Mind over Matter 2
Shift Media Survey: Summary Report
Introduction
The survey
Shift is the government programme to reduce the
stigma and discrimination experienced by people
with mental health problems in England. In January
2006, Shift published the results of its first Mind over
Matter survey of how mental health is covered in the
British media (CSIP/Shift 2006).
Part of that survey assessed the current state
of mental health coverage in the UK print and
broadcast media, thus providing a benchmark
against which any future changes in coverage might
be measured.
Mind over Matter 1 revealed that homicides and
other violent incidents involving people with mental
health problems were the most common stories
covered in March 2005, making up 27% of total
coverage.
For Mind over Matter 2, Shift commissioned
researchers at the Institute of Psychiatry to analyse
data gathered from the British press in 2006. This
report highlights some of the key findings from a
content analysis of this newspaper coverage, and
compares these findings with the data gathered in
2005.
While there are many factors that contribute to the
media’s mental health coverage in any particular
month or year, the Mind over Matter surveys,
through building up a record of mental health
coverage over a number of years, seek to record and
analyse any changes in this coverage.
page 
The challenge
The media can strongly influence people’s
understanding of mental health and ill health, and by
default their reactions to people with mental health
problems (Philo 1996; Thornicroft 2006). This places
journalists in an important position: they have the
potential to transform people’s often prejudicial and
misinformed views about mental health problems.
The newspaper column by the chat show host Trisha
Goddard in the Eastern Daily Press is exemplary
in combating mental health related stigma and
discrimination.
But mental health reporting in the media as a
whole still has a long way to travel to be considered
balanced and non-discriminatory. Alongside the
proliferation of negative imagery about mental
health problems, the media often overemphasise
and reinforce the association between mental illness
and violence. The effect of this is to increase social
distance and prejudice amongst the public towards
those with mental health problems.
The media is a powerful route through which
discriminatory and stigmatising behaviours towards
those with mental health problems can be sustained
(Stuart 2006), and through which, potentially, public
fear of ‘madness’ is deepened.
Mind over Matter 1 showed that while coverage of
common mental health problems was often on a par
with coverage of other health conditions, coverage
of severe mental health problems was significantly
different. This was in no small part because of the
significant focus on cases of homicide and other
violent incidents by people with severe mental
health problems.
 Method and Analysis
The media as allies The media survey of coverage in 2006 focused solely
on newspapers, rather than print and broadcast me-
While research has shown the the media tends to
dia as was the case in 2005. A researcher performed
present those with mental health problems in a
a content analysis of every news item retrieved, and
negative light, there is growing interest in how the
frequency tables were produced from the dataset
media can act as anti-stigma and anti-discrimination
that compared 2006 data with those from 2005.
allies.
Sample period: Mind over Matter 1 gathered media
For example, the annual Mental Health Media
coverage from one month (March 2005); Mind over
Awards were set up by voluntary organisation Mental
Matter 2 surveyed coverage across two months (2
Health Media to counter negative images of mental
March – 1 April and 8 October – 7 November 2006)
ill health in the media. The Awards instead celebrate
to gather a more representative sample of total news
those reports and programmes that challenge
coverage across the year.
misconceptions and stereotypical, stigmatising
representations of people with mental health
Newspapers: A newspaper scanning agency
problems and have become a popular annual media
acquired cuttings from the same eight national (four
event.
broadsheet and four tabloids) and eight regional
English newspapers surveyed in 2005. Scanning
In 2006, Stephen Fry’s documentary The Secret Life of
was computerised and so any story containing any
the Manic Depressive generated extensive discussion
mention of any of the key words was pulled up (i.e.
about bipolar disorder, and was warmly welcomed
not solely items whose main focus was mental health
for lifting the secrecy and shame so frequently
issues).
experienced by those with psychiatric diagnoses.
Fry’s celebrity status meant the documentary
Coding: The researcher used the same coding
attracted a wider audience than if he had been an
categories (with a few additions) that were used
unknown person with the same diagnosis.
for Mind over Matter 1 so as to make the data
comparable. One of these additions was the code
Newspapers are still most people’s primary source
‘metaphorical story’ that captured any item using
of mental health information and they have the
mental health language metaphorically to refer to a
potential to counter stigmatising and prejudicial
phenomenon (e.g. ‘crazy weather’, ‘bonkers policy’).
stereotypes. For example, since 2002 the Independent
on Sunday has led a campaign on mental health
The code ‘pejorative story’ was used in both 2005
which works to improve public awareness of mental
and 2006 for items that used mental health language
health issues and to press the Government to
metaphorically to refer specifically to individuals (e.g.
improve services.
‘loony celebrity’).

We removed all items coded as ‘metaphorical’ from

these analyses to ensure comparability between
2005 and 2006.

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Comparability of data: Care had to be taken
when interpreting differences between data from
2005 and 2006 since several factors may have
contributed to these differences. These include:
• the 2005 data being drawn from the broadcast
as well as print media, in comparison with the
2006 data coming solely from newspapers.
• technical differences in how the newspaper
scanning agencies acquired items. Computer
scanning for 2006 items is likely to have pulled
up more items in total; it is also likely to have
acquired proportionately more items that
were coded as ‘pejorative’ and ‘depression’ by
virtue of locating items likely not to have been
retrieved in 2005.
page 
Summary of Findings
Extent of mental health coverage
Over 2,500 newspaper articles were retrieved by
the press monitoring agency, of which 2,134 met
inclusion criteria. This huge number in itself indicates
how prevalent the use of mental health language is
within the press. Coded articles averaged 34 items
per day, significantly outnumbering the day average
of 12 in 2005.
A significant proportion of these articles used
mental health language out of context (22% in total
split between pejorative and metaphorical stories).
Latest research suggests that schizophrenia may
succeed references to cancer as the new ‘illness as
metaphor’, with the word standing ‘for all things weird,
contradictory or unpredictable’ (Chopra and Doody
2007).
Period of coverage
March 2006
As in March 2005, March 2006 was characterised
by two high profile homicide trials of men with
psychiatric diagnoses. Daniel Gonzalez (whose
disputed diagnosis was a major feature of the trial)
was tried for the murder of four people, and Ismail
Dogan (diagnosed with schizophrenia) for killing a
stranger and stabbing five other people.
Newspaper coverage of both trials turned to what
is a well-worn narrative in media representations of
‘madness’ – the emphasis on danger to the public
and criticism of ‘care in the community’ (Rose
1998). Coverage of the Gonzalez case included
lurid accounts of Gonzalez’s apparent desire to
spend a day ‘being Freddy Krueger’ (a horrifying film
character).
In mid March 2006 there was much media debate
around mental health charity Rethink’s erection of a
statue of Churchill in a straitjacket outside its offices
in Norwich. While opinions were starkly divided,
most press reports thought the statue insulted
Churchill’s memory. Towards the end of the month,
many articles covered the government’s decision to
drop the controversial draft Mental Health Bill.
October 2006 Headlines
Many news and opinion pieces throughout the
The use of overtly stigmatising words in headlines
autumn sample period addressed (i) the publication
was, as in 2005, comparatively infrequent, though
of David Blunkett’s diaries (in which he spoke of
there were nine instances each of the words ‘psycho’,
being ‘clinically depressed’ and said, ‘At one point I
‘maniac’ and ‘nutter/nut’.
really did think I was going mad’); and (ii) Alastair
Campbell’s interview in the Independent on Sunday
Just as in 2005, stigmatising headlines were most
(timed to fit in with World Mental Health Day on 10
noticeable in relation to homicide stories. One of
October) in which he talked about his ‘work-induced,
the Sun’s headlines, for example, read: ‘Psycho who
drink-induced, pressure induced, depression-induced
slayed four: a walking time bomb: warnings over
psychotic breakdown’ when 28, his period of intense
mad son were all ignored’.
strain at the time of Dr David Kelly’s suicide, and
about the portrayal of mental illness in the media.
Other headlines, while not using individually
stigmatising words, conveyed stigmatising messages.
There was also extensive coverage of the ITV drama
For example, the Daily Telegraph’s headline ‘Psychotic
Mysterious Creatures, which told the story of Bill
daughter knifed mother to death in frenzied
and Wendy Ainscow and their daughter Lisa. Lisa
attack’ associated psychosis with out-of-control
Ainscow has a diagnosis of Asperger’s Syndrome;
violence and could be said to reinforce the common
whether she also has a mental health diagnosis was
prejudicial link between mental illness and violence.
at the centre of both the TV drama and the events
the family has undergone.
The Daily Express headline ‘What the self-harmers
need is to confront real human suffering’ implied
Her parents attempted to take their own lives when
that those who self-harm are not experiencing
the NHS discharged Lisa from their care, and Bill
‘real suffering’. This reinforces the stigmatising and
drowned.
inaccurate view of those who self-harm as attention-
seekers (see Mental Health Foundation 2006).
Wendy’s fourth attempt at suicide in October 2006
added a further tragic charge to newspaper coverage
Sometimes the headline was stigmatising but the
of the television drama. (Mysterious Creatures was,
article itself was not: a largely sensitive article on
in fact, awarded a Mental Health Media Award for
eating disorders in the Brighton Argus was titled
Single and Serial TV Drama in 2007.)
‘Skinny craze-y’. This may be a case where the author
of the headline, the ‘sub’ or sub-editor, is not the
October’s coverage was arguably less dominated
writer of the article. This is common practice on
by high-profile homicide trials. But there were court
most national and major regional newspapers.
cases of two women: Nicola Edgington (who is
diagnosed with schizophrenia) on trial for killing her
mother, and Danielle Wails for killing her infant son
Mental health topics covered and compared
while suffering from postnatal depression. The lead spot in 2005 was occupied by homicide
stories while in 2006 it was pejorative stories (at
Edgington’s trial became entangled with tabloid 12%). While homicides stories experienced a big
outrage over Wails being given probation and not drop overall (7% in comparison with 19% in 2005),
a prison sentence. The press debate circled around they were the most frequently covered news story
whether both women were ‘mad’ and/or ‘bad’. (15%). Nearly one fifth of all non-news items
(features, opinion pieces, editorials, celebrity gossip,
etc.) were pejorative stories.

Depression (at 10%) was, just as in 2005, the most

widely covered of the mental health diagnoses.

There were noticeable shifts in the coverage of

certain types of story. Wellbeing stories fell from 8%
in 2005 to 3% in 2006; this is dismaying given the
Department of Health’s interest in marketing mental
health and wellbeing, and in ensuring that people
are well informed and motivated to look after their
page 
own mental health and that of others (National Pejorative
Institute for Mental Health in England 2005). Other mental health topics
Depression
15%
Homicides
The focus on the Mental Health Bill was much lower Stress
in 2006 (under 1% compared to 6% in 2005). This is Suicides
Arts/culture and mental health
unsurprising given that the survey month in 2005 10% Mental health services

Percentage
included the widely covered Parliamentary Scrutiny Drugs and mental health
Children's mental health
Committee Report on the draft Bill.
5%
The decrease in stories focusing on drugs and mental
health can be accounted for by the fact that the
high figure for 2005 was boosted by wide-spread 0%
discussion of the Home Office announcement of a Story Topics
review of the classification of cannabis.
Figure 1: Top Ten Story Topics in the Print Media 2006
Children’s mental health makes the ‘top ten’ list of
stories in 2006 (at 4% compared to less than 1% in
2005) – a reflection of the growing concern across a
number of sectors about the rising levels of mental ill
health in the young.

In contrast, there was not a single story devoted to

the mental health of BME populations in 2006, and
only one story in 2005.

This invisibility is troubling given the well

documented inequalities and discrimination in
mental health treatment and outcomes for BME
communities in the UK (Department of Health 2005).

The small but important rise in the number of stories

addressing stigma and discrimination (from only 1
news story in 2005 to 2% of all coverage in 2006) was Figure 2: Top Ten Story Topics in the Print Media 2005
largely due to publicity given Rethink’s erection of a
statue of Winston Churchill wearing a strait jacket.

The high percentage for ‘other mental health topics’

derives from a range of stories (e.g. reports on the
pharmaceutical industry, items on alcohol and mental
health).

Common mental health problems were most

frequently represented, and depression far more
frequently covered than any other diagnosis (it was
mentioned in a fifth of all stories).

There was a drop of almost one half in the coverage

of severe mental health problems (12% in comparison
with 23% in 2005). This may be partly accounted for
by the introduction of the generic category ‘mental
health problems’ in 2006 (which comprised nearly a
quarter of the total) into which some of those items
previously coded as ‘severe mental health problems’
fell.
 Because only the top ten topics are displayed for both years,
the percentages do not necessarily total 100.
page 
Sources of comment
The prominence of celebrities was noticeable in
the 2006 data: 15% of all mental health stories
used quotations from them, rising to 25% of stories
covering eating disorders and self-harm.

The percentage of stories quoting the law, police and

prison service more than doubled to 30%.

The percentage of stories that included a quotation

from an individual with mental health problems
also more than doubled (from 6% to 13%). Most
quotations from those with mental health problems
were confined to features in striking contrast
to carers and relatives who were quoted more
frequently in news items.

The majority of quotations tended to come from

those with common mental health problems and
eating disorders. Not one news story in the autumn Figure 3: People quoted in articles 2006
survey period included a quotation from someone
with severe mental health problems (which here
include schizophrenia, bipolar disorder and
personality disorders).

Speakers’ bureaux (including one set up by Shift)

provide journalists with the opportunity to talk
to people with the full range of mental health
diagnoses. Wider use of these bureaux could result
in more extensive representation of people with
mental health problems in media stories about
mental health.

Story sources
Where the source was clear, the highest percentage
(26%) came from businesses and similar
organisations (e.g. press releases from publishers,
PR firms, etc.). Close behind (23%) was the category
of law, police and justice professionals (which had Figure 4: People quoted in articles 2005
taken top place in 2005). Neither category can
be assumed to be well-versed in presenting non-
stigmatising mental health stories.

Service users and carers (combined) originated

under 2% of stories with a known source, a drop from
5% in 2005.

page 
Tone of coverage
Just as in 2005, the most common theme of mental
health reports (appearing in over a third of all items,
excluding those using mental health language
out of context) concerned the risks and causes of
mental health problems. Second most frequent were
messages implying the seriousness of mental health
problems (over a quarter of all items) and those
incorporating prejudicial tone (17%).

The most common message in stories covering

severe mental health problems, as in 2005,
concerned a high risk of violence from people with
mental health problems (appearing in half of all
items).

In addition, the ratio of messages implying a high

versus low risk of violence vis-à-vis severe mental
health problems was 16:1 (a jump from 4:1 in 2005).
This is despite the fact that studies consistently
show that most people with severe mental health
problems never commit a violent act, and suggest
that other variables, particularly gender, are far
better predictors of violence than psychiatric
diagnosis (Corrigan and Watson 2005).

The ratio of negative to positive messages regarding

services remained almost identical (approximately
4:1 in both sample years).

While in 2006 there were over twice as many

messages concerning positive capabilities (e.g.
ability to make decisions about one’s life, act
autonomously) as opposed to negative capabilities
in relation to common mental health problems,
there were nearly twice as many negative messages
about capabilities as positive for severe mental health
problems.

There were nearly four times as many messages

conveying negative attitudes as positive for those
with severe mental health problems in comparison
with approximately twice as many positive messages
in comparison with negative for common mental
health problems. Negative attitudes were not
confined to stories linking mental health problems
to violence: they were also found in a number of
features and in book reviews.

This overemphasis on dysfunction, deficit and

negativity in stories concerning severe mental health
problems, promotes inaccurate and stigmatising
views, since it obscures the many stories of capability
and recovery that could be told.

page 
Case studies
Prejudicial reporting
Stigmatising and/or discriminatory representations
of people with mental health problems can occur
for a variety of reasons. Sometimes, the language
used and the content of a report are prejudiced, as
when someone with (or imputed to have) psychotic
symptoms is described as a ‘psycho’.
But often the process is more complex, and practices
of selection and editing can transform a report’s
raw material into stereotypical and/or stigmatising
stories. For example, phrases such as ‘psychiatric
patient’ can draw on commonsense and embedded
understandings that equate that phrase with danger
and lack of humanity (Nairn, Coverdale et al. 2001).
While ‘psychiatric patient’ or ‘depressive’ might seem
to journalists useful shorthands, they actually make
someone’s mental health problems into the core of
their identity. (Contrast mental health with other
health conditions: someone with heart disease
would never be called a ‘cardiac’ (Thornicroft, 2006).)
To reduce people to a mental health label socially
devalues them and is therefore stigmatising.
Examples of three discriminatory representations
that were found in the 2006 survey items follow.
page 
Case study 1
Sunday Times, 29 October 2006 ‘Invasion of the
bunny boilers’
The article discusses the recently published book
Ever Dated a Psycho? and suggests that in reading the
book ‘it’s tempting to conclude that we have become a
nation of emotional nutters’. The author of the article
argues that:
‘The thing about these “psychos” – or people with
emotionally unstable personality disorder, as
psychiatrists prefer to call them – is that they are
practically impossible to recognise straight away. They
are your nice colleague or the charmer you had dinner
with the night before. And yet you soon discover that
they occupy a parallel universe, one where reality as
we know it doesn’t exist. They are beyond reason and
refuse to take no for an answer.’
Here, we can clearly see the offensive effect created
by the casual use of terms such as ‘psycho’ and
‘nutter’. The designation of a group of people (those
with a clinical diagnosis of personality disorder)
as ‘psychos’ is discriminatory and would not be
acceptable if used to characterise a group without
mental health problems.
The phrase ‘they occupy a parallel universe, one
where reality as we know it doesn’t exist’ intensifies
social distance between ‘us’ (‘we’ who are presumed
to have reason) and those ‘psychos’ (who are
presumed not to) and is an entirely inaccurate, as
well as prejudicial, representation of mental ill health.
Case study 2
Daily Mail, 24 March 2006 ‘“Chaos” over plan to
protect public from psychopaths’
‘Plans to close the alarming legal loopholes which allow
people with dangerous mental problems to roam the
streets were abandoned yesterday – eight years after
being first promised.’
The manner in which this news item introduces
the government’s decision to drop the Draft
Mental Health Bill serves to underline the risk of
dangerousness posed by an undifferentiated group
of individuals ‘with dangerous mental problems’,
the same group which the headline identifies as
‘psychopaths’.
The report presumes an unstated connection
between community mental health care and
risk to the public – an inaccurate presumption.
There is no evidence for any rise in the number of
homicides by people with mental illness during
the era of community mental health care (National
Confidential Inquiry into Suicide and Homicide by
People with Mental Illness 2006). This conjuring
up of psychopaths who roam the streets is
scaremongering in tone and works to shore up the
argument for coercive admissions and treatment.
page 
Case study 3
Times, 12 October 2006 ‘How can anyone
simultaneously be clinically depressed and hold a
top job?’
‘… Clinical depression can only mean a serious
imbalance of mind. Should the Home Office, or
the evidence on Saddam’s WMD, rest in the hands
of someone whose judgment is subject to serious
imbalance? …
… the majority of those claiming “clinical”
depression today are not clinically depressed, and it
is no unkindness to the genuinely ill to say that such
claimants are piggy-backing in swelling numbers on to
a real but less common affliction.
There is a simple reason for this apparent
explosion in numbers – neither the pressures of modern
life nor anything in the water. It’s incapacity benefit. …
… depression is the new back pain for those
that don’t want a job, and for those that want both
public office and public sympathy too.’
This story betrays a number of value-laden
and unsubstantiated judgements about those
experiencing depression, in particular, the statement
that those ‘claiming “clinical” depression … are
not clinically depressed’. (The claims are from the
journalist himself – he does not quote any expert
sources – and are presented as indisputable facts
rather than disputable opinions.) The argument
about incapacity benefit reinforces the common
prejudicial association made between
depression and laziness.
Research has demonstrated that depression, like
many physical illnesses, is both serious and treatable,
and people use a whole range of strategies to
manage it successfully. What the evidence shows
is that with appropriate support in place, there is
no reason why someone with a clinical diagnosis
of depression cannot function successfully in the
workplace.
Positive reporting
Research indicates that when those with experiences
of mental health problems speak directly to
reporters, their depictions of their own mental ill
health are qualitatively different from stereotypical
representations of mental illness. In particular,
individuals depict themselves and their experiences
as understandable, normal and human (Nairn and
Coverdale 2005).
Mind over Matter 2 came across relatively few self-
depictions of mental health problems, but those
that did exist corroborated this research through
depicting individuals with mental health problems as
credible and authoritative sources.
These items include two lengthy articles featuring
the author Clare Allan (the one in the Telegraph
was written by Allan herself ) and discussing the
publication of her book Poppy Shakespeare in light of
her own history of mental health problems.
There were several sensitive features covering
– or written by – television gardener Monty Don
and author Robin Shelton, in which they discuss
gardening as their means of combating and coping
with depression, seasonal affective disorder (SAD)
and bipolar affective disorder.
Several features on self-harm profiled individuals
talking about their own experiences. The Sun’s
Scottish edition covered Scotland’s ‘See Me’ anti-
stigma campaign with several profiles of young
people who self-harm.
The Society supplement in the Guardian produced a
‘service users edition’. The guest editors introduced
the supplement by stating that: ‘People with mental
health problems, people with learning disabilities,
and those who misuse drugs and alcohol generally
get a raw deal in the mainstream press. We are
either portrayed as the dregs of society, or as evil
psychopaths. This misrepresentation reinforces
stigma. It fuels prejudice and gives people licence
to write us off or treat us with contempt’. There were
several sympathetic features on the mental health
impacts of serving in Iraq in which members and ex-
members of the military were interviewed.
This report was written by Felicity Callard. The research term comprised: Felicity Callard, Graham
Thornicroft, Diana Rose and Georgia Butler (Institute of Psychiatry, King’s College London).
page 10
Conclusions
The survey data from 2006 indicates that:
1. Mental health coverage in the press remains,
overall, highly prejudicial, despite the drop
in the relative proportion of stories covering
homicide and other violent incidents. Pejorative
stories were the most common kind of story, and
homicides remained in top place for news items.
2. The strong association between severe mental
health problems and narratives of risk, violence
and dysfunction persists.
3. This ‘bad news’ media prism leaves readers with
a one-sided and inaccurate picture of severe
mental health problems as cataclysm. Other
mental health problems are represented – just
as was the case in 2005 – far more diversely,
with many more occurrences of sympathetic
messages and indications of capability and
recovery.
4. Those with severe mental health problems
do not have a voice in the press. Such lack of
visibility can reinforce the frequent prejudicial
assumption that they are not able to speak
authoritatively for themselves and require others
to speak on behalf of them.
5. Overall, the association between severe mental
ill health and a high risk of violence to the
public is more insistent than in 2005. While
the proportion of homicide stories decreased in
2006, there were proportionately more messages
overall that implied a high risk of violence than
a low risk than there had been in 2005. This
suggests that it will not be enough simply to
broaden the range of stories about mental health
to reduce prejudicial coverage.
6. Rather it suggests that all those involved in the
coverage of mental health – the Government,
the health sector, businesses, users and carers,
as well as, of course, the media – need to devote
greater attention to ensuring that any kind of
story involving mental health is not presented so
as to imply the risk of violence.
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