Mental Health and the Press

Research and Analysis completed for Mental Health Media by Liz Macmin



Index




 

Executive Summary

Introduction

"Those of us who have experienced mental ill health are all too familiar with people talking on our behalf about what is best for us. We have become a distant and excluded part of the picture. To remove the stigma and challenge the myths that surround mental illness, it is vital that our views on issues such as new legislation, discrimination and medication are at the core of news reporting."
Lionel Joyce, Chairman, Turning Point

The report, 'Mental Health and the Press' was commissioned by Mental Health Media to look behind the headlines and try and establish the factors affect ing coverage in national and regional newspapers about mental health issues. By talking to both newspaper journalists and mental health service users, and by assessing the quality of mental health articles in both the national and regional press, the report highlights the level of involvement current and former mental health service users have in stories about mental health with both the regional and national press.


Methodology

The research surveyed one journalist on each of five national and twelve regional newspapers on their approach to mental health stories and questioned representatives of fifty seven mental health service user groups in England and Wales about their involvement with local and national newspapers. The research also analysed print articles on mental health, collated over a two month period between mid December 2000 and mid February 2001, for favourability, content and to determine how many include the voices of people who had experience of mental distress.


Top Line Findings

Media

* Only 6.5% of all articles analysed contained the voice of a current or former mental health service users (individual or group). For national media this figure was 4% and for regional media 9.5%.

Journalists

* Most Journalists said the main barrier to contacting people with mental health problems was that they were not sure who to contact.

Service User Groups

* The biggest barriers to service user groups getting involved with local or national newspapers were not knowing who to contact and fear of negative coverage.


 

Methodology

The survey was conducted in three stages:


Stage One

Phone research by means of a questionnaire was undertaken with service user groups in 6 regions around England and Wales, totalling 57 service user groups. The regions were SE England and London, SW England, Midlands, Wales, NW England and NE England. User groups were canvassed to reflect diversity of background, sex, ethnicity & sexuality.

The questionnaire aimed to identify:

  • service users' views of their regional media and national media.
  • how much contact user groups have had with the media both in their area and nationally, and the nature of this contact.
  • whether they approached the media or responded to an enquiry.
  • the effects of this contact, and whether it has been beneficial or damaging.
  • the reasons why user groups have had no involvement with the media, or media coverage, where this is the case.


Stage Two

Telephone research questionnaires were conducted with five journalists, either social affairs or health correspondents, from five national newspapers, both broadsheets and tabloids, and twelve journalists from twelve regional newspapers (news editors, assistant news editors or health correspondants). The questionnaire aimed to identify how much contact both regional and national media have with mental health service users, and what factors determine this.

The questionnaire aimed to identify:

  • Whether journalists are aware of service user groups in their area/nationally.
  • How much contact both regional and national media have with service users, and what factors determine this.
  • Whether journalists find this contact beneficial or not.


Stage Three

Print articles were collated over a two-month period between mid December 2000 and mid February 2001 (period covered by the publication of the government's mental health white paper). They totalled 146 from all national and major regional newpapers.

Press cuttings were supplied by the International Press Cuttings Bureau (IPC). All national broadsheet and tabloid dailies and Sundays, plus 20 major provincial dailies in England and Wales were searched for articles on mental health. Articles were searched for reference to mental health, mental ill-health, mental illness, schizophrenia, depression, suicide, psychiatry, psychiatrists, and ECT (electro-convulsive therapy).

The aim of the media analysis was to discover:

  • The favourability of press coverage, both regionally and nationally, on mental health issues during the two months in question.
  • What type of story received the most attention.
  • How much the "user voice" was present in articles.


The messages

Articles were analysed for favourability according to a set of positive, negative or neutral key messages. Taking each press cutting as a unit of analysis, we determined the overall message conveyed by that article and coded each one as one of these leading positive and corresponding negative messages:

  • Mental health problems are/are not treatable
  • Mental health concerns/does not concern everyone
  • People with mental health problems should/should not be stigmatised
  • People with mental health problems lead/do not lead worthwhile lives
  • People with mental health problems are/are not dangerous


 

Findings

Analysis of Mental Health Coverage in the Press

146 print articles from all national and major regional newspapers, were analysed over a two-month period between mid December 2000 and mid February 2001 (period covered by the publication of the Government's mental health white paper). Of the articles analysed 38% were from regional press and 62% from national press.

Only 6.5% of all articles analysed contained the voice of a mental health service user or survivor (individual or group). For national media this figure was 4% and for regional media 9.5%.

Policy and legislation were the most common subjects covered in the articles analysed, followed by harm to others. (Several articles featured more than one subject so figures total 117%)

Of the articles analysed the coverage overall was 26% positive, 46% neutral and 29% negative. National press was twice as likely to be positive as regional press.

Journalists' view of mental health and the press

Telephone research questionnaires were conducted with five journalists, either social affairs or health correspondents, from five national newspapers, both broadsheets and tabloids, and twelve journalists from twelve regional newspapers (news editors, assistant news editors or health correspondants). The questionnaire aimed to identify how much contact both regional and national media have with mental health service users, and what factors determine this.

64% of Journalists said that coverage of mental health could be improved in the media.

62% of Journalists said the main barrier to contacting people with mental health problems, is that they are not sure who to contact.

62% of Journalists said they were most likely to contact a psychiatrist when considering a story on mental health. (Because many journalists said that they would contact more than one of these groups, this totals a 225% response to this section.)

When questioned about reasons for not including service user perspectives 48% said it was because they were not prepared to be photographed or named.

However, of those journalists who have been in contact with service user groups, 64% found their input useful or very useful, and 71% said they had occasionally included their views.

Only 14% of journalists said that mental health service users contacted them regularly or sometimes, and 43% of journalists said that service users only occasionally contacted them.

52% of journalists felt that they understood different diagnoses of people with mental health problems quite well or very well.


Mental Health service user groups' view of mental health and the press

A telephone survey was conducted with fifty seven mental health service user groups in England and Wales. The participating groups reflected a diversity of background, sex, ethnicity & sexuality. The questionnaire aimed to identify service users' views of their regional media and national media, and how much contact user groups have had with the media both in their area and nationally.

68% of groups felt that coverage of mental health in their local area was unbalanced or negative.

Three quarters of user groups said that they had proactively approached their local media, but only 12% had approached the national media.

The main barriers to mental health service users proactively approaching a journalist from a regional or national newspaper, was that they didn't know who to contact (25%) and because they didn't have enough time (26%).

70% of groups who had contacted the national press felt that their views had been conveyed either quite or totally positively in all cases, and 70% felt that their views had been conveyed accurately.

Of those who had proactively contacted the press 52% said they would do it again with media training and 46% said they would with or without training.

Just over half of user groups questioned (53%) had been contacted by journalists when writing an article on a Mental Health issue, all of these by a regional journalist and 9% also by a national.

All (100%) of those groups who had responded to the national press felt that their views had been covered either quite or totally positively in all cases, and all groups (100%) felt that their views had been conveyed accurately.

Groups said that the regional press were slightly less likely to provide positive and accurate coverage of their views: 40-60% said that their views were covered quite or totally positively, and 75-85.5% said that coverage was accurate. (Varies depending on whether coverage was reactive or proactive).

The biggest barrier to responding to a press enquiry was that user groups are afraid of negative coverage (21%).

Just over half (56%) of those who had been contacted said that some or all of their views had been published.

Half of those contacted by the media said that they had benefited from the coverage they had received, mostly by getting more interest in their groups work, then by recruiting more users to their group and getting good feedback.

Of those who had been contacted by the press 54% said they would take part in more media work if they had media training. 30% said they would with or without training.


 

Discussion

This study has highlighted the near absence of the voice(s) of people who have experienced mental health problems in stories specifically about mental health. Both journalists and service users agree that coverage of mental health can be greatly improved. This is evident by the fact that only a quarter of press articles analysed contained positive messages, found more frequently in national press than regional.

While mental health policy was the most covered story from articles researched, this was probably mainly due to the fact that the governments white paper on mental health was published during this period. However the next biggest topic ('harm to others') suggests that newspapers are still perpetuating the view that mental health and violence are inextricably linked.

Many journalists would like to include the perspective of people who have had experience of mental ill health, but don't know who to contact. They are in fact, far more likely to talk to a psychiatrist than a service user. This was echoed by the fact that hardly any service user groups questioned had been contacted by a national journalist. Communication is slightly better between regional press and service users.

Only half of those service users in contact with a newspaper actually had their views published, however most seemed pleased with the positive approach and accuracy of the journalists, more with the national press than regional. Nearly all who had been involved with media work said that they would do it again, particularly if they received media skills training.

It seems from this research that when journalists and mental health service user groups do speak to each other, the resulting reporting is often both accurate on issues relating to mental health and positive in its approach. However this does not happen enough, mainly because both journalists and mental health service user groups do not know how best to contact each other, and because many service user groups are concerned about negative coverage.

Clearly one of the best ways of breaking down the damaging stereotypes about mental health is for the press to speak to those with direct experience of mental distress and vice versa. Its only by doing this can a more balanced approach to reporting on mental health be achieved.


 

Appendix 1:

Analysis of mental health coverage in the press

146 Press Cuttings were carefully examined. Of these, 7 contained only a passing reference to 'mental health' and produced no messages. Of the remaining 129 a quantitative content analysis of 'key messages' showed the following results. Of the articles analysed 38% were from regional press and 62% from national press.


All newspaper cuttings:

(These Percentages are rounded)

Only 6.5% of all articles analysed contained the voice of a mental health service user or survivor (individual or group). For national media this figure was 4% and for regional media 9.5%.



Positive Messages:

People with mental health problems can live worthwhile lives - 8%
People with mental health problems should not be stigmatised - 13%
Mental health problems are treatable - 5%

Total positive messages - 26%




Neutral Messages:

There is a shortage of resources - 8%
Everyone can be affected by mental health problems - 11%
Neutral report on policy - 3.5%
Voice of user groups - 6.5%
New Resources are being provided to care for people with mental health problems - 12%
People with mental health problems don't lead worthwhile lives* - 5%
*N.B. attributed to poor standards of care

Total neutral messages - 46%




Negative Messages:

People with mental health problems are dangerous - 22%
Mental health problems are not treatable - 2%
People with mental health problems should be stigmatised - 5%

Total negative messages - 28%


Out of 86 Press Cuttings from National Newspapers:

(These Percentages are rounded)

Positive messages: 32%
People with mental health problems can live worthwhile lives - 8%
People with mental health problems should not be stigmatised - 20%
Mental health problems are treatable - 4%

Neutral messages: 41%
There is a shortage of resources - 5%
Everyone can be affected by mental health problems - 15%
Neutral report on policy - 4%
Voice of user groups - 4%
New resources are being provided to care for people with mental health problems - 5%
People with mental health problems don't lead worthwhile lives* - 8%
*N.B. attributed to poor standards of care

Negative messages: 27%
People with mental health problems are dangerous - 19%
Mental health problems are not treatable - 0%
People with mental health problems should be stigmatised - 8%


Out of 53 Press Cuttings from Regional Newspapers:

(These Percentages are rounded)

Positive messages: 16%
People with mental health problems can live worthwhile lives - 9%
People with mental health problems should not be stigmatised - 3%
Mental health problems are treatable - 4%

Neutral messages: 52%
There is a shortage of resources - 11.5%
Everyone can be affected by mental health problems - 5.5%
Neutral report on policy - 0%
Voice of user groups - 9%
New resources are being provided to care for people with mental health problems - 26%
People with mental health problems don't lead worthwhile lives* - 0%
*N.B. attributed to poor standards of care

Negative messages: 32%
People with mental health problems are dangerous - 26%
Mental health problems are not treatable - 2%
People with mental health problems should be stigmatised - 4%




Coverage by Subject

Policy and Legislation - 44%
Harm to Others - 37%
Care in the Community - 20%
Suicide - 8%
Depression - 7%
Employment - 1%
Self Harm - 0%

(Several articles featured more than one subject so figures total 117%)


Mental health policy and legislation

Most of the discussion on Mental health policy and legislation concentrated on proposals for greater compulsion and new powers of detention in mental health care. Many of them therefore coincided with articles on the 'threat' of potential harm to others posed by people who experience mental ill health and distress.

There were 57 articles on mental health policy and legislation overall, and this represents 44% of all articles in the regional press & the national press altogether. The publication of the governments white paper in December would have had a big impact on these figures. There were 41 articles on mental health policy and legislation in the National Press, and this represents 47% of National Press articles in our sample.

There were 16 articles on mental health policy and legislation in the Regional Press, and this represents 30% of Regional Press articles in our sample. As a rule, the Regional Press will concentrate on stories that highlight the effects of policy and legislation changes on local people and local places.


Harm to others

There were 47 (37% of articles overall) which discussed the threat of potential harm to others posed by people who experience mental ill health and distress. In the National Press, 29 articles discussed the threat of potential harm to others posed by people who experience mental ill health and distress. This represents 34% of all National Press articles from our sample.In the Regional Press, 18 articles discussed the threat of potential harm to others posed by people who experience mental ill health and distress. This represents 32% of all Regional Press articles from our sample.


Care in the community

The phrase 'Care in the Community' was mentioned 29 times overall (20% of articles overall). In 22 cases, the phrase is linked in the same sentence to the word 'failed' or 'failure' or 'unsuccessful'. In 7 cases the phrase is linked to the need to 'force' 'Care in the Community Patients' to 'take their medication'. This subject, proportionately, received approximately the same amount of attention in the Regional as in the National press.


Suicide

There were 12 articles overall (8%) dealing with the problem of suicide among people who use mental health services. This is noteworthy when we compare it with the 47 articles overall dealing with the perceived threat of harm to others posed by people who experience mental and emotional distress.


Depression

There were 9 articles overall (7%) in which this problem was specifically discussed. All but one (8 of them) were in the National Press (representing 9% of National Press Cuttings). An exception is one article that appeared in The Sentinel of Stoke-on-Trent (this represents 1.8% of Regional Press Cuttings).


Employment

There was one article about ways of developing employment opportunities for people with enduring mental health problems.


Self-harm

There were 0 articles on this specific subject.


Analysis of language used

  • Loony: Encouragingly, the word 'Loony' was not found in any of our sampled press cuttings.
  • Psycho: This specific term was not used. However 'Psychotic' was used 5 times, & 'Psychopath' was used 17 times.
  • The word 'Mad' was used 1 time. The word 'Madness' was used 5 times
  • The word 'Dangerous' in association with people who have mental or emotional disturbance or distress was used 42 times.
  • The term 'Mentally Ill' was used 77 times.
  • The phrase 'Person with mental illness' was used 48 times
  • The word 'Schizophrenic' was used 24 times
  • The phrase 'Person with mental health problem' was used 34 times


 

Appendix 2:

Journalists View of mental health and the press




Who would you contact when you are planning an article on Mental Health?

39% of Journalists said - People who have experienced Mental Health problems.
62% of Journalists said - Psychiatrists.
47% of Journalists said - Psychologists and others in clinical care teams.
38% of Journalists said - Mental health care workers/ trust managers.
39% of Journalists said - Mental Health groups e.g. Mind, NSF.

Because many Journalists said that they would contact more than one of these groups, this totals a 225% response to this section.


How often would you say your newspaper has included the voice of people who've experienced Mental Health problems in articles on Mental Health?

10% of Journalists said - Never
71% of Journalists said - Occasionally
14% of Journalists said - Regularly
5% of Journalists said - Don't know or didn't answer the question.

This is 100% as all Journalists only selected one option.


Are you in contact with any Mental Health groups [in your area]?

24% of Journalists said - Yes, regularly
43% of Journalists said - Yes, occasionally
0% of Journalists said - I have done in the past
0% of Journalists said - No, never
33% of Journalists said - Don't know

This is a 100% as Journalists only selected one option.


What is the main barrier to contacting people with Mental Health problems?

10% of Journalists said - Concerns about offending service users and survivors
4% of Journalists said - Concerns about distressing people
62% of Journalists said - Not sure who to contact
10% of Journalists said - Didn't feel the user perspective would be relevant
29% of Journalists said - Concern that they would not respond within timetable

Because many Journalists said that they would contact more than one of these groups, there was a total 115% response to the question.


Do Mental Health service users regularly contact you to suggest articles?

10% of Journalists said - Yes, regularly
4% of Journalists said - Yes, sometimes
43% of Journalists said - Only occasionally
33.3% of Journalists said - No, never
10% gave no specific response, or a different one.

There were very few open-ended responses. They were:

'rarely'
'Very rarely'
'People ring us up varyingly. We don't often take it forward, because these are not issues that make good news'


Do service users contact you to respond when a particular issue is in the media spotlight?

10% of Journalists said - Yes, regularly
4% of Journalists said - Yes, sometimes
28% of Journalists said - Only occasionally
20% of Journalists said - No, never
38% of Journalists - other

These are some of the open ended comments from the 38% of Journalists who did not choose any of the above options:

'Generally if people contact us, it's to complain'
'The paper does the approaching of organisations and others concerning mental health issues'
'If people approach us it is usually to health / letters page'
'rarely'
'We are approached by concerned relatives'


Do you find their input Very useful / Useful / average / not useful?

of the 13 Journalists who answered both the last two questions:

24% of Journalists said - Very Useful
40% of Journalists said - Useful
32% of Journalists said - Average
4% of Journalists said - Not Useful

This reflects a 100% response rate to the question.


What are the main barriers to including the perspective of Mental Health service users?

4% of Journalists said - Their comments are not relevant
29% of Journalists said - They did not respond quickly enough
48% of Journalists said - They were not prepared to be named/photographed
4% of Journalists said - Their views were too controversial
4% of Journalists said - They didn't have an opinion
8% of Journalists said - They didn't have a spokesperson
33.3% of Journalists said - They were not succinct/media-friendly
10% of Journalists said - They were not informed on the particular issue
10% of Journalists said - There wasn't enough space
0% of Journalists said - I did, but they were removed
0% of Journalists said - Other

Because many Journalists chose more than one of these scenarios, there was total 150% response to this section. However there were some open comments, such as:

'No barriers'
'People feel they're being hurried to explain complex points.'
'People become distressed by journalistic process & outcome'
'Their expectations are not met. Their stories reduced to a few words, not a whole spread'
'We concentrate on 'feel good' stories, which Mental Health cannot actually be'
'It is more an issue of meeting deadlines'
'Bridging the gap between journalists & service users is a problem'
'We just haven't covered the story'
'If their condition is quite serious users of mental health services can't say intelligible things'


Do you feel coverage of Mental Health could be improved in the media?

57% of Journalists said - Yes, very much so
7% of Journalists said - Yes, in part
10% of Journalists said - Not really or Not at all

However there were some open comments, for example:

'There needs to be more accurate, more fair representation of people with Mental Health problems - they aren't all violent. We need to focus more directly on people's own experiences'.

'Reporting would be profoundly improved if journalists were not so terrified of their own state of mind. They don't recognise Mental Health affects all.'

'There is too much negative coverage'

'Certain 'popular' reactions need to be challenged - Some aspects are blown out of proportion - which presents a distorted picture'

'It's a forgotten subject - they have less of a voice and it is politically unattractive to spend money on Mental Health. Our city is particularly bad for Mental Health services.'

'We generally cover Mental Health quite well'

'We need a more in-depth considered approach- proactive not reactive'

'Mental Health Charities/ users could be more proactive. They just churn out surveys complaining about stigmatisation'

'It is a problem for regional paper. We need to bring the issue to local level'

'Users have to be in the news more to get balanced coverage. I.e. violence is over represented. Other areas are ignored'

'The whole area of health delivery is huge topic & they want to cover this, including Mental Health'

'We need to make it more user friendly. It is a subject which throws up a wall between subject and reader'

'More coverage is needed. Plus we need to explain things/the issues better. The science behind issues must be explained by experts and by good communicators.'

'As well as journalists changing, users and survivors need to get a more realistic media and journalists work under'


Do you feel that you understand the issues regarding Mental Health services in your region?

10% of Journalists said - Yes, very well
47% of Journalists said - Yes, quite well
33% of Journalists said - Just about
10% of Journalists said - Not really or No, not at all

This is a 100% response, as Journalists only selected one option.


Do you feel that you understand the different diagnoses and experiences of people with Mental Health conditions?

38% of Journalists said - Yes, very well
14% of Journalists said - Yes, quite well
10% of Journalists said - Just about

38% did not choose any of these responses. Some offered open-ended comments such as:

'I'm new to the job'
'We would research prior to article'
'We're better than most publications'
'I understand diagnoses but do not understand (the issues?)'
'I've got a degree in psychology'


What is your publication's policy on Mental Health?

20% of Journalists said - Have a code of conduct on language i.e. avoiding (derogatory) words

58% of Journalists said - Always offer anonymity or confidentiality as an option to people with Mental Health problems

However there were some open comments, including:

'We would wish to avoid offending people. We would use clinically accurate terms. We don't use 'nutter'.'

'We have an informal code'

'I would never use 'nutter' etc, but the News department might be different'

'We offer anonymity on a case by case basis'

'Journalists would prefer people on record and named, but we could consider anonymity'

'We follow politically correct code'

'We always offer anonymity regardless of subject. We've made Mental Health a big issue'

'Our code is not specifically on mental health but generally'

'We are not aware of any special code of conduct. We just follow the general code of conduct. Also as local paper we can't afford to upset local people'

'No, but we have unwritten rules on style: 'nutter' wouldn't be used. We also follow complaints commission guidelines on privacy'

'this is always changing, but we never get complaints from readers on language. We have to handle people with Mental issues sensitively'

'We follow MIND guidelines or ask organisations' advice on correct terminology.'

'We take each case on its own merits & sometimes offer anonymity'

'We generally follow Politically Correct Code & offer anonymity if necessary'

'Would seek advice from experts - e.g. press officer of leading Mental Health charity + guided by politically correct code + would offer anonymity if necessary'

'We didn't think Mental Health users have a voice. The focus of story is never on Mental Health issues'


Have you submitted articles on Mental Health which have been edited in a way you are not happy with?

4% of Journalists said - Yes, always
8% of Journalists said - Yes, sometimes
4% of Journalists said - Occasionally
29% of Journalists said - No, never

55% of Journalists did not respond to any of the above choices

There were very few open-ended responses. These are:

'Yes, but this happens all the time on all issues'

'Not recently, more satisfied recently'


 

Appendix 3:

Mental Health service user groups view

of mental health and the press


General views on the media

What is your opinion of the local and regional coverage of Mental Health issues in your area?

5.5% of user groups said - they are generally positive
10% of user groups said - they are fair and balanced
30% of user groups said - they are unbalanced
38% of user groups said - they are negative
3.5% of user groups said - they are other
0% of user groups said - don't know

13% of user groups did not respond


In general, do you think coverage of Mental Health issues has improved over the last 2 years?

20% of user groups said - Yes, overall
2% of user groups said - Yes, in news
2% of user groups said - Yes, in features
38% of user groups said - Its stayed the same
0% of user groups said - No, its worse in news
2% of user groups said - No, its worse in features
14% of user groups said - No, its worse overall
22% of user groups said - Don't know

Some of the comments include:

'Sensationalism is a problem.'
'it's stayed the same, but it was bad to begin with'
'it's worse on a national level, with fairly negative high profile cases and scapegoating. The broadsheets, however, are more balanced.'


Which publications do you feel have dealt most positively with Mental Health in your area?

Several different local publications were mentioned once. These included publications produced by voluntary and campaigning organisations & some regional newspapers. The Big Issue (which publication is actually divided into regions) was mentioned six times. Open Mind was mentioned four times, but this is not a regional publication.


Which publications do you feel have dealt least positively with Mental Health in your area?

Several different local publications were mentioned once. The Western Mail (a Newspaper for the whole of Wales) received four mentions.


Do you feel coverage is better in your area than nationally?

23% of user groups said - Yes, overall
3.5% of user groups said - Yes, in news
3.5% of user groups said - Yes, in features
23% of user groups said - Its stayed the same
3.5% of user groups said - No, its worse in news
1.75% of user groups said - No, its worse in features
21% of user groups said - No, its worse overall
14% of user groups said - Don't know

6.75% of user groups did not respond.


Which national publications do you feel deal most positively with Mental Health?

65% of user groups said - The Guardian
25% of user groups said - The Independent
10.5% of user groups said - The Times
1.75% of user groups said - The Telegraph
0% of user groups said - The Mirror
0% of user groups said - The Sun
3.5% of user groups said - The Express
5.25% of user groups said - The Mail
20% of user groups said - The Observer
0% of user groups said - The Financial Times
0% of user groups said - The News of the World

Some user groups chose more than one option, therefore there was a 131% response rate to this question.


Whose opinions do you think are most common in articles on Mental Health?


12% of user groups said - Service users and survivors
9% of user groups said - User and survivor groups
76% of user groups said - Major Mental Health organisations e.g. Mind, NSF
42% of user groups said - Psychiatrists
16% of user groups said - Health care workers
17.5% of user groups said - Local MPs
26% of user groups said - Government spokespeople, e.g. Members of Parliament
21% of user groups said - Residents' or local groups who are afraid of Mental Health issues
5% of user groups said - Members of the general public


What are the key issues that you feel should be covered by journalists writing about Mental Health?

42% of user groups said - employment issues
33% of user groups said - women's issues
47% of user groups said - Mental Health Act
35% of user groups said - Mental Health policy
47% of user groups said - deaths in psychiatric care
35% of user groups said - race and ethnicity issues
22% of user groups said - other*

* User groups were asked to specify some of the other Key Issues that they feel should be covered by journalists writing about Mental Health. These included:

Lack of scientific evidence to back up theories that mental illnesses are caused by chemical imbalances in the brain

Link between nutritional deficiencies/ allergies and mental health · Lack of testing of drugs and the manipulation of clinical trials by drug companies

Vested interests in the Drug Companies

Positive Employment Statements

Educating School children & teachers about mental health issues

The positive contribution that people with mental health needs can make

Housing Issues

Children's mental health

Prisons & mental health, especially Rampton

Regional inequalities in service provision

Accident and Emergency Services for people with mental health problems

Talk about social inclusion

Mental Health & the Arts

More balanced coverage with less emphasis on violence

Success stories of people with severe or enduring mental illness

Elderly people who can't speak English properly, being given the wrong diagnosis

Social factors influencing people's mental health

Service users; experiences are most important

More information regarding treatment and the support available

Human Rights and Mental Health

Mental Health and the Elderly

Abuses of Power


When approached by the Media

Has your user group been contacted (without prior contact from you) by journalists when writing an article on a Mental Health issue?

53% of user groups said - Yes
47% of user groups said - No

[If you have been approached by the media] How often has this happened?

Out of the 30 people who answered Yes to the question above:

37% of user groups said - Once a year
7% of user groups said - Twice a year
10% of user groups said - Regularly

54% did not answer the question, or gave an answer that fell somewhere in between these periods.


[If you have been approached by the media] What was the nature of the articles?

Responses included:

Views on increase of suicides due to moving patients to wards in their parts of town

ECT and its efficacy

An article on 10 groups awarded the Kings Fund Award for Excellence

For National Depression campaign. The Freelance journalist was very sensationalistic

Protest against ECT suite in Aberystwyth

National Awards for Voluntary Endeavour

Changes to Mental Health Act

Environmental Conditions in Hospitals


[If you have been approached by the media] Have your views been published?

17% of user groups said - Yes, all
17% of user groups said - Most of them
7% of user groups said - 50/50
15% of user groups said - Some of them
14% of user groups said - No

30% of user groups did not answer the question, or indicated a category somewhere between those mentioned above.


[If you have been approached by the media] Was it for national or regional press?

Some user groups said that both applied.

9% of user groups said - National
100% of user groups said - Regional


[If you have been approached by the media] How accurate was the coverage of your views for national newspapers?

Only four groups answered these questions. The other one respondent who indicated that their views had been published in the national press did not answer these questions, perhaps because they were inappropriate to the situation.

50% of user groups said - Very accurate in all cases
50% of user groups said - Very accurate in some cases


[If you have been approached by the media] How positive was the coverage of your views?

75% of user groups said - Very positive in all cases
25% of user groups said - Quite positive in all cases


[If you have been approached by the media] How did you find the experience?

100% of user groups said - Positive in all cases (Out of 4 groups)


[If you have been approached by the media] Did you get any feedback from the journalist afterwards?

50% of user groups said - Yes in all cases
25% of user groups said - Yes in some cases
25% of user groups said - No in all cases


[If you have been approached by the media] How accurate was the coverage of your views for regional newspapers?

20 respondents answered this section: This was out of 30 groups who indicated that their views had been published in the regional press. 10 groups did not answer these questions, perhaps because they were inappropriate to the situation.

60% of user groups said - Very accurate in all cases
15% of user groups said - Quite accurate in all cases
10% of user groups said - Not very accurate in all cases
5% of user groups said - Inaccurate in all cases
5% of user groups said - Quite accurate in some cases
5% of user groups said - Inaccurate in some cases


[If you have been approached by the media] How positive was the coverage of your views?

Of the 20 respondents who answered this section:

15 % of user groups said - Very positive in all cases
25% of user groups said - Quite positive in all cases
35% of user groups said - Fair & balanced in all cases

10% could not say


[If you have been approached by the media] How did you find the experience?

Of the 20 respondents who answered this section:

20% of user groups said - Positive in all cases
45% of user groups said - Reasonable in all cases
10% of user groups said - Negative in all cases
15% of user groups said - Positive in some cases
5% of user groups said - Reasonable in some cases


[If you have been approached by the media] Did you get any feedback from the journalist afterwards?

Of the 20 respondents who answered this section:

20% of user groups said - Yes in all cases
25% of user groups said - Yes in some cases
55% of user groups said - No In all cases


[If you have been approached by the media] Do you benefit from doing media work?

Out of the 30 groups to whom this applies:

23% of user groups said - Yes, always
27% of user groups said - Yes, sometimes
7% of user groups said - Occasionally
17% of user groups said - Not really
10% of user groups said - Not at all

16% did not respond to the question


If yes, how?

Out of the 17 groups to whom this applies, some user groups indicated that they had derived one or more of the following benefits:

60% of user groups said - recruited more users to group
24% of user groups said - affected local policy
12% of user groups said - got more funding
64% of user groups said - had more interest in group's work
60% of user groups said - you had really good feedback


If no, how?

0% of user groups said - felt betrayed by the reporting
30% of user groups said - felt disappointed by the reporting
8% of user groups said - health suffered
0% of user groups said - have experienced discrimination or harassment
8% of user groups said - other (no details)

54% did not respond


[If you have been approached by the media] Would you take part in any more media work?

Out of the 30 groups to whom this applies:

30% of user groups said - Yes, with or without training
54% of user groups said - Yes, with training
0% of user groups said - Yes, if I knew the journalist
7% of user groups said - Maybe
0% of user groups said - Not at all
9% of user groups said - Don't know


If your user group has been contacted by the media, but refused to comment - what were the barriers that prevented you getting involved with the media?

Out of 28 respondents to whom this applies:

7% of user groups said - Didn't know who to contact
21% of user groups said - Afraid of negative coverage
7% of user groups said - Don't want to expose myself
7% of user groups said - I've had a bad experience before
7% of user groups said - Haven't got enough time
7% of user groups said - I've not had any training
7% of user groups said - Other

37% did not respond

E.g.

'didn't feel had information to offer about local suicides'
'fear of being portrayed as non representative'
'with training would have more confidence'
'confidentiality regarding clients'
'stigma'
'I was afraid of being set up'


When approaching the Media

Has your user group proactively approached your Regional media?

75% of user groups said - Yes
5% of user groups said - No

20% of user groups did not answer the question.


Has your user group proactively approached the National media?

12% of user groups said - Yes
10% of user groups said - No

68% of user groups did not answer the question.


[If you have proactively approached the media] How accurate was the coverage of your views for National newpapers?

60% of user groups said - Very accurate in all cases
10% of user groups said - Very accurate in some cases
20% of user groups said - Quite accurate in some cases
10% of user groups said - Don't know


[If you have proactively approached the media] How positive was the coverage of your views?

60% of user groups said - Very positive in all cases
10% of user groups said - Quite positive in all cases
10% of user groups said - Fair & balanced in all cases
10% of user groups said - Fair & balanced in some cases


[If you have proactively approached the media] How did you find the experience?

70% of user groups said - Positive in all cases
20% of user groups said - Reasonable in all cases
10% of user groups said - Negative in all cases


[If you have proactively approached the media] Did you get any feedback from the journalist afterwards?

30% of user groups said - Yes in all cases
10% of user groups said - Yes in some cases
20% of user groups said - No in all cases

40% did not answer the question


[If you have proactively approached the media] How accurate was the coverage of your views for regional newspapers?

Out of the 34 respondents who answered this section:

32.5% of user groups said - Very accurate in all cases
53% of user groups said - Quite accurate in all cases
0% of user groups said - Very accurate in some cases
3% of user groups said - Quite accurate in some cases
3% of user groups said - Not very accurate in some cases
8.5% of user groups said - Don't know


[If you have proactively approached the media] How positive was the coverage of your views?

Out of the 34 respondents who answered this section:

31% of user groups said - Very positive in all cases
6% of user groups said - Very positive in some cases
28.5% of user groups said - Quite positive in all cases
3% of user groups said - Quite positive in some cases
19.5% of user groups said - Fair or balanced in all cases
3% of user groups said - Fair & balanced in some cases
3% of user groups said - Quite negative in all cases
3% of user groups said - Quite negative in some cases
3% of user groups said - Don't know


[If you have proactively approached the media] How did you find the experience?

Out of the 35 respondents who answered this section:

43% of user groups said - Positive in all cases
7% of user groups said - Positive in some cases
30% of user groups said - Reasonable in all cases
3% of user groups said - Reasonable in some cases
10% of user groups said - Negative in all cases
7% of user groups said - Negative in some cases


[If you have proactively approached the media] Did you get any feedback from the journalist afterwards?

Out of the 35 respondents who answered this section:

6% of user groups said - Yes in all cases
14% of user groups said - Yes in some cases
54% of user groups said - No in all cases

26% did not answer; probably 'Don't Know'


[If you have proactively approached the media] What was the nature of the approach?

Out of the 35 respondents who answered this section:

46% of user groups said - to promote group's work
26% of user groups said - to raise awareness about a local issue
22.5% of user groups said - to raise awareness about a national issue
3.5% of user groups said - to complain against a published article
2% of user groups said - other

Comments included the following:

'To complain to a men's magazine about an appalling article on mental health'

'To complain about a dreadful ill informed piece, promoting Prozac'

'To raise issue about day care choices'

'never approached media, because media representation of black users is very bad.'

'to promote user conference & create awareness of the group'


[If you have proactively approached the media] Did the approach result in any coverage?

Out of the 35 respondents who answered this section:

45% of user groups said - Promote group
25% of user groups said - Raise awareness locally
16% of user groups said - Raise awareness nationally
3.5% of user groups said - Complain
10.5% of user groups said - other (no result, presumably)


[If you have proactively approached the media] Have you benefited from this coverage?

Out of the 35 respondents who answered this section:

46% of user groups said - Yes
20% of user groups said - No

34% did not respond


If yes, how?

Out of 26 respondents who completed this question (some respondents selected more than one item):

31% of respondents said - 'recruited more users to your group'
15.3% of respondents said - 'affected local policy'
4% of respondents said - 'got more funding'
69% of respondents said - 'had more interest in your group's work'
23% of respondents said - 'had really good feedback'
4% of respondents said - 'other' (no details)


If no, how?

Of the 9 groups to whom this question applies:

0% of user groups said - 'felt betrayed by the reporting'
78% of user groups said - 'felt disappointed by the reporting'
0% of user groups said - 'health suffered'
0% of user groups said - 'You have experienced discrimination or harassment'
0% of user groups said - 'other'

12% of user groups did not respond


[If you have proactively approached the media] Would you take part in any more media work?

Out of the 35 respondents to whom this applies:

46% of user groups said - Yes, with or without training
52% of user groups said - Yes, with training
0% of user groups said - Yes, if I knew the journalist
0% of user groups said - Maybe
0% of user groups said - Not at all
2% of user groups said - Don't know




If your user group has not proactively approached your local or national media - what were the barriers?

Out of 26 respondents who completed this question:

25% of respondents said - Didn't know who to contact
21% of respondents said - Afraid of negative coverage
11% of respondents said - Don't want to expose myself
0% of respondents said - I've had a bad experience before
26% of respondents said - Haven't got enough time
17% of respondents said - I've not had any training
0% of respondents said - Other


[If you have proactively approached the media] Do you feel that your involvement with the media has made a difference in your local area? If so, how? (eg perceptions of Mental Health, changes in local policy)

Responses included:

'It is still difficult to reach the general public. Responses are better from younger people.'

'Yes, our paper gets feedback and money to support it.'

Opened channels of dialogue between users and the media so they automatically telephone them to ask their opinions.'

'Slight.'

'More people are questioning their doctors about adverse effects and the appropriateness of their treatment/care.'


[If you have proactively approached the media] Do you feel that your involvement with the media has made a difference in your national area? If so, how? (perceptions of Mental Health, changes in local policy)

Responses included:

'It has helped us to make useful contacts.'

'It is probably more generally known there are issues around human rights in mental health & that there is a service user movement.'

'Not at the moment but it is part of our overall long term strategy'

'Only in terms of speed of information'

'Yes. I have been able to link people with similar experiences to one another.'


 

Appendix 4:

Notable articles

Examples of negative messages

28 Press cuttings supported the key message that 'People with mental health problems are dangerous'. Examples of some of these messages are given in the following quotations:

Sunday Times (London), December 10, 2000
'Up to one in three patients released from high-security hospitals will commit a serious crime within five years, according to new Home Office research. The figures reveal that about a third of those released in certain categories go on to commit a violent, sexual or other serious crime. The research is another headache for the government, which has already delayed an important announcement on the future of mental health.

Jack Straw, the home secretary, has promised strict new rules to lock up the most unpredictable offenders before they offend. His stance follows a number of murders, including those of mother and daughter Lin and Megan Russell, killed by released patient Michael Stone as they walked home at Nonington, near Canterbury, in July 1996. In October Andrew Ackroyd, a schizophrenic, was confined to a hospital indefinitely after killing his father'.


The Express (London), December 19, 2000
'Andrew Mackay and his fellow Tory MP wife Julie Kirkbride were confronted in their £1 million Westminster home by a deranged woman, he revealed yesterday. Mr Mackay, the shadow Northern Ireland Secretary, knocked her to the ground and held her until police arrived.

The couple were having dinner when the doorbell went shortly after 9pm and Ms Kirkbride went to answer it. As she opened the door the hysterical stranger barged past her screaming for help. Her husband rushed to her aid, hitting the woman to the floor. His adult son Hamish, who was upstairs in the bath, raised the alarm with his mobile phone.

He later learned the woman had been released from a mental health unit - and he called for tougher laws to protect the innocent and vulnerable.

Apparently this woman had left an institution elsewhere in the country where, under current laws, they were unable to detain her. This illustrates why Parliament will need to do more to protect innocent members of the public.'


Many of the press cuttings discuss the proposals of the new Mental Health Bill, in the context of controlling 'dangerous' patients. The Bill is rarely discussed in the context of improving care or the conditions in which people are cared for:

Sunday Telegraph (London), December 17, 2000
'Murderers, rapists and dangerous mentally-ill patients will face compulsory psychiatric checks to determine whether it is safe ever to release them under Government plans to be announced this week. Any who fail the tests will be detained indefinitely in a new network of secure units. Other individuals who have committed no crime, but are deemed to be so mentally ill that they present a serious danger to the public, will also be held.

Lisa Potts, the former nursery nurse who suffered horrific arm injuries trying to shield children from a machete-wielding man who burst into her classroom, welcomed the Government's move. It means she would have to be informed of any future release date for Horrett Campbell, a paranoid schizophrenic who was detained in a mental hospital after running amok at St Luke's primary school, Wolverhampton, four years ago.'


The Mirror (London), December 21, 2000
'Dangerous patients with mental disorders are to be kept off the streets of Britain and locked up indefinitely. Under sweeping reforms announced by the British Government yesterday, treatment will be made compulsory for the seriously mentally ill.'


The Express (London), December 21, 2000
'Dangerous psychopaths could be detained indefinitely and schizophrenics forcibly treated if they refuse to take their medication, under the first wide-ranging reform of mental health laws for 40 years. Powers foreshadowed in a White Paper published yesterday will allow a tribunal to incarcerate as many as 2,000 individuals who "pose a significant risk of serious harm to others as a result of a mental disorder".'


Positive messages

Eight press cuttings supported the message that 'People with Mental Health Problems should not be stigmatised':

The Express (London), December 28, 2000
'How can someone be a dangerous psychopath without ever committing a crime? You mention that 40 people a year are killed by former psychiatric patients, but this is a small number compared to the total number of murders committed.'


Seven press cuttings supported the message that 'Mental Health Problems are treatable'. An optimistic example of this kind of story is shown here:

The Sentinel (Stoke-on-Trent), December 13, 2000
'Many people suffering with SAD make up for this by using light boxes to provide some relief from the symptoms.

The light boxes, costing about £100, emit rays which help suffers of SAD overcome many of the problems associated with the disorder. This must be complemented with other factors such as eating oily fish, plenty of iron and other minerals and, of course, drinking lots of fresh water.


Many articles (25) dealt with the need for additional resources:

The News of the World, December 10, 2000
'Tory health spokeswoman Mary Scanlon said she had raised the issue of mental health care for children at Holyrood. She said: "For too long kids' mental health has been the Cinderella of the health service." "The Government must send messages of care, compassion dignity and respect for those suffering from mental illness."'


Sunday Times (London), December 10, 2000
'One person in six experiences mental health problems and around 630,000 people are in contact with mental health support services at any one time. The DSPD proposals will touch just a fraction. The White Paper has laudable aims - raising service quality, expanding the number of services and improving access to them, as well as improving safeguards for individuals.

It also states the aim "to reduce, wherever possible, the number of individuals who are subject to the use of powers for compulsory care and treatment" and to take on the stigma that turns people with mental health problems into easy targets for discrimination.'


20 Press Cuttings supported the message that 'Mental health concerns everyone' by describing how different sections of society experience mental health problems, the sub text being 'it could happen to any of us.'

The Daily Telegraph (London), January 01, 2001, Monday
'One in three ambulance workers suffers from mental health problems, according to a study published today. The report in the British Journal of Psychiatry finds that regular exposure to accidents, feeling helpless at the scene and dealing with child victims has contributed to the trend.'


The Express, January 17, 2001
'What is the problem with doctors? While researching my latest book, I spent time with 25 GPs - men and women; working in both single or group practices; black, white and Asian - over four years.

Their stories revealed a profession in crisis: morale among many is poor; stress levels high; incidence of alcoholism and even suicide are on the increase. The doctors themselves were asking questions about the adequacy of their training. They had been taught, they said, to cope and not whinge. They were supposed to have all the answers. The trouble is they often struggle with complex problems to which there were no easy answers.'


Articles featuring the voices of current and former service users

Western Daily Press (Bristol/West of England), January 15, 2001
'A charity which helps people suffering from mental illness to find work has been awarded a Government grant for a project to educate employers about keeping a balance between work and home.

The Department for Education and Employment has given Bath-based Talent to Work 30,000 for the scheme. The charity is also embarking on pioneering work in Bristol, using drama to improve the self-confidence of people who have suffered from mental illness so as to help them find work.

The charity was set up five years ago by Andrew Webster, who had suffered from manic depression, after he found problems getting work. He said that when he applied for a job he faced a number of barriers, such as explaining the gaps in his CV and overcoming prejudice about the illness.

"I had a desperate lack of self-confidence when I was competing with people who already had a job," he said. "One interviewer said straight away, 'Thank you for coming but we cannot offer you the job with your health record'."

Mr Webster said the new project in Bristol would follow on from work the charity had done in Manchester with disabled people, where it used drama to help improve individuals' self-confidence. "We will help people overcome a chronic lack of self-confidence," he said.

"It will be quite a large-scale project, which will have people coming through an intensive training course, which will use drama techniques to help people with mental health problems become more confident."

Talent to Work has already achieved a better deal for people recovering from mental illness. It managed to get the time during which people recovering from mental illness were entitled to incapacity benefit increased from eight weeks to 12 months, while they settled into a new job.'


The Express, December 28, 2000
'Your article on the proposed new Mental Health Act (Mentally ill face being locked up under new crackdown, Daily Express, December 21) raises questions. How can someone be a dangerous psychopath without ever committing a crime? You mention that 40 people a year are killed by former psychiatric patients, but this is a small number compared to the total number of murders committed.

Everyone is innocent until proven guilty and this should remain the case. This Government should concentrate on improving conditions in mental hospitals and stop infringing on our human rights.

Chris Jervis, London W12'


The Times Higher Education Supplement, January 5, 2001
'Poverty and depression left Peter Beresford a virtual prisoner in his own home. But he turned the tables when he used his experience to found a user-led research centre. Adam James reports

"I do not think I could have imagined what the poverty and distress involved were like if I had not experienced them myself. In terms of the loss of choice and hope, sense of fear and worthlessness and sheer wretchedness I would not wish it on anyone."

As if to rub salt in the wound, "experts" told Beresford, who taught social policy at Lancaster University from 1975-77, that his future prospects were not promising.

In 1986 a psychiatrist said to me that the best job I might be able to get was as a clerk," he remembers. "And I do not think the psychiatrist thought a lot of clerks."

But the psychiatrist was way off mark. Because Beresford, unlike most National Health Service psychiatric patients, was given the option of seeing a psychologist whose more empathetic and less medical "talking therapy" enabled him to address past trauma in his life and encouraged him to find ways of overcoming his mental health problems, such as trying to walk a bit further from his front door every day to overcome his agoraphobia.

Despite his remarkable transition from chronically ill psychiatric patient to high-ranking academic, Beresford is hesitant to describe himself as having "recovered". He says the days when, overwhelmed with anxiety, he just felt like running out of the lecture room are not far gone. Although he stopped using mental health services in 1993, he is aware of his vulnerabilities. Despite increasing work pressures placed on academics, Beresford tries to restrict his working hours to nine to five, Monday to Friday.'


The Guardian (London) January 24, 2001
'Rose, senior researcher at the Sainsbury Centre and herself a service user, has trained nurses, social workers and police. But she says that such involvement is fragmented and uncoordinated. "User groups persuade training managers at a local level, and then people like me get invited to speak. It's ad hoc, yet it's the only way staff ever find out what it's like to be on the receiving end of care, and what needs to change."'


The Sentinel (Stoke), December 24, 2000
'Mr McAteer, who has suffered mental illness, said: "This legislation seeks to break the trust by going against the patient's will. All it does is fuel fear, ignorance and prejudice and the stigma around mental health issues." "I am broadly in favour of treating people in the community, but not forcibly against their will. Someone who has excessive alcohol or drugs at the weekend can become violent and disruptive, but we don't suggest locking them up."

"It focuses on protecting the public from people with mental health problems but it should be the people with mental illness who are protected from public prejudices."

"The Government is riding rough-shod over the rights of human beings and victimising us further which seems unfair in a modern and liberal society. You can't label people dangerous if they have not committed any crime."'

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