Behaviour Change

PROPAGANDA FOR CHANGE is a project created by the students of Behaviour Change (ps359) and Professor Thomas Hills at the Psychology Department of the University of Warwick. This work was supported by funding from Warwick's Institute for Advanced Teaching and Learning.

Thursday, March 23, 2017

Don't Hide From Suicide - Encouraging University Students To Seek Help


The Issue:

Figure 1- Proportion of suicidal thoughts experienced, separated
according to age group and sex.
Why is it that so many of us hide from the word suicide? Rates of suicide and self-harm are an enormous concern throughout society, with 6,122 people in the UK taking their own lives in 2014 (Samaritans Suicide Statistics Report, 2016), although the figures are likely to be larger than this since many suicides go unreported. Those aged 15-24 are at particular risk, with suicide being reported as the leading cause of death in this age group (Eskin et al, 2016), greater than deaths caused by car fatalities. Of this age group, over 20% of males and females combined admitted to having suicidal thoughts at some point in their lives (see Figure 1), and self-harm rates have risen significantly between the years 2000 and 2007, particularly for females in the younger generation (see Figure 2), (McManus et al, 2009). What’s more, fewer than 4% of young adults are likely to talk to a professional about their concerns (Borrill, Fox, Flynn, & Roger, 2009). These facts troubled us, and we wanted to engage in a project to help raise awareness of suicide and self-harm amongst university students, and provide support for those who may be suffering or know someone close to them who is at risk. We felt that it was important to encourage people to fight the taboo surrounding suicide and speak out about it, as silence can be the biggest killer if this issue is neglected.

Figure 2- Proportion of self-harm rates in the years 2000 and 2007,
divided according to gender and age range.

What we did:

Figure 3- Our draft storyboard : a project in the making.
We decided to create a spoken word poem on suicide and self-harm, and used this to form a short animation. This helped to convey a story whereby a young male adult is suffering from suicidal thoughts and self-harm, and is helped by a female friend who recognises the warning signs and persuades him to seek help (see Figure 3). We provided contact details of charities where individuals can get support (e.g: Nightline, Samaritans, and Papyrus’s HOPELine). We also made a Facebook page (see: fb.me/suicide.speakoutseekhelp) where our animation can be found, and uploaded it to YouTube. Our Facebook page includes advice on what to do if an individual feels as though they or someone else is at risk, and offers a variety of distraction and coping strategies that students can try if they feel like harming themselves. A couple of the main suggestions put forward here include the idea of a ‘Hope Box’ in which the person can store things that make them happy or bring comfort (such as photographs and calming objects), and the suggestion of making a ‘Safety Plan’ which provides details of what to do when at crisis point. In the near future, we hope to have our animation shown on the student cinema to target a wider audience to raise further awareness of the issue.

Persuasion techniques used:

      Similarity Altercast-
Similarity altercasting is a theory of social persuasion which posits that perceived similarity between the self and another will increase compliance to that other person in virtue of having a shared identity. This persuasive technique was shown in a lab experiment by Baron (1971). The study manipulated the degree of a subject’s perceived attitude similarity (high or low) to a confederate (by leading them to believe that they had very similar or very dissimilar answers on an attitude questionnaire), and then instructed the confederate to request a small, medium, or large favour from the subject. Although the small request elicited similar rates of compliance for low and high similarity conditions, there was a large discrepancy between rates of compliance in the low and high similarity conditions for medium requests (30% low vs 90% high) and large requests (50% low vs 100% high). The experiment demonstrates how high levels of perceived similarity by an audience to a source makes their actions far more likely to be influenced by the source.   
      We tried to persuade others to change their behaviour and speak openly about suicide by using similarity altercasting in our animation. First, as Warwick University students ourselves we targeted our animation towards Warwick University students by stressing the prevalence of suicide within our university. Second, we created a simple look for our male and female characters to provide a literal and metaphorical ‘blank canvas’ onto which the audience can view themselves as being in the story and identifying with their plight. The hope is that identifying with the audience in this way will create a shared sense of identity which will increase the likelihood of the audience complying with our request to speak out about suicide.  
Elaboration Likelihood Model-
     The Elaboration Likelihood Model (Petty & Cacioppo, 1986) tells us that attitude change is mediated by the way in which the following two factors interact with a piece of persuasive communication: the audience’s ability to think about the message, and the audience’s motivation to think about the message. If the audience are able and motivated to think about the message, they may take the “central route” to persuasion. The central route to persuasion means engaging with and being persuaded by the content of the message. For example, someone who votes for a political candidate after careful consideration of her arguments has taken the central route to persuasion. If the audience are not able to decode the message and are not motivated to do so, they may be influenced by cues other than the content of the message, thus taking the “peripheral route” to persuasion. For example, marketers often use other cues such as celebrity endorsements to motivate their audience to purchase their product or service. In this case, the audience might not be persuaded by a genuine need for the product itself but because their favourite celebrity uses it, so it seems that it would be a good idea for them to use it, too. According to Petty and Cacioppo, “Attitude changes that result from processing issue-relevant arguments (central route) will show greater temporal persistence, greater prediction of behaviour, and greater resistance to counter persuasion than attitude changes that result from mostly peripheral cues” (1986: 21).
     Thus, through our project we aimed to persuade people via the central route. In order to do this, we had to ensure that the audience were able to understand our message and were motivated to do so. This lead to one of the primary motivations for creating an animation: we felt that creating a storyline would communicate the aspects of suicide that we wanted to get across (such as its prevalence, the warning signs, what to do if you are affected, and the importance of not hiding from the issue) in an easy way to follow and understand, rather than throwing lots of information about suicide at the viewer. To motivate our viewers, we realised that the issue had to come across in a way that genuinely mattered to them. That is why we decided to focus on suicide at university - an issue that is present within the audience’s environment, and as such directly affects their community.

Measuring behaviour change:

It is difficult to garner an instant measure of behaviour change with regards to suicide, as the primary indicator would be rates of suicide at university which requires time to elapse before the data can be collected. However, one of our main aims was to remove the stigma around suicide, so those who suffer can seek help before it is too late. Just by getting our message out to people helps to get people talking about suicide, which helps to remove the stigma. Therefore, our first measure is the number of views of our animation on our YouTube account. This view count will reflect how many people we have managed to reach. Our second measure is our Facebook page, which provides an extensive measure of audience engagement, including page views, page likes, post engagements, and reach (posts that get likes and comments appear on user’s news feeds, so reach is a measure of how many people see our posts). The numbers are rising day by day, and we hope that this continues.

Concerns:

There were some issues that we had to consider during the making of our project, one of which is the phenomenon known as ‘The Werther Effect’ (Phillips, 1974). This refers to copy-cat suicide, in which an individual is more likely to attempt the act after a suicide story has been highly publicised. This ‘suicide contagion’ effect has been witnessed in the past, for instance, when Marilyn Monroe took her life in 1962 there were 200 more suicides in the USA in the following month; a rise of 12% (Stack, 2003). It has been noted that the risk of imitative suicide is higher up to ten days after a media report (Phillips, 1982). It has also been found that the younger generation are more susceptible to this effect, especially if the publicised figure was someone they could relate to, for instance, a well-known or liked celebrity, or someone who was of a similar age and the same gender, or facing similar circumstances (Sisask & Värnik, 2012).  

However, other research has suggested that this phenomenon is misleading, and evidence for the Werther Effect is much less consistent than it first appears (Sullivan, 2007). Charities trying to raise awareness of youth suicide (such as Papyrus), emphasise the importance of talking about the issue and state that this itself does not cause an increase in figures. Despite this mixed research, we wanted to ensure that our project did not have an adverse effect on students by making the idea of suicide more salient and alluring. For this reason, we tried to present the problem and offer a solution, emphasising the idea that there is hope for those who are suffering, and paid particular attention to those who had attempted suicide and survived, having overcome their obstacles; for instance, Tina Turner, Ian Thorpe, and Mike Tyson. This led us to develop our motto, “What would Tina Turner do? Keep singing. What would Ian Thorpe do? Keep swimming. What would Mike Tyson do? Keep fighting. So don’t give up your battle.”

Why the project is late (a more personal note):

You may have noticed that this post has appeared a bit later than other Behaviour Change student’s. This is because of just how personal this project has been for us. Since making the storyboard, many of my friends have confided in me about suicidal thoughts and self-harm urges. I have felt overwhelmed by the number of people who are feeling so troubled that they have actually hurt themselves or thought about giving up. I’ve had to take someone to hospital because of their thoughts and urges. I have wiped and bandaged wounds, given hugs, made drinks and most importantly listened to their thoughts. I’m not going to lie, it was difficult. I avoided work, broke down and even ended up hurting my friends because of the stress. This is a really important topic for me and I really want people to be able to talk about their feelings or support their friends. However, that does NOT mean you should handle everything yourself. If there’s one message I want you to take home from this, it’s this: You are NOT alone. If you’ve spotted signs that your friend is not okay, please don’t try to take on everything yourself. The most important thing to do is listen. There is help out there and though you may desperately want to help them, you cannot control them. They are NOT your responsibility. Take them to the doctor or suggest people they can contact. You can even help make a plan or suggest coping strategies, but don’t let their issues take over your life. You can’t help others if you are not okay yourself (and trust me, I learnt that the hard way). So listen to your friends and speak up about suicide. Find someone to talk to about your own feelings. Don’t hide from suicide.

If you have been affected by anything from our project (or anything else), please don’t hesitate to contact any of the following:


You can make it through this. Just keep doing what you do.


Catherine Turvey, Sara Jane Sutty, & Lloyd Caffrey-Thanacoody

References:

Baron, R. A. (1971). Behavioral effects of interpersonal attraction: compliance with requests from liked and disliked others. Psychonomic Science, 25, 325-326. 
Boehm, L. E. (1994). The validity effect: A search for mediating variables. Personality and Social Psychology Bulletin, 20, 285-293.

Borrill, J., Fox, P., Flynn, M., & Roger, D. (2009). Students who self-harm: Coping style, rumination and alexithymia. Counselling Psychology Quarterly, 22, 361-372.

Eskin, M., Sun, J. M., Abuidhail, J., Yoshimasu, K., Kujan, O., Janghorbani, M., Flood, C., Carta, M. G., Tran, U. S., Mechri A., Hamdan, M., Poyrazli, S., Aidoudi, K.,Bakhshi, S., Harlak, H., Moro, M. F., Nawafleh, H., Phillips, L., Shaheen, A., Taifour, S., Tsuno, K., & Voracek. M. (2016). Suicidal behavior and psychological distress in university students: a 12-nation study. Archives of Suicide Research, 20, 369-388.

McManus, S., Meltzer, H., Brugha, T., Bebbington, P., & Jenkins, R. (Eds.). (2009). Adult psychiatric morbidity in England, 2007: Results of a household survey. Leicester: The Health & Social Care Information Centre.

Mitchell, S. (2015). Why do people keep dying at the University of Warwick? Retrieved from http://thetab.com/uk/warwick/2015/01/23/people-keep-dying-university-warwick-5795

Office for National Statistics,. (2011). Total number of deaths by suicide or undetermined intent for Students aged 18 and above in England and Wales, 2014. London: Office for National Statistics. 

Petty, R. E., & Cacioppo, J. T. (1979). Effects of message repetition and position on cognitive response, recall, and persuasion. Journal of personality and Social Psychology, 37, 97-109.

Petty, R. E., & Cacioppo, J. T. (1986). The elaboration likelihood model of persuasion. In Communication and persuasion (pp. 1-24). Springer New York.

Phillips, D. P. (1982). The impact of fictional television stories on US adult fatalities: new evidence on the effect of the mass media on violence. American journal of sociology, 87, 1340-1359.

Phillips, D. P. (1974). The influence of suggestion on suicide: Substantive and theoretical implications of the Werther effect. American Sociological Review, 340-354.

Scowcroft, E. (2016). Suicide statistics report, 2016. Retrieved from http://www.samaritans.org/about-us/our-research/facts-and-figures-about-suicide

Sisask, M., & Värnik, A. (2012). Media roles in suicide prevention: a systematic review. International Journal of Environmental Research and Public Health, 9, 123-138.

Stack, S. (2003). Media coverage as a risk factor in suicide. Journal of Epidemiology and Community Health, 57, 238-240.

Stanley, N., Mallon, S., Bell, J., & Manthorpe, J. (2009). Trapped in transition: findings from a UK study of student suicide. British Journal of Guidance & Counselling, 37, 419-433. 

Stotland, E., Zander, A., & Natsoulas, T. (1961). Generalization of interpersonal similarity. The Journal of Abnormal and Social Psychology, 62, 250-256. 

Sullivan, G. (2007). Should suicide be reported in the media? A critique of research. In Mitchell, M. (Ed.), Remember me: Constructing immortality - Beliefs on immortality, life and death (pp. 149-158). New York, NY: Routledge. 

Werkmeister, W.H. (1948). An Introduction to Critical Thinking. Lincoln, NB: Johnsen Publishing Nebraska. 

No comments:

Post a Comment

Note: Only a member of this blog may post a comment.