The unintended consequences of campaigns designed to challenge stigmatising representations of mental illness in the media

Abstract

The media is widely recognised as contributing to stigma associated with mental illness by portraying it in connection with violence and/or undesirable traits. In response, campaigns directed at policing language use, imagery and story content in the media have been implemented. But these interventions can themselves perpetuate stereotypes and assumptions that ultimately run counter to the original intent of challenging stigma. By way of illustration this paper analyses an Australian campaign that I argue invites people to see stigma in innocuous uses of ordinary language and imagery, effectively associating mental illness with that which it seeks to challenge. The grounds for its criticism and praise of stories about mental illness are also often tenuous and based on a limited approach to determining the impact of story content. The pitfalls of this type of campaign can be avoided by taking heed of the shifts in thinking advocated by postpsychiatry and the deconstructionist strategies employed by activists in the mental health field.

Keywords:

• madness
• mental illness
• stigma
• postpsychiatry
• media
• anti-stigma
• mental health literacy

Acknowledgements

I would like to thank the anonymous reviewers for their valuable comments on earlier drafts of this paper.

Notes

1. When writing or speaking about “mental illness” no single term will be acceptable to everyone. In this paper I use the term madness in the interests of cultural and historical inclusiveness (Cross 2010; Harper 2009; Porter 1987) but also use mental illness as this is the term most commonly used in the anti-stigma campaign that I analyse. In the spirit of deconstructing psychopathology I question the pathological implications of terms such as “mental illness”, “mental disorder” and “psychiatric disability”, and the sets of oppositions in which they are constituted as inferior (Parker et al. 1995). I occasionally use “mental distress” to avoid these pathologising implications.

2. The concept of mental health literacy is defined by Jorm et al. (2006, 4) as “knowledge and beliefs about mental disorders which aid their recognition, management and prevention”. In relation to what is known about mental health literacy, they say that the initial Australian survey “showed that many people cannot give the correct psychiatric label to a disorder portrayed in a depression or schizophrenia vignette”. They argued this “lack of appropriate recognition … may lead to delays in seeking help and inappropriate help-seeking” (2006, 3; see also Jorm 2000).

3. The term “disease mongering” has been used to describe “the selling of sickness that widens the boundaries of illness and grows the markets for those who sell and deliver treatments” (Moynihan and Henry 2006, 1). Researchers have examined pharmaceutical company influence on representations of several mental illnesses in scientific and popular culture discourses, including premenstrual dysphoric disorder (Gardner 2003; Moynihan and Henry 2006; see also Ussher 2003), attention-deficit hyperactivity disorder (Baughman 2000; Phillips 2006), social phobia or social anxiety disorder (Cottle 1999; Scott 2006), depression and bipolar disorder (Healy 2006; Moynihan and Henry 2006).

4. This paper takes the view that audiences are active in their interpretations of media texts and that blaming the media for the status of public opinion glosses over the ways in which news and cinematic portrayals draw on audience's existing knowledge (Anderson 2003). The lack of audience research has also meant that insufficient attention has been paid to the way in which people's responses to media content are shaped by their experiences of madness and their relations with mental health services.

5. The address for SANE Australia's website is: http://www.sane.org/ Follow the link to StigmaWatch for further details of the campaign.

6. Reporting Suicide and Mental illness was first published in 2002 and the most recent edition was published in 2010. The resource is available from the Mindframe website (http://www.mindframe-media.info/site/index.cfm?display = 84375). Language is a key focus of this resource as it is of StigmaWatch complaints. However, in this paper I suggest that StigmaWatch seeks to apply these guidelines in an overly prescriptive manner that extends their original intent to improve media reporting of mental illness. StigmaWatch also monitors the reporting of suicide but this paper is focused on its interventions in relation to mental illness only.

7. Where possible I have directly viewed the media items to which StigmaWatch directs its criticism and praise. However, this has not always been possible as a result of an inability to access them, and on these occasions I have relied on the description and comments about them offered on the StigmaWatch website.

8. The company did not take SANE's advice and an image of Crazy John can be found on the mobile phone company's website (http://www.crazyjohns.com.au).

9. It is interesting to note that on its website the National Alliance on Mental Illness in the USA, which runs the Stigma Busters campaign, concedes the use of the word “schizophrenic” to describe a “split decision” made by congress has become part of the cultural language. Stigma Busters does not protest the use of single words, such as crazy, psycho, wacko or loon, unless they are used to directly refer to people “struggling with mental illness or to the illness itself”.

10. See also Scott's (2006) work on “Shy Pride” as one response to the medicalisation of shyness in the form of social phobia or social anxiety disorder.