Suicide was the seventh leading cause of death for Coloradans in 2018, with men across all ages representing 76% of deaths by suicide. 

In 2009, the Colorado Department of Public Health and Environment’s Office of Suicide Prevention brought the issue of high suicide rates in working-aged men to the Denver-based marketing agency Cactus, founded by Colorado State University alumnus Joe Conrad. 

“We had a history of doing a lot of social marketing campaigns around public health issues, and so I was asked to take on the issue of suicide among working-aged men because 4 out of 5 suicides come from that demographic,” Conrad said. 

This campaign culminated in Man Therapy, an online platform geared toward men who do not know how or where to get mental health help. 

“We knew we needed to build a website; we knew we needed to build a character who could represent the brand, and then we started creating a lot of promoting and marketing aspects that we could push out to drive traffic,” Conrad said. “It was a lot of campaign planning, tactical planning and then creative execution and production, including digital website production.”

A key feature of the site is its use of humor and a guiding fictional character, Dr. Rich Mahogany, to make difficult mental health conversations feel more approachable. 

The first image that appears on the site has a different message every time you open it, one of which reads, “As it turns out, there are worse feelings than being kicked in the giblets.” 

We listened to people, and we reflected their experiences in the thing that we created,” -Sally Spencer-Thomas, CEO of the Carson J. Spencer Foundation

“There’s a lot of humor built into the website, really creating that foot in the door to having a conversation about sometimes really difficult topics,” CDPHE OSP Director Sarah Brummett said. “Making it a little bit more approachable and taking some of that more sterile, traditional mental health language out of it, I think, was a very deliberate approach to engaging men and making sure that the messages that we’re using resonate with and engage that community.” 

To understand how to better reach working-aged men, who there were previously few resources for, Cactus worked with professional speaker, clinical psychologist and co-founder and CEO of the Carson J. Spencer Foundation Sally Spencer-Thomas to conduct research and find the most effective means of communication with suicidal men. 

Spencer-Thomas is no stranger to suicide, as her younger brother Carson died from suicide in 2004, just five years before the Man Therapy project began. Spencer-Thomas said that after her brother’s death, her family decided to do “bold, gap-filling work” to prevent what happened to Carson from happening to other people. 

Spencer-Thomas said that around the same time she made that resolution, the state of Colorado was noticing the state suicide data and working to partner with Cactus. 

“We started coming together and working to figure out how to fill the gap, how to reach these guys that were falling through the cracks,” Spencer-Thomas said.

Part of their research showed that men would be more likely to respond to a mental health program on a website, Brummett said, where they have an anonymous, safe space to access at any time. 

Spencer-Thomas said she led multiple focus groups to understand the perfect platform to build and that listening to men’s stories was the best way to learn. 

We have clear evidence, statistical evidence, that Man Therapy is highly effective.” -Joe Conrad, Cactus founder and CEO

“What we were doing prior was not working, and they told us to be bold, and they told us to do a bunch of things like highlight men’s stories and have an easy way for people to self-check themselves for depression, anxiety, substance abuse and anger,” Spencer-Thomas said. “We listened to people, and we reflected their experiences in the thing that we created.”

Conrad said that after Man Therapy launched, they received a lot of positive feedback but also a lot of doubt regarding the effectiveness of the program. 

“People would always say, ‘Yeah, but does it work? It was intended to reduce suicide, and is it working?’” Conrad said. “That’s a hard thing to prove. … We have a lot of evidence that it’s working, including stories from men saying ‘Your website saved my life,’ so we know it’s working, but to have a robust evaluation done by a third party that is a clinical study takes a lot of time and money.”

Conrad said Man Therapy caught the eye of a researcher at the University of Maryland Baltimore about five years ago, who approached the Man Therapy team about conducting a study on the effectiveness of the program. 

The Centers for Disease Control ended up sponsoring a four-year, $1.3 million study to evaluate the program, Conrad said. The study took five years instead of four but was recently completed and will be published this summer. 

“We have clear evidence, statistical evidence, that Man Therapy is highly effective,” Conrad said. “So what it means is that it’s going to create a lot of confidence and support for the campaign because we now know we have an intervention that is effective.”

Serena Bettis can be reached at news@collegian.com or on Twitter @serenaroseb.