The SANE Guide to Reducing Stigma explains the harm stigma causes people affected by mental illness, examines the role played by the media, and gives practical suggestions on what you can do to reduce stigma.
The media – newspapers and magazines, movies, advertising, websites, TV and radio – all play an important part in shaping how we perceive the world.
Sometimes, though, the media promotes a view of mental illness that is inaccurate and offensive to those affected, their families and friends. Inappropriate reporting and representation of suicide in the media is also hurtful and stigmatising, and can be harmful to those who are vulnerable. Likewise balanced, responsible and accurate reporting can contribute to a more open and welcoming society. Taking action to reduce stigma, then, is important for lots of reasons.
This guide is part of SANE’s StigmaWatch program that promotes accurate and respectful representation of mental illness and suicide in the media.
By using this guide and other resources on the SANE website, you can play an important part in reducing stigma.
There are many forms of stigma in society, some are based on negative attitudes or beliefs, others are due to a lack of understanding or misinformation.
Stigma is due to misunderstanding as well as to prejudice.
Stigma can lead to a lack of support or empathy for people with a mental illness, leaving people embarrassed, misunderstood, and marginalised. Stigma can cause more than hurt feelings. It can result in symptoms being ignored, lead to poor recovery and a lower quality of life due to isolation.
People living with mental illness are often unfairly and inaccurately labelled as ‘scary’, ‘comical’ or ‘incompetent’. If you’re living with a mental illness, stigma is one more stress you don’t need. In fact, some people say that the effects of stigma and prejudice can be as distressing as the symptoms of their illness.
The World Health Organisation defines stigma as: A major cause of discrimination and exclusion: it affects people‘s self-esteem, helps disrupt their family relationships and limits their ability to socialize and obtain housing and jobs.
It hampers the prevention of mental health disorders, the promotion of mental well-being and the provision of effective treatment and care. It also contributes to the abuse of human rights.
StigmaWatch is a SANE program which represents people affected by mental illness, campaigning for improved understanding, fair representation,and stigma reduction in the media. It is supported by Mindframe, the Australian Government’s National Media Initiative to promote accurate and responsible representation of mental illness and suicide in the media.
Mindframe has also developed resources for media professionals, journalism students, scriptwriters, police and courts, and conduct briefing sessions with media organisations to discuss issues relating to mental illness and suicide.
It is unlawful to vilify people on the grounds of religion,race, sex or sexual preference in most parts of Australia. However, in most States and Territories, it remains lawful to vilify people with a disabilty, including those living with a mental illness. That’s why taking action to reduce stigma is so important.
The media play an important role in society, informing and educating readers, listeners or viewers about major events, political decisions and the way other people live their lives.
For many people, their favourite current affairs television show, newspaper, or radio host helps them interpret and find meaning in the complex world around them. This direct impact shows the power of the media and its influence on public attitude. Sometimes the media help improve understanding by providing accurate and positive stories about people living with a mental illness. Unfortunately, the media can also perpetuate stereotypes. Research tells us that:
The media’s power and influence makes it important for us to hold it to account for inappropriate or stigmatising reports on mental illness or suicide. By acting to fight stigma in the media we can help change community attitudes.
Media reports are stigmatising if they represent mental illness in ways that are inaccurate or offensive.
A stigmatising report may encourage people to fear or be unsympathetic towards people with a mental illness, to mock or invite ridicule of them, or give inaccurate or misleading facts about mental illness.
Here are some of the ways the media does this:
Sensationalised reporting of violent acts by people with mental illness often fails to provide information as to why someone was acting aggressively. The person may not have been receiving effective treatment, for example. Repeat coverage gives the impression that these events are common, and that everyone affected by mental illness is aggressive. A 2013 University of Melbourne study found 47 per cent of Australian media articles regarding schizophrenia linked the illness to violence.
In fact, research shows that:
By associating mental illness with violence and crime, the media promote the myth that all people with a mental illness are dangerous and to be avoided.
'On a TV drama last night, a character with bipolar disorder was shown deliberately running someone over with a car. That sort of negative portrayal makes it hard for me to tell people that I have bipolar, and I have to explain that I’m not a ‘dangerous’ person.'
Most people who make fun of mental illness do so thoughtlessly, not realising the hurt they cause. Whether done intentionally or not, this can cause harm in a number of ways – making people affected and their families feel mocked and excluded by society, perpetuating community misunderstanding, and discouraging people from seeking treatment.
TV dramas have depicted people with a mental illness as comical or violent. While producers and scriptwriters may claim ‘artistic licence’, drama still plays a major role in representing mental illness and perpetuating stigma.
If a person is labelled as their illness, rather than as someone living with or being treated for a mental health issue, it gives the impression that this defines their life. This use of labels is often upsetting as it classifies someone by their symptoms. A person may feel the label ties them to a negative stereotype that ignores their personal strengths.
Sometimes media articles include statements that use mental health diagnoses to explain particular behaviours. Misusing medical terminology is not only inaccurate it is also misleading. This can result in community misunderstanding of mental illness symptoms, or cause a person to experience ‘self-stigma’. Self-stigma can affect self-esteem and confidence, or make people reluctant to accept diagnosis or treatment.
Jaelea Skehan, of the Mindframe National Media Initiative, discusses the issue of stigma and labels with ABC Radio’s Lingua Franca. Jaelea says the issue is more than political correctness – it’s about reducing stigmatising language, which can reinforce discrimination.
Proving positive feedback is an important and effective way to reduce stigma in the media. By praising the media for their good work we reinforce the important role journalists play in representing mental illness and sharing inspirational stories.
The media increasingly recognises the importance of responsible reporting on mental illness and suicide-related issues. The Australian government’s Media Monitoring Project found an increase in responsible coverage of mental illness (5 per cent) and suicide-related issues (18 percent) between 2001 and 2007. The Australian Press Council recently updated its Suicide Reporting Standards, encouraging the media to report responsibly on the topic.
SANE’s StigmaWatch includes examples of ‘Good News Reports’ which recognise positive reporting by the media.
Participants in a recent StigmaWatch Media Survey believed the media’s coverage of schizophrenia (83 per cent) and bipolar disorder (64 per cent) was ‘poor’.
Stigma tarnishes the lives of people with a mental illness, causes stress and unhappiness for their family and friends, and deters people from seeking treatment.
Stigma has a profound effect on the lives of those affected in a range of ways.
Like most health problems, mental illness is easier to treat if diagnosed early. But many people with the early symptoms of mental illness are reluctant to seek help because they don’t understand what these symptoms mean, or associate mental illness with negative and inaccurate stereotypes.
Stigma makes recovery from mental illness harder. Mental wellbeing has a lot to do with staying active and engaged, living a contributing life, and feeling accepted by others as part of the community. For a person with a mental illness, stigma can erode their self-confidence and make them shy away from engaging with others, fearing misunderstanding and ridicule.
A study by the Mental Health Council of Australia (MHCA), found 85 per cent of Australians with a mental illness surveyed were worried other people would view them unfavourably because of their mental illness. The survey also found 83 per cent of those surveyed had seen offensive reports about mental illness in the media.
Fear and ignorance about mental illness contributes to discrimination, making it harder for people with a mental illness to find work, a place to live, and be accepted as valued members of the community. The MHCA study found 71 per cent of people with a mental illness had been treated as less competent after revealing their mental illness to other people. Just over half were advised to ‘lower their expectations’ because of their mental illness.
These concerns were supported by a 2013 international study ‘The Backbone of Stigma’ which found 58 per cent of people studied believed someone with schizophrenia shouldn’t supervise employees at work. Forty-three per cent of respondents also said they would not want to work closely with a colleague who had schizophrenia.
The fear of negative attitudes and community misunderstanding can cause people to withdraw from society. As well as being distressing, social isolation – a low level of interaction with others – and loneliness makes it harder for people to cope with the symptoms of mental illness, or seek help to treat their illness.
SANE’s Research Bulletin, Social inclusion and mental illness found over half (52 per cent) of the respondents did not feel part of their local community. Many people said they had been treated disrespectfully at some time because of their mental illness (42 per cent).
Social isolation and withdrawal discourages people from sharing their stories, reducing the community’s awareness of symptoms, treatments, and the ability of people with a mental illness to live a contributing life.
The University of Melbourne’s 2011 National Survey of Mental Health Literacy and Stigma suggests there is a link between increased community awareness of mental illness and social acceptance. It concludes that better community awareness of mental illness could lead to an increased number of people sharing their experience. This in turn would increase personal contact and improve public attitudes towards mental illness.
The distress which may be caused by caring for a person with a mental illness is often unrecognised. As well as being frustrated by the practical problems of caring, it is also hurtful and upsetting to see the person you care for being mocked and vilified.
Many carers avoid telling people outside their immediate family that they care for a person with a mental illness, not wanting to be the object of insensitive or offensive comments.
'I was watching TV with my sister, who’s been through a really tough time with schizophrenia. She has a lot of courage to put up with the symptoms. This ad came on for a warehouse sale – ‘we must be CRAZY to sell at these prices!’ and a guy thrashing around in a straitjacket.
I could feel her tense up, thinking that this is what society thinks of her. I was so angry, I nearly wept. How dare they make fun of such vulnerable people!'
Stigma against mental illness is one of a number of reasons why people can feel excluded or alienated by society. Like racism and other forms of prejudice, stigma suggests that people with a mental illness are ‘outsiders’ –inferior, incapable, or dangerous, and are not equal members of the community.
Stigmatising attitudes make society harsher and less considerate or supportive for people affected by mental illness. The media play a big part in influencing public attitudes, and have a responsibility not to unfairly represent people with a mental illness. We can help them do this by drawing their attention to cases of stigma, and encouraging more accurate and respectful reporting of mental illness and suicide.
Some of the most harmful effects of stigma occur when it affects how people view themselves. Self-stigma happens when someone accepts and takes on the prejudiced perception held by others. Sociologist, Erving Goffman, who studied the impact of institutionalisation on people with a mental illness, described self-stigma as: ‘internalised feelings of guilt, shame, inferiority and wish for secrecy experienced by those who live with mental illness.’
Self-stigma has a range of effects: hurtful, harmful, and some with long-term consequences.
The mental health sector, the media and the community can help reduce self-stigma by ensuring mental illness is not mocked, trivialised or ridiculed. Improvements in attitude and community awareness can reduce the selfstigma felt by people with a mental illness.
SANE’s Research Bulletin 4: Stigma and mental illness found many people believe the community attitude towards mental illness is improving. The majority of respondents (56 per cent) felt community attitude was slowly improving, 37 per cent felt the attitude was about the same and 7 per cent considered it to be worse.
Reporting of suicide in the media is also a serious issue, as research shows it may lead to ‘copycat’ attempts or normalise suicidal behaviour. This does not mean the issue should not be covered, but it requires sensitivity and responsibility from journalists and the media.
The Mindframe National Media Initiative’s Guidelines on suicide recommend that specific details relating to the suicide method and location should not be reported, rather generalisations such as ‘a cocktail of drugs’ or ‘died at home’ are suggested. The guidelines also state the issue should not be sensationalised or glamorised, and that suicide should not be viewed as a desirable solution – for example, describing a suicide as ‘successful’.
Helpline numbers should also be included in every story to support people who may be distressed by references to suicidal behaviour.
The Australian Government’s Media Monitoring Project analysed the extent and nature of media reporting on mental illness and suicide. It found that between 2000 and 2007, the Australian media had increased reporting of suicide by 74 per cent and improved the overall quality by 18 per cent.
The Australian Press Council’s Standards Relating to Suicide reflect changing media industry and community attitudes towards the representation of suicide in the media.
A 2012 report by ABC Radio’s Lexi Metherell on The World Today focused on reaction to the updated standards and included views from the media, mental health sector and people with experience of mental illness. The report showed that, despite these changes, there were still conflicting opinions and expectations across all interested parties.
Coverage of suicide-related issues has seen a number of media organisations coordinating their own suicide reduction campaigns. Regional newspaper, The Border Mail, won a Walkley Award for Journalism Leadership for its ‘Ending the suicide silence’ campaign. This highlighted the pain and suffering suicide was causing families throughout the region, calling for improved local services.
This initiative demonstrate how the media can responsibly report on suicide; highlighting risk-factors and the damage suicide causes people bereaved, without sensationalising the issue or mentioning specific suicide methods
There are many ways to report on suicide. Some are responsible and provoke sympathy in readers, while others unecessarily and irresponsibly disclose risky facts such as suicide method and location, or glorify the act.
For example, in 2011 the Geelong Advertiser ran a story about a suicide pact between a mother and her son. Unfortunately, the newspaper included a detailed description of the suicide method, listing the location and specific steps taken Rockhampton’s Morning Bulletin also reported the story, however it omitted these details and included positive comment from the son’s friends and teammates, highlighting his personal strengths, and the sad loss to the community.
The Australian Government’s Mindframe Initiative encourages the media to report on suicide responsibly – framing suicide as a tragic waste and an avoidable loss, highlighting the devastating impact suicide can have on family and friends.
StigmaWatch encourages journalists to follow this advice, focusing on the loss, grief, and waste of life, rather than a detailed report on the fatal actions taken by the person who has died.
Taking action on stigma is simple. You can report it to SANE StigmaWatch. You can contact those directly responsible. You can also alert the relevant industry body or regulator.
There are three important steps to an effective response to stigma in the media:
It is important to be as accurate as possible about the case of stigma you are reporting.
If the report can’t be identified and verified, then it is unlikely to be taken further, and the person responsible cannot be notified of the issue.
Be clear on what you found stigmatising, keeping in mind that just because you do not like something does not automatically make it stigmatising. Ask yourself, is this inaccurate? Is this disrespectful towards people with a mental illness? Bear in mind that if a media outlet reports a stigmatising comment by a public figure, then the journalist and publication are not responsible for what is said.
Record the name of the publication, website, or program. (Remember to include the name of the TV or radio station as well as the program.) If it is a print publication, note the page number and keep a copy if possible. Remember that the source needs to have been produced in Australia in order for it to be followed up by SANE StigmaWatch.
The date of publication or broadcast is essential, so the case can be verified. For a broadcast, note the time as well.
You can now report the case to SANE StigmaWatch or make a direct complaint. confident all the details are correct.
Send the details of any case of stigma you see in the media to SANE StigmaWatch for assessment and action. TV and radio items, especially, need to be reported promptly so they can be easily verified.
All submissions are evaluated against the Mindframe Media Guidelines and the StigmaWatch criteria.
If a report falls within these criteria, StigmaWatch may take up the case with the journalist, editor or person responsible, and post a report in the Stigma and Good News files.
You can also sign up to the StigmaWatch Bulletin to receive regular reports on progress of ongoing cases.
Reports can be sent in a number of ways.
Before lodging a report with StigmaWatch, check that it meets the reporting criteria.
As well as reporting a case to SANE StigmaWatch, you can contact the media outlet yourself.
Telephone feedback can be effective, but there is no guarantee that you have spoken to the right person, and there is no record of the feedback.
In general, an email, letter, or fax is better because it is an exact record of your feedback, and you can keep a copy to follow up. It also means you can send a copy to someone with more authority. For example, as well giving feedback to a journalist who wrote an article, you could send a copy to the editor of the newspaper that published it.
Tips to make your feedback effective
The majority of cases of stigma in the media arise because of thoughtlessness rather than malice. Those responsible may also be unaware of the Mindframe Reporting Suicide and Mental Illness guidelines. A polite letter – along the lines of ‘I was saddened to see .. .’ – is more likely to get a sympathetic response and encourage the journalist to be responsible in the future.
1. Get straight to the point with your complaint.
2. Give full details of the item you wish to complain about.
3. Explain why the item was inaccurate or hurtful to people with a mental illness. Back this up with a relevant fact or two (see the Fact File at the end of this section).
4. Politely request that they write more accurately and respectfully in the future.
5. Refer them to the SANE website (www.sane.org) for more information, and note that you have copied the complaint to SANE StigmaWatch.
6. Make clear that you expect a response.
See this model letter as an example. You can also write a letter to the editor.
1. Get straight to the point with your feedback.
2. Give full details of the item you wish to give feedback on.
3. If making a complaint, explain that the reporting of suicide was inappropriate, and give the reasons why (see The Media Codes and Guidelines section below for specific regulations).
4. If making a complaint, politely request that they report the issue more responsibly and appropriately in the future.
5. Refer them to Mindframe and the Reporting Mental Illness and Suicide guidelines, and note that you have copied the feedback to SANE StigmaWatch.
6. Make clear that you expect a response. See this model letter as an example. You can also write a letter to the editor.
Write to the journalist who wrote the article and send a copy to the Editor. Call the organisation’s reception for the journalist and Editor’s contact details.
If you would like your letter, or email published, send another copy to the publication’s Letters Editor.
Where a complaint is serious and you don’t receive a satisfactory reply, send full details of your complaint and
correspondence to the Australian Press Council within 60 days of publication.
Australian Press Council
GPO Box 3343
Sydney nsw 2001
Freecall 1800 025 712
Fax (02) 9267 6826
Write to the person who made the stigmatising remark and send copies to the program’s Producer and Executive Producer. Where a complaint is serious and you don’t receive a satisfactory reply, or if the station doesn’t answer your complaint within 60 days, send full details of your complaint and correspondence to –
Assistant Manager, Investigations Section
Australian Communications and Media Authority
PO Box Q500
Queen Victoria Building
Sydney nsw 1230
Freecall 1800 226 667
Fax (02) 9334 7799
Write to the Chief Executive Officer of the company promoted in the ad and send a copy to the media outlet where it appeared. Where a complaint is serious and you don’t receive a satisfactory reply, send full details of your complaint and correspondence to the Advertising Standards Bureau. (Note the ASB does not deal with complaints about ads on the Internet or in direct mail.)
Advertising Standards Bureau
97 Northbourne Avenue
Turner ACT 2612
Tel (02) 6173 1500
Fax (02) 6262 9833
Depending on the company, or website, it is best to address your complaint to the Website Manager, Online Editor or the Online Community Coordinator. A responsible manager will respond to your complaint.
If you don’t receive a satisfactory reply, there is less scope for further complaint, as the Internet is not subject to the same regulation as other media. However you may be able to leave a public message in the Comments section of the webpage, or alert the website moderator to the stigmatising content.
Where a complaint is serious and the source is Australian, check whether it contravenes the Disability Discrimination Act with the Australian Human Rights Commission.
If you believe the website content may be discriminatory towards people with a psychiatric disability, send full details of your complaint and correspondence to:
Director, Complaint Handling
Australian Human Rights Commission
GPO Box 5218
Sydney nsw 2001
Tel 1300 656 419
Fax (02) 9284 9611
If you see a media report, ad, or online content you feel is inappropriate and stigmatises mental illness, it may be in breach of an industry code or guideline.
Government legislation and industry codes of practice cover all media content and the presentation of news and entertainment programs. This includes discrimination or the representation of groups or individuals, and the classification of material based on suitability to the audience.
If you intend to contact a media outlet directly, informing them of the offence caused, it often helps to cite the code or guideline the report may have breached.
News websites and social media increase the ability of Australians to connect, share their own news, and provide their opinion on a variety of issues. However, this greater connectivity increases in the likelihood of causing hurt or offence to others.
The speed of the online news cycle, the number of media reports and the mass of online comments means cases of stigma can be easily missed. The online world also provides users with anonymity, allowing them to post deliberately offensive or contentious comments, also known as ‘trolling’.
Many online news sources such as ninemsn.com.au and abc.net.au have user-guidelines and moderators to regulate comments and feedback. Australian newspaper websites, such as theage.com.au and theaustralian.com.au, are also governed by the Australian Press Council Standards. For other Internet news sources, the Australian Communication and Media Authority or the Australian Human Rights Commission may be the most appropriate agencies for complaint.
If you have seen an online media item that you feel is offensive and stigmatising, it is important to report the item immediately. If the website is a social media community, such as YouTube or Facebook, you may be able to lodge a complaint directly under their Community Standards . If it is a news website then you can lodge a complaint with the website moderator. You may want to report the stigmatising item to StigmaWatch, so we can follow up and include your report in the Stigma and Good News files.
Sometimes international news websites, or small community noticeboards, fall outside Australian legislation and the StigmaWatch criteria. In these cases it is advisable to write to the Online Editor or Online Community Manager, explaining why the item is offensive, requesting removal or modification.
It is helpful to include relevant facts about mental illness in your complaint about stigma, such as the following from SANE Factsheets.
SANE StigmaWatch campaigns tirelessly for the reduction of mental illness stigma in the Australian media. Over the past decade, StigmaWatch has seen improvement in media awareness and reporting on complex issues such as mental illness and suicide.
The Australian Government’s Media Monitoring Project:Changes in media reporting of suicide and mental health and illness in Australia, found that between 2000 and 2007, the Australian media had improved the quality of its reporting on suicide by 18 per cent and mental illness by 5 per cent.
In 2011, StigmaWatchers also identified an improvement in media reporting; with 58 per cent of respondents to a survey believing the media had improved its coverage over the previous two years.
The past decade has also seen a number of Australian and international stigma campaigns and initiatives. The Queensland and South Australia governments ran awareness campaigns, with non-government organisations also contributing to stigma reduction and social inclusion of people with a mental illness.
In New Zealand, the United Kingdom, Scotland and Ireland mental health organisations are working on more substantial anti-stigma campaigns with the media, businesses and the public. Other countries like Canada are working towards implementing their own national initiatives.
See the links below to see what is happening across the world to reduce stigma towards mental illness.
Like Minds Like Mine
See Me, Scotland
Time To Change
Bring Change to Mind