejections could be based on the current oversaturation of requests to “follow and like” content from other social media creators in addition to the lack of monetization. Although social media accounts that were followed were promised that their content would be promoted for free, if appropriate for Healing Mental Circles’ audience, social media accounts often preferred to obtain money. Rejections from community outreach efforts were often a result of various factors. One common reason for rejection came from the fact that many locations only allowed for the posting of events happening in the community. This was often due to policy of the business or organization towards promotional material. Another common reason for rejection came from a lack of bulletin boards to place flyers. Various locations that had bulletin boards in the past indicated that they no longer had a physical bulletin board. These locations were therefore, unfortunately, no longer accepting physical flyers. As a result of the increase in technology and social media, this has made many businesses make the switch towards a digital promotion of services or materials. Some businesses rejected the promotion of mental health related content as a whole due to the stigma that still surrounds the topic of mental health. One business in particular did not want to promote “such content” due to the policies superimposed by management. Unfortunately, these findings solidified the prevalence of the stigma in the community towards mental health related content even if deeded helpful or appropriate for viewers of all ages. Similarly to social media outreach findings, some businesses did not want to be involved in the promotion of the mental health education program if it did not result in a mutually beneficial relationship where money was involved. In some cases, promotion was only achievable through purchased ads spaces.
3.2 Referral Link Engagement by Outreach Method
When it came to engagement and expressed interest from people according to the two outreach types, community outreach proved to be more effective. As seen in Figure 1, community outreach was shown to have a greater engagement amongst potential participants in overall link visitors and subscribers in comparison to social media outreach. Results also indicated that people are more likely to visit the link to sign up for a free public health educational program rather than actually subscribe to the services. When looking at visitors, 48 people visited the link to the program via community outreach in comparison to the 11 that visited the link through social media outreach. 6 people signed up for the free online public health education program via community outreach versus the one person who signed up via social media outreach. Although people are more likely to subscribe to a free online public health educational program through community outreach, there is a rather small difference of 5 subscribers from which to make this analysis. There are many factors that could be potentially attributed to this phenomenon. Given that the referral link in the community outreach efforts was posted in public areas where everyone could see, this explains the larger visitor population. Whereas social media outreach efforts were also public but mainly restricted to those who either engaged on the social media profiles or were direct followers of the social media accounts.
4. Discussion
4.1 Limitations of Social Media Outreach Data Collection
Given that social media use spans throughout the world, there was no ability to limit social media outreach solely to people residing within the United States. Rather, findings from analytics determined that the majority of followers and people engaging with the mental health related content that was posted on social media came from other countries such as the United Kingdom and India as seen in Tables 2 and 3.
Given that mental health in many of these countries is still not a topic of open discussion, this can indicate that the need for mental health services across the world as a whole are in high demand. Additionally, limited resources in lower socioeconomic countries can contribute to the heightened need for mental health services. This demonstrates that future online mental health and public health education programs should consider developing mental health services that will cater to individuals across the world.
4.2 Limitations of Community Outreach Data Collection
Community outreach methods were limited in their collection of data due to proximity of the data collection source. Community outreach was done primarily in the Chicagoland area and the surrounding suburban area of Chicago. From 2021 to 2022, an approximated 64.6% of adults in Chicago classified as having serious psychological distress and not taking medicine or receiving treatment for any mental health condition or emotion problem (Chicago Health Atlas, 2024). This indicates the dire necessity for a solution that can encompass all the mental health needs of a large metropolitan area such as Chicago. Therefore, the community outreach efforts that were done in this area could provide some impact to the mental health crisis in this area in the long run. Further research would be needed to solely measure the impact of the long-term benefits of a free online public health program specifically in the Chicagoland area or in other areas of the United States.
An additional limitation to community outreach efforts is the digitalization of services. With the rise of technology, many businesses and organizations are making the switch to digital billboards or menus and no longer contain places such as bulletin boards to post flyers. Most businesses that did still contain bulletin boards included locations such as libraries, coffee shops and restaurants. However, this does not guarantee that all of these businesses or organizations had bulletin boards nor that they would allow the posting of mental health related material as seen indicated in Figure 2. This will require that the program in the future adapts to these changes in community outreach with the continued digitalization of services and that the mental health education content be formatted accordingly.
4.3 Utilizing Social Media Analytics for Future Program
Development Social media analytics provided by Instagram and TikTok can be used to further tailor the online public health education program to provide mental health resources that will be beneficial to the demographics that are accessing the content on the established platforms. As seen in 0 2 4 6 8 10 12 Library Coffee Shop Restaurant Thrift Store Supermarket Number of Locations Business Type Mental Health Flyers Allowed by Business Type Yes No Figure 3, when looking at the distribution of followers that are accessing Healing Mental Circles’ platforms, the majority interacting with the content are females.
Additionally, when looking at the age ranges of the followers of Healing Mental Circles’ social media platforms on Figure 4, one can see that the majority fall within the age ranges of 25 to 34 on both Instagram and TikTok. However, if one generalizes the age ranges, we can see that young to middle aged adults are the demographic that is most likely to access the mental health information that is placed on social media.
The utilization of these analytics could therefore be beneficial in either continue to appeal to the demographics that are accessing Healing Mental Circles’ social medica accounts or can be used to implement changes to the other demographics which are not as active on the social media accounts. Ultimately, the choice to make changes to the mental health content that is provided on social media by Healing Mental Circles should also appeal to the current statistics indicating which demographics are being most affected by the mental health crisis within the United States. 0% 5% 10% 15% 20% 25% 30% 35% 13-17 18-24 25-34 35-44 45-54 55+ Percentage of Total Followers Age Range Distribution of Followers Age Ranges Across Social Media Platforms Instagram Tiktok
4.4 Establishing Future Community Partnerships
To further confirm that community outreach efforts are truly more effective than social media outreach, it is recommended that this study be conducted in various locations throughout the United States where is has been determined that there is a need for mental health services from statistical analysis. The establishment of partnerships may need to evolve according to findings from this study. Working with institutions such libraries and coffee shops are beneficial for promoting mental health content given the diverse demographic that visits these locations. Additionally, some of these businesses and institutions, such as libraries, are considered to be locations that are welcoming to all individuals regardless of their socioeconomic background. Therefore, continuing to seek partnerships with similar businesses and institutions could prove to be helpful in attempting to promote health education content related to mental health. However, there are benefits to catering to other businesses as locations such as universities, public transportation and shopping centers tend to obtain more visitors than a library or a local coffee shop. In order to move forward with this approach into diversifying and expanding partnerships with other businesses, one must consider venturing into approaches outside of public health or psychology and begin focusing on marketing. Given that many of these locations operate mostly on paid advertisements, this would require a separate study to be conducted on how the addition of marketing and monetized partnerships aid in the establishment of a public health education program.
4.5 Future Studies and Improvements
This study begins to understand the benefits and differences between two different forms of outreach in diminishing the mental health crisis. However, to truly understand if a free online public health education program will be beneficial, additionally studies should be conducted. For example, a cohort study where a group of people participate in the program and learn Health Coregulation and see if the state of their mental health improves over a prolonged period of time. Studies such as this, will require the need of a much larger sample size than the one utilized in this study to be able to provide data that is statistically significant. Other findings from this study that could be continued to be examined include the long-term benefits of each form of outreach, how each outreach can differ in different areas of the United States and how including more diverse “partners” can change the findings determined from this study.
This study overall provides a glimpse into the differences and benefits of each form of outreach. Given the relatively small sample size from which to generate conclusions, it would be best to continue to generate findings over a prolonged period of time. This will aid in determining if community outreach is statistically proven to be a better solution to implementing a public health education program. Overall, the data and findings from the study indicate that there is room for improvement. One must consider that most of the education that is being given from this program is self-taught and requires the initiative of a person to agree to access the materials via email. Additionally, the teaching of Health Coregulation as a whole is centered around the aspect of conversing with another individual. There is the possibility that this program may be better suited to be tailored to those who are interested in helping to ameliorate the mental health crisis in the United States rather than those who are affected by mental health conditions. More than half of all people with mental illnesses do not seek or avoid treatment due to factors that include stigma or the social determinants of health (American Psychiatric Association, 2020). Therefore, changing the approach to focus on teaching others without mental health conditions to reach out to those who have mental health conditions with the approaches of this public health education program may provide better results in engagement.
5. Conclusion
Ultimately, there is no easy solution to the mental health crisis that is impacting the United States. To diminish the strain that psychosocial disconnection has placed on the mental health of people in the United States will require outreach efforts that involve the mixture of both social media and in person community outreach in addition to changes to the program as a whole. Continuing to examine the long-term benefits and challenges that arise from the implementation of a public health education program that is focused on mental health can ultimately aid in the determination of a solution that will help solve the mental health crisis in America. As programs continue to be developed, it is important to recognize the benefits of continuing to merge public health and psychological practices into solutions to the mental health crisis in addition to exploring the continued utilization of both forms of outreach.
References
Pinals, D. A., Fuller, D. A., & Pinals, M. J. (2021, December). Social Determinants of Health and Mental Health. https://www.ncsc.org/__data/assets/pdf_file/0025/70864/Social-Determinants-ofHealth.pdf
Metcalf, R. (n.d.). With growing Public & Mental Health Crises Harming Millions, These Activists Believe There’s a Better Solution.