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Challenging Stereotypes: Introduction

By: the Substance Abuse and Mental Health Services Administration

Recovery from mental illness is a complex process. As with all serious illness, the well-being of recovering individuals is affected by the attitudes that surround them. Despite increasing sensitivity about most disabilities, mental illness all too often remains a target for ridicule and misrepresentation in advertising, entertainment, and the mainstream media.

Most of what we know as individuals comes not from personal experience, but from the stories that surround us from birth. In the past it was families, religious institutions, schools, and respected members of the community who instilled cultural attitudes. “Today, this is done by the mass media,” says George Gerbner, founder of the Cultural Environment Movement, and a researcher whose career includes 30 years of monitoring the cultural impact of television on society.

Television is, in Gerbner’s words, “the wholesale distributor of the stigma of mental illness.” His research has shown that characters portrayed on television as having mental illnesses have four times the violence rate and six times the victimization rate of other characters. Gerbner notes that “Violence and retribution are shown as inherent in the illness itself and thus inescapable. No other group in the dramatic world of television suffers and is shown to deserve such a dire fate.”1

The portrayal of mental illness in the movies is similarly distorted. In the late 1980s, Steven E. Hyler of Columbia University and his colleagues identified six categories of psychiatric characters in films: homicidal maniac, narcissistic parasite, seductress, enlightened member of society, rebellious free spirit, and zoo specimen. Hyler concluded that these predominantly negative stereotypes had a damaging effect on the viewing public and on the patients themselves, their family members, and policy makers.2 More recently, Otto F. Wahl of George Mason University, an authority on public images of mental illness, found that in the decade from 1985 to 1995, Hollywood released more than 150 films with characters who have mental illnesses, the majority of them killers and villains.3 There can be no doubt that Hollywood stereotypes are a large part of what people know, or think they know, about people with psychiatric vulnerabilities.

Newspaper reports about mental illness are often more accurate than the characters one sees in TV entertainment and movies. Still, people with psychiatric histories generally are reported negatively. In 1991, researchers Russell E. Shain and Julie Phillips, using the United Press International database from 1983, found that 86 percent of all print stories dealing with former mental patients focused on violent crime.4 A 1997 British study found similarly skewed stories,5 and a 1999 German study (to be published) concludes that selective reporting about mental illness causes audiences to distort their view of the “real world.” 6

Media stereotypes of persons with mental illness as villains, failures, buffoons — together with the misuse of terms like “schizophrenia” and “psychotic” in negative contexts — have far-reaching consequences. On the most deeply personal level, biased stereotypes damage the sense of self-worth of millions of persons diagnosed with serious psychiatric illnesses. On the social and economic levels, negative stereotyping may result in large-scale discrimination against an entire class of people in the areas of housing, employment, health insurance, and medical treatment.

Increasingly, the media are doing better work; at times, their efforts are excellent. Diana Ross’s moving and realistic portrayal of schizophrenia in Out of Darkness, an ABC television drama7, was praised by mental health activists. “Good” characters with mental illness are appearing from time to time in prime-time television entertainment. In an outstanding documentary for Dateline NBC, John Hockenberry followed for two years the uneven course of recovery of a young man with schizophrenia8.

Feature stories about the achievements of individuals diagnosed with mental illness — such as Newsweek’s account of Tom Harrell,9 a jazz trumpet star; The San Diego Union-Tribune’s account of pro golfer Muffin Spencer-Devlin;10 and a New York Times business section feature about John Forbes Nash, Jr., the winner of a Nobel Prize for economics11 — also help shatter stereotypes. A New York Times Magazine cover story, for example, brought new understanding to a highly publicized homicide when it chronicled a young man’s search for help in a crumbling mental health system.12

And increasingly, people with first-hand experience of mental illness are writing books, appearing on television news and talk shows, producing documentaries and radio programs, and contributing articles to the print media. The disparity between mental illness as it is perceived by much of the public and mental illness as it is lived and experienced is a gulf to be bridged. In his 1999 landmark report to the Nation on mental illness and health, Surgeon General David Satcher called on America to tear down the barriers of prejudice that block access to services and recovery.13 Nothing short of a national commitment to de-stigmatize mental illness will achieve this goal.


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