"From an illness to a wellness model in mental health marketing; an interpretive phenomenological examination of the influence of cultural stigmas on consumer mental wellness check up behaviour”.
Despite a growing trend of consumer interest in wellness overall, the use of mental wellness check up and counselling services is currently not a normalised behaviour.
While researchers have demonstrated that mental illness is stigmatised and that help-seeking behaviours in this area are negatively influenced as a result, it is not known if the same is true in the domain of mental wellness.
The research focus of this study is therefore to ascertain whether cultural stigmas influence check-up and broader help-seeking behaviours in the mental wellness arena.
Why is it important and worthy of research effort?
This research is important as it will provide consumer insights that will assist marketeers to develop programs that help consumers to overcome barriers to seeking help in developing positive mental health strategies.
These programs are important because mental health is a major concern in Australia and comes at a public cost of AU$207 billion annually (Source; The Fairfax-Lateral Economics Wellbeing Index, 2016).
However, mental wellness is much more than the mere prevention and treatment of mental illness. It represents a transformational change in attitudes and behaviour towards mental health itself. This new paradigm for mental health can be paraphrased in the simple consumer question ‘how mentally well could I be?'. The deeper understanding of consumer awareness, saliency, and attitudes towards mental wellness and usage of mental wellness services that this research will deliver are a start point in the development of a new body of knowledge to help to inform answers to this question.
In addition, and for the same reasons as cited above, this research is also of potential value to government marketing departments, public health organisations, academics and mental health thought leaders globally.
Research gaps and contribution
The key research gaps that this study will address fit into two broad categories; the first concerns creating a new academic narrative on stigma that focuses on wellness, and the second concerns the more complex area of comprehension and interpretation of the term mental wellness itself.
A new narrative on stigma and mental wellness
The academic narrative concerning the stigmatisation of mental health services is inherently focused on mental illness.
Recent research effort has focused on defining and categorising stigmas associated with mental illness and their impact on help seeking behaviour. Although Corrigan began researching mental illness stigmatisation in the late 1990's it wasn't until 2002 that with Watson, he categorised stigma as ‘public stigma' and ‘self stigma' and broke each of these down further into stereotypes, prejudice and discrimination. This definition is reviewed and revised by Thornicroft et al (2007), in which the term stigma is broken down into three problem areas: problems of knowledge (ignorance or misinformation), problems of attitudes (prejudice), and problems of behaviour (discrimination). Schomerus and Angermeyer (2008) and Hunt and Eisenberg (2010) agree that fear of psychological labelling often leads people to avoid or delay seeking professional help for mental illness and that, if the stigma is internalised, as Corrigan and Watson (2002) asserted, it can further reduce the likelihood of seeking help.
In the social marketing discipline, Nelson GD, Barbaro MB (1985) agree that while there are stigma associated with mental illness, there are communication solutions to address it. They also found that the degree of impact is contingent on how amenable the target audience is to the message. In the case of mental illness, the lower level of acceptability presents an even greater challenge.
However, mental illness and mental wellness are different and as such it is necessary to start a new narrative and examine stigmas from a lens of mental wellness (free from assumptions that the same outcomes will necessarily prevail). This is a clear research gap that merits specific research effort.
Conducting this study in the marketing discipline will provide consumer insights that will assist marketeers to develop strategies that help consumers to overcome barriers to seeking help from mental wellness professionals.
Comprehension and interpretation of the term mental wellness
As far as academic literature is concerned, mental wellness covers two perspectives (1) the subjective experience of happiness and life satisfaction (the hedonic perspective) e.g., Kahneman, 1999; and (2) positive psychological functioning, good relationships with others and self realisation (the eudaimonic perspective) e.g. Ryff, 1989.
Most wellness researchers believe that a combination of both hedonia and eudaimonia is needed for an optimal existence. Keyes (2002) has described this as “flourishing” and Seligman (2002), and Peterson et al., (2005) have described it as the “full life”.
However, while researchers are directionally agreed on the meaning of the term mental wellness, consumer comprehension is not as good. The broad term wellness is used ubiquitously and variably in consumer literature and broadcast media and, as a result, mental wellness lacks clear and consistent meaning.
It is a stated aim of this research to create a clear consumer definition of mental wellness and articulation of its component parts through phenomenological enquiry.
A second research gap in the area of comprehension of mental wellness stems from the fact that much of it is focused on the development and validation of quantitative measurement instruments which include, or exclude, measurement scales depending on the perspective of the researcher.
For example Stewart-Brown and Janmohamed (2008) developed the Warwick-Edinburgh Mental Well-being Scale consisting of 14 scales that include both hedonic and eudaimonic perspectives. However, neither spirituality nor purpose in life are covered. The researchers considered these to go beyond current consumer understanding of mental well-being and their inclusion was thought likely to increase non-response.
Regardless of the validity of the rationale for doing this, it nonetheless prematurely edits out aspects of mental wellness that may be of potential importance to the consumer.
The second limitation is derived from the nature of the items actually included in the scales. For example the Affectometer 2 developed by Kammann & Flett (1983) was viewed predominantly as a measure of mental illness, despite a balance of positive and negative items (Tennant et al., 2006). Again, this limits and potentially even misinforms the dialogue about mental wellness.
These limitations surface an important signpost regards research methodology.
As we are interested in all aspects of mental wellness, the proposed phenomenological approach will ensure that the responses solicited cover the complete and unedited spectrum of consumer perspectives on the subject.
Summary of Research Contribution
In summary, this study will start a new narrative on stigmatisation of mental health services that is focussed on mental wellness. It will deliver a consumer definition of mental wellness and an articulation of all of its facets. It will also ascertain whether mental wellness check up and other help seeking behaviour is negatively influenced by stigma by exhuming consumer insights pertaining to the comprehension of, attitudes towards and propensity to use mental wellness services.
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