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Either mad and bad or Jekyll and Hyde: media portrayals of schizophrenia

People with schizophrenia are still perceived as dangerous and unpredictable, and these perceptions have increased in recent years. JD Hancock

Stigma can take a heavy toll on people who suffer from mental illness. Being shunned, feared, devalued and discriminated against can impair recovery and deepen social isolation and distress. Many sufferers judge stigma to be more difficult to cope with than the symptoms of their illness.

Thankfully, there are grounds for hope. Australian researchers have shown that mental illness stigma, such as the unwillingness to interact with affected people, generally declined from 2003 to 2011. Some credit for this improvement must go to media campaigns by beyondblue and SANE, and to the willingness of many people to speak publicly about experiences that would once have been shamefully private.

The dark cloud inside this silver lining is schizophrenia, a serious condition that impairs thinking, emotion and motivation. While Australians’ attitudes towards depression have become more accepting, the stigma of schizophrenia has remained largely unchanged.

Misusing and misunderstanding

People with schizophrenia are still perceived as dangerous and unpredictable, and these perceptions have increased in recent years. Attitudes to people with schizophrenia have also worsened in the United States at the same time as attitudes to depressed people have improved.

Just as the media can take some credit for the declining stigma of other conditions, it must take some of the blame for the continuing stigma of schizophrenia. Media portrayals commonly associate it with violence and danger.

Schizophrenia is also often misused to refer to split personality or incoherence. This Jekyll-and-Hyde misconception persists despite countless corrections. One study of Italian newspapers, for instance, found that the term was employed in this way almost three times as often it was used correctly to refer to people with the diagnosis or their illness.

But just how negative are current media depictions of schizophrenia? My students and I recently examined this question in a study that we published in the academic journal Psychosis. We located every story published in major national, state and territory online and print news media outlets in the year ending August 2012 that cited schizophrenia or schizophrenic.

We then counted how many stories misused these terms and coded how often the condition was linked to violence or presented in a stigmatising way.

Our results were striking. Almost half (47%) of stories linked schizophrenia to some form of violence, and 28% of these associated it with attempted or completed homicide. The schizophrenic person was identified as a perpetrator of violence six times more frequently than as its victim.

Schizophrenia was misused as a split metaphor in 13% of stories. And fully 46% of stories were coded as stigmatising.

It’s hardly surprising that the public’s views of the condition continue to be laced with fear and loathing if they usually find schizophrenia presented in the context of violent aggression or as a metaphor for internal contradiction.

Better ways

What can be done about all of this? For one thing, journalists and the general public need to become aware that schizophrenia doesn’t mean split personality and it bears no resemblance to caricatures of craziness. This mistaken usage should be retired not because the police say it’s offensive, but because it perpetuates a misunderstanding that hurts real people.

Journalists and editors also need to think carefully before linking schizophrenia to violent behaviour. Often the proposed link is dubious and speculative, and adds nothing important to the story. Just as violence supposedly committed by people experiencing mental illness is over-reported – producing an exaggerated sense of their dangerousness – their victimisation is often under-reported.

An equally important corrective would be to publish more stories that feature people with schizophrenia living well, present their everyday struggles and adversities or showcase promising treatments and research findings.

Coverage can be improved. Our study found that stories from broadsheet newspapers were less stigmatising than tabloid stories, and longer, more developed stories were less stigmatising than briefer ones.

This is not a matter of white-washing the news. People with schizophrenia are indeed at a somewhat increased risk of committing violent offences (and of being their victims). They can behave in challenging ways. But the media landscape that our study surveyed is so tilted towards depicting schizophrenia as dangerous that it’s seriously unbalanced.

The news media can do better and, if they do, the stigma of schizophrenia may start to erode.

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