How ‘asking the question’ led local partners to national honor
June 8, 2023
This easily could be a story about a perfect score in a national business competition.
It just as easily could become a case study about marketing optimization – research through collateral to leveraging a message through unique constituencies.
But, in the big, most important picture, this is a story about nothing less than saving lives.
How many? We’ll never truly know.
If it’s one, it’s worth it, those involved say. But it’s likely many more.
“Asking the question directly is critical,” said Janet Kittams, CEO of the Helpline Center.
“’Are you thinking of hurting yourself?’ is a different aspect from ‘Are you thinking about suicide?’”
Ask the question. Ask that question. Are you thinking about suicide?
“I think a lot of people are hesitant to use the word ‘suicide,’ and this campaign puts it right out there for them to ask the question,” Kittams said. “I think because of that, it has lowered the stigma and reluctance people have.”
Technically, Ask the Question wasn’t a Helpline Center campaign. That point somehow is both irrelevant and entirely relevant to its success.
It was conceived by Avera Health last year, following an increase in suicides in 2021. But it’s the way so many organizations embraced the campaign that set it apart.
Ask the Question recently won two Gold Stevie awards for Avera Marketing, including the highest rated nomination of the year out of more than 3,700 entries.
“This took a lot of partners to make happen,” said Lindsey Meyers, vice president of public relations for Avera Health.
“I think we’re all stronger if we work on something together rather than go our separate directions, and I think you’ll see that with this campaign and this effort.”
‘A burning platform’
In 2021, the first full year of the COVID-19 pandemic also brought a record number of suicide deaths in South Dakota with 189.
“One suicide is too many, but that was a record, all-time high,” said Thomas Otten, assistant vice president for Avera Behavioral Health Hospital.
“We clearly saw both mental health and suicides were increasing over the last several years – COVID was certainly a piece of that – but there were a whole lot of other factors. … If there was a burning platform, that was part of that platform – to say, ‘We’ve got to do something.’”
Avera had begun internally evaluating what that “something” looked like when the crisis hit tragically close to home.
The health system’s board chair, Interstate Office Products CEO Gary Gaspar, died from suicide in March 2022.
“What can be done? What does it look like?” Otten said.
Partnering with the state of South Dakota, Avera reviewed the patient files of every person who had ever touched the health care system and later committed suicide.
“We were trying to figure out is there any sort of precipitating factor,” Otten said. “When ‘X’ happens, suicide is going to follow.”
The short answer is not really. For a small number, chronic pain was a precipitating sign. For an even smaller number, it was financial issues. But for the vast majority, “there was nothing that would trigger it,” Otten said. “There was no significant event you could ever guess who was going to commit suicide and who wasn’t.”
What the research did reveal, however, was the effectiveness of asking one key question: Are you thinking about suicide?
“The question has to be very direct,” Meyers said. “Are you thinking about committing suicide?”
Not “are you having a bad day?” Or “are you thinking about hurting yourself?”
“This is not the way to go and is not going to save lives,” Meyers said.
So what began as an idea for internal communication shifted to an external awareness campaign.
“It was a very backwards approach to marketing,” Meyers said. “We backed into the campaign through an internal issue we were trying to solve.”
Creating a campaign
The timing fit. The Avera Foundation was in the middle of its Light the Way campaign to support expansion of the Behavioral Health Hospital and its services.
“Our community and benefactors were informed about the behavioral health challenges that our community – and really, across the nation you’re seeing statistics – and we were able to highlight those,” said Dzenan Berberovic, chief philanthropy officer.
“We had individuals provide six- and seven-figure gifts to the capital campaign who then provided support to Ask the Question as well. And for many, it was (precipitated) through lived experiences, watching someone they care about live those challenges.”
The philanthropic support allowed a marketing campaign that hadn’t been originally planned to start to be delivered.
“We wanted to make sure we were reaching multiple audiences because suicide prevention touches so many lives,” said Nikki Foster, Avera Health marketing strategy partner.
That meant leveraging not only traditional marketing techniques such as social media and mass media but also enlisting partners to help spread the message.
“We leveraged all our partnerships across the Avera footprint, and that’s where our most powerful messaging came from. We were able to extend the messaging more than we could have ever imagined,” Foster said. “One thing we found early on in this campaign is people are really hungry for this type of information and tools.”
The tools led to conversations. For instance, school districts across the Avera footprint – including Sioux Falls – placed banners in the halls but also marketing pieces in restrooms. They included QR codes leading to resources.
“Marketing doesn’t normally advertise in the restroom, but that was an effective place to have this messaging,” Meyers said. “It’s where people are alone and more vulnerable and could take a minute to snap that QR code.”
The Sioux Falls School District also approached Avera for monthly information that could be provided to parents and counselors on mental health topics ranging from bullying to gaming.
Then, the teens themselves became involved in the campaign, including a contest to produce the most effective short video to convey the message of Ask the Question.
“We wanted to not pretend we had the best message for teens,” Meyers said. “So we did a for-teens, by-teens project with one of the video classes, and they made reels for us of how they would want (to receive the message).”
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At the same time, Helpline Center was launching its 988 number designed for those in crisis. Kittams had worked with Avera throughout the formation of the Ask the Question campaign.
“I truly believe this marketing campaign prompted some of those conversations,” she said of 988 calls. “We receive a lot of third-party calls from family and friends.”
At Avera Behavioral Health, an urgent care center has opened, and patients are using it.
“We definitely saw volumes increase when this campaign was going on or even going to your own emergency department,” Otten said, adding that Avera also is working more closely with primary care and pediatric physicians to help them address mental health concerns.
Most critically, provisional data from 2022 shows the year appears not to have built on the prior year’s record increase.
“It’s trending downward,” Kittams said.
National honor, future plans
The Stevie Awards brands itself as the nation’s premier business awards. Created in 2002, its purpose is to honor and generate public recognition of the achievements and positive contributions of organizations and working professionals worldwide.
In this year’s American Business Awards competition, there were 3,700 submissions. Ask the Question won a Gold Stevie and also a Grand Stevie Award as the highest-rated nomination of the year and the only entry to receive a perfect 10.0 score.
One judge commented that the campaign was an “extremely important initiative in the present times of cut-throat competition, pressures on youth, general depression and many other factors that prompt abrupt end to life.”
Another judge said it was an “important campaign for so many people who struggle with mental illness,” with “solid messaging and clear outreach strategies.”
The perfect score left Meyers shocked, she said.
“It was amazing to read the judges’ comments and how they connected in such a short period of time and felt like it was truly important work happening in the United States,” she said.
The recognition already is leading to increase interest in the campaign from national organizations, said Kendra Calhoun, senior vice president for marketing, communications and digital experience for Avera Health.
“We have been asked by the Scottsdale Institute to present Ask the Question to their health system members from across the country,” she said. “This is such important work that Avera will share it with any health system who wants to help raise awareness and provide support for suicide prevention. Avera has a deep commitment to mental health care.”
From here, the campaign is looking at a second phase, Foster said.
“It’s an exciting time looking at the data from our first-round campaign,” she said. “We’re seeing engagement across the board, so really trying to work with the team and develop more education pieces and tools and information that’s going to really relate to all those age groups and audiences.”
The Avera Foundation is supporting that effort too, with a goal of launching in September with the start of school and suicide awareness month.
“It’s rare for donors to support marketing campaigns,” Berberovic said. “For us to find a project that people were so passionate about was really inspiring for our foundation team … and as we visited with constituents about phase two, we had folks say we’re happy to support this again.”
In the meantime, Avera will be honored next week by the Stevie Awards at a banquet in New York City.
This Saturday, Helpline Center will host its annual Step Forward to Prevent Suicide Walk in downtown Sioux Falls.
Gary Gaspar’s son James will be the featured speaker.
“After losing my dad to suicide, my family has found it important to be advocates for mental health care and suicide prevention,” he said. “We want to reduce the stigma around behavioral health care and encourage those in need to speak up and seek care. Suicide can affect anyone, even those who would otherwise be perceived to have a happy and healthy life. It’s my turn to come alongside other suicide-loss survivors and share my story about how suicide has impacted my life.”
Suicide loss has become so prevalent that on some level, it likely impacts nearly every life.
And while there are no universal solutions, there are three words now known to resonate.
Ask the question. It can make all the difference.
“I think last summer, when we started the work, we all felt that tingle that we were part of something really meaningful and special to each one of us,” Meyers said. “It’s uplifted our entire team.”
To connect with the resources provided by the Ask the Question campaign, click here.
Step Forward to Prevent Suicide Walk
Help raise awareness and funds with this annual event that includes a remembrance ceremony and 1.5-mile walk.
- When: 9 a.m. June 10.
- Where: Raven Amphitheater, 205 E. Sixth St.
- To learn more: Click below.
