AXA is an insurance company and Sabrina Cheung, chief brand and communications officer of AXA Asia & Africa, and Bernice Fong, brand and content strategy director of AXA Asia & Africa, speak to WARC Asia Editor Rica Facundo about the AXA Mind Health Survey and the role of brands in changing the narrative.

This article is part of a Spotlight series on consumer anxiety and mental health in Asia. Read more

Key insights

  • Despite mental health being a taboo subject, 41% in Asia feel the stigma has been reduced, higher than the 36% globally.
  • The 4 mind health states are struggling, languishing, getting by and flourishing; Thailand has the most flourishing respondents.
  • Marketers can create awareness that leads to breaking down the stigma about mental health so people don't feel so ashamed to speak up.
WARC: In the research report, AXA has made a conscious decision to use “mind health” over “mental health”. Why is this difference important for our region?

Sabrina Cheung: There tends to be a negative perception around mental health. By broadening the definition through the term “mind health”, we are trying to break down the stigma and promote the idea that there is an important emotional, psychological and social well-being aspect involved.

In Asia, when people feel stigma, they feel some sense of shame. There are people who might struggle alone because they're afraid to ask for help. There are also people who would like to help but cannot really identify and necessarily recognise the signs of what somebody is going through. That’s why it’s important for us to make sure that people feel psychologically safe to talk about the topic so that they can ask for help.

Mental health was always taboo in Asia. But because of the pandemic, there’s a sense that the stigma is starting to decrease. Did you see this in your study?

Yes, our survey has revealed encouraging signs of progress. Globally, 36% of respondents felt that stigma has been reduced, up from 31% last year. It's even higher in Asia at 41%, compared with just 33% last year.

There are different kinds of stigma. Is there a specific type of stigma that’s becoming more normalised?

When people feel stigma, they feel shame. When people feel stressed, they don’t want to talk about it because they don't want to be isolated or labelled as having a problem that people don't understand. Suffering alone is probably the worst possible thing that can happen because these people are really afraid to reach out and ask for help.

This decline in stigma around mind health does factor into an improving sense of wellbeing as it means fewer people are suffering in silence. By making the topic a little bit more mainstream, people feel less alone, less ashamed, more likely to seek support, and more likely to connect with others and their work.

What types of support tools do you see emerging to help mind health more accessible to people?

Many companies might offer employee assistance programs, also known as EAP. Some companies even offer their own in-house counsellors. But we're also looking at a number of different digital solutions that are easily available and accessible anywhere around the region.

At AXA, we have Emma, our digital assistant which we made available for all of our customers and non-customers during the pandemic. We offer telehealth services across all our markets in the region. At one point during COVID, we had offered over 10,000 free teleconsultations to people in the region.

A lot of telehealth services emerged from the pandemic to democratise access to healthcare. Any best practices you can share around telehealth marketing for mind health?

It's important to understand your audience and how they would like to interact with the brand. For example, some people want the convenience of booking an appointment online, while others really value seeing a doctor in-person.

In Hong Kong, we offer an online chat consultation where people can text instead of talk. We found that a lot of people actually prefer to write. If somebody feels that they don’t necessarily want to see someone face to face for whatever reason – whether due to confidentiality or they want the added convenience and flexibility – then a text option gives them that comfort.

This tailoring of options for people depending on their comfort level is important. Not everyone wants to have a talking therapy session. Sometimes, they prefer to be more discreet, or just have a few quick questions to ask. We try to make a format available for everyone, taking a more inclusive approach to enable people to ask for help by making sure that they feel psychologically safe.

The study also mentioned four mind health states. What are they?

According to our study, respondents typically fall into one of four categories – struggling, languishing, getting by, or flourishing.

If you're struggling, this means a person is really showing some signs of emotional distress, which is not healthy. Those who are languishing are essentially people who exhibit a lack of positive well-being and are not functioning at their full capacity. If you're getting by, you have signs of well-being, but you could be doing better. Lastly, flourishing means that you're operating at the pinnacle of good mind health.

Are there any market differences you are seeing in SEA/Asia?

This year, we added the Philippines and Thailand to our study in Asia, alongside Japan, Hong Kong and mainland China. We discovered that 25% of people globally were flourishing, but Thailand was actually in the lead at 37%.

On the other hand, the Philippines has the largest proportion globally of people who are getting by at 39%. In second place was Hong Kong at 37%.

The one country which shows the highest proportion of languishing and struggling people was Japan at 31% and 14% respectively.

This reflects a wide spectrum of situations across our region, which necessitates their different conditions and stages of maturity as well as a need for tailored solutions.

Why is Thailand flourishing?

I'm going to say to a certain degree, it probably has to do with culture and outlook. There have been a number of different studies done about happiness in the country, which is closely related to achieving a flourishing state of mind health. Having a culture where you're close to your family and community means that you have a good level of support in your life, which can be a significant positive factor.

Any cohort that stood out?

This year, we wanted to focus more on Gen Z because this age group shows a lot of vulnerability. Our survey revealed that over half of this group globally are either struggling or languishing. This is the largest proportion among all age groups.

Our discussions with experts have revealed a few drivers behind this situation. Young people have been in their formative years during the pandemic and their exposure to the world is high, given everything is online and they are closely connected through social media. As a result, they have developed a sense of uncertainty about their future, including the potential impact of unemployment or losing relevance in the face of a rapidly changing landscape. Our research found that they struggle to separate their work and personal lives, are challenged by the pace of change, and often feel that they don’t have the right job-skill fit.

That is why we want to help employers understand how to engage and support this younger segment. Gen Z are bearing the brunt of poor mind health and performance, which may drive a wave of resignations if workplace wellness initiatives are not put in place to improve their overall well-being. We found that Gen Z has the highest percentage of people who resigned in the past 12 months at 26%, and that also intend to resign in the next 12 months at 21%. This will be a significant issue for employers who want to attract, retain and develop their talent pipeline.

AXA's 'Make time for me time' campaign, created by Publicis Groupe Hong Kong. 

Let’s talk about another cohort that feels a lot of anxiety – Asia’s sandwich generation. The brand recently launched the “Make time for me time” campaign that targets this group. But isn’t “me time” generally seen as “too individualistic” and running counter to Asian values?

Bernice Fong: It’s a delicate balance to navigate. As we all know, the sandwich generation over here is overworked. They spend a significant portion of their waking hours caring for others, whether their children or elderly parents. And they may deprioritise me-time. They tend to feel guilty when they make time for themselves.

The pressures of family and work have made the sandwich generation put themselves and their health last. COVID has actually made them more health aware. But as pressures increased, so did the barriers to becoming healthier. Health becomes even more of a paradox.

What should brands be mindful of when targeting this demographic?

To effectively connect to this specific demographic, we must be mindful that we are not preaching the obvious. When it comes to health, we believe people do not need a preacher, they need a partner.

The rest of the category might take a more authoritative route when it comes to health, prescribing consumers with maybe a template or checklist, this is what you should do in order to be healthy. AXA always believes that health is diverse. So we wanted to break the conventions of health by redefining health.

Overall health is all connected and at the centre of health, there's you, your mind, your body and your relationships, and all three are interconnected. We wanted to give permission to people to say no and the confidence to give yourself self-care. To take care of others effectively, you have to take care of yourself first.

Do you think the role of brands in this space is to help give permission to consumers to practise mind health when traditionally, our culture does not?

Yes. I think it’s important to promote that it’s okay to say no. In Asian culture, we are afraid to say no. We feel ashamed and guilty to say no, whether to our family members, to our children or at work.

It's not in our culture to say no and to push back. But it is okay to say no and start taking care of yourself.

How did the brand localise the campaign to make sure it resonated across specific markets?

Our creative would change based on the localised situation of stress. We identified what scenarios are the key root causes of stress for the sandwich generation and how we could help them think about healthcare as more than just physical health.

This influenced our media selection, based on where our target audiences in each market were the most stressed, so that we also generate the most impact in order to drive more brand relevance.

OOH was one of our main channels. In the Philippines, we had a digital OOH. We deployed the campaign during prime time, 6-8pm at all sites, where we showcase the art care exercise catering for commuters looking for some me-time after work.

What are the tactics that can help marketers be braver and bring more taboo topics, such as mental well-being, to the fore?

Bernice Fong: Providing education and information can help reduce the stigma and increase awareness. These days, schools are doing it. My daughter recently said to me “hey mommy, don’t stress me out.” I think that’s important because at an early stage, they already know what stress is. That is good because at an early age, they dare to speak out.

Marketers can create content that helps people understand what mental health is, how it affects people, and where to get help.

Sabrina Cheung: If we can change the narrative and normalize the topic of mind health, people can feel less ashamed of the topic and less fearful of being ostracized. Creating awareness is therefore key to breaking down stigma, so people can ask for help. People can also be more aware of what to look for and what to do to improve their overall health.

I hope that very soon people will be able to talk about their mind health in the same way that they do their physical health. It's very normal today for people to say, hey, what's your gym regimen? Oh, I'm trying to tone, or I'm trying to lose weight, or I'm trying to increase my stamina. Can we talk like that when it comes to mind health, seeking and sharing advice and support? The day when we're able to do that will be the day that we can say that our efforts have been successful.