stopping stigma

South Dakota Department of Social Services, Division of Behavioral Health

When you think of behavioral health, what comes to mind? Thanks to more awareness than ever, that picture is changing from one of stigma or bias to acceptance and support.

But in South Dakota – with fierce pride and an independent spirit – some of those stigmas remain, preventing people from getting help or checking in on people they love.

The truth is, 1 in 6 South Dakotans live with a mental illness, and behavioral health affects all of us no matter where we live or who we are. That’s why the South Dakota Department of Social Services (DSS) Division of Behavioral Health enlisted the help of L&S to launch a statewide campaign to eliminate stigmas and promote support.

  • 2023-2024
  • American Advertising Award: District 8 - Silver, Integrated Media Public Service Campaign
  • American Advertising Award: Best of Class, Integrated Media Public Service Campaign
  • American Advertising Award: Gold, Integrated Media Public Service Campaign
  • American Advertising Award: Gold, Public Service Film/Video/Sound Campaign
  • American Advertising Award: Silver, Public Service Television
Family smiling and looking off into the distance

mindsets on mental health

Our team surveyed more than 500 South Dakotans and led focus groups with providers, law enforcement and individuals with lived experience.

The study found that stigmas still exist – for example, that people living with behavioral health disorders are unpredictable, dangerous or hard to trust. Individuals with lived experience shared how this causes shame, prevents them from reaching out and feeds isolation.

We needed to eliminate this “us vs. them” mentality. To remind the public that behavioral health is everyone’s business – and for those in need of help, that everyone has someone who cares about them. As one care professional said, “People need to feel like they belong. That they are valued, and that they deserve whatever it is they want in life.”

So we took that note to heart.

Woman standing in front of a mural
Old photos of a U.S. veteran
Farmer smiling

notes to self

A note, text, coffee date or phone call – it’s not much to ask. But for someone who needs to feel seen, it’s the answer.

Sticky note that says

Based on this sentiment, the “Notes to Self” campaign was born, using a series of notes, reminders and positive affirmations to remind people that they are seen, they matter and that help is always here. For support people, the campaign focuses on little things we can do every day to remind people that they belong and that their behavioral health matters.

We created a series of video spots featuring teens, Native Americans, veterans, ag producers and more, showing how even the smallest act can make the biggest impact.

Radio used the voices of real people reading notes to their future selves, notes to friends or notes to those in need expressing support and compassion.

Digital ads and dynamic social media posts paired different notes with messages for both people in need of help and those looking to support someone. We launched social media videos called “Mental Notes,” sharing quick tips for daily mental health, plus long-form videos teaching grounding techniques, mindfulness practices, refusal skills and box breathing.

Sticky note that says
Note on hand that says
Phone that has texts of a friend checking in
Drink coasters

Billboards, direct mail, movie theatre advertising, restaurant table tents, napkins and print advertising promoted resources for prevention and crisis situations.

Ad on a movie theatre big screen

Through a unique partnership with the editorial team at 605 Magazine, we also produced a feature article on Native American behavioral health stories, sharing resources and resilience.

Magazine spread

Providers and health care professionals also signed up for free resources like affirmation cards, stickers, temporary tattoos, postcards and more to share literal notes with South Dakotans.

A set of temporary tattoos
Affirmation Cards that read,

All campaign efforts directed to a microsite, linking people with resources, conversation starters and a behavioral health quiz to point people looking for help in the right direction.

noteworthy successes

Sticky note that says

Embraced by both the public and providers, “Notes to Self” brought about open conversations, new perspectives and shined a new light on the importance of behavioral health across South Dakota.

Since the campaign launch, contacts to South Dakota’s 988 Lifeline are pacing 42% ahead of last year. While crisis calls are up, what’s more encouraging is that early intervention calls for support, listening and resources are up an amazing 228% over the same period last year, meaning more people are aware of resources and reaching out sooner instead of staying quiet or searching for help on their own.

Hand holding phone

Paid media has resulted in more than 81 million impressions with 4.5 million campaign interactions. Storytelling platforms have performed best, with viewing completion rates of up to 98%.

Paid search has also connected folks with help right when they need it, with top-performing terms like “crisis lifeline” or “depression lifeline.” With 11-13% click-through rates (vs. a goal of 3.5%), paid search is connecting people at the right time with the right help.

Our campaign microsite has seen more than 136,000 visits in six months, with 7,400 people completing the behavioral health quiz. More than 80% of these individuals are seeking help for themselves vs. someone else.

“Notes to Self” also won one silver and two gold South Dakota American Advertising Awards and earned the “Best of Class” distinction among all public service advertising.

But the best feedback has come in the notes we’ve received from real people, like one 605 Magazine reader:

stopping stigma