Engaging men in conversations about masculinity and suicide – An evaluation of the Man Up social media campaign

© 2020 Marisa SchlichthorstMale suicide continues to be a major public health concern both internationally and in Australia. While a number of factors have been found to contribute to high suicide rates, little is known about what drives the much higher rates in men compared to women. Mostly, risk factors for suicide are considered in isolation, with little regard for the mechanisms that may underpin them. In more recent discussions on male health, masculinity has been highlighted as a potential driving force underpinning unhealthy male behaviors. In Australia, the “dominant masculinity” is one that endorses the norms of stoicism, independence, invulnerability and avoidance of negative emotions. Conformity to these masculine norms has been associated with suicidal thinking, poor mental health and reduced and delayed help-seeking. Men also describe experiencing stigma and how the fear of being alienated prevents them from seeking help for mental health issues. For these reasons, men are often described as a “hard-to reach” population group when it comes to mental health messaging. Suicide prevention interventions are needed that adopt a gendered approach and attend to the influence of masculine norms on mental health and suicide. The Man Up intervention was an innovative media-based male health promotion and suicide prevention intervention that featured a three part television documentary and digital campaign delivered via a website and five social media platforms (Facebook, Twitter, Instagram, YouTube and tumblr). It was funded by the Movember Foundation in Australia and its aim was to address the high suicide rate among men by promoting help-seeking for personal or emotional problems via an exploration of Australian masculinity. The documentary and digital campaign examined how society shapes the way men and boys see themselves and explored how this might affect mental health and, potentially, lead to thoughts of suicide. It was aired by the Australian Broadcasting Corporation (ABC), Australia’s national public free-to-air broadcaster, in October 2016. This thesis explores the potential for social media to be used in health promotion with the view to generate and increase engagement and influence conversations on the issue of male suicide and its link to masculinity. As such, this thesis focuses on the evaluation of the social media components of the digital campaign. The thesis is based on the idea that masculinity, the rules prescribed by society about how men should live their lives, is a fundamental determinant influencing how men negotiate their health throughout life. Following social constructionist theory, this thesis proposes that by challenging dominant masculinity social learning processes can take place that will support redefining restrictive behavior patterns and opening up alternative behaviors which in turn will help reducing stigma for men facing mental health problems, increasing male help-seeking and ultimately reducing male suicide rates. The above aim was addressed through two empirical studies that analyzed various data sources collected through two social media platforms: Facebook and Twitter. In Study 1, Twitter Insights data were used to assess reach and engagement with the campaign and to determine highest and lowest performing tweets. We also analyzed the volume of conversations over time by tracking the use of common campaign hashtags and conducted thematic analysis on a sub-set of tweets to determine most engaging campaign content themes. Study 2 was a qualitative study of comments published on the Man Up Facebook page with the aim to provide further insight into the conversations that were instigated by the campaign. Both studies have been published as peer-reviewed journal articles and together they demonstrated that the Man Up social media campaign was able to generate an impressive reach and exposure to campaign messages in the Australian population and beyond. Overall, the studies showed that the Man Up campaign messages were perceived positively across both Twitter and Facebook. Campaign content was widely shared on social media and positive feedback showed endorsement for the campaign. It highlighted the need to openly talk about male suicide and the stigma introduced by gendered practices. The increased use of the hashtag keywords of the Man Up campaign in line with the campaign phases and the fact that the hashtag MANUP was trending during the campaign signaled a strong uptake and sharing of campaign messages. Despite this, the hashtag analysis could not find a lasting increase of engagement. The analysis of Facebook comments confirmed that the social media campaign triggered conversations about masculinity and suicide that might otherwise not have happened. For some, this may have led to shifting attitudes towards expressing emotions and reaching out to others for help, however, this could not be formally investigated based on social media data alone. This thesis concludes that social media interventions can be used successfully in engaging men in discussions about male mental health, suicide and gender norms and therefore demonstrate potential for suicide protective properties of social media. However, more research is needed to better understand how and where on the internet to best engage men, particularly men at high risk of suicide. While gender-transformative campaigns such as Man Up can help to further destigmatize help-seeking for men, the longevity of changes needs further consideration. Addressing these issues will require high quality interventions and evaluation designs for social media campaigns which follow a systematic framework for measuring effectiveness