Mental health and the media
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Issue 168 September & October 2011
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feature
Covering mental health: a comparison of the UK/US press Despite some progress, mental health coverage in newspapers remain variable and, for the most part, persistently negative. Mary O’Hara
T
ime and again in the course of my work as a social affairs journalist mental health professionals, campaigners and service users have told me they think media coverage of mental health issues is often excessive, exaggerated, inaccurate and negative, especially in newspapers. Many have claimed that coverage has been worsening and that this contributes to stigma.
Studying the media Each time one of these conversations has taken place I have sought out studies to see if any confirmed one way or the other whether such impressions were correct. After many hours poring over research papers it was evident that some key questions about the nature of coverage remained stubbornly unanswered. Some studies identified connections between media depictions of madness and stigma. Others – usually involving a ‘snap shot’ analysis of coverage in a particular week, month or year – concluded that negative coverage, such as linking mental health problems with violence, was commonplace. But is coverage of mental health issues in the press really as poor as people
think? And if it is, is reporting any better now than in previous years? I decided to conduct research probing not only how coverage has evolved over time but how the British press compared with a culturally similar country. With the aid of a scholarship from the UK Fulbright Commission and working alongside world-renowned stigma expert and professor of psychology at the University of California, Berkeley, Stephen Hinshaw, I embarked on an ambitious project which ended up producing some fascinating results. We analysed articles and headlines in a range of mainstream national and regional newspapers in the UK and the US, randomly sampling years from 1985 to 2009.
Not overtly sensational The research measured the tone of articles and headlines on a
four-point scale: neutral, positive, negative, sensationalist. The first significant finding was that the proportion of overtly sensationalist coverage (that is coverage typified by hyperbole and pejorative or offensive language like ‘schizo’ or ‘nutter’) was relatively small. In the British press just two per cent of articles and seven per cent of headlines over the entire period of the study were categorized as ‘sensationalist’. In the US the proportion was similarly small at six per cent and one per cent. Neither the US nor the UK press sample had any sensationalist articles in 2009 (although the UK press did have a small number of sensationalist headlines). Taken at face value this could be interpreted as an indicator of improvement in coverage but other findings on tone suggest a more complex picture.
Overall, a higher proportion of UK articles were negative compared with their US counterparts. This was primarily due to the influence of tabloid journalism in the UK for which there is no equivalent in the American press.
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a comparison of UK and US press
If one goal for mental health camp aigners is to see fewer negative or sensationalist articles then do they need to rethink how they go about convincing media organisations of this? Messages remain negative
Comparing the UK and US press: key findings The single most common message communicated in headlines was ‘risk of violence’. In the UK this accounted for 15 per cent of all messages and 18 per cent in the US. ● News stories in both countries are much more likely to be negative than features, perhaps because feature writers have more time and space to consider nuance? ● UK newspapers, including broadsheets, were much more likely to use inflammatory or pejorative language. ● Depression is the most common condition mentioned in publications in both countries and across all years. ● Schizophrenia is the second most mentioned condition in headlines, although in a very small number. ● References to stigma and discrimination are rarely made in headlines or articles in either country. ● The proportion of coverage referring to ‘firstperson’ or service user experience of mental health is more common in the UK and has been increasing over time. ● Headlines reporting suicide are highly likely to be negative. In the UK, 68 per cent of suiciderelated headlines were negative. ● Stories about overcoming adversity appear more in the US press. ● UK coverage, especially more recently, is much more likely to refer to celebrities or public figures. ●
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In the UK, we found significant differences between tabloids and broadsheets. Almost two thirds (67 per cent) of all broadsheet articles between 1985 and 2009 in the UK were either neutral or positive; in fact almost half (45 per cent) were outright positive. By contrast, tabloid reporting was considerably more negative. Factor in that tabloid circulation far outstrips broadsheets and this result is even more significant as it means negative messages are reaching far more people. When it comes to how headlines, in effect the ‘advertisement’ for stories, compare with articles, the UK had almost the same proportion of negative headlines (47 per cent) as articles (45 per cent). In the US, however, headlines tended to be more negative – 58 per cent versus 35 per cent – suggesting that they are being used more to hype stories than they are in the UK. Nevertheless, overall, a higher proportion of UK articles were negative compared with their US counterparts (45 per cent versus 35 per cent). This was primarily due to the influence of tabloid journalism in the UK for which there is no equivalent in the American press. Over the 24-year-period, the proportion of negative articles in the UK press (tabloids and broadsheets combined) declined between 1985 and 1995 suggesting a longer term change in favour of neutral or positive reporting. However, the proportion of negative articles in 2009 was identical to that in 1995 signifying that earlier progress may
have stalled. In addition, looking only at tabloids, there is no indication over the quarter century we studied of a reduction in negative reporting.
Implications for campaigns So why are these findings on the tone of coverage important? Arguably they could have potentially serious implications for future campaigning around mental health and the media. For a start, they raise considerations about how campaigners should engage with editors and journalists. If one goal for mental health campaigners is to see fewer negative or sensationalist articles then do they need to rethink how they go about convincing media organisations of this? What is clear from this research is that coverage of mental illness in newspapers remains complex, variable and, for the most part, persistently negative. As with all studies of this kind ours was limited in scope but it is nevertheless another step toward identifying and understanding media depictions of mental illness. If the links between press coverage and stigma are to be fully understood, further research into the reality of mental health reporting and how it alters over time is without doubt central to achieving it.
Find out more • Find out more about the research at: http://www.gresham.ac.uk/ professors-and-speakers/mary-ohara
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viewpoint
Hitting the headlines Increasing your chances of getting positive media coverage requires careful preparation. Raza Griffiths
I
t was the local media’s campaign against the opening of a mental health day centre that first made me want to improve media coverage of mental health. I was sliding towards a breakdown at the time, but the media stereotypes of ‘mad’ people, mirroring those of society at large, hindered me in acknowledging that I had a problem and needed help. As a result, I ended up on an inpatient ward where I was forcibly medicated. I had to abandon the PhD I was doing, but later completed an MA in Investigative Journalism after a lucky break in which I was sponsored by a radio
station. I was angry and wanted to write about social injustice including the stigma surrounding mental distress.
Developing a critical voice After working as a freelancer for Eastern Eye, The Big Issue, Gay Times and Mental Health Today, I started working as media skills training officer for a service user-led project called Media Bureau in the Londonbased charity, Mental Health Media. The project trained service users in getting their voice heard in the media around mental health issues. As part of the Media Bureau
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hitting the headlines
Most journalists are not out to 'get you', nor are they generally negatively set against balanced portrayals of mental distress. But they often lack accurate information and people willing to talk about their mental distress.
Media work: some basic tips 1. Prepare for media work with allies so you feel supported and get honest feedback. 2. Be very clear about your objectives, for example, to promote a user-led service, protest at cuts etc. 3. Stick to no more than three key messages. People will not remember more than that. 4. If you use personal anecdotes, always relate it to your key messages rather than emotionally offloading, as you may end up saying things you later regret. Ask yourself: could I handle it if my friends, family or neighbours read or hear what I have said? 5. Become more newsworthy by relating your story to something already relevant in the news, such as new research or existing campaign. You can also adopt a memorable slogan, use an eye catching stunt which would make a good picture or get the backing of a celebrity. 6 Rehearse answering difficult questions you may be asked. Journalists are trained to pick up on your hesitations and use it as a cue to probe you further. 7. To help put you in the picture, ask what the angle to the story is, who else will be interviewed and if reference will be made to any reports. 8. You can try and negotiate confidentiality but bear in mind this will be easier to do for print media than for TV. In the end, it depends how much the media want you. 9. Dress appropriately and make your body language relaxed and authoritative. People generally judge you on how you appear more than what you say. This will be true of a TV audience but also of the journalist, even if he/she is a print journalist. 10. The vast majority of interviews are not hostile or negative but be prepared for journalistic traps like the ‘long silence’ and flattery which are designed to get you to disclose more than you want to disclose.
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team, I was interviewed for ‘Newsnight’ on BBC2, The Times, Radio 4 and my local newspaper, and co-trained and supported over 200 individual service users and groups between 2001–2003, many of whom got successful media coverage. Most memorable of these was the three minutes on BBC Newsroom Southeast for a Mad Pride stunt in which an oversized papiermâché syringe ‘injected medication’ into the backsides of service users outside the annual gathering of the World Psychiatric Congress as a protest against the power of the pharmaceuticals in psychiatry.
is available’ if you are feeling suicidal, together with details of local sources of help. These had, in the first wave of publicity, received scant coverage.
Taking control
In my experience, most journalists are not out to ‘get you’, nor are they generally negatively set against balanced portrayals of mental distress. But they often lack accurate information and people willing to talk about their mental distress. By supplying them with that you can do them a favour, and hopefully become seen as a reliable contact so that Campaign around they will contact you in a future suicide coverage breaking news story. However, it is important to realise that media I later worked as an expert media work is certainly not risk free and adviser for Shift, an anti-stigma iniI have had a few cases where tiative funded by the Department of Health that ran from 2006–2011. things did not go according to plan. For example, an otherwise I advised on Shift’s regular moniexcellent article in The Observer toring of media coverage, which created a benchmark against which giving a sympathetic portrayal of a service user used a photo of future changes in media reporting her which made her look like an of mental health could be measarchetypal ‘sad victim’. ured. Shift also undertook media But remember, if we do not training and support for service take up the possibility of getusers and collaboratively wrote What’s the Story?, a guide on sensi- ting our voice heard in the media, tive reporting of suicide for journal- with the right support or training if necessary, then we conists. I used this to good effect in my work with service users in Kent who demn ourselves to a long silence. I continue offering this support wanted to challenge the coverage through my role as the coordinaof three suicides in Whitstable. tor of PowerUp!, a London-based Following the deaths, the media project which offers training and had referred to the location as a support to carers and service ‘suicide hotspot’ and used sensausers from minority ethnic and tional images. Using the guide as lesbian, gay, bisexual and transa reference to underline that the Press Complaints Commission Code gender communities to enable them to voice their views on the and the World Health Organisation changes happening around the advised against drawing attention ‘big society’ and personalisation to the place and manner of suicide agendas. because of the danger of ‘copycat’ suicides, we were successful in persuading journalists to avoid this kind of sensationalistic reporting Further information for the second wave of coverage • What’s the story? Reporting after the inquests. I also mentored mental health and suicide: http:// a service user who had tried to take www.shift.org.uk/mediahandbook/ his own life to communicate suc• PowerUp!: raza.griffiths@scie. cessfully the message that ‘help org.uk
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in practice
Digital stories: challenging stigma, changing attitudes Mind Cymru is supporting people with experience of mental distress to document their lives and challenge stigma using digital technology. Shelly Hodder
P
eople are increasingly aware of the fact that one in four people will experience a mental health problem in any given year. However, given society’s misconceptions about mental health issues and those of us who experience them, it is not surprising that many people choose not to disclose their experiences, or are concerned about the impact of any disclosure. Mind Cymru is passionate about finding new and innovative ways of tackling the prejudice and discrimination against people who experience mental distress. We are committed to giving people a platform to voice their opinions and change public attitudes to more positive, informed positions.
Why digital stories? Digital stories are an increasingly popular way of challenging stigma and breaking down barriers. Storytelling is innate in all of us; everyone has a story to tell, a journey that is uniquely theirs. We believe that people’s stories are a powerful way of challenging myths and stigma and ‘humanising’ mental health. Reading a paragraph about someone’s experiences may help us understand the challenges they have faced, but watching a film about it, hearing their story told in their own voice, helps us connect with them. Digital stories can help others going through
similar issues to realise they are not alone. They can show how people overcame their issues, proving that people can recover from mental distress.
The digital stories project Digital stories are short films made when someone writes a script, recounting their personal story and illustrates it with their own photographs. Participants have complete autonomy over the story they tell and the images they use, so it is possible for everyone to disclose as much as they are comfortable with or even to remain anonymous if they chose to do so. Mind Cymru worked with Storyworks at the University of Glamorgan to give eight people the opportunity to tell their story. In three-day workshops, the
participants learned how to write a script recording their experiences, create their film and edit it. The storytellers are from a range of backgrounds. Some are volunteers with Mind Cymru, while others are drawn from our network of local Mind associations across Wales.
Structured storytelling The first day of the workshop consisted of some exercises to help participants feel at ease with one another and get to know each other’s lives and experiences. One such exercise was to ask people to share their memories of a favourite childhood toy or game, which helped everyone to find a common ground, share similar experiences and to bond with one another. Structured writing exercises helped build participants’ confidence and imagination. For instance, the participants were asked to construct a short story incorporating a series of random words given to the group. This was followed by an exercise where various photographs and pictures were given as stimulus for writing a short piece. The aim of this work was to help participants to find their writing ‘voice’ and develop their confidence and style. During days two and three, the participants focused on writing their scripts, editing and
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digital stories
recording them, uploading the images they had chosen to support their stories and, finally, to join the images and voiceover into a finished film.
A cathartic process Making a digital story can be a cathartic process which helps people on their journey to recovery. It can also develop self-expression, confidence and self-esteem. The participants learned new skills and had the chance to tell their stories, and made firm friends with each other through the intimacy and sharing processes of the workshop. In return, Mind Cymru got powerful, inspirational films to help educate the public and break the stigma surrounding people with mental health issues. The feedback from participants and workshop facilitators showed that they have really enjoyed the experience: “The process itself was interesting, learning how to use the computer programmes to put the digital story together, but also going through old photographs with the other participants on the workshop. This brought a lot of memories back about our childhoods and past events, whether good or bad, but usually a bit of both. There was a good camaraderie between the three of us on the workshop and I think that helped not to make the process overwhelming as we could help each other if any difficult feelings arose.” (Katherine, filmmaker) “Writing my story down was both painful and healing for me as I realised how far I have now come. Being given the opportunity to make my film has meant a lot to me because I was able to say thank you to my mum, the one person who always believed in me and my ability to recover.” (Lucy, filmmaker) “Digital storytelling is becoming increasingly popular as a tool for
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advocacy. It can be a powerful way for people to express what they have really experienced, and get their own message across, in their own words and at their own pace.” (Karen Lewis, project leader, Storyworks)
Reception The stories have been wellreceived, often making a powerful impact on those who have seen them. BBC Wales asked to feature the first three stories on their regional news websites and on Twitter over the course of a week. The films featured in newspapers in Wales, including the Western Mail, and have turned up on a website as far away as Texas. One of the stories was used to launch the Mind Cymru Manifesto in the lead up to the National Assembly for Wales elections in May 2011, and the politicians present were very impressed. Other people who have seen the stories have spoken of how moving they are and have suggested that they should be incorporated into training packages. Like the participants, Mind Cymru has learnt a great deal from the process of making and using digital stories. We look forward to working with this type of technology and new forms of social media to explore and illustrate other areas of people’s experiences to reach new audiences and challenge the discrimination against people with mental health problems. The next batch of films will be launched by Mind Cymru later this year.
Find out more • Watch the films at: http://www. mind.org.uk/mind_cymru/videos
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