Take Space to Pause (TSTP) Campaign

​​About the Evaluation

The Children and Youth Behavioral Health Initiative (CYBHI) is a multi-year statewide effort led by CalHHS to transform California's behavioral health system for youth ages 0–25. CDPH's Office of Health Equity (OHE) leads the public education and behavior change campaign, focusing on reducing stigma and improving mental health literacy. The campaign (TakeSpacetoPause.org) is youth-centered, equity-focused, and designed to meet young people where they are—online, in schools, and in communities. 
The mid-way evaluation, conducted in partnership with Sentient Research, measured campaign awareness, stigma reduction, mental health literacy, and behavior change among youth aged 13-17. It uses aided and unaided awareness metrics, self-efficacy scales and behavioral intention indicators. Findings from the midway evaluation showed: 

• Campaign Reach: Nearly half of California youth (ages 13–17) were aware of the campaign within the first four months
• Impact on Stigma: Youth with high campaign awareness had a 23% lower mental health stigma score.
• Behavioral Outcomes: Increased awareness was associated with greater confidence in seeking help and more frequent use of healthy coping strategies.
• Equity Highlights: The campaign successfully reached system-impacted, Native American/Alaska Native, and Black/African American youth—groups often underserved in mental health outreach.
• Youth Voice: The campaign's authenticity and tone were shaped by youth advisors, ensuring relevance and resonance with the focal audience.

For additional questions about this midway evaluation report, please email: ​​ohe@cdph.ca.gov​

At a Glance

TSTP is a public education and behavior change campaign for youth ages 13–17. As of June 2025:

• The campaign has generated over 980 million impressions via a strong online presence and in physical locations across the state.
  
• More than 12,700 personalized mental health care plans have been created using the TSTP website.
  

Source: CYBHI Take Space to Pause Data by Month 2024-11-18 through 2025-06-30. TSTP Campaign Metrics Report, Rescue Agency, August 27, 2025. ​​​

Main Takeaways

The Take Space to Pause (TSTP) statewide campaign launched on November 18, 2024, to help youth ages 13–17 by promoting mental health literacy, strengthening self-efficacy, and reducing stigma—ultimately encouraging them to seek help when they need it. The campaign remains active.

Four months after the launch, a survey of 1,557 youth across California showed that nearly half (48%) were aware of the TSTP campaign. The survey ensured strong representation from youth populations that are often disproportionately affected by mental health challenges.

Key findings show that youth with higher campaign awareness were significantly more likely to:

• Have lower mental health stigma
• Feel more confident in helping themselves
• Know of a greater number of mental health resources
• Seek information about managing stress and emotions
• Use healthy coping strategies as opposed to unhealthy ones
  

Introduction and Campaign Overview

Youth Mental  Health  in  California

Over the past two decades, mental health issues have become a leading cause of hospitalization among California youth under 18, now surpassing all other causes.^1,2 The COVID-19 pandemic intensified these challenges, with particularly severe impacts on youth from historically underserved and marginalized communities.

In 2022, Governor Gavin Newsom announced an over $4 billion investment to address the youth mental health crisis.³ This funding launched the Children and Youth Behavioral Health Initiative (CYBHI), a multi-year plan aimed at improving the mental, emotional, and behavioral health of young people ages 0–25. As part of this effort, the California Department of Public Health's Office of Health Equity (CDPH OHE) produced and deployed the TSTP campaign.

About the Take Space to Pause (TSTP) Campaign

TSTP is a public education and behavior change campaign for youth ages 13–17. It was developed using primary research with California teens, including listening sessions and a statewide online survey (n = 549). The campaign also drew on intervention research showing that when teens learn to manage stress and negative emotions early, they are less likely to develop more severe mental illnesses.^4-7

Grounded in behavioral health frameworks, such as the Seeking Mental Health Care Model,⁸ which examines how factors like stigma and knowledge influence help-seeking behavior, the campaign aimed to promote positive action by reducing stigmatizing attitudes, increasing mental health literacy, and building self-efficacy.

The campaign was heavily informed by ongoing collaboration with youth across the state, including two dedicated groups of youth collaborators: the Rescue Agency's Youth Advisory Council and CDPH's Youth Co-Lab. Their insights shaped the strategic approach, messaging, production, website tools, and final communication assets (see Figure 1 for sample youth quotes).​​

​The TSTP campaign is one of two major prongs of CDPH OHE's strategy to support youth wellness. Complementing TSTP's statewide media approach, 28 community organizations were selected and funded to create localized Community Alliances for Local Impact (CALI) campaigns.

Campaign Goals

The campaign's primary goals are to reduce mental health stigma, enhance mental health literacy, and promote healthy coping strategies that help prevent mental health concerns from escalating.

Focal Populations

The campaign was designed to reach youth from communities historically and disproportionately affected by mental health challenges. These focal populations include:

• African American/Black youth
• Hispanic/Latinx youth
• Asian/Pacific Islander youth
• Native American/Alaska Native youth
• LGBTQ+ youth
• Youth living in rural areas
• Youth with disabilities
• Youth who have been involved in the foster care and/or juvenile justice systems ("system-impacted")

The campaign was launched in both English and Spanish.

Reaching Focal Populations

To reach these youth groups, TSTP employed an intentional equity approach to media. This included selecting highly accessible online and in-person channels and using advertising techniques to reach areas often deprioritized. The campaign engaged teens through school placements, billboards, community events, and tailored digital outreach.

Evaluating the Campaign's Progress

About the Midway Campaign Evaluation

To assess whether the campaign is advancing its objectives, we surveyed 1,557 youth aged 13–17, four months after its launch. The online survey assessed campaign awareness, mental health–related factors (e.g., perceived stigma, mental health literacy, prior experience with treatment, and knowledge of resources), and demographic characteristics (e.g., race/ethnicity, age, zip code). The survey was developed using scientifically validated scales and was then tested and refined with 15 youth in the same age range to ensure the questions were relevant and clearly stated.

Youth Recruitment

Youth were recruited statewide, with intentional oversampling of the campaign's priority populations to ensure sufficient representation of historically underrepresented groups for meaningful analysis.

Survey Measures and Key Outcomes

In the survey, we asked youth to respond to statements to understand their awareness of the TSTP campaign, their engagement with it, their attitudes and knowledge regarding mental health, their knowledge of available mental health resources, and their use of coping strategies to manage stress. These statements were meant to measure key campaign outcomes.

Survey Analyses

We assessed the relationship between each outcome and youth respondents' level of campaign awareness, defined as: no awareness; lower-level awareness (saw or heard campaign advertisements seven or fewer times in the last 30 days); and higher-level awareness (saw or heard campaign advertisements eight or more times in the last 30 days). In the analyses, we also accounted (controlled) for other factors that might influence the results, including demographics (e.g., age, gender identity, and race/ethnicity, among other measures) youths' mental health state (e.g., stress level, anxiety, and depression), experience with mental health treatment, annual household income level, and California region of residence.

Campaign Awareness and Engagement

Of the 1,557 youth who participated in the midway campaign evaluation, 746 youth (48%) were aware of the TSTP campaign. The effectiveness of the campaign's messaging was underscored by high youth recall of unique concepts taught in the campaign, such as the body's 'calming system'. On average, youth aware of the campaign saw or heard advertisements more than eight times in the past 30 days, resulting in strong engagement.

As shown in Figure 2, youth primarily engaged with the campaign through social media. More than half of those aware of the campaign reported watching its videos, clicking on ads, and liking or commenting on its posts. Over half also reported talking with a friend or family about the campaign. This high level of interaction demonstrates that the campaign's content is successfully capturing the attention of young people.​

Figure 2. Measuring TSTP Campaign engagement behaviors by percentage (n=746)*

*Multiple mentions may not add up to 100%

Campaign Awareness by Focal Populations

The campaign's intentional equity approach demonstrated success in reaching several focal populations. Awareness was highest among youth impacted by the foster care or juvenile justice systems (64%), Native American/Alaska Native youth (60%), and Black/African American youth (57%). Awareness among LGBTQ+ youth (52%) was also higher than the overall sample average (48%).

These results provide valuable insights for future campaign phases, highlighting opportunities to deepen engagement with Asian/Pacific Islander youth (39%), youth living with disabilities (38%), and youth residing in rural areas (29%), to ensure that all teens benefit from campaign resources.

Figure 3. TSTP campaign awareness by focal populations by percentage

**p≤.01, ***p≤.001 based on comparisons to all other categories combined. Non-exclusive categories will not add up to the total sample size (N=1,557). Rural based on rural county of residence in Alpine, Amador, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Inyo, Lake, Lassen, Mariposa, Mendocino, Modoc, Mono, Nevada, Plumas, Sierra, Siskiyou, Tehama, Trinity, or Tuolumne.

Key Findings from the Midway Campaign Evaluation

Our evaluation reveals a strong link between the frequency of youth exposure to our campaign and improvements in their mental health. While any exposure was better than none, frequent exposure was the most effective—youth who saw the messaging at least eight times a month demonstrated the most significant positive impact. The results indicate that the campaign messaging is effective, and ensuring it is seen widely and repeatedly, appears to be the key to success.

For each of the outcomes below, a score was calculated by combining a youth's responses to a series of related survey questions. This method provides a more comprehensive measurement than a single question alone.

Specifically, in comparison to non-exposed youth (not shown here), youth with high campaign exposure:

• Had mental health stigma scores that were 23% lower.
• Showed 10% greater confidence in their ability to help themselves.
• Had 69% greater awareness of mental health resources.
• Were 89% more likely to seek information about managing stress and emotions.
• Were 32% more likely to use healthy coping strategies to manage stress.
• Were 12% less likely to use unhealthy coping behaviors to manage stress.

Note on these findings: The percentages reported above are derived from statistical models (e.g., odds ratios, linear regressions) that compare the outcomes of youth who were aware of the campaign to those who were not, while controlling for other factors.

Conclusion

In its first four months, the Take Space to Pause (TSTP) campaign gained strong recognition among California youth and is associated with multiple positive outcomes. The campaign's youth-informed design was a key driver of its success, resulting in authentic messaging that resonated with teens. The evaluation reveals that increased exposure to the campaign is associated with lower mental health stigma, higher confidence, greater knowledge of resources, and the use of healthier coping strategies.

While the evaluation was not designed to prove causation, its findings—particularly the increases in resource awareness and information-seeking—point to a significant positive impact. Perhaps the most potent indicator of the campaign's real-world success is that once aware of the campaign, 53% of teens reported talking to friends or family about TSTP. This finding demonstrates a level of engagement that goes beyond viewership, showing the campaign is sparking vital conversations in the community.

These promising early findings have created a valuable foundation for the next phase of youth outreach. Future efforts will focus on empowering local partners and community- based organizations to build on this momentum, connecting California's diverse youth with the direct, culturally relevant support they need to thrive.

​References

1. Hospital Discharges, by Primary Diagnosis. KidsData. Accessed Aug. 4, 2025. Available from: https://www.kidsdata.org/
2. ​Ghaly, M., & Darling-Hammond, L. (2021). We need to ensure the mental health and well-being of all our children. CalMatters. Available from: https://calmatters.org/
3. Governor Newsom Unveils New Plan to Transform Kids' Mental Health. Governor Gavin Newsom. Accessed Aug. 4, 2025. Available from: https://www.gov.ca.gov/2022/08/18/governor-newsom-unveils-new-plan-to-transform-kids-mental-health/
4. Brent, D. A., Brunwasser, S. M., Hollon, S. D., et al. (2015). Effect of a cognitive-behavioral prevention program on depression 6 years after implementation among at-risk adolescents: A randomized clinical trial. JAMA Psychiatry, 72(11), 1110–1118.
5. Durlak, J. A., Weissberg, R. P., Dymnicki, A. B., et al. (2011). The impact of enhancing students' social and emotional learning: A meta- analysis of school-based universal interventions. Child Development, 82(1), 405–432.
6. Stice, E., Shaw, H., Bohon, C., & Marti, C. N. (2009). A meta-analytic review of depression prevention programs for children and adolescents: Factors that predict magnitude of intervention effects. Journal of Consulting and Clinical Psychology, 77(3), 486–503.
7. Werner-Seidler, A., Perry, Y., Calear, A. L., et al. (2021). School-based depression and anxiety prevention programs: Systematic review and meta-analysis. Clinical Psychology Review, 89, 102079.
8. McLaren, T., Peter, L. J., Tomczyk, S., Muehlan, H., Schomerus, G., & Schmidt, S. (2023). The Seeking Mental Health Care model: prediction of help-seeking for depressive symptoms by stigma and mental illness representations. BMC Public Health, 23(1), 69.​​