Stigma does not affect everyone with a mental illness in the same way. Reinforcing the differences between illnesses, an international study by Indiana University, which involved 16 countries, found that when compared to depression, stigma against schizophrenia is significantly higher across the world. This study also looked at cultural barriers and community beliefs, which provide an important context. For example, if people believe that mental illness is caused by bad deeds in one’s ancestry or by evil spirits, or that simply talking about mental illness can make it worse, then any stigma reduction activity has to start there (Rooney, R et al 1997. Investigation of Stigma and Mental Illness Amongst Non-English Speaking Background Communities and Development of Approaches to its Reduction.
Australian Transcultural Mental Health Network; Pescolido B. et al 2013. The ‘Backbone’ of stigma
. American Journal of Public Health, 103,5, pp.853-60).
Research by SANE Australia (SANE Research Bulletin 4: Stigma and mental illness) suggests that the majority of people living with a mental illness have experienced stigma and regard improved media reporting as the most effective way of reducing stigma.
The inaccurate depiction of people with mental illness in the media – especially in news reports and advertising – is clearly one of the most visible and harmful forms of stigma. People may be shown as violent, comical or incompetent: objects of fear or ridicule.
SANE Media Centre and StigmaWatch
In 1999 SANE Australia launched StigmaWatch, an innovative program voicing community feedback about representations in the media that stigmatise mental illness or inadvertently promote self-harm and suicide. StigmaWatch also shares positive feedback with the media following accurate and responsible portrayals of mental illness and suicide, thereby helping to break down stigma and increase understanding of mental illness.
Funded as part of the National Suicide Prevention Program, StigmaWatch is part of the SANE Media Centre, which provides the media and mental health sector with day-to-day guidance about reporting and portrayal of mental illness and suicide-related issues. StigmaWatch invites anyone who hears, reads or sees a portrayal of these complex issues in the media that they believe is offensive or inaccurate or reported well, to contact the team. They review and follow up with the journalist or advertiser if the issue meets certain criteria. StigmaWatch encourages people who have concern with media portrayal, or want to congratulate a reporter, to contact the media outlet and pass on their feedback.
In recent years there have been some improvements in media reporting and portrayal of mental illness in Australia. At the same time there has been a significant increase in reporting about suicide in the media. This is positive, as research increasingly indicates that the media can work to prevent suicide. The positive role that the media can play in reaching out to many different audiences, to improve attitudes, reduce stigma and promote mental health literacy is also being recognised.
A review of mental illness and suicide reporting in the media (Pirkis J et al 2008. The Media Monitoring Project: Changes in Media Reporting of Suicide and Mental Health and Illness in Australia: 2006-07. Commonwealth of Australia) found that in 2006/7, the Australian media had almost doubled its coverage of suicide compared with 2001/2 and responsible reports increased from 57% to 75%. In addition, reference to method – seen as a possible trigger for those vulnerable - had reduced substantially.
However a recent study by the University of Melbourne (Cain B et al, 2013. Schizophrenia in the Australian print and online news media. Psychosis, DOI:10.1080/17522439.2013.764 349 3) of 630 Australian online and print news media stories citing ‘schizophrenia’ over 12 months, found violence featured in 47% stories and 46% were assessed as stigmatising. People identifed as ‘schizophrenic’ were disproportionately reported as male and as perpetrators rather than victims of violence and the more stigmatising stories were found in tabloids.
Mental health policies in Australia and comparable countries have acknowledged the need to tackle stigma, but the challenge remains to translate these policies into effective action. In its recent report A Life without Stigma, SANE Australia argues we need a national, long-term strategy and campaign to reduce the stigma and discrimination associated with mental illness, with a particular focus on psychotic illness. According to the WHO, attempts to fight stigma by undertaking massive public education programs alone, have been of limited effectiveness in reducing the stigma associated with mental illness and suicide.
New, innovative methods that are more target-group specific, 'top-up' community-based, and that creatively use social media need to be developed and tested. As the International Association for Suicide Prevention has stated ‘Despite the difficulty and complexity of fighting stigma, we don't have an option. Unless stigma is confronted and challenged, it will continue to be a major barrier to the treatment of mental illnesses and to the prevention of suicide.’