A mental illness is a health problem that significantly affects how a person feels, thinks, behaves, and interacts with other people (Stuart, 2006). Eating Disorders (EDs) fit into a large group of disorders based around severe disturbances in eating behaviour characterised by preoccupation with weight concern and body image, damaging health and psychosocial functioning (Dawson, Mullan, Touyz, Rhodes, 2018). Occurring worldwide yet most commonly in young women in Western cultures with an estimate that about 1% develop anorexia nervosa and 2-3% develop bulimia nervosa (Anderson & Yager, 2005). Whilst the etiology of these disorders is complex, nonetheless, the “thin ideal” or media pressure, promote and increase the obsession with weight loss and body image (Shaw & Homewood, 2015). EDs have a standardised mortality rate that is 12 times higher than the annual death rate from all causes in females aged 15 to 24 years of age (NEDC, 2019).
Stigmas create social distance and therefore decrease the likelihood that society responds to EDs as a problem worth helping (Puhl & Suh, 2015). This stigma creates prejudice and discrimination which encourages feelings of helplessness and embarrassment amongst those struggling with EDs, forming a barricade between diagnosis and treatment (Hay, 2009). The NEDC Youth Consultation identified significant levels of stigmatising attitudes amongst 12–17-year-olds with 51.3% strongly agreeing that individuals with EDs should ‘snap out of it’ (NEDC, 2019).
Mental health awareness initiatives are an intervention strategy reducing the prevalence of EDs given highly exposed programs stimulate discussion and enhance public exposure. An example is Eating Disorder Awareness Week, increasing public recognition of the preventive and supportive alternatives for individuals suffering from EDs. The erroneous notion that ED’s are subject to typical young Western women image persists, fuelled by continuous stereotypes within social media (Madden, Morris, Zurynski, Kohn & Elliot, 2009). To reduce stigma correlated with EDs, it is crucial that public awareness is increased within society. Achieved through the ‘Me Too’ and ‘Support Not Stigma’ models targeting the elimination of stigma, shame and loneliness within individual’s with EDs (Bulik, Sullivan, Wade & Kendler, 2000). Social media plays an imperative role in propagating inaccurate and discouraging information about EDs, nurturing negative body image and unhealthy eating behaviours (Berkman, Lohr & Bulik, 2007). A failure to address the medias’ role in the promotion of unhealthy social norms results in the limited effectiveness of an ED awareness campaign (Beaumont & Touyz, 2003).
Awareness programs provide individuals supportive interactions helping foster well-being and courage positively impacting mental health outcomes as they educate society and illustrate an encouraging view of mental health (Hoagwood & Erwin, 1997). The current campaign is a social media ad post on Twitter, Facebook and Instagram aiming to increase the awareness of EDs and provide a resource for individuals to seek help, share their experiences and feel as if they are not alone. Social media is a predominant element amongst awareness campaigns as social networking provides spaces to increase public awareness and provide accurate information regarding mental health (Saha, Webber, Birnbaum, & Choudhury, 2017). Social Media is emerging as a powerful tool increasing awareness of EDs effectively rather than direct communication given the continuous expansion of technology (Branley & Covey, 2017). Facebook, Twitter, and Instagram facilitate many-to-many communication rather than customary one-to-one communication. Through using social media as a platform for ED awareness, campaigns actively work as a catalyst altering the dynamics opinions based around EDs (Sharma, Kilian & Leung, 2014). Data suggest that 83% of 18-29-year-olds use social networking sites hence younger demographic (15–30-year-old women) target audience (Duggan & Brenner, 2012). Women are targeted given that females have a 1.75-3 times higher lifetime prevalence of EDs compared to males (Hudson, Hiripri, Pope & Kessler, 2007).
Within campaigns several psychological methods are employed to influence individuals such as the use of colour provoking emotional responses, underlying messages, and statistics (O’Shaughnessy & O’Shaughnessy, 2004). The use of colour elicits emotional responses from individuals as specific colours influence the emotional behaviour through attracting attention and highlighting elements of campaigns (Lee & Barnes, 1989). Given the target audience of the campaign is young women the pink and purple colour scheme is a key element in the success of the campaign. Purple is the ED awareness colour correlated with emotions of power and strength whereas pink provokes qualities related to femineity: nurturance and compassion (Schindler, 1986). Combining these colours creates a foundation for an individual to react to exposure of the campaign through psychological response resulting in either a provoked feeling or an interaction to find out more (Hay, 2009). The absence of information provided on the campaign is due to decreasing the cognitive load of the individual. Studies have shown that an individual’s cognitive load, amount of mental effort used by the working memory, dramatically impacts the evaluation of the information presented (Snyder & DeBono, 1985). Individuals presented with increased cognitive load, result in a decreased process of information (Manning & Amare, 2009). Therefore, the small amount of information provided is to the point which increases individuals to respond emotionally require minimal cognitive effort (Sweller, 2011).
The #METOO hashtag and the QR code in the campaign are techniques of social proof heuristics. Social Proof is the theory that individuals adopt beliefs or actions of a group (Cialidini, 1984). The ‘Me Too” movement is an example of this theory within society. The idea that if an individual sees the response of a many people, they are more likely to join in, emphasising the social influence on an individual’s behaviour, decreasing feelings of loneliness and stigma (Sah & Fugh-Berman, 2013). Mental health recovery narratives are known as first-person lived experience accounts of recovery from mental illnesses relating to events which are comprised of features of adversity and struggle throughout mental health journeys (Llewellyn-Beardsley et al., 2019). The QR code on the campaign links a Beyond Blue sharing page where individuals can read other ED stories and post their own experiences. This recovery narrative provides elements that resonate with personal experience to increase empathy and understanding as well as provide companionship throughout times of isolation (Deegan, 1988)
Research indicates that social media is a successful assessment strategy for analysing public attitude toward controversial topics, such as mental health (Berryman, Ferguson & Negy, 2018). Therefore, social media platforms aid in providing resources to effectively reach individuals struggling with EDs. The social media platform provides a foundation for promotion individuals searching for information and encourage getting in touch with health care providers (Booth, Allen, Jenkyn, Li & Shariff, 2018). Studies have found that individuals engaging social media awareness campaigns results in behaviour related to seeking help is a crucial factor in decreasing the stigma around mental health of young people (McLean, Caldwell, Roberton, 2019). On average more than 2.1 billion people use Facebook and Instagram every day given this, the campaign is promoted on social media as such a large amount of the population will be exposed to the campaign, increasing the chances of awareness (Levac & O’Sullivan, 2010). Given social media platforms are available 24/7, the campaign is consistently available to those all around the world. According to social modelling, an individual’s behaviour and actions are affected by other’s actions (Bandura, 1977). Demonstrated in a study in 2018, 90% of teenagers aged 13-17 use social media and 51% use these social media sites more than once per day (American Academy of Child and Adolescent Psychiatry, 2018). Therefore, further influencing the importance of the target audience.
It is imperative that a community is built through individual awareness of EDs and an understanding of the importance behind seeking support and treatment, achieved through social media campaigns such as the advertisement at hand. A strength of the campaign, as previously mentioned, is that given it is uploaded onto social media platforms, this allows for it to be accessible 24/7 and is able to reach a larger demographic all around the world. Although, given there is such an extensive supply of content on social media, this can disadvantage the campaign as it needs to be catchy or it will just be scrolled past (Latha, Meena, Pravitha & Dasgupta, 2020). The effectiveness of the campaign is able to be tracked through the QR code, allowing for the number and the location of scans to the Beyond Blue sharing recovery story page. However, recovery narratives can also contribute to distress or act as a trigger within an individual, e.g., if the individual feels angry perceiving that they have experienced greater hardship than the narrator (Shaw & Homewood, 2015). Whilst the short-term effects of reducing stigma and raising awareness around EDs increases the reported incidence of ED in our community, the longer-term goal is the effective immunisation of individuals against the risk of EDs (Nurser, Rushworth, Shakespeare & Williams, 2018).