I gave this speech at the Royal Society of medicine at an event called Psychiatry as a career: Everything you wanted to know but were afraid to ask. It loses something without having the opposing view available but I hope will be of some interest. There’s a list of links I used for research which may be of use.
I wish to propose the motion “This house believes psychiatry has been unfairly treated in the media”
By the end of what I have to say, you will have no difficulty in agreeing with me that this is indeed the case.
First allow me to define what I wish to examine:
- Psychiatry’ has no exact meaning but encompasses psychiatric disorders, their treatments and those who provide them. I include psychiatric patients also; not least as many people – including doctors – are unaccustomed to separating the disorder and the patient.
- The media is collection of means for mass communication. Here the newspapers, television, radio and cinema continue to be the most influential.
- Fairness’ is very much in the news, and to be fair is to be just and to be aware of the right way to value things.
The vehicles for mass communication in this country regularly treat people who work in or are treated by psychiatry as if they have no need for any consideration, as if they have no value.
This is unfair
Unlike psychiatry, the media is a business, and is subject to very different pressures.
As a result it is uniquely ill suited to report the richness of the fascinating human stories with which psychiatrists daily deal.
In essence the people who work within the media are primarily interested in one thing: selling the content they produce.
This could be newspapers or DVDs, TV advertising or cinema tickets.
Their output is driven by the overriding need to gain and sustain attention. Their central question is ‘Is this engaging to busy people?”
All other things including truth, and fairness, are subsidiary to this.
This is a shame, but it is the world in which we live
Under this imperative the media show no contrition in using crude stereotypes of the psychiatrically unwell and those that treat them that are unchallenging to lay people.
These stereotypes are appealing as they confirm peoples’ view of the world and their place in it. Whilst in sometimes engaging, comforting and even entertaining, they often misrepresent and stigmatize.
Maybe you should cover your ears if you don’t already know the ending.
Hitchcock knew how to unsettle his audience. Although cinematically a masterpiece, Psycho has no shame drawing on and thus perpetuating popular stereotypes and fears.
The knife wielding maniac
The violent and unpredictable madman.
The film’s anti-hero Norman Bates is a murderous ‘psycho’ whose mother resides in his psyche.
This is a rather unlikely diagnosis in my opinion.
Tensions between these alternative personalities drive him towards his crimes.
Following in Hitchcock’s footsteps, films that feature psychiatrically-disturbed serial killers are now so numerous that they merit their own sub-genre.
Another example is Halloween – one of the first ‘slasher’ movies- where on Halloween an escaped psychiatric patient stalks and kills teenagers. He is pursued, with mixed results, by his heroic psychiatrist played by Donald Pleasance. This film’s popularity was such that it spawned seven sequels and a recent remake.
This stereotype of the dangerousness and unpredictability is also seen in printed media as one of its most consistent features of reports about patients with psychiatric disorders.
Journalists like stories about violence and mental health as they are inherently newsworthy and tap into our fears and anxieties.
Many newspaper articles leave the unquestioned impression that there is a link between all people with mental health problems and crime or violence.
The Health Education Authority’s ‘Making Headlines’* report found that negative coverage of acts of violence by people with mental health problems outnumbers more balanced reporting by 3:1, with stories about harm and crime accounting for the biggest quantity of all mental health pieces in broadsheets and tabloids.
Here are three recent headlines from the Daily Mail. Note that these headlines compound their insult by combining this corrosive stereotype with pejorative language
There is an increased risk of someone with psychosis being involved in an act of violence, but such headlines leave all people with mental health problems under a cloud of suspicion.
Such treatment would not be tolerated if it were applied to other vulnerable groups.
I put it to you this is unfair. Psychiatry is treated unfairly in the media
So psychiatric patients get a raw deal. But it goes wider than that. The Psychiatric Bulletin has reported that psychiatry in general gets a bad press when compared to medicine.
Balanced discussion of psychiatry’s controversies is of course to be welcomed but what has emerged in the media is rarely sober and considered.
This is unfair
Our treatments are often under fire:
Our antidepressants are addictive.
We reach too quickly for a prescribing pad.
The draft of the new fifth edition of the Diagnostic and Statistical Manual of Mental disorders was met by a hailstorm of criticism about how psychiatrists wishing to medicalize ‘normality’.
Psychiatrists are not well represented by the media either.
Who do you think is the best know psychiatrist in popular culture?
Who is Hannibal Lecter?
Not a learned clinician or venerated academic, but a murderous serial killer with a curious lack of insight into his own condition and a penchant for torture and cannibalism.
Dr Lecter is hardly a good role model for aspiring psychiatrists.
Another TV psychiatrist is Fraiser Crane from the long running American TV show. He is uptight and pompous and has great troubles sustaining romantic relationships.
That doesn’t sound like anyone I know
This is an improvement on Dr Lecter, but not exactly complementary figureheads for a profession soberly striving to treat humankind’s most difficult of diseases.
Worst of all is Dr Silberman, who in Terminator 2 is responsible for incarcerating Sarah Connor who we know – but Dr Silberman cannot see – is trying to save the world.
I put it to you that it is truly unfair to accuse psychiatrists of trying to stop planetary salvation.
It’s a shame that the media has proved so unbalanced in its portrayal of our work. Not least because we are all interested in the same thing: attempting to explain human behaviour and motivations.
The media do not cope well the subtleties of meaning that psychiatry regards as commonplace and instead dehumanisation, inaccuracy and sensationalism are their stock-in-trade.
Their portrayal of psychiatry is demonstrably unfair.
Please join with me in supporting this motion.
The Psychiatric Bulletin (2000) Newspaper coverage of psychiatric and physical illness
The Guardian 22 July 2010 Hollywood’s mental block
Advances in Psychiatric Treatment Psychiatry and the media
The Psychiatric Bulletin Terminator 2: Judgement Day
Politics of Health Group The media: agents of social exclusion for people with mental illness?
The Psychiatric Bulletin The stigma of mental illness: how you can use the media to reduce it
* 2018 review – sadly this report is no longer available it seems