Helen Osborne: Welcome to Health Literacy Out Loud. I’m Helen Osborne, President of Health Literacy Consulting, founder of Health Literacy Month and your host of Health Literacy Out Loud.

In these podcasts, you get to listen in on my conversations with some really remarkable people. Today, I’m talking with Adriana Bobinchock, who is a Senior Director of Public Affairs and Communications for McLean Hospital, the largest psychiatric affiliate of Harvard Medical School.

Adriana has worked in healthcare communications for more than 17 years and has a keen interest in educating the public about mental health.

In 2016, Adriana, along with her colleague Scott O’Brien, spearheaded McLean’s national public awareness campaign called Deconstructing Stigma: A Change in Thought Can Change a Life.

I read a news release about this project and was really intrigued, especially with how it raises awareness about such a difficult topic as mental illness by using stories, photos and much more, and does so in a very public space at Boston’s Logan Airport.

Welcome, Adriana.

Adriana Bobinchock: Hi, Helen. Thank you so much for having me today.

Helen Osborne: I’m so glad you’re on our podcast. Deconstructing Stigma, explain it to all of us. I’ve been to your website. I have yet to se it at Logan Airport, but I’m going there soon. Describe it to all of us.

Adriana Bobinchock: Deconstructing Stigma is a campaign that we started thinking about early last year, actually almost a year ago exactly. Really, what it is intended to do is to be really thought provoking and to get the public to think twice about how they perceive people with mental illness.

The campaign itself, as you eloquently addressed already, is really multi-modal. We have these larger-than-life images up at Logan Airport. We have a website and a book. We’ve been doing a lot of media, and all of the people who are participating in the project, in some way, have been affected by mental illness.

Helen Osborne: Paint a picture for us. We’re one media right now, just auditory, but make it multimedia for us. Can you describe one of these images of what it’s like?

Adriana Bobinchock: One of our participants, Rachel, has an eating disorder, depression and self-harm, and she joined the project because she wanted to educate people about what it’s like to live with these illnesses.

Helen Osborne: Rachel is a real person, right?

Adriana Bobinchock: She is a real person. Everybody that’s a participant is an actual person from somewhere in the United States.

What we wanted to capture though is that, yes, she has an eating disorder and she lives with anxiety, but that doesn’t define her.

We said to her, “What makes you happy?” and she said, “I love being outside. I love just soaking in the sunshine.” We took a gorgeous photo of her in an open field and she looks like an average 25-year-old woman who could be out for a daily hike and enjoying nature.

Helen Osborne: I’ve seen your images. They are compelling. They are absolutely stunning. It’s this larger-than-life image. You’re talking many feet high, bigger than the size of a real person?

Adriana Bobinchock: That’s correct. These images are eight feet tall.

Helen Osborne: Oh my goodness. Here is Rachel and a gorgeous picture of her outside. How do you start conveying the message about mental illness and deconstructing the stigma?

Adriana Bobinchock: We know that people don’t have a lot of time, particularly when they’re in the airport, so we created a narrative that was about 50 words to go onto these posters, and we hit it with a really large headline. Rachel says, “I want to educate people,” and then we go into her narrative.

The idea was we know it’s the images that are going to get people to stop. We have 38 of these pictures up at Logan Airport. It’s hard to miss.

Our idea was maybe somebody isn’t going to pick up and stop at Rachel’s because she doesn’t look like anybody they know, but three posters down they might recognize Darryl McDaniels from the hip hop band Run-D.M.C. They might recognize Howie Mandel or say, “Oh my gosh, I see that woman at the grocery store all the time.”

Helen Osborne: It’s 38 images in a row as you’re going down one of the terminals?

Adriana Bobinchock: Exactly. We call it a gallery. It’s between Terminal E and B. Any time you go to the airport now, you see people stopping and reading. In between the posters, we’ve also done infographics.

Helen Osborne: What’s that?

Adriana Bobinchock: We’ve created these really cool images to go along with statistics about mental health in general and also about mental health stigma. The idea was to tie everything together with the stories and also be providing some education.

One in five Americans will experience a mental illness. 75% of people who have been diagnosed with a mental illness also say that they’ve experienced stigma around it.

I think those are really powerful numbers. If you break them down with really eye-catching images, it’s a nugget of information that somebody can digest really easily and it’s going to stick with them.

Helen Osborne: What you’re describing to me is so powerful, hearing you talk about this and seeing the images online. Soon, I’ll see them in person, and I’ve heard from people who have been there in person who have come back just telling me about how wonderful they are.

You’re doing what we talk about in health literacy. You may not call it health literacy, but we’re talking about communicating important health messages in ways that people, patients and the public can understand.

You’re doing this so vividly with photographs, stories, very succinct stories, some statistics and in this public space. How did this idea get cooked up?

Adriana Bobinchock: Through McLean hospital, we have a three-part mission: clinical care, research and education. My department is very much focused on education, and specifically public education.

About a year ago, the President of our hospital approached the head of Massport who runs Logan Airport and said, “Would you ever be interested in partnering with us on a public education campaign?” Tom Glynn, who is the CEO of Massport, said, “Absolutely.” Logan pretty much said to us, “Whatever you come up with, we’ll find space for.”

That was the genesis of it. Then after I’d had that conversation with our President, Dr. Rauch, I was out at Alcatraz, of all places.

Helen Osborne: Out in California?

Adriana Bobinchock: Out in California, exploring the national park out there. They happened to have an exhibit called Prisoners of Age. They used compelling images and stories to really tell the narrative of elderly prisoners to get you to think about whether or not it’s worth having a prisoner that’s 89 or 90 years old still incarcerated. I don’t do it justice when I talk about it.

The exhibit was so powerful that I thought, “If I could feel empathy about a stranger, a prisoner, why couldn’t we use similar tactics to address mental health?”

Helen Osborne: I’m just really impressed how you take something that’s been in another format, that worked for you on that visceral, internal level, and thought about putting it in a very different structure on a very different topic.

I really treasure that level of creativity and that willingness to take a risk, and your hospital president and the President of Massport did the same thing. This hasn’t been done before.

Adriana Bobinchock: That’s correct. We did a lot of research while we were starting to do the groundwork for this, and as far as we’ve been able to identify, there’s no other campaign quite like this at this scale.

Also, we partnered with a lot of other organizations. The American Foundation for Suicide Prevention, NAMI Massachusetts and Project 375 are partners.

By getting other like-minded organizations to share their voices with us and to say, “We like this idea or we don’t,” I think that’s part of why it became such a powerful and successful campaign. It’s not just one group driving it.

The other thing that I think is somewhat unique for this campaign was every single person who signed on to participate, when we had our initial conversations with them, we made it clear that we’re a partner with each person.

This is not a McLean Hospital project. This is our project collectively and we really wanted to empower the participants to really own this campaign.

Helen Osborne: Do you mean someone like Rachel, who somehow has her eight-foot high picture out there? Someone with anxiety having a picture that’s eight feet high at Logan Airport, that’s a leap. How did you get people willing to do this?

Adriana Bobinchock: McLean has a large clinical component to our hospital, so we put out an ask to all of our clinicians. Our very first person to sign up, Sean volunteered, so we got some volunteers from internal communications. But then really most everybody came to us via Facebook.

Helen Osborne: Facebook? Oh my goodness.

Adriana Bobinchock: Of all places. One evening, I said, “We’re not getting enough participants and I’m anxious.” I get really excited about projects like this and I wanted it done really quickly, so I put a note out on our Facebook page, forgetting that we have 43,000 followers.

When you put out a note saying, “Hey, would anybody want to participate in this?” I thought I’d get 10 or 15 responses, and within 24 hours we had over 100 people who had responded.

Helen Osborne: Oh my goodness. Wow.

Adriana Bobinchock: That is really how we recruited people. Then for our celebrities, we just asked. We were overwhelmed by the celebrity response saying, “Of course I’ll do this.”

We never expected Howie Mandel to say yes right away and to invite us to his studio out in California to have an interview and photograph him. Everybody in this project was just phenomenal.

Helen Osborne: Wow. You’re phenomenal, too, to put this together. I’m just thinking about all these lessons learned. I want to get into that, like what you’d recommend for those of us not doing something on this scale, but trying something new, really taking a chance, raising awareness and teaching the public.

I want to get your tips, but I also just want to ask you about issues of confidentiality, HIPAA patient protection and all that. I noticed you mentioned someone’s first and last name. You’re identifying them by mental illness and all of that. How do you get around that?

Adriana Bobinchock: We debated a lot about it internally, because everybody who signed on for the project gave us permission to use both their first and last name, their age, their hometown and state.

Initially, that’s what we were going to move forward with. Then, as the project got larger and we realized just how public it was going to be, I made the decision not to use everybody’s first and last name.

I was criticized a little bit for that because by not using first and last name, many people say, “That just adds to the stigma.” The way I looked at it was it was less about the stigma around not using Rachel’s last name or Sean’s last name. It was more about here are these posters eight feet tall in a very public location.

Somebody with the name John Smith that lives in Boston, you can Google and you’re going to get 1,000 John Smiths in Boston. However, somebody with a name like Adriana Bobinchock that lives in Boston, if you Google me, you are going to get my home address, my phone number, where I work and anything I’ve ever done online.

We decided it was more privacy than anything and protection of our participants. That’s why we chose not to use first and last name on the website or on the posters.

However, in press briefings, we worked with a handful of our group to make sure that they were okay with using first and last names.

Helen Osborne: That’s wonderful. You really worked with your participants, your audience and the partnerships here. That’s another enduring principle of health literacy. You just don’t impose something on people, but you work with them.

What are some of your lessons learned for all of us? I’ll tell you a little bit about Health Literacy Out Loud listeners. We all care about health communication. We might be clinicians, public health, librarians or teachers. Whatever range we come at, we care about educating the public about health and communicating clearly.

We’re not likely going to do a ginormous project like yours, but what lessons can we take away from this?

Adriana Bobinchock: I do think our biggest lesson was, from the very beginning, being up front with people in what the expectations were for how this would roll out, what our goals were, clear communication with the people involved and, as I said, really partnering with them.

I can’t imagine signing up on a Facebook page saying, “I’m going to tell you some of my deepest, darkest secrets,” and trust that a complete stranger is going to put it out there in the public and do okay with it. We wanted everybody to feel comfortable.

Whether you’re doing a podcast that goes out to 1,000, 15,000 or a million people, I think the idea of really partnering with each individual that’s a participant is important and empowering them.

I think part of why we were so successful is that we have this core group of people that want to talk about it. They’re on their own social media pages and they’re at work talking about it.

There’s been this grassroots effort to get more publicity, more people to Logan and more people to the website, not because the machine of my group is running it out, but it’s because our participants feel so strongly.

Helen Osborne: Even someone like Rachel? I’m using her as just an example, but everybody was an advocate on their own first?

Adriana Bobinchock: No. People were not advocates on their own first. A lot of the people who signed on for this said that they wanted to, but they didn’t know how to be out there, so they signed on to this as a way of their first step in advocacy.

There are 38 people at Logan and there are 42 people on the website, but we have 60 people for Phase 1. We’re still adding people to the website and to the book.

Participants have really become their own advocacy organization where they’re out talking to their own folks and their friends and family, but they also are now talking amongst themselves.

We’ve created a newsletter for them and their own private Facebook area so they can exchange ideas and talk to one another.

Some of them have said this whole process has been very therapeutic for them because it’s the first time they’ve really talked openly about their experience with mental health.

Helen Osborne: This is just the beginning? This isn’t even the end?

Adriana Bobinchock: This is just the beginning. Since launch, we’ve received hundreds of inquiries from people all over the country and also in Europe who have asked to participate in the next phase of the project.

We’ve also been getting a lot of response from other organizations, airports and universities asking us to develop a Deconstructing Stigma display that would be able to go into one of their venues.

Our real goal is to be able to do this on a national scale in different airports in other areas.

Helen Osborne: Adriana, your work is phenomenal. I am just wowed by this.

Adriana Bobinchock: Thank you.

Helen Osborne: I hope that listeners of Health Literacy Out Loud will also take some of this and use it in their own spheres in their own ways to also get across difficult messages, as that’s what healthcare’s all about.

It’s something that’s hard, but you found a way. I hear the excitement in your voice, and you tell me excitement worldwide about this project.

Do tell, what’s the URL? What’s the website people can go to to start learning more? We’ll have even more than that on your Health Literacy Out Loud web page.

Adriana Bobinchock: www.DeconstructingStigma.org is the URL.

Helen Osborne: Perfect. You are phenomenal. I am honored that you saved us a little bit of time to talk about this project on Health Literacy Out Loud. I can’t wait to see what’s going to be next in your world as you expand on this and also what listeners will do in theirs.

Thank you so much for being a guest on Health Literacy Out Loud.

Adriana Bobinchock: Thanks for having me, Helen. I enjoyed the conversation.

Helen Osborne: As we just heard from Adriana Bobinchock, it’s important to raise awareness about issues, even hard ones like mental illness. But doing so sure isn’t easy.

For help clearly communicating your health message, please visit my Health Literacy Consulting website at www.HealthLiteracy.com. While you are there, feel free to sign up for the free monthly e-newsletter, What’s New in Health Literacy Consulting.

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Until next time, I’m Helen Osborne.

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