Partnerships to address the portrayal of mental illness on stage and screen: A focus on the Living Library Jaelea Skehan, Program Manager Hunter Institute of Mental Health (Mindframe National Media Initiative)
The purpose of the Hunter Institute of Mental Health is to promote mental health and prevent mental ill health in Australia and to improve the outcomes for people directly and indirectly affected by mental illness and suicide through education and training, health promotion, research and evaluation. The Mindframe National Media Initiative aims to influence media representation of issues related to mental illness and suicide, encouraging responsible, accurate and sensitive portrayals by working with the news and entertainment media and a range of other sectors.
Stigma Stigma is defined as a sign of disgrace or discredit, which sets a person apart from others. The stigma of mental illness, although more often related to context than to a person s appearance, remains a powerful negative attribute in all social relations. (Byrne 2000)
The top-ranking factor that Australians with mental illness say would improve their lives is reducing stigma (SANE Australia). People with mental illness experience stigma and discrimination in almost every aspect of their lives (HREOC). there is enough money around to help those with mental illness but it is not available because of the attitude of most decision makers and a large part of the general public towards mental illness and all that surrounds it (Sartorius). There is evidence that in countries where less stigma is attached to mental illness, the prognosis of illnesses such as the psychoses is better (Littlewood).
Types of Stigma Public stigma Self stigma The reaction that the general public has to people with mental illness including avoidance, labelling, false beliefs etc. The negative view that people who live with mental illness have of themselves including hiding their illness, and negative emotions which people may feel towards themselves such as shame, embarrassment, alienation and fear.
Stigma is reinforced by: Public attitudes, misconceptions and stereotypes; The media; The community by the use of discriminatory language such as "psycho", "schizo", "nut" and "crazy". Stigma contributes to: People not disclosing problems to friends, family, colleagues; Not accessing professional help for emerging mental illness; Isolation and less opportunities for recovery.
The Mindframe model AIM: to improve media portrayals of suicide and mental illness. SECTORS: media professionals and media organisations, journalism and public relations educators, the mental health and suicide prevention sectors, police, courts, and stage and screen. THE APPROACH: 1. Evidence based and sector appropriate print and online resources; 2. Professional development and sector engagement; 3. Changes to policies, procedures and codes of practice; 4. National Leadership.
Project Background: Stage & Screen Managed by a partnership between HIMH, AWG, and SANE, it commenced in November 2006. AIM: To influence scriptwriters approaches to fictional portrayals of mental illness and suicide in Australian. Based on current research: Pirkis et al. (2005; 2010). Strategies developed in partnership with scriptwriters: 3 o Develop specific print and online resources for writers o Develop pilot training approaches and then roll out o Conduct face to face briefings with key television story departments o Target key conferences for workshop opportunities o Evaluate project activities 9
Evidence: Portrayal of Mental Illness EXTENT & NATURE: Coverage is extensive and often perpetuates myths and stereotypes. People with mental illness portrayed as violent and aggressive as well as eccentric, seductresses, self obsessed, simpletons and/or failures. Skewed picture of mental health treatments (eg ECT or therapy) and professionals are variously portrayed (Pirkis et al, 2005). EFFECTS: Evidence suggests negative portrayals can perpetuate stigma and reduce help seeking. Some evidence that entertainment media may have more influence than news media. Negative attitudes do not dissipate over time (Pirkis et al, 2005).
Key Issues to Consider Mental Illness Why am I introducing mental illness into the story? Will my portrayal be fresh and original? Am I perpetuating or challenging common stereotypes? Will my portrayal be truthful and show a range of experience? Can I improve the accuracy and authenticity of my portrayal? Can the story model or promote help seeking behaviour?
Stage & Screen Workshops Mixed workshops for television writers, screenwriters, producers and playwrights (n=4); Workshop for playwrights only (n=1); Workshops for television writers only (n=3); 6 Consistent agenda with some variation. Intro to portrayal of suicide and discussion of issues for scriptwriters/playwrights (use of video examples); Intro to the portrayal of mental illness including a brief public reading of the back cover of each book (participants with lived experience); Conduct Living Library; Final writing task, discussion and feedback. 12
The Living Library What is a Living Library? An opportunity for people to understand the lives of those living in their own communities Original concept trialled in 2000 in Denmark. Has since been widely used for various purposes around the world. How does it work? Borrow 1 book per 15 minute period. Can have multiple borrowers in any one period. Borrower can ask questions as can the book. The book may close at any time. 5 13
The workshops 14
Evaluation snapshot Pre and post surveys with scriptwriters, including the General Attribution Questionnaire (G AQ 20) Post workshop semi structured interviews Consumers/carers/service providers Scriptwriters 15
G AQ 20 results (e.g.1 mixed) Subscale Pre workshop mean Post workshop mean Direction Sig. Fear 6.88 4.88 0.005* Dangerousness 7.25 6.13 0.174 Avoidance 6.50 3.75 0.024* Anger 6.13 4.63 0.026* Pity 19.63 19.50 0.917 Responsibility 9.25 9.50 0.878 Help 22.38 24.75 0.037* 16
G AQ 20 results (e.g.2 Playwrights) Subscale Pre workshop mean Post workshop mean Direction Sig. Fear 7.50 5.25 0.010* Dangerousness 7.13 5.50 0.035* Avoidance 7.00 4.75 0.115 Anger 6.13 4.25 0.002* Pity 19.50 18.88 0.729 Responsibility 12.00 11.75 0.831 Help 18.75 21.50 0.032* 17
Other post workshop responses (e.g.) Question Mean Range To what extent did the presentation by consumers, carers and service providers discussing direct experience increase your knowledge about mental health and mental illness? How would you rate the usefulness of this section in increasing your knowledge and awareness of the issues involved in writing about people with mental illness? To what extent would you say the Living Library activity increased your knowledge about mental health and mental illness? To what extent would you say that this activity increased your knowledge and awareness of the processes involved in the characterisation of people experiencing mental illness? To what extent do you think the experience of constructing a short scene will impact your approach to writing about mental illness and suicide in the future? 5.00 5 5 4.00 3 5 5.00 5 5 3.50 3 5 2.88 1 4
Interviews consumers & carers I found that the writers were sincere and interested and asked lots of great questions. I felt supported I liked the sharing experience in this (workshop). At first I felt a bit intimidated thinking about it before I got there. When I got there I was quite relaxed. Overall it was a wonderful experience for me to work with scriptwriters of that calibre; it was excellent. The way that I look at this it s a great chance to tell your story and to the people that need to hear it, because they are going to make the difference. 19
Interviews scriptwriters Great for writers to get a deeper insight into what it s all about. Writers wanted to share also their experience with mental health. Not a draining experience. I thought it was a stimulating experience. I appreciate where they are coming from and I will do anything to help with stigma and cures for mental illness. My experience was they are learning from your experience and you are learning from their experience. It was a two way thing. Reciprocal sharing. 20
Interviews playwrights The whole mechanism of the living books and talking to people about their experience was terrific I loved the Living Library hearing what people had experienced in a really clear way, it was not abstract, it was really specific. Hearing first hand from people who had mental illness, I thought they were quite brave and strong to make themselves available like that. The living library session was enormously useful. 21
Suggestions for improvement? I would have liked for the workshop to be two days, I felt the process of writing became a bit rushed there was so much to offer and share I really wanted more of it, the chance to explore more The living library could have been longer 22
Implications? In line with the work of Corrigan and others, the use of the Living Library has confirmed the impact of direct contact in reducing stigma associated with mental illness; For perhaps the first time direct contact strategies (through the Living Library) have been used with scriptwriters and playwrights in an attempt to influence the portrayal of mental illness on stage and screen; These contact strategies appear to appeal specifically to creative people such as scriptwriters; The outcomes on portrayals, however, are yet to be formally assessed, but anecdotal evidence suggests an impact. 23
www.mindframe-media.info
Contact details www.mindframe-media.info Jaelea.Skehan@hnehealth.nsw.gov.au mindframe@hnehealth.nsw.gov.au @jaeleaskehan (on Twitter) Presentation www.himh.org.au