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The Media and Mental Health

December 16, 2014

By Basket Press

We have come a long way from the appalling state of affairs which formerly existed: several TV channels now air good programmes and series, papers such as the Guardian run regular columns by the likes of Clare Allan or interviews with Charlotte Walker (aka Purple Persuasion), but let’s not kid ourselves that we now live in The Promised Land of Reasonable Media.

October 2013 saw the resurrection of old, lazy, negative stereotypes with The Sun‘s “Mental Patients kill 1200” headlines. OK, so they did, eventually and with very bad grace in my opinion, apologise for this inaccuracy, but the damage of reinforcing negative images of those with serious Mental Health conditions had already been done. Those effects are described very well here should anyone be in any doubt. And fair play to them that they did actually interview Ceriduck about her experiences.

Fortunately that “mad axe murderer” or “psychokiller” trope is less frequent than it was a few years back. But that is not the only problem in coverage of Mental Health issues, as not long before that we had Carol Sarler throwing around insults and inaccuracies in the Daily Mail. That one rankles partly because of the total misrepresentation of Attention Deficit Hyperactivity Disorder (ADHD), but also because I was part of the “gender identity industry” (I made 2% of the referrals to the Tavistock that year).

That article provoked several complaints to the Press Complaints Commission (as it was then) about factual accuracy and the like, which were rejected because it was “an opinion piece”, i.e. spout as many lies as you like as long as you call it “opinion”. This sort of “journalism” reinforces lazy assumptions that many Mental Health issues either don’t exist, are not real or are made up to suit clinicians and keep them in work – none of which remotely resemble either my experience or that of my patients and makes all of our lives that bit harder.

Even when someone writes a piece challenging myths, misleading things crop up. In that link the writer trots out the “1 in 10 children between 5 and 16 have a diagnosable mental health problem” line, which does come from a very good source and is the best set of figures for prevalence in the UK. However, if you read the full Office of National Statistics report – and I have – you find that half of this “1 in 10” is conduct disorder, which is not what most would think of on hearing the term “diagnosable mental health problem”.

However, there is another media tendency a lot more insidious and harder to detect, that is “report by press release”, in which press releases, especially from official bodies are regurgitated with no questioning, no challenges, no critical consideration, just presented as factoids.

An example earlier this year was the reporting of Closing the Gap, a Department of Health (DoH) publication about priorities in Mental Health. If reported at all it was essentially the DoH’s press office line. I saw no critique or comment at all. Now it is actually a very flawed, disingenuous, if not outright hypocritical, document, displaying a worrying lack of insight into what is really happening out in Mental Health Land. But you wouldn’t know that from any media coverage.

Even more worrying is that I wrote to several health and social care journos (as well as a couple of politicians) with a critique of Closing the Gap, but didn’t even receive an acknowledgement, indicating to me that they aren’t really interested in dissent or alternative views.

And it happens in clinical areas, with the media reporting drug company press releases or brief to the point of misleading snippets about “research”. The day Straterra (atomoxetine, the non-stimulant medication for ADHD) came on the market I was asked about it in my first appointment of the day, as it had been all over Sky News. The official guidance telling us that it was now available for use came a couple of days later…

Talking of ADHD: there was a BBC report about the possible role of vitamins in treating ADHD, which was discussed further here making it far clearer than the Beeb’s piece that the research was a very small and methodologically flawed study and hadn’t actually compared vitamins to any standard ADHD medication or other forms of treatment. How many clinicians working with those with ADHD and their families have now had to fend off questions about vitamin supplements, based on some optimistic reporting of a very limited and poor study?

Or this report about a tool for predicting depression – which doesn’t at all as it didn’t pick up half of a “high risk” group and used an assessment tool I’ve not seen in clinical practice. It relies on self-reporting rather than, as is more usual, clinical observation, a full history, information from people who know the patient and..and…But, no, the reporting is that there is a predictive tool.

As ever, I could give more examples. Don’t start me on MMR and autism…

If our supposedly “free” media are not prepared to help hold officialdom to account or report issues in a reasonable manner and are complicit in drugs company marketing strategies, what options are open to us?

Blogging and twittering are all well and good, but can become something of an echo chamber as all of us who hold certain views talk to each other and read each other’s writings. How many of us have the reach and readership that will actually take any dissenting or critical views to a wider audience?

I really don’t know, but it isn’t going to stop me tapping away at the keyboard and sticking this stuff up in an obscure corner of the web, so that at the very least I can scream “I told you that!”

  1. RGN007 permalink

    Slightly off track…but then that’s me…

    I was struggling with Trafford Health Authority for around 10 years where even their own departments appeared to not know the difference between autism, mental health and learning disabilities. After my son, now aged 31, being on a diagnostic roundabout since he was 19 being passed off by one department and the other as not their kind of patient, it makes me wonder if some health / social professionals don’t know, how can we expect popular journalism to know?

  2. Basket Press permalink

    Hi RGN007 and thanks for commenting!

    As a former CAMHS bod the parlous state of adult service provision for ASD appalled me: until quite recently in my old trust adult MH services would not accept transfer of our 18+ year olds with ASD (NB this is not LD! Some autistic people may, repeat may, have LD as well, but many do not), claiming it wasn’t anything to do with MH services. The trust could never explain to us why we in CAMHS took patients on the autistic spectrum but then, magically, at age 18+ the rest of the trust could wash their hands…And no service was provided. Which led to an awful lot of overage people still on CAMHS books…

    I also, only a couple of years ago, encountered a tutor in our local university who questioned why one of our students was producing a piece of work, based on her experience with us in community CAMHS, about ASD on the grounds that “it’s a learning difficulties diagnosis!”…My colleague and I tossed a coin to decide which of us would tear him a new one. Sadly I lost!

    For many, many moons now ASD, without concomitant significant LD, has been part of mainstream CAMHS, but trusts and commissioners have allowed adult services to get off the hook and pretend that it isn’t anything to do with them.

    There now exists (don’t have link to hand, sorry) a supposed national strategy for adults with ASD…But I don’t recall any money coming with it…

    I hope your struggles had a successful outcome for you and your son.

  3. Basket Press permalink

    Perhaps I should elaborate on RGN007’s predicament: this sounds to me like a touch of turf war, rather than the trust not understanding what ASD is.

    Adult MH services run a mile from ASD because they have even less training and experience in it than CAMHS (this is a whole other story) and so will fall back on the old-fashioned and erroneous view that ASD is automatically LD. LD services will have a cut off point for accepting people – my old trust used a particular IQ score (the validity of IQ is a matter for another discussion) – and will argue their corner on that basis. Obtaining a cognitive assessment to establish whether someone does have LD is problematic, especially for adults – in my part of the world educational psychology would not do this, so CAMHS psychologists had to…

    Round and round and round we go…

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