A framework for understanding media depictions of mental illness.

Mass media depictions of persons with mental illness are generally negative and stigmatizing. From the earliest published studies (1, 2) to more recent work (3–5) media portrayals of mental illness have been characterized by crime and violence (6, 7), unpredictability (8–10), and social incompetence (11, 12). These portrayals are of great concern to mental health professionals because they subvert the recovery of people experiencing a mental illness (13, 14), threaten funding for mental health services (15), and encourage fear of those living with a mental illness (16, 17). Factual or fictional media depictions are the primary source of information on mental illness for the general public (18). George Gerbner (19), directing his comments to mental health professionals, said that the persistent nature of these negative depictions reflect “deeply rooted and highly functional cultural mechanisms that maintain a social structure with all its inequities” (p 22). In our view, four particularly important cultural mechanisms contribute to the persistence of these negative depictions: language in use, culture, social practices, and institutions. Understanding how these cultural mechanisms sustain the stigmatizing depictions is an important step in effectively reducing stigma. The primary goal of this column is to provide psychiatrists and other mental health professionals with a framework that enables understanding of the role of each of these cultural mechanisms in media depictions of mental illnesses. To this end, we provide brief descriptions of each mechanism and outline how the mechanisms combine in media depictions. To assist understanding and to illustrate the relevance of the theoretical discussion, we provide illustrative examples of how each cultural mechanism operates.