Presentation on the media and mental illness at November 2012 Conference at Birmingham (On the day the Leveson Inquiry report was published!)

1. Public Education Conference
West Midlands Royal College of Psychiatrists
Birmingham, November 2012
A Perspective on the Media and
Mental Illness
Arun Chopra
Consultant Psychiatrist

2. Why this is important
A brief overview of work
Current Issues

3. Reduce Stigma

4. Reduce Stigma
Negative publicity in media contributes to the stigma of
schizophrenia (Kingdon,2006)

5. Reduce Stigma
Negative publicity in media contributes to the stigma of
schizophrenia (Kingdon,2006)
Implications of stigma: political, service, &
clinical level (Lalani,2006; Byrne,2001,Sartorius,2005)

6. Reduce Stigma
Negative publicity in media contributes to the stigma of
schizophrenia (Kingdon,2006)
Implications of stigma: political, service, &
clinical level (Lalani,2006; Byrne,2001,Sartorius,2005)
Social Justice

7. Reduce Stigma
Negative publicity in media contributes to the stigma of
schizophrenia (Kingdon,2006)
Implications of stigma: political, service, &
clinical level (Lalani,2006; Byrne,2001,Sartorius,2005)
Social Justice
75 % mentally ill felt media portrayed them
unfairly (Counting the cost, MIND 2006)

8. The media is the publics foremost source of
mental health information (Borinstein,1982; Robert Johnson Foundation,
1990)
Newspaper Circulation Figures
Early studies reported 70% negative tone
(Nunally,1961; Day & Page,1986)

9. The media is the publics foremost source of
mental health information (Borinstein,1982; Robert Johnson Foundation,
1990)
But what media? Where do
we get our information
from? Is this changing?
Newspaper Circulation Figures
Early studies reported 70% negative tone
(Nunally,1961; Day & Page,1986)

10. The media is the publics foremost source of
mental health information (Borinstein,1982; Robert Johnson Foundation,
1990)
But what media? Where do
we get our information
from? Is this changing?
Newspaper Circulation Figures
Circulation of newspapers is falling
but the influence of the print media...
Early studies reported 70% negative tone
(Nunally,1961; Day & Page,1986)

12. 27 Studies found
Overall 40% portrayals
negative
Improvements in US,
Australian, New
Zealand & European
coverage
(Corrigan,2005; Francis,2004; Nairn,
2001;Meagher, 2003;Pieters,2003)
Crime and violence
predominant
association

13. Author N= Brief results
Goulden et al (2011) 1161 1992,2000, 2008 scz negative dep >
Clement & Foster (2008) 1300 1996, 2005 little change
Chopra & Doody (2007) 600 metaphor, crime association,negative
Lawrie, S(2000) 306 64% negative
Hart&Philipson(1998) RCPsych 1292 54% negative
Ward (1997) DoH 1035 49% crime tabs<bs
Philo et al(1994) 562 66% negative
Scott, J (1994) 241 Crime tabs<broads
Barnes & Earnshaw (1993) 101 60%dangerousness

16. 600 articles < September 2005
‘Schizophrenia’, ‘schizophrenic’ or ‘schizo’
Each article categorised;
Tone: Positive, Negative, Neutral (Wahl,2002)
Context: Education, Reference, Incidental Reference,
Medically inappropriate, Charity Related, Obituary,
Metaphor (Duckworth ,2003)
Narrative
Kappa=0.8

17. Examples Results by tone

18. Examples Results by tone
Negative
40%
Neutral
50%
positive
10%

19. Broadsheets and tabloids

20. Broadsheets and tabloids
P<.001
Broadsheet
Tabloid
60.0%
Percent
40.0%
61.6%
55.6%
41.2%
20.0%
31.6%
6.8%
3.2%
0.0%
Negative Neutral Positive

21. Crime and Reporting of Schizophrenia

22. Crime and Reporting of Schizophrenia

25. Scz:CA::11%:1% p<.001

26. Mary O’Hara’s
research 2010

27. ENOUGH SUPPORT? NO.
24 MILLION
WHAT WORKS?
PSYCHOLOGICAL AND Cognitive Behaviour Therapy
(CBT), arts therapy, family therapy.
PSYCHOSOCIAL TREATMENTS
people worldwide (220,000 in England) are affected by Anti-psychotic medication
schizophrenia, more than 50% are not receiving
appropriate care. PHARMACOLOGICAL TREATMENTS (though this can have serious
physical side effects).
10% 15-20 YEARS
Effective treatment People with schizophrenia
doesn’t yet mean die 15-20 years earlier
effective receipt- than average, mostly
Only 10% receive a full due to preventable
course of CBT. physical conditions.
DANGER?
Sensationalist news media
exaggerate links
between mental illness
and criminal violence. 14x People with schizophrenia in the
community are 14 times more
likely to be victims of a violent
crime than arrested for one.
The reality is, violence is more closely
linked to alcohol and drug misuse in
those with and without mental illness.
THE CAUSE?
Historically, it was claimed schizophrenia
could be caused solely by poor upbringing.
This is a myth.
The leading theory suggests it develops due The risk of developing schizophrenia
to genes combined with life events. Over 10 studies show schizophrenia is more increases if one or more family members
likely to occur in urban areas. are also affected.

28. ENOUGH SUPPORT? NO.
24 MILLION
WHAT WORKS?
PSYCHOLOGICAL AND Cognitive Behaviour Therapy
(CBT), arts therapy, family therapy.
PSYCHOSOCIAL TREATMENTS
people worldwide (220,000 in England) are affected by Anti-psychotic medication
schizophrenia, more than 50% are not receiving
appropriate care. PHARMACOLOGICAL TREATMENTS (though this can have serious
physical side effects).
10% 15-20 YEARS
Effective treatment People with schizophrenia
doesn’t yet mean die 15-20 years earlier
effective receipt- than average, mostly
Only 10% receive a full due to preventable
course of CBT. physical conditions.
DANGER?
Sensationalist news media
exaggerate links
between mental illness
and criminal violence. 14x People with schizophrenia in the
community are 14 times more
likely to be victims of a violent
crime than arrested for one.
The reality is, violence is more closely
linked to alcohol and drug misuse in
those with and without mental illness.
THE CAUSE?
Historically, it was claimed schizophrenia
could be caused solely by poor upbringing.
This is a myth.
The leading theory suggests it develops due The risk of developing schizophrenia
to genes combined with life events. Over 10 studies show schizophrenia is more increases if one or more family members
likely to occur in urban areas. are also affected.

30. Celebrities
Ed Milibands
Speech

31. Help for the
are more likely to develop mental health
conditions.
They experience better outcomes if their
enter mental health conditions are treated.
ogan. Similarly, people who suffer from serious
mental illnesses like schizophrenia are more likely
to develop physical health problems like diabetes
sufferers hit
and heart disease. Services need to be better at
taking a ‘whole person’ approach to an
individual’s healthcare needs.
Another reason why sometimes people choose
not to raise the issue of mental health needs is
that they are a bit mystified and sometimes
scared about what the treatments might be and
whether they really can help.
by ‘black,
The evidence base for the treatments is good.
The National Institute for Health and Clinical
Excellence provides guidance about the available
options and professionals are better able to work
collaboratively with patients to help them choose
what treatment options are best for their needs.
Talking therapies are more accessible than
despairing
before and for many conditions, particularly mild
or moderate depression or anxiety, are all that is
needed.
For those people who need medication, these
can be better tailored to an individual to get the
best possible benefits and to reduce or avoid any
side effects. The message is not to suffer in
silence.
feeling’ of
Although sometimes people get better
a spontaneously, if symptoms are not improving
t 15. through exercise, relaxation, sleep and being in
tish Heart the company of people you care about, it is
tly working better to seek help early than allow things to get
n the Love worse.
reness of I’ve met people who turn to street drugs and
alcohol, initially in order to ‘self-medicate’.
depression
really However, these soon become terrible problems.
to avoid. Occasionally people have severe depression
killer of and require admission to hospital. Sometimes if
ays. the depression is causing thoughts of self-harm
women or preventing people from eating or drinking
lth risk, nor properly and if other treatments haven’t worked,
ol and ECT can be used.
Dr Arun Chopra (right) talks to patient Geoff Smith who is recovering from depression. G See panel for activities and events. For more
gh talking information, go to www.mhaw.org.uk.
icators and
s in that Mental Health Awareness Week starts next week. DR New government legislation that makes it
KEEPING AWARE
become
ARUN CHOPRA, a consultant psychiatrist with easier for employers to hire but also to let go of
workers must be seen in the context of the
e such a
ciety now,
Nottinghamshire Healthcare NHS Trust, discusses some of misery that this might cause.
ternal, so the key issues and urges ‘don’t hesitate to ask for help’’ Mental health awareness events in Nottingham
include:
Fortunately, most people who suffer from
mental ill health do not commit suicide. Their own
vious that
eart disease, Tomorrow: Mind Freedom, open mic and resilience, the support from people around them
FORMER teacher Geoff Smith is currently not all people who choose to take their own life music night, Jam Cafe, Heathcote Street, and the care from services help them recover and
sease is
suffering from severe depression – something suffer from a mental illness, many do. Nottingham, from 6-10pm. get back on track.
d with big
that has afflicted him on and off over the last 20 The past decade has seen a huge Tuesday: Don’t Sweep It Under the Carpet – However, we also know people can suffer from
p butties,” as
years. improvement in our ability as a society to talk a discussion about living with bipolar disorder, symptoms for many years before they seek or
Mr Smith, 64, from Sherwood, agreed to speak openly and honestly about mental illness. But Central Library, Angel Row, Nottingham, from receive help. It can be years before they receive a
ried diet for
about his experience of mental illness to there is still further to go to remove the stigma 7-8.30pm. diagnosis and start to get the help they might
e aim at the
encourage others to seek help. that prevents people from seeking help and that Wednesday: World Mental Health Day need to begin their recovery.
home.
The avid pianist describes his depression as a creates further barriers for those who experience Ecoworks Garden barbecue. Ransom Road, St Research carried out by the Royal College of
ces are
“black, despairing feeling.” the symptoms of mental illness to return to active Ann’s, 12-2pm. Contact Paul 07973 116291. Psychiatrists earlier this year showed that, on
alth and
He first noticed the onset of the symptoms as lives within the communities that they live in. Friday: Families Rooting for Recovery, average, it takes 13 years for someone to get the
d vitality.”
an inability to concentrate at the start of term. It This year’s World Mental Health Awareness 10am-3pm. To book e-mail events@ correct diagnosis of Bipolar disorder (an illness
are
affected his motivation and his enthusiasm. He Day falls on Wednesday and is an opportunity to brightideasnottingham.co.uk or call 0115 associated with periods of mania and
ed, red meat
describes a sense of relief when he was raise awareness of mental illness and treatments 8379474. depression).
r of chicken
diagnosed with depression by his GP. His family and have those open discussions that we need. Monday, October 15: Art Outlook Healthcare professionals need to be better
has been supportive of him through his illness. Exhibition, Nottingham Contemporary, trained at recognising the signs and symptoms of
’t a priority
As Mr Smith’s depression didn’t respond to 10am-1pm. someone who is unwell. Unlike a broken arm or
ecently
wear
eedo,
medication alone, he is currently receiving
electroconvulsive therapy (ECT) and occupational ‘I’m fortunate to share the Tuesday, October 16: Celebrating Success
and Recovery, Council House, Nottingham,
hypertension, there are no x-rays or
measurements that accurately diagnose mental
essively
mother of
therapy on an in-patient ward at the QMC.
ECT has a bad image in the media – I think joy of the many patients 11am-3pm. To book e-mail maureen.black@
nottinghamcity.gov.uk
illness – we rely on carefully listening to the
stories that people tell us about the difficulties
ng about
unjustly. For some people it can be life-saving.
Portrayals of ECT are quite often inaccurate. with mental illness who G For full list go to www.mhaw.org.uk that they are experiencing.
Unfortunately many people still find it difficult
eat for your
Mr Smith’s enthusiasm has returned and he is
about to return home. He is looking forward to recover and more to talk about mental health issues.
Although attitudes have changed significantly
ably find it Since 1997 the number of suicides across the
be
spending time with family and friends. In the near
future a mental health team in the community will importantly, get on with the country started to fall each year. However since since celebrities have been more open about
their own experience of mental health problems,
believes. the economic recession, this downward trend
s to pass on
work with him to try to prevent recurrences of the
depression. things they value in life’ has been reversed and in 2008 and 2009 we’ve the stigma that surrounds mental illness has been
part of our culture for so long that it is taking time
er children. seen a rise in the number of people taking their
An estimated one in four of us will experience for it to be stamped out.
o talk to There are activities and events in and around own lives. The number fell slightly in 2010 but it
some form of mental illness during our lifetime. It I’m pleased that at the moment the Mental
s making Nottingham in the coming week, all aimed at has not returned to 2007 levels.
is the leading cause of people needing support Health Discrimination Bill, making its way through
any encouraging people to challenge negative Research has shown that economic recessions
through the benefits system and the cost to the Parliament, will repeal a section of the Mental
e perceptions that they might hold about people are associated with an increase in suicides. The
economy of treating mental illness and the loss of Health Act that meant MPs had to vacate their
productivity is £77 billion. who’ve experienced mental health difficulties. causes that underlie this association are not fully
s all about clear but it is well known that unemployment, seats if they were detained under the act. This
But from my perspective as a consultant I’m fortunate to share the joy of the many sent the wrong message – that people with
psychiatrist working in an in-patient ward at patients with mental illness who recover and alcoholism and homelessness are risk factors.
ieves it’s A research study in the British Medical Journal mental illness couldn’t recover (when the truth is
Nottingham’s QMC, it is the impact of mental more importantly, get on with the things they we see people recovering every day) and that
fresh value in life. in August found that those areas of the country
illness on individuals and their families and people with mental illness shouldn’t be able to
of time However, this year as we celebrate mental that had experienced greater levels of
friends that is far more apparent. play a full role in our democracy and in public life.
Without treatment and support, mental illness health day and the remarkable journeys of joblessness in recent years had also experienced
sit down a greater rise in the number of suicides. The East If the bill is passed, it will be another step
can rob so many people of their ability to reach recovery, I’m also mindful of the fact that these towards removing stigma and creating parity
ours,” she are difficult times for many people with mental Midlands had the third highest rates of suicide.
their full potential and so many families see their between physical and mental health.
loved ones in anguish. health difficulties. We need to have systems to support people who
ve Your might be experiencing distress while searching In many ways, the distinction between physical
Most tragic of all, each year around 5,000 I am also concerned about the rise in the and mental health is not a helpful one. People
urheart.com number of people who are dying by suicide. for work and prevent them from becoming
people in the UK take their own lives. Although who suffer from chronic physical health problems
unwell.
Visit our website www.thisisnottingham.co.uk NEP-E01-S2 EP01 NEP-E01-S2 EP01 Visit our website www.thisisnottingham.co.uk October 6, 2012 WEEKEND 27