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Joy On

Nathan Hellmers

English Composition II

24 October 2020

Media Representation and Mental Illness

According to Mental Health America, using data from a national survey, mental illness

rates were increasing even before the pandemic; between 2017 and 2018, the number of mentally

ill people increased by 1.5 million compared to the year before. However, with the COVID-19

pandemic and other factors, mental illness rates have been rising even more as stress levels

skyrocket. Every day, the rates of media consumption rise as well. Social media, the internet,

new movies and books, and other forms of media constantly influence people’s thoughts and

emotions with increasing potential. With mental health being a pressing concern more than ever,

the media becomes integral to promoting acceptance, encouraging help-seeking, and spreading

education on the topic. Unfortunately, studies show that the media has consistently portrayed

mental illnesses and psychiatrists inaccurately, stereotypically, and harmfully. As a person with

friends who have heavily stigmatized mental disorders such as schizophrenia and dissociative

identity disorder, or DID, I have experienced the hurt with them when they see movies such as

Split portray DID as dangerous and violent or when a prominent figure on social media

denounces the disorder. This experience is not limited to just my circle; throughout the U.S. and

other countries, people are affected, positively or negatively, by media representation of their

mental illnesses. Overall, the way mental disorders are represented in media has a potent effect

on public perception, as it can stigmatize and alienate those with or in the field of mental

illnesses, but also normalize and humanize them when done correctly.
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The media portrays mental illness through various formats, able to reach many audiences.

Anat Klin and Dafna Lemish, in a review of two decades of research behind the influence of

mass media on mental illness stigma, report that soap operas, magazines, the news, broadcast

media, and other types often feature mental illness representation (4). Otto Wahl, a clinical

psychologist, also pointed out other forms of media that show mentally ill characters such as

cartoons, comics, and even the music industry (5-6). For example, one in every eleven popular

adult television show had a character with a mental illness, and in a study of 49 children’s films

released between 2000 and 2001, twelve films featured mental illness, with fourteen characters

total who were mostly white, male and single (Wahl 4). Even in fiction, rates of mental health

depiction are higher. According to Heather Stuart, in a study of media portrayal of mental illness,

one-fifth of all prime-time television shows had mental illness in them and 2-3% of adult

characters were mentally ill. One-fourth of them killed someone and half of them hurt other

characters, giving them a 30% offense rate compared to the 3% of “normal” characters (2). Not

only that, but Wahl found that characters are seen as unkempt and ugly, and they are thought of

as always acting irrationally or villainously (5). A common depiction in media is schizophrenia,

a disorder that significantly affects someone’s ability to think, feel, and behave clearly, as seen in

many movies and shows that often portray it inaccurately and as something dangerous and

violent, causing it to be one of the most stigmatized disorders (Zimbres 1).

Schizophrenia is not the only mental disorder often targeted by the media. In news

reports, oftentimes stories of mentally ill people committing crimes are sensationalized and

dramatized, parading the crimes as intentional violent attacks (Klin). Television and film also

tend to show that mental disorders cause people to become aggressive and erratic or stop them

from being responsible and functional members of society in a derogatory manner (Klin). Not
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only are the mental illnesses themselves depicted inaccurately, but their causes and treatments

are as well. Due to many films showing electroshock therapy as only a cruel punishment by cold

professionals for misbehaving patients, many, including new medical students, are lead to

believe that it is inhumane when it can, in reality, be useful in helping people with some mental

disorders (Srivastava). Psychiatrists who administer treatment are also portrayed as depraved,

controlling, and vindictive caricatures who use drugs to hold power over their patients

(Srivastava). Gender bias is also common; males are disproportionately shown to be a majority

in the mental health field when the opposite is true, and the media often describes the women

that are part of it as “lacking femininity and professional power” (Klin).

Some reasons behind the inaccurate representation of people with mental disorders are

that people are drawn to content that elicits strong emotional responses, such as fear. When news

reports sensationalize certain situations, such as a person that is mentally ill committing a

murder, people flock to the story because of the dramatized spin and “gruesome” story; they

become fearful of the “other.” Other reasons are that news reporters are often ignorant about

mental health knowledge, and when they tell the stories, the audience is usually uninformed as

well and take what they hear as fact. Positive representations are few and far between compared

to the number of negative ones, and they are often drowned out because “ordinariness lacks

dramatic power” (Nairn 6). By focusing on controversy and causing anxiety, news reporters can

be more memorable while unintentionally perpetuating stigma (Stuart 3). In television, the

production focuses on maintaining pace and keeping suspense and tension over accuracy;

research is seen as unnecessary as it wastes too much time (Nairn 6). Because people and

characters seen in the media are intended to reflect reality, they become resources that

continually compound the stigma and stereotypes surrounding mental disorders.

These portrayals illustrate heavily inaccurate and harmful ideas about mental illness

because they are so prevalent. When depicted as violent and irrational, it implies that mentally ill

people are socially unacceptable, creating an “us vs. them” type of mindset that causes people

with mental disorders to be treated with prejudice and hostility because they are perceived as

dysfunctional or a danger to themselves and especially others (Klin 2). News narratives and

others often use frames, which rely on previous background knowledge, to tell the story; by

forcing audiences to rely on previous images of mental illness they have seen to gain context for

the current one, it reinforces stereotypes in a person’s brain (Stuart 3). According to five

different studies reviewed by Raymond Nairn, the media explicitly juxtapose a layman’s view of

madness--animal-like, damaged, and out of control--with mental illness, especially

schizophrenia, because images of hysteria and delusions are already so commonly associated and

easily accessible in people’s minds (7). Furthermore, oftentimes the perspective of someone

getting properly treated and recovering from mental illness is omitted (Fawcett). If there were

only a few negative depictions, the problem would not be as major as it is; however, as that kind

of portrayal is so common and widespread, it compounds and multiplies itself across every

person’s perception with each share, creating the impression that the depictions are common,

frequent events in real life (Stuart 5).

Moreover, young children are especially affected by the media. Stuart states that starting

from an early age, children develop their views using media before they even learn how to

discern fact from fiction (4). When they reach school age, children would have already seen

three years’ worth of television, meaning they could have witnessed countless numbers of news

reports about people with mental illness committing crimes. Therefore, they constitute a new

generation internalizing the same stigmas and stereotypes of previous ones, even with the recent
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education and campaigns starting up (Stuart 4). Again, children’s shows also portray people with

mental disorders as unworthy members of society, unpredictable, and dangerous as well as likely

to fail, be manipulated, be harmed, or be killed. Wahl states that children likely learn the

meaning of “crazy” when they are starting elementary school (2). As children are so easily

influenced and react with more intense emotional responses, media can exert stronger forces on

their mindsets and can “override” personal experiences with mental illness, previous education,

and positive news/sources. For two instances, psychiatric treatments for mental disorders are

often viewed with suspicion despite the clear evidence that it works, and although many studies

show that those with mental disorders are more likely to be victims, people believe them to be

violent criminals more than anything else.

On the other hand, some say that because mental illness is portrayed in a fictional format,

such as a television show, that it does not affect people’s perceptions, or that people know that it

is fictional and that it will not affect them. However, a representation being fictional does not

diminish anything from its effect on public perception. For example, in the movie Split, the

villain has dissociative identity disorder and is portrayed as evil, cannibalistic, violent, and

sadistic. While part of the fictional genre, the movie had an immense impact on how people

began viewing dissociative identity disorder (DID), likely a mental disorder that they had not

heard of before the release of the movie. Because having personal experiences forms a stronger

and more stable attitude, those with indirect or no experience with a subject matter will be more

inclined to persuasion through messages and other means (Zimbres 2). Therefore, audiences who

watched the movie would be shocked by all of the terrible crimes and actions the villain

committed, subconsciously developing a negative perception of the disorder and believing it to

cause those affected to be violent and murderous. In reality, the disorder is rooted in intense
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childhood trauma and is formed to protect the child from further harm (Bhandari). Those with

DID are victims of violence themselves more than they ever are perpetrators of violence. Yet,

because of the bad representation of DID, audiences are led to believe the opposite and are

encouraged to harbor fear against the disorder. Regardless of whether a portrayal of mental

illness is fictional, it will always have the ability to affect reality and public perception.

Furthermore, some people believe that the media has no effect at all and that proper

representation of mental health or other subjects is unnecessary. However, studies have clearly

shown that the media has a large role in shaping one’s views. According to Julia Crant in her

experiment of the relationship between schizophrenia and its media portrayal, in a study done in

2003, findings displayed that watching a documentary about schizophrenia helped lower fear of

the mental disorder and reduce stigma (2). In Crant’s experiment, those who viewed the video

portraying a person with schizophrenia leading a successful life then saw schizophrenia as

significantly more positive and less dangerous than those who viewed the control video of koalas

(4). Some people also argue that even if media portrayals of mental illness do affect perception,

it is a weak influence. Yet, as outlined previously, the media can be a powerful agent in

influencing the public, especially when certain portrayals are so commonplace. According to

Nairn, the way one experiences is the world is real, but it is one’s interpretation of that

experience that leads to the creation of one’s meaningful “reality,” and one’s interpretation is

influenced by the media (2). “Meaning-making,” as he refers to it, is social, and by talking about

one’s experiences and listening to others, one absorbs different fragments and images, and over

time, one becomes familiar with a “cultural image bank” of different resources to draw from in

the future (2). Therefore, when in one’s “cultural image bank” there are many images of mental

illness associated with violence and madness, it becomes normal for one to continue to draw
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connections with those images. Nairn compares the process to the song The Twelve Days of

Christmas; each time images of people with mental illnesses committing crimes on the news are

absorbed, it combines with previous images to strengthen and compound the associations within

one’s head (2).

Media representation has a profound effect on mental illness stigma and therefore on the

people with those mental illnesses. The effects of representation can be short-term or long-term,

but oftentimes, they are long-term. For example, Ka-Fai Chung et al. created a study in China of

22 people with mental illness, interviewing them once in 2001 and again in 2017 in an attempt to

see how their experiences with stigma had changed over time and how they thought mass media

could affect it. Many participants reported that things had barely changed over the years, stating

things such as “I think there is no reduction in stigma. Maybe people just do not show it

explicitly, but deep inside they still want to distance from us … the situation has not changed at

all” and “...they still think we are less capable. So they would exclude us …” (3). These feelings

caused them to feel unworthy and excluded and caused deep frustration for many of the

participants. As one participant said, “Whenever there were negative comments about me, my

mood would be affected. I was not a person with high self-esteem and how others thought about

me had a great influence on me,” showing how those with mental illness are fully aware of how

the media and society view them and that it can affect them (3). Another participant said that if

other people “know your illness, you will definitely lose your job” and that even if you do not,

“the criticisms from your colleagues make you feel like you have to leave” (4). Many were given

lower salaries and less responsibility after employers learned of their mental illness as well(5).

Bad media representation can prevent one from applying for a job at all or even volunteer (Stuart

5). One participant’s friends rejected them and refused to interact with them after they learned
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they were mentally ill (4). Stigma and stereotypes have a strong effect on those with mental

illness, causing them stress in their daily lives and feelings of inadequacy.

Not only does stigma cause those with mental disorders to feel negative, but it can also

have disastrous consequences. With so many people believing mental illness to be so dangerous,

it can lead to people justifying forced legal action, coerced treatment, and bullying/victimization

(Stuart 4). Many of these actions can be viewed as inhumane, but if the public views a person

with mental illness as less than human already due to the many negative lights they are shown in,

then they feel right in doing so. Not only that, in a study done by Patrick E. Jamieson on the

effects of films showing suicide on teenagers, he found that exposure to films with mentally ill

characters related to believing treatment for depression and other illnesses to be useless

(Jamieson). Stuart’s results confirm this; many psychiatrists blame the media for causing people

to deny their symptoms, avoid seeking treatment, and ignore their prescribed treatment

guidelines. Films that portray suicide can increase the chance of a youth committing suicide

because it can cause them to go from ideation to action; if teens already believe that treatment

would be worthless and are already suicidal, films that depict and dramatize suicide can have an

even stronger effect because they are already vulnerable (Jamieson). Films are not the only

media that can encourage people, especially adolescents, to commit suicide, however; news

reports of things like celebrity suicides have also been shown to increase the number of suicide

attempts significantly (Srivastava). Overall, depictions of mental illness, treatment, and suicide

in the media can cause people, in particular adolescents, to reject seeking help and even commit

suicide themselves.
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Fig. 1. The graph labeled “high” represents those who are already depressed or suicidal and

the graph labeled “low” represents those who are not. The predictions were based on the results

of a study by Patrick E. Jamieson (“Do Films about Mentally Disturbed Characters Promote

Ineffective Coping in Vulnerable Youth?”).

However, when used correctly, the media can also be a powerful tool in helping a

positive perception of mental illness when done correctly and carefully. Some measures have

already been made in this direction with educational programs as well as ones that want to locate

stigmatizing media, such as an Australian campaign called StigmaWatch. StigmaWatch sorts

news media into two different categories: the Good News file and the Stigma File. The criteria

for going into either category is based on its usage of potentially derogatory language, the

amount of stereotyping it does in its imagery or story, and others. While the campaign may seem
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like a great thing for those with mental illness, StigmaWatch represents something that still

needs revision to be of the best service possible. Kate Holland, from the University of Canberra,

undertook an analysis of the campaign and its potential effects, finding that it could be damaging

towards the work done for lowering the amount of stigma in mental health. The paper questions

the effectiveness of what StigmaWatch aims for because many of its complaints often focus on

surface-level, innocuously-intended language, reinforcing a connection between the words and

ideas of mental illness by purposely searching for what can be deemed as offensive (15). Though

the language one uses can affect the way they think about mental illness, Holland points out that

by policing language so heavily rather than focusing on broader topics, StigmaWatch can cause

people to internalize a “stigma consciousness” that makes them worry about and anticipate being

shot down for unintentionally using the wrong word (11-12). This shifts a person’s thoughts

away from the big ideas of stigma and stereotypes and more towards being criticized for the

simple use of words, causing a sense of frustration and thus more negative associations with

mental illness.

Even though StigmaWatch may need to revise its criteria for good news and stigma, it is

still an important step for mental illness getting better representation in media and can serve as a

building block to work off of. Holland found that rather than the policing of language, the

reclaiming of derogatory language by those it is aimed towards can prove more effective in

reducing stigma’s effect on people by causing pride and positivity rather than hurt when the

language is used. It challenges the way psychiatric labels placed on people can stigmatize them

because it reframes their experiences into something personal and part of their identity (13).

Other solutions may include training those in the mental health field on how to work together

with mass media to educate the public or review forms of media to help people like reporters and
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writers avoid stigma and stereotypes (Stuart 6). In news specifically, telling reporters and

stations to avoid glamorizing and dramatizing things like suicide and mental illness and to

maintain a solemn tone of mourning rather than agitation or excitement can help greatly, as well

as instructing them to complete proper research, encourage help-seeking within the news, and

offer hope (Srivastava). Giving a voice and platform for those with mental illness to speak out

about their experiences and lives to a wide audience as well as the ability to interact with

someone with a mental disorder can also help to humanize and normalize mental illness because

it gives the reminder that people with mental disorders are still people (Nairn 7) (Stuart 6). In

terms of educational campaigns, various methods can be used, but the most important thing is

that they exist at all and are informative. In Zimbres’ study of the effectiveness of two stigma-

reducing campaigns for schizophrenia, one specifically addressing people’s responsibility and

the other addressing the media’s, he found that both were effective in decreasing the perception

of the dangerousness of the disorder (8). Not only should adults be educated, though, as children

and teenagers are also very impressionable by the media and would benefit from the

normalization of mental disorders; it is the only way that stigma reduction campaigns will have

long-term success (Wahl 8).

Though the mass media has been used for decades to spread misinformation and increase

stigma and stereotypes of mental illness, affecting public perception of them, it can be a

formidable ally in spreading education and encouraging help-seeking behaviors. Stigma and

stereotypes have slowly gotten better over the years, but it is still inadequate. Movies need to

stop using mental disorders to demonize their villains and news reports need to learn to tell their

stories mindfully and respectfully rather than jumping on the gun to sensationalize them. Those

with mental disorders should not have to deal with discrimination or fear for things that they
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cannot control; no one ever chooses nor wants to have a mental illness. They should be able to

ask for help and treatment when they need it without fear of being ostracized or that the doctor

will end up harming them due to the way psychiatrists and psychologists are so often portrayed.

My friends and others afflicted by mental illness should not have to feel unworthy, broken, or

that they are faking because of how they see those like them treated by the media and how so

many online influencers have spoken out against them. The mass media so far has been used to

stigmatize, stereotype, and hurt those with mental illness, intentionally or not, but there is so

much hope and potential for it to change and begin helping and informing. It can be used to turn

the tide of public perception towards positivity and kindness. In a world where mental illness is

treated with compassion and empathy rather than derision and fear, human beings would be able

to receive the help they need and find the solace and support from friends to encourage recovery

rather than worry about how the rest of the world will treat them or be against them.
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