What Was the Elimination of Barriers Initiative (EBI)?

• A SAMHSA initiative to identify and evaluate effective strategies for reducing stigma and discrimination associated with mental illnesses

• Goal: Achieve a society that promotes acceptance of all persons with mental illnesses

Objectives of the EBI

• Reduce stigma and discrimination

• Eliminate barriers to treatment

• Build public support for concepts of recovery and resiliency

• Build public support for an array of accessible, quality community-based services

Pilot EBI States

• California

• Florida

• Massachusetts

• North Carolina

• Ohio

• Pennsylvania

• Texas

• Wisconsin

Initiative Design—Strategy and Timeline

• Multiple strategies: education, contact, and reward approaches

• Coordinated by Departments of Mental Health

• 3 education campaigns:

– General public (all 8 States)

– Business community (CA, FL, PA, TX, WI)

– Schools (MA, NC, OH, WI)

• Pilot implementation period: May 2004–July 2005

• Awards program: July 2005

• Process evaluation: Fall 2005

Initiative Design—Partnership

• National-State Partnership Committee

– Diverse group of participants

• Representatives from Federal government, State mental health departments, non-profits/advocacy groups, academia, and foundations

– Attended kick-off meeting (January 2003); State Summit (September 2003); ongoing communication via LISTSERV

– 3 subcommittees: Communications, Partnership, Evaluation

Initiative Design— Implementation Team

• Vanguard Communications

– Communications development and implementation; technical assistance

• The Gallup Organization

– Administrative oversight; focus groups

• James Bell Associates

– Evaluation

• The ADS Center and the Mental Health Association of Southeastern Pennsylvania

– Consumer outreach and advocacy

• Al Guida

– Partnership development

Technical Assistance

• Each State assigned a Technical Assistance liaison as primary point of contact

• Regular conference calls

– Training and technical assistance relating to implementing the EBI

– Topics included: online marketing; May Is Mental Health Month; multicultural outreach

– State and Initiative updates• LISTSERV for information updates, group

discussion

• 100-page roll-out kit to help with implementation

• Mini-grants to help States create additional opportunities for contact strategies, additional outreach to diverse audiences

Evaluation

• Process and case study evaluation to study Reach, Awareness, and Utilization of EBI

– Process evaluation tracks usage of all EBI products, including general public, school, and workplace materials

– In-depth case studies to capture qualitative information on State implementation, including challenges and innovations

– Site visits to each EBI State

– Technical assistance tracking database

• Evaluation results will be used to inform future stigma and discrimination reduction initiatives

EBI General Public Portfolio

• Public Service Announcements– Broadcast talent and print models were

consumers of mental health services

• Drop-in articles – Featured recovery vignettes in each State

• Bilingual brochure– State-specific bookmarks

• Web Site– In English and Spanish

Creative Challenges

• Recovery language

– “In recovery” vs. “recovery/recovered”

• “Mental Illness” vs. “Mental Health Problems”

• Call to action

• Stats

Tagline Development

• Understandable by general public

• Generate awareness of importance and prevalence

• Thematically adaptable

– “It’s part of our workplace”

– “It’s part of our schools”

• Positive, strength-based, inclusive

EBI Call to Action

• Directed people to a bilingual toll-free number answered by SAMHSA’s National Mental Health Information Center and offering:

– Bilingual brochure containing general information about mental health

– Service referrals

• Also directed to Web sites

– www.allmentalhealth.samhsa.gov

– www.nuestrasaludmental.samhsa.gov

State Activities—General Public Campaign

• Trained to follow up with PSA directors to encourage placement, link to Web site, distribute brochures, etc.

• Some used their consumer networks and partners to do so; some did so themselves or via a contractor

• States held launch events between May and October 2004

• States were also responsible for distributing drop-in articles, as well as promoting business and schools packages

• With the assistance of mini-grants, States developed or enhanced existing speakers bureau activities to promote EBI messages

Print PSAs

Web Siteswww.allmentalhealth.samhsa.gov

www.nuestrasaludmental.samhsa.gov

TV PSAs

Radio PSAs

Overall PSA Results

• More than 273 million audience impressions

• Equivalent airtime/advertising value: nearly $3 million

PSA Placement Results—TV

• Commitments for over 9,589 placements equal to more than 207 million audience impressions as of December 15, 2005

– English broadcast: 4,924 placements on 76 stations equal to 171 million audience impressions

– Spanish broadcast: 1,240 placements on 25 stations equal to 32 million audience impressions

– Cable: 4,225 pledged placements on 33 systems equal to 3.7 million audience impressions

• Equivalent airtime value: $1.4 million

PSA Placement Results—Radio

• Commitments for more than 24,000 placements on 250 stations equal to almost 62 million audience impressions through December 15, 2005

– 22,062 English placements on 224 stations equal to more than 55 million audience impressions

– 2,069 Spanish placements on 26 stations equal to more than 6.2 million audience impressions

• Equivalent airtime value: $1.5 million

PSA Placement Results—Print

• Commitments for over 186 placements in 56 publications equal to 4,685,00 audience impressions through December 15, 2005

– 146 English placements in 36 newspapers equal to 814,700 audience impressions

– 22 Spanish placements in 11 newspapers equal to 189,700 audience impressions

– 18 English placements in 9 magazines reaching 3,681,500 readers

• Equivalent advertising value: $42,600

EBI Schools Portfolio

• Training curriculum for teacher audience

• Administrators’ guide

• Poster

• Print PSAs

• Drop-in articles

EBI Business Portfolio

• Resource for HR managers

• PowerPoint training for managers

• Top executives’ booklet

• Poster

• Print PSAs

• Drop-in articles

The Voice Awards

• Honor entertainment writers and producers, States, MH advocates in reducing stigma

• Writers and producers of over 50 productions nominated; 10 received awards

• Awards also to consumers, States, Brooke Shields, Maurice Benard, Univision, Neil Baer

• Over 230 attend gala ceremony in L.A.

• Covered in Variety, The New York Times, L.A. Times and online

• SAMHSA makes Voice Awards annual event

EBI Resource Kit

• Supports the activities of those who plan to mount a statewide, regional, or local initiative to reduce stigma and discrimination

• Guidance on planning and implementation

• Sample materials and templates for development and customization

• Tactics to enhance and maximize outreach

• Directories of resources for creating public education materials

• Both hard copies and electronic files on CD

Lessons Learned

1. Use a multifaceted approach

2. Use a participatory process

3. Involve consumers

4. Work closely with a smaller subgroup of key partners

5. Involve stakeholders early and often throughout the creative process

6. Identify your audience(s) and speak to them in their own language

Lessons Learned

7. Focus on positive, strength-based messages that demonstrate that recovery is both real and possible

8. Localize and personalize educational strategies

9. Choose a campaign theme that can be tailored to specific audiences

Lessons Learned

10. Develop and implement a comprehensive evaluation

11. Use existing commemorative events

12. Generate and maintain enthusiasm

13. Provide basic training and tools on media outreach

14. Utilize train-the-trainer opportunities

Lessons Learned

15. Provide forums for peer-to-peer information sharing

16. Additional training may be required in the development and ongoing operation of speakers’ bureaus

17. Recognize that messages directed at media gatekeepers may vary from those directed at the general public

Questions or Comments?

Paolo del VecchioAssociate Director for Consumer Affairs, CMHS Project Officer240–276–1946paolo.delvecchio@samhsa.hhs.gov

Richard GilroyEBI Project Director202–331–4323rgilroy@vancomm.com

James BellEBI Evaluation Director743-243-3017bell@jbassoc.com