Anderson (2003) states that throughout the past decade there has been an increase in media attention on issues relating to community care and the discharge of people from institutions. He maintains that newspapers in the UK have a great deal of influence when reporting violent incidents involving patients who have mental health problems. Most research into news reporting and mental illness has looked at whether negative images lead to negative public attitudes.
VOL: 100, ISSUE: 34, PAGE NO: 33
Rachel Harris, BSc, RMN, is registered mental health nurse, Worcestershire Mental Health Partnership NHS Trust
Appleby and Wessely (1988) looked at the impact of the Hungerford massacre on public attitudes. They discovered a short-lived increase in the number of people who associated mental illness and crime, which decreased a few months after the incident. In their view, press reporting added force to public opinion at that time.
Philo et al (1994) looked at the impact the media have on the public view of mental illness, with two-fifths of those questioned believing violence and mental illness were connected. Others had based their judgements on personal experience. They concluded that more work needed to be done with the media to reduce the stigma of mental illness.
Anderson (2003) feels that although some of the methodology may be questionable, research has shown that reports on mental illness and public opinion are related. Anderson likens the situation to that of the miners’ strike, where the media were accused of shaping the views of the public. However, Anderson also believes that although the media may present information in a certain way, the public forms its own opinions. Blame for creating stigma cannot therefore rest wholly with the media. He concludes that the media and mental health promoters should work together to ensure the accurate portrayal of mental health.
Media coverage and perception of risk
Laurance (2003) calls attention to the fact that until the killing of Jonathan Zito by Christopher Clunis (a patient with a diagnosis of paranoid schizophrenia) in 1992, the UK’s main concern related to mental health care was the well-being of patients discharged into the community following closure of the asylums. After the killing, concern shifted to public protection. However, Laurance (2003) points out that although an estimated 600,000 people in England have a diagnosed severe and enduring mental health problem, such as schizophrenia, less than one per cent of these require intensive care as a result of being a risk to others. However, the rare cases of homicide that have occurred have provoked fear among the public.
Since the Clunis case, carers’ organisations have campaigned for the need to identify risk, highlighting rare homicides by people with mental health problems and the government inquiries into these cases. The press has also played a role in this.
Ward (1997) discovered that stories involving mental illness, criminality and violence were given more exposure than positive stories involving mental health issues. Allen and Nairn (1997) challenged this idea with their belief that journalists may not have a wide-ranging knowledge of mental health issues and they aim to produce stories that will hold their readers’ attention.
As indicated by Anderson (2003), it is not only newspapers that depict mental health issues in a negative manner. He says that films also portray dangerous people with mental health problems. In their review of empirical and theoretical literature, Cutcliffe and Hannigan (2001) indicate that present media representations of mental health patients appear to highlight violence, dangerousness and criminality. However, this review is a limited one.
Reducing perceived risk
Laurance (2003) notes that from 1994, the Department of Health ordered inquiries into all homicide cases involving mental health services. More than 120 inquiries had been established by 2002 according to the Zito Trust (the mental health charity founded by Jayne Zito, the widow of Jonathan Zito).
The murder in 1996 of Lin Russell and her daughter Megan by Michael Stone, a man with a diagnosis of severe personality disorder, finally led to promises by the government to change the law. Despite Stone’s history of violence, and involvement with mental health services, psychiatrists did not consider him to have a mental illness and therefore concluded he could not be detained under the mental health act.
In 2000 the white paper Reforming the Mental Health Act proposed detaining those who posed a serious risk to the public. Proposals for a new Mental Health Act (draft bill) in 2002 continued to suggest imposing treatment on patients in the community and detaining dangerous people. This caused much concern. The Mental Health Alliance, for example, felt it would increase stigma and discourage people from seeking help.
According to Laurance (2003), although mental health and violence have been linked by the press and the government, studies have not found this to be the case unless in combination with drug or alcohol use. Laurance also (2003) feels that branding those with mental health problems as dangerous will increase the isolation and suffering that they already face.
Work aimed at reducing stigma
The Mental Health Foundation is an organisation working with the media to provide accurate information and help raise awareness of mental health issues.
Chadda (2000) refers to a survey published by the Mental Health Foundation that found those with mental health problems were experiencing extensive discrimination from friends and family as well as at work or when trying to find work. They also found that this group were faced with discrimination from health professionals.
Through their research and involvement in various projects, the Mental Health Foundation aims to help those with mental health problems. The foundation believes that changing the way these issues are represented in the media will expand the awareness and understanding the public has of mental health issues. Unfortunately, it is unable to challenge every item of media coverage, but provides useful addresses on its website for individuals who wish to make complaints.
Warrington Health and Well-being Partnership (2003) has funded the ‘Challenging stigma, removing labels, workplace mental health project’, which aims to combat discrimination and promote mental health awareness within the workplace.
The mental health charity MIND is actively involved in the ‘Mind out for mental health’ campaign, which aims to put an end to the stigma and discrimination surrounding mental health issues. This campaign was commissioned by the DoH, and aims to combat the stigma and discrimination that surrounds mental health.
MIND runs a programme for employers to improve policies and practice with regard to mental health. It also runs workshops for those in the media on portraying mental health issues. People are also being encouraged to complain about any unfair or unbalanced portrayals of mental health within the media.
Although there is a Press Complaints Commission Code of Practice, which points out that the media should avoid being prejudiced or causing offence when referring to people’s colour, religion, gender, sexual orientation, physical or mental illness, this code did not seem to apply to the reporting of Frank Bruno’s mental health problems in 2003.
The Sainsbury Centre for Mental Health (2003) reported in November last year that six national charities and five mental health service user organisations are working together to warn of the dangers of derogatory media coverage of people with mental health problems.
Both the government and mental health organisations are aiming to reduce stigma through their work and campaigns. In addition, research indicates we are becoming less tolerant towards discrimination. However, we still have a long way to go. As long as the media continue to sensationalise negative aspects of mental health and the government continue to give mixed messages about tolerance on the one hand and public protection on the other, it may be an uphill struggle.
This article has been double-blind peer-reviewed.