I happened to be browsing through The American Journal of Psychiatry the other day1 when I noticed an article discussing the persistence of stigmatised social attitudes about mental illness. Researchers conducted a study using brief vignettes and asking respondents to discuss their reactions to them2. The study found two interesting things:
The first was that a greater percentage of the population understands the neurobiological origins of mental illnesses. Not only do people have a better understanding of the origins of mental illness, but they are also more likely to recommend treatment for the people described in the vignettes. People support services for individuals with mental illness, in other words, although it’s important to note the publication this appeared in; it’s clear that these ‘services’ are heavily skewed towards psychiatrisation, and it’s also important to consider that this can correlate with increased pressure on people who choose not to pursue treatment.
The second thing they found was that although people understand mental illnesses better than they did before, there hasn’t been a significant change in terms of attitudes about mental illness. Despite social campaigns organised by a number of groups, social attitudes about mental illness are primarily negative and people continue to hold a lot of false beliefs about mental illness.
People understand mental illness better, but it hasn’t changed the way they think about people with mental illness. Given that 20% of people in the US experienced symptoms of mental illness in 2009, this is a disturbing finding. Many of the respondents probably had mental illness themselves, though not necessarily the illnesses discussed in the study, or know some of the one in five people who experience mental illness in the United States.
As the article itself says:
Public attitudes matter. They fuel ‘the myth that mental illness is lifelong, hopeless, and deserving of revulsion.’ …Attitudes can translate directly into fear or understanding, rejection or acceptance, delayed service use or early medical attention. Discrimination in treatment, low funding resources for mental health research, treatment, and practice, and limited rights of citizenship also arise from misinformation and stereotyping. Attitudes help shape legislative and scientific leaders’ responses to issues such as parity, better treatment systems, and dedicated mental illness research funds.
What this study shows is that beliefs about reduction of stigma appear to be erroneous, suggestive that campaigns to end stigma are, perhaps, not working as well as intended. Indeed, some of these campaigns seem to actively reinforce stigmatised attitudes about mental illness.
I write a lot about pop culture, here and elsewhere, both because I love pop culture and I think it’s important. This study reminds me of the information about mental illness that people absorb through pop culture consumption. What people learn about mental illness from pop culture is that it is scary and that people with mental illness are frightening and dangerous. But, ‘they’ can be controlled with the use of medication. Both of these attitudes are clearly reflected in the study, which tells us that more people support treatment while still feeling negatively about mental illness.
The increased understanding of the neurobiological origins of mental illness can be attributed to a lot of things, I suspect, but one of them may well be the popularity of mental illness storylines on medical dramas. House, for example, often uses mental illness and includes expository scenes with (some) medical information. This, along with Dr. Google, results in a lot more understanding about the workings of the mind. On the surface, this might seem to be a good thing, but not when it fails to be presented with a shift in depictions of mental illness.
It’s all well and good for people to learn that, for example, people cannot control or prevent the onset of schizophrenia, and that people with mental illness aren’t at fault for what is happening in their minds any more than people who have asthma are at fault for having difficulty breathing. This is an important thing to convey to members of the public. But when it’s paired with a storyline involving violence or deceit on the part of the patient, it still leaves people with the impression that mental illness is bad. It might not be someone’s fault, but people are still bad because they’re mentally ill.
This is why we talk about things like the depiction of mental illness in pop culture: Because people take things away from what they engage with and they apply those things to their larger lives. Someone who learns about mental illness primarily by watching, say, House or Grey’s Anatomy may learn more about the medicine behind mental illness, but doesn’t take away anything new about the human beings involved. When TV shows tell us primarily that mental illness is a frightening unknown that can be controlled with medication, that doesn’t do much to break down social stigma.
Campaigns attempting to destigmatise mental illness have used a variety of creative media for trying to get their point across, from having people with mental illness enter classrooms to talk to students to running advertisements. If you ask me, they might be more effective if they went straight for the heart of pop culture; getting more mentally ill people involved in consulting when it comes to how we are depicted, publicly addressing stigmatised depictions of mental illness in pop culture, and challenging creators of pop culture to integrate more positive and factually accurate depictions of mental illness.
- No, really. ↩
- If you’re interested in seeing a critique of the study methods, they handily printed an editorial in the same issue. ↩