N518 Module 6 assignment: media coverage of mental illness and stigma discussion post, a full sample

Module 6 Discussion: Initial Post

The Headline Said 'Mentally Ill': Media Coverage, Accuracy, and the Cost of Stigma

The coverage I analyzed is a pattern I see often: a local television news story about a shooting whose headline identified the suspect as "mentally ill" before any diagnosis was confirmed. The story quoted a neighbor who said the man "was always strange," mentioned that he had once been hospitalized, and ended with a call for tighter controls on "people with mental illness." There was no mention of treatment, recovery, or the far more common link between mental illness and suicide.

Accuracy. The framing is typical but misleading. McGinty et al. (2016) studied a random sample of 400 U.S. news stories about mental illness from 1995 to 2014 and found that violence was the most frequently mentioned topic, appearing in 55 percent of stories, and that stories in the second decade were more likely to mention mass shootings. Only 14 percent described successful treatment or recovery. That emphasis does not match reality. Epidemiologic studies show that the large majority of people with serious mental illness are never violent, while mental illness is strongly associated with suicide, which accounts for more than half of U.S. firearm deaths (Swanson et al., 2015). The violence most strongly linked to mental illness, in other words, is the kind the story never mentioned. Coverage that pairs mental illness with violence teaches audiences to fear the people who most need them to be understanding.

Impact of stigma on treatment. Stigma matters clinically because it keeps people from seeking care. A systematic review of 144 studies with more than 90,000 participants found that stigma had a small to moderate negative effect on help-seeking; internalized stigma and stigma about treatment itself were most often associated with avoiding care, and concerns about disclosure were the most commonly reported barrier (Clement et al., 2015). The review also found that ethnic minorities, young people, men, and people in military and health professions were disproportionately deterred. A viewer with early psychotic symptoms who sees that headline has one more reason to stay silent.

Implications for assessment. For advanced practice nurses, this matters during every mental health assessment. Patients may minimize symptoms because they fear being labeled dangerous. Asking about mood, thoughts, and suicidal ideation in a routine, nonjudgmental way, explaining why the questions are asked, and using person-first language (a person with schizophrenia, not a schizophrenic) reduce that fear. Our own words in charts and handoffs shape how colleagues see patients as much as headlines shape the public.

Did anyone find coverage that portrayed mental illness accurately or highlighted recovery?

References

Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., Morgan, C., Rüsch, N., Brown, J. S. L., & Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45(1), 11-27. https://doi.org/10.1017/S0033291714000129

McGinty, E. E., Kennedy-Hendricks, A., Choksy, S., & Barry, C. L. (2016). Trends in news media coverage of mental illness in the United States: 1995-2014. Health Affairs, 35(6), 1121-1129. https://doi.org/10.1377/hlthaff.2016.0011

Swanson, J. W., McGinty, E. E., Fazel, S., & Mays, V. M. (2015). Mental illness and reduction of gun violence and suicide: Bringing epidemiologic research to policy. Annals of Epidemiology, 25(5), 366-376. https://doi.org/10.1016/j.annepidem.2014.03.004