Public Education ConferenceWest Midlands Royal College of Psychiatrists      Birmingham, November 2012      A Perspective ...
Why this is importantA brief overview of work     Current Issues
Reduce Stigma
Reduce StigmaNegative publicity in media contributes to the stigma ofschizophrenia (Kingdon,2006)
Reduce StigmaNegative publicity in media contributes to the stigma ofschizophrenia (Kingdon,2006)Implications of stigma: p...
Reduce StigmaNegative publicity in media contributes to the stigma ofschizophrenia (Kingdon,2006)Implications of stigma: p...
Reduce StigmaNegative publicity in media contributes to the stigma ofschizophrenia (Kingdon,2006)Implications of stigma: p...
The media is the publics foremost source ofmental health information (Borinstein,1982; Robert Johnson Foundation,  1990)Ne...
The media is the publics foremost source ofmental health information (Borinstein,1982; Robert Johnson Foundation,  1990)  ...
The media is the publics foremost source ofmental health information (Borinstein,1982; Robert Johnson Foundation,  1990)  ...
27 Studies foundOverall 40% portrayalsnegativeImprovements in US, Australian, New Zealand & European coverage (Corrigan,20...
Author              N=            Brief resultsGoulden et al (2011)        1161    1992,2000, 2008 scz negative dep >Cleme...
600 articles < September 2005‘Schizophrenia’, ‘schizophrenic’ or ‘schizo’Each article categorised;Tone: Positive, Negative...
Examples   Results by tone
Examples              Results by tone           Negative           40%                                        Neutral     ...
Broadsheets and tabloids
Broadsheets and tabloids                                   P<.001                                                         ...
Crime and Reporting of Schizophrenia
Crime and Reporting of Schizophrenia
Scz:CA::11%:1% p<.001
Mary O’Hara’sresearch 2010
ENOUGH SUPPORT? NO.24 MILLION                                                               WHAT WORKS?                   ...
ENOUGH SUPPORT? NO.24 MILLION                                                               WHAT WORKS?                   ...
CelebritiesEd Milibands  Speech
Help for the                                                                                                              ...
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Presentation on the media and mental illness at November 2012 Conference at Birmingham (On the day the Leveson Inquiry report was published!)

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  • Distressing for patients and carers\nEffects it has on the illness course and quality of life\nWhat kind of society we wish to live in\n
  • Distressing for patients and carers\nEffects it has on the illness course and quality of life\nWhat kind of society we wish to live in\n
  • Distressing for patients and carers\nEffects it has on the illness course and quality of life\nWhat kind of society we wish to live in\n
  • Distressing for patients and carers\nEffects it has on the illness course and quality of life\nWhat kind of society we wish to live in\n
  • A British Journal of Psychiatry study 2006 Powell &amp; Clarke 2006 looked at how people are using the Internet for mental health information\n24% said they&apos;d use the Internet to seek information\n 18% of all people had used the Internet to seek mental health information\nOnly 12% thought it would be in the top 3 most accurate sources.\n\nReavley and others in a 2012 paper in psychol med. Wikipedia is generally as good or better than that provided by centrally controlled website, encyclopaedia brittanica or a psych textbook.\n
  • A British Journal of Psychiatry study 2006 Powell &amp; Clarke 2006 looked at how people are using the Internet for mental health information\n24% said they&apos;d use the Internet to seek information\n 18% of all people had used the Internet to seek mental health information\nOnly 12% thought it would be in the top 3 most accurate sources.\n\nReavley and others in a 2012 paper in psychol med. Wikipedia is generally as good or better than that provided by centrally controlled website, encyclopaedia brittanica or a psych textbook.\n
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  • stanley cohen 1972, mods v rockers\nRingo starr was asked mocker.\n
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  • He was stabbed in the back by a community schizophrenic who showed no remorse for his actions (tabloid,reported,negative)\nAgainst Schizophrenic Manchester City, Michael Owen scores (broadsheet, reported, metaphor)\n
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  • 55 articles from Nottingham Evening Post; 43 articles from This Is Dorset ; over 2 years\nNottingham crime rate 61.5/1000 persons\nNottingham Evening Post (circulation 68,355)\nDorset crime rate 20.2/1000 persons\nThis Is Dorset (circulation 53,344)\n\n\n
  • Diseases with mysterious aetiologies likely to be metaphors e.g., consumption, cancer\n28% US, 58% German, &amp; 31% Swiss use of the word in newspapers is metaphorical (Duckworth,2003; Hoffmann-Richter 2003; Hoffmann-Richter,1998)\nIs schizophrenia the new illness as metaphor? \n\n\n
  • Diseases with mysterious aetiologies likely to be metaphors e.g., consumption, cancer\n28% US, 58% German, &amp; 31% Swiss use of the word in newspapers is metaphorical (Duckworth,2003; Hoffmann-Richter 2003; Hoffmann-Richter,1998)\nIs schizophrenia the new illness as metaphor? \n\n\n
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    1. 1. Public Education ConferenceWest Midlands Royal College of Psychiatrists Birmingham, November 2012 A Perspective on the Media and Mental Illness Arun Chopra Consultant Psychiatrist
    2. 2. Why this is importantA brief overview of work Current Issues
    3. 3. Reduce Stigma
    4. 4. Reduce StigmaNegative publicity in media contributes to the stigma ofschizophrenia (Kingdon,2006)
    5. 5. Reduce StigmaNegative publicity in media contributes to the stigma ofschizophrenia (Kingdon,2006)Implications of stigma: political, service, &clinical level (Lalani,2006; Byrne,2001,Sartorius,2005)
    6. 6. Reduce StigmaNegative publicity in media contributes to the stigma ofschizophrenia (Kingdon,2006)Implications of stigma: political, service, &clinical level (Lalani,2006; Byrne,2001,Sartorius,2005)Social Justice
    7. 7. Reduce StigmaNegative publicity in media contributes to the stigma ofschizophrenia (Kingdon,2006)Implications of stigma: political, service, &clinical level (Lalani,2006; Byrne,2001,Sartorius,2005)Social Justice75 % mentally ill felt media portrayed themunfairly (Counting the cost, MIND 2006)
    8. 8. The media is the publics foremost source ofmental health information (Borinstein,1982; Robert Johnson Foundation, 1990)Newspaper Circulation FiguresEarly studies reported 70% negative tone (Nunally,1961; Day & Page,1986)
    9. 9. The media is the publics foremost source ofmental health information (Borinstein,1982; Robert Johnson Foundation, 1990) But what media? Where do we get our information from? Is this changing?Newspaper Circulation FiguresEarly studies reported 70% negative tone (Nunally,1961; Day & Page,1986)
    10. 10. The media is the publics foremost source ofmental health information (Borinstein,1982; Robert Johnson Foundation, 1990) But what media? Where do we get our information from? Is this changing?Newspaper Circulation Figures Circulation of newspapers is falling but the influence of the print media...Early studies reported 70% negative tone (Nunally,1961; Day & Page,1986)
    11. 11. 27 Studies foundOverall 40% portrayalsnegativeImprovements in US, Australian, New Zealand & European coverage (Corrigan,2005; Francis,2004; Nairn, 2001;Meagher, 2003;Pieters,2003)Crime and violence predominant association
    12. 12. Author N= Brief resultsGoulden et al (2011) 1161 1992,2000, 2008 scz negative dep >Clement & Foster (2008) 1300 1996, 2005 little changeChopra & Doody (2007) 600 metaphor, crime association,negativeLawrie, S(2000) 306 64% negativeHart&Philipson(1998) RCPsych 1292 54% negativeWard (1997) DoH 1035 49% crime tabs<bsPhilo et al(1994) 562 66% negativeScott, J (1994) 241 Crime tabs<broadsBarnes & Earnshaw (1993) 101 60%dangerousness
    13. 13. 600 articles < September 2005‘Schizophrenia’, ‘schizophrenic’ or ‘schizo’Each article categorised;Tone: Positive, Negative, Neutral (Wahl,2002)Context: Education, Reference, Incidental Reference,Medically inappropriate, Charity Related, Obituary,Metaphor (Duckworth ,2003)NarrativeKappa=0.8
    14. 14. Examples Results by tone
    15. 15. Examples Results by tone Negative 40% Neutral 50% positive 10%
    16. 16. Broadsheets and tabloids
    17. 17. Broadsheets and tabloids P<.001 Broadsheet Tabloid 60.0%Percent 40.0% 61.6% 55.6% 41.2% 20.0% 31.6% 6.8% 3.2% 0.0% Negative Neutral Positive
    18. 18. Crime and Reporting of Schizophrenia
    19. 19. Crime and Reporting of Schizophrenia
    20. 20. Scz:CA::11%:1% p<.001
    21. 21. Mary O’Hara’sresearch 2010
    22. 22. ENOUGH SUPPORT? NO.24 MILLION WHAT WORKS? PSYCHOLOGICAL AND Cognitive Behaviour Therapy (CBT), arts therapy, family therapy. PSYCHOSOCIAL TREATMENTSpeople worldwide (220,000 in England) are affected by Anti-psychotic medicationschizophrenia, more than 50% are not receivingappropriate care. PHARMACOLOGICAL TREATMENTS (though this can have serious physical side effects).10% 15-20 YEARS Effective treatment People with schizophrenia doesn’t yet mean die 15-20 years earlier effective receipt- than average, mostly Only 10% receive a full due to preventable course of CBT. physical conditions.DANGER? Sensationalist news media exaggerate links between mental illness and criminal violence. 14x People with schizophrenia in the community are 14 times more likely to be victims of a violent crime than arrested for one. The reality is, violence is more closely linked to alcohol and drug misuse in those with and without mental illness.THE CAUSE?Historically, it was claimed schizophreniacould be caused solely by poor upbringing.This is a myth.The leading theory suggests it develops due The risk of developing schizophreniato genes combined with life events. Over 10 studies show schizophrenia is more increases if one or more family members likely to occur in urban areas. are also affected.
    23. 23. ENOUGH SUPPORT? NO.24 MILLION WHAT WORKS? PSYCHOLOGICAL AND Cognitive Behaviour Therapy (CBT), arts therapy, family therapy. PSYCHOSOCIAL TREATMENTSpeople worldwide (220,000 in England) are affected by Anti-psychotic medicationschizophrenia, more than 50% are not receivingappropriate care. PHARMACOLOGICAL TREATMENTS (though this can have serious physical side effects).10% 15-20 YEARS Effective treatment People with schizophrenia doesn’t yet mean die 15-20 years earlier effective receipt- than average, mostly Only 10% receive a full due to preventable course of CBT. physical conditions.DANGER? Sensationalist news media exaggerate links between mental illness and criminal violence. 14x People with schizophrenia in the community are 14 times more likely to be victims of a violent crime than arrested for one. The reality is, violence is more closely linked to alcohol and drug misuse in those with and without mental illness.THE CAUSE?Historically, it was claimed schizophreniacould be caused solely by poor upbringing.This is a myth.The leading theory suggests it develops due The risk of developing schizophreniato genes combined with life events. Over 10 studies show schizophrenia is more increases if one or more family members likely to occur in urban areas. are also affected.
    24. 24. CelebritiesEd Milibands Speech
    25. 25. Help for the are more likely to develop mental health conditions. They experience better outcomes if theirenter mental health conditions are treated.ogan. Similarly, people who suffer from serious mental illnesses like schizophrenia are more likely to develop physical health problems like diabetes sufferers hit and heart disease. Services need to be better at taking a ‘whole person’ approach to an individual’s healthcare needs. Another reason why sometimes people choose not to raise the issue of mental health needs is that they are a bit mystified and sometimes scared about what the treatments might be and whether they really can help. by ‘black, The evidence base for the treatments is good. The National Institute for Health and Clinical Excellence provides guidance about the available options and professionals are better able to work collaboratively with patients to help them choose what treatment options are best for their needs. Talking therapies are more accessible than despairing before and for many conditions, particularly mild or moderate depression or anxiety, are all that is needed. For those people who need medication, these can be better tailored to an individual to get the best possible benefits and to reduce or avoid any side effects. The message is not to suffer in silence. feeling’ of Although sometimes people get better a spontaneously, if symptoms are not improvingt 15. through exercise, relaxation, sleep and being in tish Heart the company of people you care about, it is tly working better to seek help early than allow things to get n the Love worse.reness of I’ve met people who turn to street drugs and alcohol, initially in order to ‘self-medicate’. depression really However, these soon become terrible problems.to avoid. Occasionally people have severe depressionkiller of and require admission to hospital. Sometimes ifays. the depression is causing thoughts of self-harm women or preventing people from eating or drinkinglth risk, nor properly and if other treatments haven’t worked,ol and ECT can be used. Dr Arun Chopra (right) talks to patient Geoff Smith who is recovering from depression. G See panel for activities and events. For moregh talking information, go to www.mhaw.org.uk.icators ands in that Mental Health Awareness Week starts next week. DR New government legislation that makes it KEEPING AWARE become ARUN CHOPRA, a consultant psychiatrist with easier for employers to hire but also to let go of workers must be seen in the context of thee such a ciety now, Nottinghamshire Healthcare NHS Trust, discusses some of misery that this might cause. ternal, so the key issues and urges ‘don’t hesitate to ask for help’’ Mental health awareness events in Nottingham include: Fortunately, most people who suffer from mental ill health do not commit suicide. Their own vious thateart disease, Tomorrow: Mind Freedom, open mic and resilience, the support from people around them FORMER teacher Geoff Smith is currently not all people who choose to take their own life music night, Jam Cafe, Heathcote Street, and the care from services help them recover andsease is suffering from severe depression – something suffer from a mental illness, many do. Nottingham, from 6-10pm. get back on track.d with big that has afflicted him on and off over the last 20 The past decade has seen a huge Tuesday: Don’t Sweep It Under the Carpet – However, we also know people can suffer fromp butties,” as years. improvement in our ability as a society to talk a discussion about living with bipolar disorder, symptoms for many years before they seek or Mr Smith, 64, from Sherwood, agreed to speak openly and honestly about mental illness. But Central Library, Angel Row, Nottingham, from receive help. It can be years before they receive a ried diet for about his experience of mental illness to there is still further to go to remove the stigma 7-8.30pm. diagnosis and start to get the help they might e aim at the encourage others to seek help. that prevents people from seeking help and that Wednesday: World Mental Health Day need to begin their recovery.home. The avid pianist describes his depression as a creates further barriers for those who experience Ecoworks Garden barbecue. Ransom Road, St Research carried out by the Royal College of ces are “black, despairing feeling.” the symptoms of mental illness to return to active Ann’s, 12-2pm. Contact Paul 07973 116291. Psychiatrists earlier this year showed that, onalth and He first noticed the onset of the symptoms as lives within the communities that they live in. Friday: Families Rooting for Recovery, average, it takes 13 years for someone to get thed vitality.” an inability to concentrate at the start of term. It This year’s World Mental Health Awareness 10am-3pm. To book e-mail events@ correct diagnosis of Bipolar disorder (an illness are affected his motivation and his enthusiasm. He Day falls on Wednesday and is an opportunity to brightideasnottingham.co.uk or call 0115 associated with periods of mania anded, red meat describes a sense of relief when he was raise awareness of mental illness and treatments 8379474. depression). r of chicken diagnosed with depression by his GP. His family and have those open discussions that we need. Monday, October 15: Art Outlook Healthcare professionals need to be better has been supportive of him through his illness. Exhibition, Nottingham Contemporary, trained at recognising the signs and symptoms of ’t a priority As Mr Smith’s depression didn’t respond to 10am-1pm. someone who is unwell. Unlike a broken arm orecentlyweareedo, medication alone, he is currently receiving electroconvulsive therapy (ECT) and occupational ‘I’m fortunate to share the Tuesday, October 16: Celebrating Success and Recovery, Council House, Nottingham, hypertension, there are no x-rays or measurements that accurately diagnose mental essively mother of therapy on an in-patient ward at the QMC. ECT has a bad image in the media – I think joy of the many patients 11am-3pm. To book e-mail maureen.black@ nottinghamcity.gov.uk illness – we rely on carefully listening to the stories that people tell us about the difficulties ng about unjustly. For some people it can be life-saving. Portrayals of ECT are quite often inaccurate. with mental illness who G For full list go to www.mhaw.org.uk that they are experiencing. Unfortunately many people still find it difficult eat for your Mr Smith’s enthusiasm has returned and he is about to return home. He is looking forward to recover and more to talk about mental health issues. Although attitudes have changed significantlyably find it Since 1997 the number of suicides across thebe spending time with family and friends. In the near future a mental health team in the community will importantly, get on with the country started to fall each year. However since since celebrities have been more open about their own experience of mental health problems, believes. the economic recession, this downward trends to pass on work with him to try to prevent recurrences of the depression. things they value in life’ has been reversed and in 2008 and 2009 we’ve the stigma that surrounds mental illness has been part of our culture for so long that it is taking timeer children. seen a rise in the number of people taking their An estimated one in four of us will experience for it to be stamped out.o talk to There are activities and events in and around own lives. The number fell slightly in 2010 but it some form of mental illness during our lifetime. It I’m pleased that at the moment the Mentals making Nottingham in the coming week, all aimed at has not returned to 2007 levels. is the leading cause of people needing support Health Discrimination Bill, making its way through any encouraging people to challenge negative Research has shown that economic recessions through the benefits system and the cost to the Parliament, will repeal a section of the Mental e perceptions that they might hold about people are associated with an increase in suicides. The economy of treating mental illness and the loss of Health Act that meant MPs had to vacate their productivity is £77 billion. who’ve experienced mental health difficulties. causes that underlie this association are not fullys all about clear but it is well known that unemployment, seats if they were detained under the act. This But from my perspective as a consultant I’m fortunate to share the joy of the many sent the wrong message – that people with psychiatrist working in an in-patient ward at patients with mental illness who recover and alcoholism and homelessness are risk factors.ieves it’s A research study in the British Medical Journal mental illness couldn’t recover (when the truth is Nottingham’s QMC, it is the impact of mental more importantly, get on with the things they we see people recovering every day) and that fresh value in life. in August found that those areas of the country illness on individuals and their families and people with mental illness shouldn’t be able toof time However, this year as we celebrate mental that had experienced greater levels of friends that is far more apparent. play a full role in our democracy and in public life. Without treatment and support, mental illness health day and the remarkable journeys of joblessness in recent years had also experienced sit down a greater rise in the number of suicides. The East If the bill is passed, it will be another step can rob so many people of their ability to reach recovery, I’m also mindful of the fact that these towards removing stigma and creating parityours,” she are difficult times for many people with mental Midlands had the third highest rates of suicide. their full potential and so many families see their between physical and mental health. loved ones in anguish. health difficulties. We need to have systems to support people whove Your might be experiencing distress while searching In many ways, the distinction between physical Most tragic of all, each year around 5,000 I am also concerned about the rise in the and mental health is not a helpful one. Peopleurheart.com number of people who are dying by suicide. for work and prevent them from becoming people in the UK take their own lives. Although who suffer from chronic physical health problems unwell. Visit our website www.thisisnottingham.co.uk NEP-E01-S2 EP01 NEP-E01-S2 EP01 Visit our website www.thisisnottingham.co.uk October 6, 2012 WEEKEND 27
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