Schizophrenia in the News: The Role of News Frames in Shaping Online Reader Dialogue about Mental Illness

The depiction of people with schizophrenia in news media: A cross-national analysis

BACKGROUND

Though people with schizophrenia have been habitually stigmatized in the media, the past two decades have seen a substantial rise in public awareness and anti-stigma intervention plans.

AIMS

In this comprehensive cross-national study, we examine the portrayal of people with schizophrenia in the news media across four countries: the U.S., the U.K., Russia, and Israel.

METHODS

We employed thematic content analysis to analyze 80 articles from four prominent middle-market and tabloid news media outlets.

RESULTS

Findings suggest people with schizophrenia were routinely depicted in the news media as violent and dangerous perpetrators who were typically young adult white males.

CONCLUSIONS

Though some differences existed between venues in different countries, this study suggests that despite the rise in public awareness and anti-stigma intervention plans, the media overall - regardless of country origin - mostly failed to deliver the desired anti-stigma results.

The Suicide of Egyptian Queer Activist Sarah Hegazi in the News: A Comparative Analysis of the Coverage in Egyptian, Lebanese, and American Media

This study is a textual analysis of Egyptian queer activist Sarah Hegazi's suicide in 2020. Based on a grounded theory approach, qualitative analysis was performed on 23 media articles from Egypt, Lebanon, and the United States, with particular focus on episodic/thematic frames and the stigma/stigma-challenging frames due to their significance in studies about mental illness. The main findings reveal that Egypt had the highest stigma frames coupled with the lowest sympathy theme and the least attack on the Egyptian regime, whereas US and Lebanese outlets displayed high sympathy and vehemently attacked the Egyptian regime. Further, the study explains the findings in relation to country media systems. The significance of the study lies in its analysis of media coverage in three countries to help us understand how Arab and American media discuss the intersection of mental health and queerness in the Arab world. It also enriches the health communication literature as the first study to analyze the framing of the suicide of an Arab woman outside the context of war.

Swapping Insults, Neglecting Policy: How U.S. Presidential Candidates Communicate About Mental Health

Candidates for high office in the United States play an important role in determining the political agenda and shaping public and mass media understanding of which issues should receive attention. Critics contend politicians rarely address mental health, despite the importance of the federal government in ensuring Americans access to quality care. Two studies sought to understand how candidates for the presidency communicated about mental health using formal (mental, depress, anxiety) and informal (crazy, insane) terminology in social media posts and debates. Two coders examined 1,807 tweets from 41 politicians who competed in the 2016 and 2020 races, plus transcripts from 47 debates during the primaries and General Elections. Politicians often stigmatized mental illness, using mental health-related slang to insult opponents. They afforded less attention to policy and calls for action. The authors offer recommendations for mental health professionals and advocates to encourage politicians to address mental health policy while avoiding stigmatizing language.

Mental health awareness of secondary schools students: Mediating roles of knowledge on mental health, knowledge on professional help, and attitude towards mental health

Purpose

The mental health situation among adolescents in Malaysia has reached a worrying state with the rising number of cases. Despite a significant increase in the literature on mental health, there is a lack of studies that focused on mental health awareness. Therefore, this study aimed to investigate the factors affecting Malaysian youth's mental health awareness as well as the mediating roles of knowledge on mental health, knowledge on professional help, and attitude towards mental health.

Methods

Self-administered questionnaires were distributed to 450 secondary school students aged 15-19 years old in Kuala Lumpur and Melaka who were recruited via purposive sampling. Data analysis was performed using SPSS and SmartPLS to obtain the descriptive analysis, measurement model, and structural model.

Results

The results indicated that mental health awareness was influenced by knowledge on mental health and attitude towards mental health. The findings also revealed that familiarity and media exposure were important determinants of knowledge on mental health, knowledge on professional help, and attitude towards mental health. Moreover, the results indicated that knowledge on mental health positively mediated the relationship between media exposure and mental health awareness. Besides, attitude towards mental health also found to play mediating roles between familiarity and mental health awareness, as well as between media exposure and mental health awareness.

Conclusion

This study contributed important knowledge to the limited literature in this contemporary domain. An effective public mental health campaign is needed to reduce the burden of disease and the cost of mental illness.

Stigmatizing Monkeypox and COVID-19: A Comparative Framing Study of The Washington Post's Online News

BACKGROUND

Stigma relating to health can result in a broad range of vulnerabilities and risks for patients and healthcare providers. The media play a role in people's understanding of health, and stigma is socially constructed through many communication channels, including media framing. Recent health issues affected by stigma include monkeypox and COVID-19.

OBJECTIVES

This research aimed to examine how The Washington Post (WP) framed the stigma around monkeypox and COVID-19. Guided by framing theory and stigma theory, online news coverage of monkeypox and COVID-19 was analyzed to understand the construction of social stigma through media frames.

METHODS

This research used qualitative content analysis to compare news framings in The Washington Post's online news coverage of monkeypox and COVID-19.

RESULTS

Using endemic, reassurance, and sexual-transmission frames, The Washington Post predominantly defined Africa as the source of monkeypox outbreaks, indirectly labeled gays as a specific group more likely to be infected with monkeypox, and emphasized that there was no need to worry about the spread of the monkeypox virus. In its COVID-19 coverage, The Washington Post adopted endemic and panic frames to describe China as the source of the coronavirus and to construct an image of panic regarding the spread of the virus.

CONCLUSIONS

These stigma discourses are essentially manifestations of racism, xenophobia, and sexism in public health issues. This research confirms that the media reinforces the stigma phenomenon in relation to health through framing and provides suggestions for the media to mitigate this issue from a framing perspective.

A 20-year review comparing the use of 'schizophrenia' and 'psychosis' in UK newspapers from 2000 to 2019: Implications for stigma reduction

BACKGROUND

There have been increasing calls for schizophrenia to be renamed to reduce negative associations with the diagnosis. 'Psychosis' is one proposed alternative, yet some research suggests this has greater negative connotations. This study compared the use of both terms within UK newspapers longitudinally to assess which is more negatively portrayed in the media.

STUDY DESIGN

Using LexisLibrary News, six UK newspaper archives were searched for the terms 'schizophrenia' and 'psychosis' in articles published between 2000 and 2019; the included article total was n = 9802. Articles were analysed using Linguistic Inquiry and Word Count software.

STUDY RESULTS

A two-level multilevel model was created of newspaper articles nested within newspapers. Adding predictors revealed that diagnostic term was a significant predictor of the emotional tone of articles (β = -2.30, SE = 0.51, p < .001, 95 % CI -3.30 to -1.30), with 'psychosis' having a more negative tone than 'schizophrenia.' Tabloids were shown to have a significantly more negative tone than broadsheets (β = -9.32, SE = 1.04, p < .001, 95 % CI -11.36 to -7.28), and emotional tone of writing had become more negative over time (β = -0.26, SE = 0.04, p < .001, 95 % CI -0.34 to -0.18).

CONCLUSIONS

These findings suggest 'psychosis' is associated with greater negativity than 'schizophrenia' within UK newspapers, and may be a poor substitute term to reduce stigma. As article tone worsened for both diagnoses over time, increased stigma reduction campaigns are required to target negativity within the media.

[Digital life in a networked world: opportunities and risks for psychiatry]

This overview addresses some opportunities and risks of digital transformation in their significance for the diagnostics and therapy of mental illnesses under the aspect of the convergence of new digital technologies. Possibilities of smartphone-based technologies for the recording of the lifeworld context are explained and the application of this approach to the investigation of resilience mechanisms for improving mental well-being is presented on the basis of two current research results. Subsequently, the increasing networking of the environmental context itself is taken into account against the background of the so-called internet of things (IoT). These converging technologies, combined with new developments in artificial intelligence, enable a new generation of ecological momentary interventions (EMI) based on innovative sensors, local assessment of the lifeworld context and their evaluation using artificial intelligence.

Stigma in the News: The Representation and Trivialization of Stigma in U.S. News Publications

Stigma represents an important social issue, one rooted in communication. The present study used a quantitative content analysis to examine the representation of the term stigma in one national and six regional news publications in the United States between 2000 and 2018. In the 1,524 stories examined, journalists explicitly defined stigma once. Stigma was discussed in relation to serious, often dehumanized conditions such as schizophrenia, substance abuse, and HIV/AIDS. However, journalists and news sources frequently trivialized stigma by referencing it in relation to bad football teams, food, motor vehicles, and other objects that do not experience the full impact of stigma: stereotypes, prejudice, and discrimination.

A retrospective examination of the content of violence in headlines of news related to individuals with mental disorders

BACKGROUND

Headlines are usually read first. Since headlines are designed to be remarkable and memorable in terms of form and meaning, their impact on the positive or negative attitudes of the society towards individuals with mental illness may be greater than the news texts.

AIMS

This study aimed to retrospectively examine and analyze the content of violence headlines related to people with mental disorders.

METHOD

The study was designed to examine headlines retrospectively. Six-hundred-ten headlines on the websites of four nationally published newspapers in Turkey were reviewed. Headlines mentioned people with mental disorders and violent events. The News Headline Review Form was used to evaluate the headlines. Descriptive statistics, the chi-square test and logistic regression analysis were used in data analysis.

RESULTS

It was determined that violent events in headlines were mostly associated with homicidal behaviors (72%; n = 439), self-harming behaviors (20.2%; n = 123) and exploitation by others (7.8%; n = 40), respectively. The most common actions in headlines were, within the homicidal behaviors, "murder" (30.4%; n = 186); within the self-harming behaviors, "commit suicide" (13.6%; n = 83) and within the exploitation-by-others category, "being murdered" (4.4%; n = 27). People with mental disorders were in an active position in three fourths of the headlines on violence/aggression (77.3%; n = 471).

CONCLUSION

Headlines have the effect of normalizing the relationship between violence and mental disorders, which already exists in society. Portraying violence as a typical part of a mental disorder could create social perceptions that it is the nature of these individuals to exhibit violent behavior.

Improvement for most, but not all: changes in newspaper coverage of mental illness from 2008 to 2019 in England

AIMS

Time to Change, an anti-stigma programme in England, has worked to reduce stigma relating to mental illness in many facets of life. Newspaper reports are an important factor in shaping public attitudes towards mental illnesses, as well as working as a barometer reflecting public opinion. This study aims to assess the way that coverage of mental health topics and different mental illnesses has changed since 2008.

METHOD

Articles covering mental health in 18 different newspapers were retrieved using keyword searches on two randomly chosen days of each month in 2008, 2009, 2010, 2011, 2013, 2014, 2016 and 2019. A content analysis approach using a structured coding framework was used to extract information from the articles. Logistic regression models were used to estimate the change in odds of each hypothesised stigmatising or anti-stigmatising element occurring in 2019 compared to 2008 and 2016 with a Wald test to assess the overall significance of year as a predictor in the model. Further logistic regression models were used to assess the association between the diagnosis that an article was about and the odds that it was stigmatising, and whether this relationship is moderated by year of publication.

RESULTS

A total of 6731 articles were analysed, and there was a significant increase in anti-stigmatising articles in 2019 compared to 2008 (OR 3.16 (2.60-3.84), p < 0.001) and 2016 (OR 1.40 (1.16-1.69), p < 0.001). Of the 5142 articles that specified a diagnosis, articles about schizophrenia were 6.37 times more likely to be stigmatising than articles about other diagnoses (OR 6.37 (3.05-13.29) p < 0.001), and there was evidence that the strength of this relationship significantly interacted with the year an article was published (p = 0.010). Articles about depression were significantly less likely to be stigmatising (OR 0.59 (0.69-0.85) p = 0.018) than those about other diagnoses, while there was no difference in coverage of eating disorders v. other diagnoses (OR 1.37 (0.67-2.80) p = 0.386); neither of these relationships showed an interaction with the year of publication.

CONCLUSION

Anti-stigma programmes should continue to work with newspapers to improve coverage of mental illness. However, interventions should consider providing specific guidance and promote awareness of rarer mental illnesses, such as schizophrenia, and evaluation should examine whether reductions in stigma extend to people with all mental illness diagnoses.

Sharing on Social Network Sites following Carrie Fisher's Death: Responses to Her Mental Health Advocacy

Grounded in work on health narratives of public figures, an online survey (N = 305) explored amplification of Carrie Fisher's mental health advocacy following her death through sharing about mental health on SNSs. Parasocial relationship (PSR) to Fisher and grief in response to her death both predicted greater sharing about mental health on social network sites, but parasocial grief fully mediated the influence of PSR on social sharing. Prosocial motivations (pleasure, pressure) moderated the relationship between parasocial grief and social sharing. In a separate analysis, parasocial grief predicted greater exposure to both media about mental health and media that mourned/celebrated Fisher. Mental health-related media exposure mediated the influence of parasocial grief on social sharing, but this mediation occurred only among people who were not aware of Fisher's mental health advocacy prior to her death.

Media language preferences and mental illness stigma among Latinx adolescents

PURPOSE

Media-a powerful influence on mental illness stigma-varies by language and culture. Nevertheless, recent meta-analyses have demonstrated scant attention to Spanish language media as well as historically low Latinx participation in mental illness anti-stigma intervention. To better inform how to improve equity in mental health service utilization, this study assessed how language preferences in mass media influence stigma among Latinx adolescents, compared to family language and social preferences.

METHODS

Sixth-graders self-identifying as Latinx self-completed assessments of mental illness knowledge/positive attitudes and desired separation from peers and adolescent vignette characters experiencing mental illness (N = 179; Texas, U.S., 2011-2012). Participants also responded to measures of language preferences (any Spanish versus only English) for consuming media (film/television, music/radio) and speaking with family (parents/grandparents), and social preferences for parties or social gatherings (Latinx versus Anglo persons). Linear regression models adjusting for student and household factors examined the associations between media and family language and social preferences on mental illness stigma.

RESULTS

Latinx adolescents preferring any Spanish versus English-only media reported less mental illness knowledge/positive attitudes and greater social separation from peers and vignette characters with a mental illness, net of all covariates. Family language and social preferences were not associated with any mental illness stigma outcomes.

CONCLUSIONS

Spanish media preference is associated with greater stigma suggesting more stigmatization may exist in Spanish- versus English-media. Ensuring anti-stigma messaging in Spanish media may reduce disparities in mental illness stigma among Latinx adolescents. These findings have implications for populations with other non-English media preferences.

A systematic review of the impact of media reports of severe mental illness on stigma and discrimination, and interventions that aim to mitigate any adverse impact

PURPOSE

This review aims to summarise the evidence on the impact of news media and social media reports of severe mental illness (SMI) on stigma, and interventions that aim to mitigate any adverse impact.

METHODS

A systematic search of electronic databases was conducted in December 2017 to identify studies that report on the impact of media coverage or media interventions on stigma related to schizophrenia, psychosis, bipolar disorder, or mental illness in general. Data were synthesised narratively.

RESULTS

12 studies met inclusion criteria; seven explored the impact of news media on stigma towards SMI or general mental illness, two explored the impact of social media, while three evaluated interventions that aimed to mitigate this impact. These studies showed that positive news reports and social media posts are likely to lead to reductions in stigmatizing attitudes and negative reports and social media posts are likely to increase stigmatizing attitudes. There were a limited number of interventions aiming to mitigate the negative impact of news reports of mental illness on stigma; however, these were ineffective. Interventions with media professionals appear to be successful at reducing their stigmatizing attitudes, but can also act to increase both positive and negative reports in the media.

CONCLUSIONS

Given the limited research evidence on the impact of news and social media on stigma towards SMI, and on the effectiveness of interventions aiming to mitigate this impact, further studies of higher quality are needed in this area. Due to mixed findings, interventions with media professionals are also an area of research priority.