THE CARTER CENTER

MENTAL HEALTH PROGRAM

Words Matter: Transforming

Reporting of Behavioral Health
Issues
Rebecca Palpant Shimkets, M.S.
Associate Director
The Carter Center Mental Health
Program

OUTLINE
WORDS MATTER
Two personal stories

THE PROBLEM
Why should we care?

SOLUTIONS
What is being done to address the
problem?
How effective are the interventions?

THE GUIDELINES
How do we move forward from here?

THE PROBLEM
We have to get the
word out thatmental
illnessescan be
diagnosed andtreated,
and
almosteveryonesuffer
ing from mental illness
can livemeaningful
lives in their
communities.
- Rosalynn Carter

DEFINING STIGMA

A mark or label imposed by

others that leads to
devaluation and
discrimination.
-Otto Wahl, PhD

DEFINING STIGMA

What people believe about mental

illnesses may be more disabling than
the illness itself. At the core of
stigma is the belief that our thought
process is broken.
- Larry Fricks, leading consumer
advocate

THE MANY FORMS OF STIGMA

Public Stigma The general population endorses the
prejudice and discrimination of mental illnesses.
Self Stigma Awareness, agreement, and selfapplication of stereotypes.
Courtesy Stigma The stigma that befalls
associates of people with mental illnesses.
Structural/Institutional Stigma Policies or
systems are discriminatory toward people with mental
illnesses.
Label Avoidance People do not seek services or
drop
out
of services
tohealth
escape
the
Corrigan,
P (2004).
How stigma prematurely
interferes with mental
care. American
Psychologist, 59: 614-625
stigmatizing label of mental illness.

STIGMA

DISCRIMINATION

Institutional Barriers: funding, insurance,

affordability
Lack of public information on prevalence and
effectiveness
Quality of Services: challenge of research
Limited Resources (workforce, clinicians)
Basic Needs Challenged: Housing, and
Supported Employment

Mental Illnesses in the

News

rison
p
in
e
rs
o
m
re
g
in
w
o
h
s
t
o
zona killer n
e priso
look dead hes pure evil on

01-17

eyes
ho killer Jared Lee Loughners
ker told a visitor.
st
-New York Po

E.tv 'criminal' is
schizo

2010-02-11

Johannesburg - The man allege

d to have
threatened to
"rob and kill" tourists during the
2010 World Cup
is a
schizophrenic and will undergo
observation, the
Johannesburg
Magistrate's Court found on Th
ursday.
-News24.com

MENTAL ILLNESSES & VIOLENCE

In the US, most news coverage of SMI and gun violence were
event focused (69%) rather than thematic (31%) over a 15
year period

Frequency of coverage suggests that SMI and gun violence are

commonly reported only after a mass shooting

In Canada, 83% of articles over a 5 year period did not include

the testimony of a person with mental illness or an expert on
the subject

Danger, violence, and criminality were identified as themes in

40% of articles

Only 18% of articles

McGinty, Webster, Jarlenski, and Berry (2014); Whitley and

focused
on rehabilitation or recovery, and
Barry (2013)

MENTAL ILLNESSES & VIOLENCE

Four assumptions frequently arise in the
aftermath of mass shootings in the U.S.
(1) That mental illnesses cause gun
violence
(2) That psychiatric diagnosis can predict
gun crime,
(3) That shootings represent the deranged
acts of mentally ill loners, and
(4) That gun control
wont
prevent
(Am J Public Health.
2015;105:240249.
doi:10.2105/
AJPH.2014.302242)
another Newtown
(Connecticut school mass

MENTAL ILLNESSES & VIOLENCE

[Studies] show notions of mental illness
that emerge in relation to mass shootings
frequently reflect larger cultural
stereotypes and anxieties about matters
such as race/ethnicity, social class, and
politics. These issues become obscured
when mass shootings come to stand in
for all gun crime, and when mentally
ill ceases to be a medical designation and
(Am J Public
2015;105:240249.
doi:10.2105/
becomes a sign
ofHealth.
violent
threat.
AJPH.2014.302242)

SOLUTIONS

What is being done?

How effective are the interventions?

THE ROSALYNN CARTER

FELLOWSHIPS FOR MENTAL
HEALTH JOURNALISM
Journalists with diverse backgrounds in media are
selected each year by The Carter Center to receive:
$10,000 unrestricted stipend (or country
equivalent)
Training (2 trips to Atlanta + support
throughout the year)
Resources and contact with experts in
journalism/mental health
Mentoring
Continue reporting without relocation on mental
health issues

SOLUTIONS
Fellowship Goals:
Increase accurate reporting on mental health issues
and decrease incorrect, stereotypical information
Help journalists produce high-quality work that
reflects an understanding of mental health issues
through exposure to well-established resources in
the field
Develop a cadre of better-informed print and
electronic journalists who will more accurately report
information through newspapers, magazines, radio,
television, film, and online and social media,

FAIR AND ACCURATE

COVERAGE MATTERS
Has power to increase public understanding
through accurate depictions of mental
illness
Can counter misperceptions, prejudice, and
negative beliefs often associated with these
conditions
Can help create a society where people feel
supported and are willing to seek and
receive help

IMPACT
One in seven journalists reported their fellowship
project resulted in changes to local/state/national
programs or policies
(1) Hospital superintendent forced to resign
(2) Lawmakers read articles and immediately introduced
and passed laws to ban secrecy agreements in settlements
with state funds
(3) Governor announced he would shut a hospital based on
reporting of inhumane practices at the facility

IMPACT (Cont.)
(4) First law about the rights of individuals with autism
approved by Parliament
(5) Formation of quick-response mental-health crisis
teams
(6) Changes in jailing procedures for offenders with
mental illnesses
(7) $47 million in state legislature budget allocated to
psychiatric beds in WA

PROGRAM EVALUATION RESULTS

60% reported on mental health beyond the fellowship
project. Developing content on mental health is an
essential/high priority for 65% of respondents
1 in 7 reported that their fellowship project resulted in
changes to local, state, or national programs or
policies. About 61% of fellows reported some other
impact, such as increasing awareness or
understanding, validating experiences of people with
mental illnesses, and contributing to help seeking
60% reported changes in their newsroom from their
participation in the fellowship program

MAY 2013- AP STYLEBOOK

STANDARDS
Do not describe an individual as
mentally ill unless it is clearly
pertinent to a story and the
diagnosis is properly sourced.
Do not use derogatory terms, such
as insane, crazy/crazed, nuts, etc.
Do not assume mental illness is a
factor in a violent crime.
Avoid descriptions that connote pity.
Wherever possible, rely on people
with mental illness to talk about
their own diagnosis.
Avoid using mental health terms to
describe non-health issues.

Source:

SEPTEMBER 2015- THE CARTER

CENTER RESOURCE GUIDE
Substance Abuse and
Mental Health
Services
Administration
(SAMHSA),
Entertainment
Industries Council
(EIC), and California
Mental Health
Services Authority
(CalMHSA) technical
expertise and
financial support
Released broadly to
media and social

CONTENT ANALYSIS
Method: 94 articles published by 29 journalists between
2004 and 2015 (Codebook was developed to describe the
articles and assess AP standards)
Results: The fellows articles generally adhered to the AP
Stylebook standards
Not using mental health terms (e.g., schizophrenic) to
describe non-health issues (90%)
When articles described a person with mental illness
(65%), they provided a source and did not speculate on
the diagnosis (95%). Most of the time the individual with
mental illness (44%) or a family member (25%) was the
source
11.7% of articles mention mental illness as a factor in a
violent crime (this excludes articles that do so for

THE GUIDELINES

ASK THE IMPORTANT

QUESTIONS
Is mental illness or substance use relevant
to the story?
What is your source for the mental illness
and substance use diagnosis?
What is the most accurate language to use?

WORDS MATTER
Person-first language helps humanize the
issue

DIAGNOSTIC LANGUAGE
1.

Shes such a
spaz.

2.

Im completely
OCD about that.

3.

Youre a
complete schizo.

4.

My boss is
psychotic.

5.

Hes so bipolar
today.

INCLUDE TREATMENT
OPTIONS
Consider reporting the following facts
to help minimize barriers to
treatment:
Treatment is effective.
Treatment is accessible and affordable in
most cases.
People are supportive of those in
treatment.
Treatment is available.

HIGHLIGHT RECOVERY
To help the public understand that
people can and do recover, when
possible:
Tell the story to let people know that
recovery is possible.
Suggest that recovery supports are often
critical.
Feature individuals in long-term recovery.
Mention support systems, such as therapy,
mutual self-help and peer support.

VIOLENCE AND MENTAL

ILLNESS
Several guides are available for
reporting on suicide, traumatic events,
and violence.
The Dart Center for Journalism and
Trauma
U.S. Centers for Disease Control and
Prevention
reportingonsuicide.org

REFERENCE CREDIBLE
RESOURCES
National Survey on Drug Use and Health:
http://www.samhsa.gov/data/population-data-n
sduh
Resources to talk about mental health and get
help:
http://www.mentalhealth.gov
NIMHs mental health information and educational
resources:
http://www.nimh.nih.gov/health/index.shtml
The Carter Center Journalism Resource Guide on
Behavioral Health
http://bit.ly/1ToaCE6

CONCLUSION
Mental

disorders are highly prevalent and,

untreated, enormously costly to our society.

Stigma

remains the greatest barrier for access to

treatment

While

improving in many ways, the overwhelming

depiction of mental illnesses remains one of
violence and crime.

The

media can play a critical role in garnering

attention toward discriminatory or stigmatizing
policies through national and local campaigns,
ultimately a driving force behind policy change

better-informed media reporting accurately on

QUESTIONS?

Contact:
Rebecca Palpant Shimkets, M.S.
Associate Director
Mental Health Program
Rebecca.palpant@cartercenter.org