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Comic strips have always been a medium for more than humor. Many comic strips published on social media sites address mental health issues. Despite their popularity, the field of graphic medicine, which examines the intersection of health care and comics, has seen little to no examination of how these comics function on social media. Utilizing the popular comic The Awkward Yeti, this research examines how the rhetorical devices of comics make them an ideal medium for communicating about mental health issues and providing social support to social media users. This study conducts a content analysis of 15 Instagram posts from The Awkward Yeti. Employing a modified version of Cuatrona & Suhr's Social Support Behavior Code (SSBC), three dimensions of social support were measured: information support, emotional support, and network support. The results revealed emotional support and network support to be the most frequently utilized dimensions of social support found in comments on The Awkward Yeti's posts. Additionally, the results suggest that for comics to be effective as a means of social support and mental health education on social media, they must be grounded in authentic experiences and should provoke emotional responses from social media users.

As medical students progress through their training, they experience a decline in empathy, mental health struggles, and difficulties in learning. The prevalence of depression, anxiety and burnout among medical students, along with the decline of empathy in medical students can impact their professionalism and quality of patient care as future physicians. This literature review shows how the integration of graphic medicine in provider training can address these problems, giving a new perspective on what medical education should look like. Thirty-three articles were found and reviewed by searching through the databases Academic Search Premier, PubMed, and Google Scholar, along with the website graphicmedicine.org. The findings revealed that graphic medicine promotes empathy by highlighting the patients’ experience of their illnesses through personal stories. Graphic medicine can also aid learning by increasing engagement and offering alternative ways to learn. Additionally, multiple studies showed how creating graphic memoirs can be a form of therapy for medical students, allowing them to express their difficult experiences in medicine through a creative outlet.

Cette thèse porte sur le développement et la validation d’un outil visuel de transfert de connaissances en santé mentale. Cet outil est nommé le PicMH-U, un acronyme pour picture-based mental health tool – university version. Cet outil de transfert de connaissances a été développé avec la participation de la population cible, soit les étudiant.e.s universitaires. L’information qu’il contient porte sur les problèmes de santé mentale qui ont le plus grand impact sur les étudiant.e.s universitaires, tel que recensé en 2016 par l’Enquête sur la santé psychologique étudiante (ESPE), et une liste de ressources psychosociales à laquelle les étudiant.e.s peuvent accéder. Ces éléments ont été ciblées pour répondre aux taux disproportionnés de problèmes psychologiques et l’importance de mettre en place des interventions psychosociales appropriées pour les étudiant.e.s universitaires. Cette thèse poursuivait deux objectifs: 1) connaître l’état de la recherche sur l’utilisation des images pour communiquer/transférer la recherche en santé mentale et en psychologie aux adultes nord-américains; et 2) de développer et valider des outils de transfert de connaissances avec un échantillon de cette population, soit : des étudiant.e.s d’une université canadienne. Le premier objectif a été satisfait à l’aide d’une revue systématique de la littérature (Article 1; Chapitre 3) et le deuxième grâce à des consultations avec la population cible (Chapitre 2) et un essai contrôlé randomisé longitudinal (Article 2; Chapitre 4). Les deux articles sont soumis à des revues évaluées par des pairs mais ils ne sont pas publiés. Les résultats présentés dans le premier article montrent que la recherche sur l’utilisation des images pour transférer des connaissances en santé mentale auprès d’adultes nord-américains se limite exclusivement à la lutte anti-tabagique. Les résultats présentés dans le deuxième article montrent de meilleurs résultats pour la condition « avec les images » (PicMH-U) que pour la condition « texte » (TextMH-U) sur tous les tests de mémoires, mais pas sur la satisfaction des utilisateurs, l’intention d’utiliser les ressources, ni l’utilisation des ressources. Cette thèse contribue à l’amélioration des domaines portant sur la communication à l’aide d’images et le transfert de connaissances en santé mentale communautaire en étudiant une intervention fréquemment utilisée dans les communautés de pratique mais qui n’est pas validée par la recherche empirique. En validant l’utilisation des images pour la communication de résultats de recherche en santé mentale chez la population étudiante, cette thèse fournit des données probantes permettant de renforcer cette pratique. / This thesis documents the development and validation of a picture-based mental health Knowledge Transfer tool for university students, named the PicMH-U. As a knowledge transfer tool, the PicMH-U was developed with the participation of the potential users (stakeholders): Canadian university students. The information it seeks to communicate is the mental health difficulties that have been found to most affect Canadian university students – as assessed by the 2016 Enquête sur la Santé Psychologique Étudiante – along with psychosocial resources they can access to seek assistance. This information and population are used in order to address the demonstrated alarming rate of mental health difficulties among university students and need for mental health awareness and intervention. The objectives for this thesis are two-fold: 1) to describe the state of the field of using images to communicate mental health/psychological research to North American adults; and 2) to develop and validate a mental health knowledge transfer/mobilization (KT) tool for a section of the adult population: university students. The first objective was satisfied through a systematic review (Article 1; Chapter 3) and the second objective through consultation with stakeholders (Chapter 2) and a longitudinal randomized controlled trial (Article 2; Chapter 4). The articles in this thesis have been submitted to peer-reviewed journals but are currently unpublished. Results from the systematic review (SR) indicate that experimental research on image-based mental health communication to North American adults is limited to tobacco use and control. The SR found that Picture Warning Labels spurred more negative affect and more conversations about the Health Warning Labels, were rated as more effective at encouraging quitting, and increased actual quit behaviors. Secondly, the randomized controlled trial found that the PicMH-U (image condition) had better results on tests of short-term, long-term, prompted and free recall, but not on user satisfaction, intention to use services, or actual use of services when compared to the text condition. This thesis contributes to the advancement of the field of picture-based communication, knowledge transfer and community mental health by researching an intervention often used in community practice but not commonly validated by experimental research. By validating the use of the picture-based mental health tool among university students, this thesis aims to provide empiric evidence to support the use of picture-based communication methods within mental health.