How the Stigma of Mental Health Is Spread by Mass Media

How mental health is portrayed in the media often perpetuates stereotypes and stigmatized attitudes about mental illness. In the aftermath of an unconscionable act of random violence, many people are inclined to label the perpetrator “crazy.” That’s unfortunate, because if a criminal has mental illness, automatically assigning the label “crazy” does a great disservice to people who live with mental illness every day.

In reality, somebody with mental illness is much more likely to be a victim—rather than a perpetrator—of violence. Calling a violent offender “crazy” spreads a dangerous stereotype and belies the complex relationship between criminality and mental illness.

We learn much about people we don’t routinely interact with from the media. Sometimes, it can be a way to learn new things about diverse groups, but it’s also often the source of misinformation. This constant flow of data gives us incessant social cues about the nature of other groups of people—including which groups of people should be praised or scorned.

Consequently, all forms of media—including television, film, magazines, newspapers, and social media—have been criticized for disseminating negative stereotypes and inaccurate descriptions of those with mental illness.

What Is Stigmatization?

Stigma involves negative beliefs, attitudes, and behaviors directed toward people based on some distinguishing characteristics. In the case of mental health stigma, it consists of the presence of mental health symptoms or a mental health diagnosis.

In other cases, stigma can also involve health conditions, disabilities, gender, race, sexuality, culture, religion, and sexuality.

Mental health stigma has significant negative consequences. Evidence suggests that it is linked to worse mental health outcomes because it reduces the likelihood that a person will seek help, receive adequate care, and adhere to their treatment plan.

Stigmatization of Mental Illness By the Media

When looking at mental health in the media, it’s easy to see that signs of stigma are rampant. For example, certain mental health conditions, such as schizophrenia, are seen as being so disruptive that people with those conditions must be isolated from society.

The stigmatization of mental illness is so entwined with the media that researchers have used newspaper articles as a proxy metric to examine the prevalence of stigma in our society.

Media accounts tend to focus on the individual with mental illness rather than framing mental illness as a societal issue. The result? Media consumers are more likely to blame an individual for their condition instead of considering the biological, environmental, and societal factors that play a role in the onset of illness.

For instance, common depictions are that all people with depression are suicidal, and all people with schizophrenia hallucinate. In reality, 60% and 80% of people with schizophrenia experience auditory hallucinations. An even smaller number of people experience visual hallucinations.

It’s also not uncommon for media portrayals to discount that many people with mental illness don’t need to disclose their condition to everyone around them.

Instead, mental illness often goes unrecognized (whether that is intentional or not). The portrayals in the media tend to present situations where everyone in a character’s life knows about their mental illness.

According to the American Psychiatric Association, mental illness can take many forms. It can also range from mild to more severe, which can affect how it impacts a person’s daily life. It’s also treatable, but each person’s treatment is individualized and depends on their condition and needs. Therapy, medication, complementary and alternative therapy, and lifestyle changes are just a few options that can be helpful. For many, a combination of therapy and medication is most effective.

Trivialization of Mental Illness By the Media

Another way that mental health in the media is often misportrayed involves trivialization; it often suggests that mental illness isn’t actually something to worry about.

For instance, people who have eating disorders such as anorexia nervosa often feel that the media doesn’t treat the condition as a serious problem. It often downplays the seriousness of the disease, hiding its serious consequences. Even more concerning, the media’s fixation on thinness can inadvertently normalize and encourage disordered eating behaviors, further perpetuating the problem.

The truth is, the death rate for people with anorexia is high. In reality, anorexia has one of the highest mortality rates of any mental health condition. Research suggests the risk of dying is 10 times higher for people who have anorexia nervosa. 

The symptoms of mental illness are sometimes portrayed as being beneficial. For example, in the popular television series Monk, the protagonist is a detective with OCD. The fact that he pays close attention to detail helps him solve crimes and advance his career.

People who do not have disabilities can use media channels to mock people who do have disabilities, such as by appropriating mental-illness terminology. For instance, the hashtag OCD (#OCD) is commonly used on Twitter to describe one’s attention to cleanliness or organization.

Depictions of Schizophrenia in Film

Probably the most disparaging stigmatizations of mental illness in media lie in the film portrayals of antagonists with mental illness. In particular, when characters with schizophrenia are presented as “homicidal maniacs” in “slasher” or “psycho killer” movies.

In one study, researchers analyzed 41 movies that had been released between 1990 and 2010 for depictions of schizophrenia.

Based on the findings of the analysis, researchers drew several conclusions.

• Most of the characters displayed “positive” symptoms of schizophrenia, with delusions being featured most frequently, followed by auditory and visual hallucinations.
• The majority of characters displayed violent behavior toward themselves or others.
• Nearly one-third of violent characters engaged in homicidal behavior.
• About one-fourth of the characters committed suicide.
• The cause of schizophrenia was infrequently noted. However, in about one-fourth of the movies it was implied that a traumatic life event for the character had been a significant causative factor.
• Of the movies that alluded to or showed mental illness treatment, psychotropic medications were most commonly portrayed.

How Mental Health in the Media Are Damaging

These portrayals of mental health in the media are not only incorrect but damaging—and for several reasons.

They Spread Myths About Mental Illness

The portrayals of schizophrenia often focus on symptoms such as visual hallucinations, bizarre delusions, and disorganized speech, and present them as commonplace. In reality, symptoms like decreased motivation, poverty of speech, and flat affect are more common.

They Link Mental Illness to Violence

Several movies have spread the false stereotype that people with schizophrenia are prone to violence and unpredictable behavior. Some films even presented people with schizophrenia as being “possessed.”

They Exaggerate Suicide Risk

While suicide is a significant concern for people with schizophrenia, the research on media portrayals of schizophrenia found that this risk is often exaggerated in film and tv representations. In one study, 24% of the characters with schizophrenia committed suicide.

In reality, estimates suggest that between 4% and 13% of people with schizophrenia die by suicide, and approximately 18% to 55% attempt suicide at some point in their lifetime.

They Misrepresent Who Is Affected

Demographics is another aspect of mental illness that is often misrepresented by media portrayals of mental illness.

For example, characters with schizophrenia are frequently depicted as being white males, but schizophrenia disproportionately affects African Americans. It also affects men and women almost equally.

They Spread Myths About Causes of Mental Illness

In a few movies, schizophrenia was depicted as being secondary to traumatic life events or curable by love—both of which are misrepresentations of the condition’s causes and treatment.

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What’s Accurate In Media Portayals?

Not all the information presented about schizophrenia was found to be incorrect, misleading, or stigmatizing. For example, in more than half of the movies that researchers analyzed, the use of psychiatric medications was depicted or alluded to.

Even when some movies get it right, the negative media portrayals—especially those that are violent—of people with schizophrenia and other severe forms of mental illness still contribute to stigmatization, stereotyping, discrimination, and social rejection.

Impact of the Media on Mental Health

The impact of mental health stigmatization by the media can contribute to a number of different effects.

• Self-stigma: Media portrayals can contribute to self-stigma, which refers to feelings of internalized shame, negative beliefs, and negative attitudes that people have about their own mental health condition.
• Incorrect information: Because of media portrayals of mental illness, people often get incorrect ideas about the symptoms of mental health conditions. It can also lead people to develop inaccurate ideas about how mental illness is diagnosed and treated.
• Barriers to treatment: Media messages can also create barriers to treatment. Because people internalize stigmatized attitudes about mental illness, they may be less likely to seek out help or treatment when they experience symptoms.
• Poor treatment adherence: People are more likely to adhere to their treatment if they have social support and encouragement from others. Negative attitudes toward mental illness and stereotypes portrayed in the media may contribute to worse attitudes about mental health treatments and poorer adherence.
• Self-diagnosis: People might also be more likely to self-diagnose themselves based on viral social media posts seen on TikTok and Instagram. Such information is often shared by people who are not mental health professionals and is often inaccurate.

What Can Be Done?

We need a better understanding of how these messages are disseminated by the media before we can rectify them. There is limited research looking at how media promotes mental-illness stereotypes, stigmatization, and trivialization.

Nevertheless, certain suggestions have been made on how to improve the depiction of people with mental illness in the media, such as:

• Analyzing mass-media production procedures to better understand screenwriters, producers, and journalists’ current practices, needs, values, and economic realities (for instance, understanding the balance between being newsworthy or emotionally arousing and verifiable).
• Implementing a mental health short course when training journalists.
• Including expert input from psychiatrists during a film’s production.
• Preferring non-individualized descriptions of mental illness and instead focusing on the societal aspects.
• Presenting mental illness only when relevant to the story.
• Using mental-health terminology with precision, fairness, and expertise.

Research suggests that anti-stigma information campaigns designed to reduce media bias can help teach media professionals report on mental health issues more accurately.

Takeaways

Only a specialist can make a diagnosis of OCD, depression, bipolar disorder, schizophrenia, and other mental health conditions. When we give someone the label of being mentally ill without clinical evidence, we hurt people who live with mental illness on a daily basis.