The Effect of Newspaper Publicity on a Mental Health Center's Community Visibility James K. Morrison, Ph.D.* Judith A. Libow, B.A.
ABSTRACT: A community mental health center conducted a street survey to determine the community visibility of its facility and service. Following newspaper publicity about the center, another sample was taken which indicated the publicity had significantly increased the community's awareness of the center. Six weeks later the community was again surveyed and results indicated that the publicity effect on visibility was generally quite stable. It is concluded that centers with low visibility in the community can drastically increase that visibility through use of the media.
Although some researchers (Goldman, 1970; Heinemann, Perlmutter, & Yudin, 1974; Ring & Schein, 1970; Tomlinson, 1971) have recently studied the community's awareness of available mental health services, no one has yet reported figures indicating that the community is very knowledgeable of such services. Even though it is certainly not unusual for community mental health centers to make use of the media to heighten community awareness of their services, no one has yet reported an attempt to study the effect of publicity on community awareness of psychiatric services. Unlike professionals in the advertising industry, mental health professionals have not taken the time to evaluate the effect of the media on public awareness or knowledge of mental health services (Rosen & Tallman, 1965). It was the purpose of the present study to (1) determine the level of awareness within a specific community related to a mental health center's existence, location, and services; (2) specify the impact of limited newspaper publicity on that level of awareness; and (3) determine the stability of that impact over time. DESCRIPTION OF CENTER AND ITS SERVICES The Capital District Psychiatric Center is a comprehensive mental health facility, providing services in a four-county area through a number of satellite outreach offices. The center offers aftercare services primarily to patients living in the community who have a history of psychiatric hospitalization in state mental institutions. The center's satellite clinic in
*Dr. Morrison is a clinical psychologist and team leader with the Capital District Psychiatric Center in Cohoes, New York ( 1 4 Woodlake Road South, Albany, New York 12203). Ms. Libow is presently completing her doctoral studies in psychology at the State University of New York at Albany. Further details on the Visibility Survey Questionnaire and on the study itself may be obtained from the senior author. 58
Community Mental Health Journal, Vol. 13 (1), 1977
James K. Morrison and Judith A. Libow
59
C o h o e s , N e w York, i n e x i s t e n c e for 5 y e a r s , e m p l o y s f i v e f u l l - t i m e staff ( o n e p s y c h o l o g i s t , o n e social w o r k e r , t h r e e m e n t a l h e a l t h t h e r a p y ai d es) , t h r e e p a r t - t i m e staff ( o n e p s y c h i a t r i s t , o n e v o c a t i o n a l r e h a b i l i t a t i o n c o u n s e l o r , o n e p s y c h o l o g i s t ) , a n d a n u m b e r of s t u d e n t s ( p s y c h i a t r i c r e s i d e n t s , p s y c h o l o g y i n t e r n s , a n d so on). T h i s clinic p r o v i d e s a w i d e r a n g e of s e r v i c e s i n c l u d i n g i n d i v i d u a l a n d g r o u p p s y c h o t h e r a p y , m e d i c a t i o n , e d u c a t i o n a l a n d social p r o grams, and advocacy assistance. THE COMMUNITY The Cohoes community,
t o t a l i n g a p p r o x i m a t e l y 19,000
p e o p l e ( a c c o r d i n g to a r e c e n t f e d e r a l c e n s u s ) , is s i t u a t e d i n t h e m i d s t of a l a r g e tricity area. T h e c o m m u n i t y
is a l m o s t e x c l u s i v e l y w h i t e , a n d h a s a h i g h
n u m b e r of c i t i z e n s o n w e l f a r e . O n c e a h i g h l y i n d u s t r i a l i z e d c o m m u n i t y , t h e city p r e s e n t l y f i n d s itself w i t h a l a r g e n u m b e r of u n e m p l o y e d r e s i d e n t s w h o ar e e x p e r i e n c i n g a w i d e r a n g e of social, e c o n o m i c , a n d p s y c h i a t r i c p r o b l e m s .
METHOD
The Survey Instrument The measure employed in this study to determine the visibility of the clinic and its services in the community is the Visibility Survey Questionnaire (VSO). This instrument consists of five questions 1. Have you ever heard of the Capital District Psychiatric Center in Cohoes? 2. Do you know the location of their offices? 3. Do you know what services this agency provides? 4. Do you know anyone in Cohoes who receives services or help from this agency? 5. Would you care to make any comments about this agency? Only the first three questions are of concern in the present study. The sample was asked to respond to each question with one of three answers (yes, no, not sure). The questionnaire form also included space to record comments and limited demographic data (age and sex of respondent).
Procedure Since random and stratified sampling of the community would have been too costly in terms of time and manpower, an "accidental sample" appeared to be the procedure of choice. Ten persons (five male and five female), ranging in age from 16 to 36 years, conducted the visibility survey in one area of the community, that is, the one main street of the city. All of the interviewers were trained in interviewing skills and procedures by the senior author. The interviewers attempted to interview each person (16 years of age or older) who approached their survey area unless the interviewers were already actively engaged in the interviewing process. After the first survey (n = 105) was conducted, a relatively short article (with accompanying picture) about the Capital District Psychiatric Centers office appeared in a local newspaper. The article described the dinic, its location, and its service. The day after the article appeared, a second survey sample (n = 100) was taken in the same area of the community. Finally, 6 weeks after the newspaper article, a third survey (n = 106) was conducted in the same location to determine the stability of the effect of the newspaper article on the reported visibility (that is, awareness of the existence, location, and services) of the psychiatric center office. It should be mentioned that even though the sample number was limited and the sampling procedure not randomized, the three samples were comparatively similar in age and sex distribution. The age and sex distributions of the samples also compared favorably with the same distributions in the total population according to the most recent federal census.
60
Community Mental Health Journal
RESULTS Analysis of the effect of publicity on the agency's visibility in the community was performed by using the Z test for differences between proportions. Table 1 presents the percentage of respondents in each sample who answered "yes," "no," and "not sure" to each of the three survey questions of relevance to this study. These results indicate that the article had a significant effect on the reported visibility of the Capital District Psychiatric Center in the community. Comparing the change in percentages over samples related to responses to question 1 (whether respondents had heard of the district center), it was evident that the agency's visibility (defined here as the percentage responding "yes") had significantly increased from sample 1 (before the article) to sample 2 (day following the article) in the predicted direction (Z = 3.70, p < .01). Similarly, the visibility increase remained relatively stable as indicated by the significant difference in visibility, evidenced in the follow-up at 6 weeks, between samples 1 and 3 (Z = 3.15, p < .01). Related to question 2 (location of offices) the awareness of the psychiatric center office location significantly increased from sample 1 to sample 2 (Z = 2.69, p < .01). However, this effect evidently was not lasting as indicated by the comparison of sample 1 and sample 3 percentage differences (Z = 1.00, n.s.).
After the article, the community's awareness level of the clinic's services TABLE 1 Percentage Response to Each Question Over Sample Phases
Response
i.
yes
28,6
53.0
49.1
no
63.8
47.0
50.0
not sure 2.*
7.6
0~
Phase III (n=106~
0.9
yes
17.1
33.0
22.6
no
10.5
15.0
25.5
8.6
5.0
1.9
yes
13.3
27.0
27.4
no
17.2
24.0
22.6
5.7
2.0
0.0
not sure 3.
Phase I (n=105)
SAMPLES Phase II (nffilO0)
Question
not sure
*The p e r s o n s r e s p o n d i n g t o q u e s t i o n s 2 and 3 were t h o s e sample
r e s p o n d e n t s who answered " y e s " o r " n o t s u r e " t o Q u e s t i o n 1.
James K. Morrison and Judith A. Libow
61
(question 3) appeared to increase significantly (Z = 2.54, p < .05). This effect was stable 6 weeks later as indicated by the significantly different visibility percentages from sample 1 to sample 3 (Z = 2.66, p < .01). None of the comparisons of sample 2 and 3 percentages differed significantly, indicating that the stability of the effect of publicity on community awareness was genuine. In analyzing the visibility increases (questions 1, 2, and 3) related to the sex of the respondents, it was evident that the newspaper article had had its greatest initial impact on females, but that the effect was much more permanent among males. Related to the age of respondents, the newspaper publicity appeared to have the greatest impact on the 45 to 64 year-old group, and the least impact on the 15 to 24 year-old group. However, some caution should be taken in forming conclusions from the data related to sex and age breakdowns. The samples were actually too small to reach any firm conclusions related to the differential effect of publicity dependent on sex and age. Further study with larger samples will be necessary before any strong conclusions can be drawn. DISCUSSION It was most surprising to the authors that one newspaper article could have such impact on the visibility of the Capital District Psychiatric Center satellite office. Not only was the dramatic visibi|ity increase after the article quite unexpected, but the stability of this increase over 6 weeks time was equally surprising. The one exception concerned the community's awareness of the office location after 6 weeks. However, it is not surprising that after such a length of time people would tend to forget the location of an agency. (In the newspaper article the location of the agency had actually been mentioned only once.) One may well question whether the change in agency visibility may have perhaps been due to other factors. Although this is, of course, always possible, the authors could recall no event from the time of sample 1 to sample 3, other than the newspaper article, that could have accounted for the dramatic change. Furthermore, the survey team was instructed on sample 2 to ask a further question ("How did you hear about the Capital District Psychiatric Center?") of those responding affirmatively to question 1. Of those responding "yes" to this question, 63% declared that they had heard of the psychiatric center through the newspaper article. This would suggest that the article had indeed accounted for much of the visibility change. The results of this study, related to the percentage of respondents w h o had heard of the agency in question, compare favorably with the results of other studies (Goldman, 1974; Heinemann, Perlmutter, & Yudin, 1974; Tomlinson, 1971). The visibility changes of the psychiatric center seem surprisingly great in light of the visibility percentages, ranging from 4% to 30%, mentioned in the studies cited above.
62
Community Mental Health Journal
CONCLUSIONS Newspaper publicity, focusing on mental health centers and their services, can apparently have rather dramatic effects on the visibility of such facilities in the community; and the impact of such articles seems to remain quite strong even 6 weeks after the publicity event. Although such a conclusion can be only tentative at this time, preliminary results also suggest that publicity regarding community services may differentially affect persons of different sex and age. Further examination of the effectiveness of different media on reaching particular populations would allow for more effective community outreach to targeted community groups. REFERENCES Goldman, A. Jefferson Community Mental Center, 1970. Personal communication to S. H. Heinemann, 1974. Heinemann, S. H., Perlmutter, F., & Yudin, L. W. The community mental health center and community awareness. Community Mental Health Journal, 1974, 10, 221-227. Ring, S. I., & Schein, L. Attitudes toward mental illness and the u s e of caretakers in a black community. American Journal of Orthopsychiatry, 1970, 40, 710-716. Rosen, A. C., & Tallman, F. F. A study of the u s e of mental health media by the lay public. Mental Hygiene, 1965, 49, 36-45. Tomlinson, F. L. A study of consumers' a w a r e n e s s of resources in their own community for the treatment of emotional problems. U n p u b l i s h e d masters thesis, school of Social Work, University of Pennsylvania, 1971.
ABSTRACT: A community mental health center conducted a street survey to determine the community visibility of its facility and service. Following newspaper publicity about the center, another sample was taken which indicated the publicity had significantly increased the community's awareness of the center. Six weeks later the community was again surveyed and results indicated that the publicity effect on visibility was generally quite stable. It is concluded that centers with low visibility in the community can drastically increase that visibility through use of the media.
Although some researchers (Goldman, 1970; Heinemann, Perlmutter, & Yudin, 1974; Ring & Schein, 1970; Tomlinson, 1971) have recently studied the community's awareness of available mental health services, no one has yet reported figures indicating that the community is very knowledgeable of such services. Even though it is certainly not unusual for community mental health centers to make use of the media to heighten community awareness of their services, no one has yet reported an attempt to study the effect of publicity on community awareness of psychiatric services. Unlike professionals in the advertising industry, mental health professionals have not taken the time to evaluate the effect of the media on public awareness or knowledge of mental health services (Rosen & Tallman, 1965). It was the purpose of the present study to (1) determine the level of awareness within a specific community related to a mental health center's existence, location, and services; (2) specify the impact of limited newspaper publicity on that level of awareness; and (3) determine the stability of that impact over time. DESCRIPTION OF CENTER AND ITS SERVICES The Capital District Psychiatric Center is a comprehensive mental health facility, providing services in a four-county area through a number of satellite outreach offices. The center offers aftercare services primarily to patients living in the community who have a history of psychiatric hospitalization in state mental institutions. The center's satellite clinic in
*Dr. Morrison is a clinical psychologist and team leader with the Capital District Psychiatric Center in Cohoes, New York ( 1 4 Woodlake Road South, Albany, New York 12203). Ms. Libow is presently completing her doctoral studies in psychology at the State University of New York at Albany. Further details on the Visibility Survey Questionnaire and on the study itself may be obtained from the senior author. 58
Community Mental Health Journal, Vol. 13 (1), 1977
James K. Morrison and Judith A. Libow
59
C o h o e s , N e w York, i n e x i s t e n c e for 5 y e a r s , e m p l o y s f i v e f u l l - t i m e staff ( o n e p s y c h o l o g i s t , o n e social w o r k e r , t h r e e m e n t a l h e a l t h t h e r a p y ai d es) , t h r e e p a r t - t i m e staff ( o n e p s y c h i a t r i s t , o n e v o c a t i o n a l r e h a b i l i t a t i o n c o u n s e l o r , o n e p s y c h o l o g i s t ) , a n d a n u m b e r of s t u d e n t s ( p s y c h i a t r i c r e s i d e n t s , p s y c h o l o g y i n t e r n s , a n d so on). T h i s clinic p r o v i d e s a w i d e r a n g e of s e r v i c e s i n c l u d i n g i n d i v i d u a l a n d g r o u p p s y c h o t h e r a p y , m e d i c a t i o n , e d u c a t i o n a l a n d social p r o grams, and advocacy assistance. THE COMMUNITY The Cohoes community,
t o t a l i n g a p p r o x i m a t e l y 19,000
p e o p l e ( a c c o r d i n g to a r e c e n t f e d e r a l c e n s u s ) , is s i t u a t e d i n t h e m i d s t of a l a r g e tricity area. T h e c o m m u n i t y
is a l m o s t e x c l u s i v e l y w h i t e , a n d h a s a h i g h
n u m b e r of c i t i z e n s o n w e l f a r e . O n c e a h i g h l y i n d u s t r i a l i z e d c o m m u n i t y , t h e city p r e s e n t l y f i n d s itself w i t h a l a r g e n u m b e r of u n e m p l o y e d r e s i d e n t s w h o ar e e x p e r i e n c i n g a w i d e r a n g e of social, e c o n o m i c , a n d p s y c h i a t r i c p r o b l e m s .
METHOD
The Survey Instrument The measure employed in this study to determine the visibility of the clinic and its services in the community is the Visibility Survey Questionnaire (VSO). This instrument consists of five questions 1. Have you ever heard of the Capital District Psychiatric Center in Cohoes? 2. Do you know the location of their offices? 3. Do you know what services this agency provides? 4. Do you know anyone in Cohoes who receives services or help from this agency? 5. Would you care to make any comments about this agency? Only the first three questions are of concern in the present study. The sample was asked to respond to each question with one of three answers (yes, no, not sure). The questionnaire form also included space to record comments and limited demographic data (age and sex of respondent).
Procedure Since random and stratified sampling of the community would have been too costly in terms of time and manpower, an "accidental sample" appeared to be the procedure of choice. Ten persons (five male and five female), ranging in age from 16 to 36 years, conducted the visibility survey in one area of the community, that is, the one main street of the city. All of the interviewers were trained in interviewing skills and procedures by the senior author. The interviewers attempted to interview each person (16 years of age or older) who approached their survey area unless the interviewers were already actively engaged in the interviewing process. After the first survey (n = 105) was conducted, a relatively short article (with accompanying picture) about the Capital District Psychiatric Centers office appeared in a local newspaper. The article described the dinic, its location, and its service. The day after the article appeared, a second survey sample (n = 100) was taken in the same area of the community. Finally, 6 weeks after the newspaper article, a third survey (n = 106) was conducted in the same location to determine the stability of the effect of the newspaper article on the reported visibility (that is, awareness of the existence, location, and services) of the psychiatric center office. It should be mentioned that even though the sample number was limited and the sampling procedure not randomized, the three samples were comparatively similar in age and sex distribution. The age and sex distributions of the samples also compared favorably with the same distributions in the total population according to the most recent federal census.
60
Community Mental Health Journal
RESULTS Analysis of the effect of publicity on the agency's visibility in the community was performed by using the Z test for differences between proportions. Table 1 presents the percentage of respondents in each sample who answered "yes," "no," and "not sure" to each of the three survey questions of relevance to this study. These results indicate that the article had a significant effect on the reported visibility of the Capital District Psychiatric Center in the community. Comparing the change in percentages over samples related to responses to question 1 (whether respondents had heard of the district center), it was evident that the agency's visibility (defined here as the percentage responding "yes") had significantly increased from sample 1 (before the article) to sample 2 (day following the article) in the predicted direction (Z = 3.70, p < .01). Similarly, the visibility increase remained relatively stable as indicated by the significant difference in visibility, evidenced in the follow-up at 6 weeks, between samples 1 and 3 (Z = 3.15, p < .01). Related to question 2 (location of offices) the awareness of the psychiatric center office location significantly increased from sample 1 to sample 2 (Z = 2.69, p < .01). However, this effect evidently was not lasting as indicated by the comparison of sample 1 and sample 3 percentage differences (Z = 1.00, n.s.).
After the article, the community's awareness level of the clinic's services TABLE 1 Percentage Response to Each Question Over Sample Phases
Response
i.
yes
28,6
53.0
49.1
no
63.8
47.0
50.0
not sure 2.*
7.6
0~
Phase III (n=106~
0.9
yes
17.1
33.0
22.6
no
10.5
15.0
25.5
8.6
5.0
1.9
yes
13.3
27.0
27.4
no
17.2
24.0
22.6
5.7
2.0
0.0
not sure 3.
Phase I (n=105)
SAMPLES Phase II (nffilO0)
Question
not sure
*The p e r s o n s r e s p o n d i n g t o q u e s t i o n s 2 and 3 were t h o s e sample
r e s p o n d e n t s who answered " y e s " o r " n o t s u r e " t o Q u e s t i o n 1.
James K. Morrison and Judith A. Libow
61
(question 3) appeared to increase significantly (Z = 2.54, p < .05). This effect was stable 6 weeks later as indicated by the significantly different visibility percentages from sample 1 to sample 3 (Z = 2.66, p < .01). None of the comparisons of sample 2 and 3 percentages differed significantly, indicating that the stability of the effect of publicity on community awareness was genuine. In analyzing the visibility increases (questions 1, 2, and 3) related to the sex of the respondents, it was evident that the newspaper article had had its greatest initial impact on females, but that the effect was much more permanent among males. Related to the age of respondents, the newspaper publicity appeared to have the greatest impact on the 45 to 64 year-old group, and the least impact on the 15 to 24 year-old group. However, some caution should be taken in forming conclusions from the data related to sex and age breakdowns. The samples were actually too small to reach any firm conclusions related to the differential effect of publicity dependent on sex and age. Further study with larger samples will be necessary before any strong conclusions can be drawn. DISCUSSION It was most surprising to the authors that one newspaper article could have such impact on the visibility of the Capital District Psychiatric Center satellite office. Not only was the dramatic visibi|ity increase after the article quite unexpected, but the stability of this increase over 6 weeks time was equally surprising. The one exception concerned the community's awareness of the office location after 6 weeks. However, it is not surprising that after such a length of time people would tend to forget the location of an agency. (In the newspaper article the location of the agency had actually been mentioned only once.) One may well question whether the change in agency visibility may have perhaps been due to other factors. Although this is, of course, always possible, the authors could recall no event from the time of sample 1 to sample 3, other than the newspaper article, that could have accounted for the dramatic change. Furthermore, the survey team was instructed on sample 2 to ask a further question ("How did you hear about the Capital District Psychiatric Center?") of those responding affirmatively to question 1. Of those responding "yes" to this question, 63% declared that they had heard of the psychiatric center through the newspaper article. This would suggest that the article had indeed accounted for much of the visibility change. The results of this study, related to the percentage of respondents w h o had heard of the agency in question, compare favorably with the results of other studies (Goldman, 1974; Heinemann, Perlmutter, & Yudin, 1974; Tomlinson, 1971). The visibility changes of the psychiatric center seem surprisingly great in light of the visibility percentages, ranging from 4% to 30%, mentioned in the studies cited above.
62
Community Mental Health Journal
CONCLUSIONS Newspaper publicity, focusing on mental health centers and their services, can apparently have rather dramatic effects on the visibility of such facilities in the community; and the impact of such articles seems to remain quite strong even 6 weeks after the publicity event. Although such a conclusion can be only tentative at this time, preliminary results also suggest that publicity regarding community services may differentially affect persons of different sex and age. Further examination of the effectiveness of different media on reaching particular populations would allow for more effective community outreach to targeted community groups. REFERENCES Goldman, A. Jefferson Community Mental Center, 1970. Personal communication to S. H. Heinemann, 1974. Heinemann, S. H., Perlmutter, F., & Yudin, L. W. The community mental health center and community awareness. Community Mental Health Journal, 1974, 10, 221-227. Ring, S. I., & Schein, L. Attitudes toward mental illness and the u s e of caretakers in a black community. American Journal of Orthopsychiatry, 1970, 40, 710-716. Rosen, A. C., & Tallman, F. F. A study of the u s e of mental health media by the lay public. Mental Hygiene, 1965, 49, 36-45. Tomlinson, F. L. A study of consumers' a w a r e n e s s of resources in their own community for the treatment of emotional problems. U n p u b l i s h e d masters thesis, school of Social Work, University of Pennsylvania, 1971.
