Media Critique 1

Media Critique Jaime U. Verastegui University of Ontario Institute of Technology NURS3701 Professor: Wendy Stanyon, RN, Ed.D

Media Critique 2 From the beginning of times, men have been scared of the unknown and the mysterious. Generations have created mythological creatures and unnatural beings to try to explain the inexplicable. Similarly, different cultures have attached a stigma of unknown to people suffering from mental illnesses. These patients have been shunned from their communities and left outside from civilization without any proper medical attention. Evidence that the stigmatization of people with mental illnesses occurred from remote times can be found in the Bible. In the different gospels, Jesus casts out demons from people that have been expelled from the cities and sent to live in caves where they cannot be visible. Although the Bible speaks of demons, one can only imagine that it could have been similar to a person suffering from the hallucinations and delusions that the different psychotic illnesses produce in a person. This has not changed in the recent times. Today, society in general isolates people that seem not ordinary. This phenomenon can be seen in particular towards people suffering from mental illnesses. People that are seen in the streets untidy or speaking to apparently no one are often evaded. Often, people refer to the mental health institutions as the hospitals for crazy people. This stigmatization is often aggravated by media such as television, movies, and newspapers. Frequently, media portrays people with mental illness in a negative way and gives them an aura of doom. A classic example of this occurs in Jack, the character of Stanley Kubricks adaptation of the Shining. Jack suffers from what appears to be cabin fever and starts chasing his family with an axe in an attempt to murder them. There are also movies that portray aspects of mental illnesses that reflect positive outcomes of it, but the biggest impact to society most often occur when the illnesses are depicted in a negative way. The stigma that media fuels, in terms of the perception that patients suffering from mental illnesses are dangerous and capable of committing

Media Critique 3 the most horrendous crimes, are detrimental to the recovery of the patients and their reintegration into society. Media have been perpetrating the stigma that has been associated to mental illnesses for years. Disorders such as schizophrenia, depression, bipolar disorder and dissociative personality disorder have been themes for many fictional and non-fictional pieces. Fictional shows such as movies and television shows often contribute to the stigma of people suffering from mental illnesses. These shows often refer to mental health institutions as asylums, a term that has not been used for a long time in the Health Care system and whose actual definition refers to it as a place for outlaws and prisoners. The asylums have been portrayed in media as dark places with white padding on the walls and full of patients wearing straitjackets. Newspapers and nonfictional TV shows have also contributed to the problem. Often, the news that get more air time and first-page publications are the news that have to do with crimes that shock society. If the perpetrator of the crime has a mental illness, the condition that affects the person tends to get special attention. A recent example of this was the case of Clay Duke, a person suffering from bipolar disorder, who entered the school board of Florida, started shooting at the board members and then took his life. A clear example of the stigmatization caused by media is the case of Vince Weiguang Li, the man that attacked a passenger in a greyhound bus in 2008. Every description of the events contains words such as horrific, gruesome, or sickening. On March 5th, 2009, the Associated Free Press released an article that was disseminated through several publications including the online newspaper Zimbio.com in regards to the case of Vince Weiguang Li. The title of the article was Schizophrenic Canada bus beheading man found not guily; a title for a news article to be at best completely stigmatizing and offensive. The title of the article emphasizes the mental condition of Li by having it on the first position of

Media Critique 4 the sentence, and attaches the mental illness to the word beheading. The title of this article suggests that the only person capable of doing such atrocity would be a person suffering from schizophrenia. The article goes on to describe the scene with particular details to the events that would be shocking to any reader. The author of the article describes how Li beheaded his victim and sliced pieces of him to show them later to the passengers of the bus. The article depicts to gruesome details how were specific organs of the victim cut off and then eaten in such a manner that could only be imagined in a horror movie. The descriptions are completely unnecessary and begin to describe the events by predisposing the reader to an atmosphere that depicts the perpetrator as a sanguinary and cannibalistic murderer. The article then proceeds to discuss the status of Li as not criminally responsible. However, he does not state why Li was not criminally responsible or the process that Li would have to follow after his court. The article makes no justice to the mental forensic system that Li will be placed. Up to 15% of the population of the jails in the United Stated have a severe mental illness (Lamn & Weinberger, 1998). These inmates do not receive the appropriate treatment and often have acute and chronic exacerbations of their illness. If the purpose of the judicial system is to reform a person to be reintegrated into society, then the system will not be effective to prisoners suffering from a mental illness. The description of the author continues to offer words such as grotesque to refer to the crime scene. By the time the author discusses the legal status of Li, he has already created an atmosphere of gore and cruelty created by the actions of Li. The next step of the description of the events is the opinion stated by the psychiatrist that performed the initial forensic assessment on Li to determine his criminal responsibility. According to the author, the psychiatrist stated that Li had auditory hallucinations and delusions of persecution. The description did not indicate any process or implication behind the hallucination and delusions

Media Critique 5 suffered from a person with schizophrenia. To the public in general, just having the information of the changes in perception that Li was having is stigmatizing if it does not offer a description of the process of the disease. This is evident with the comments that people have posted on different online discussion boards. The author also gathered a brief interview with the mother of the victim. She expressed her disappointment at the verdict and declared that she feared that Li would be released from criminal detention short after his court hearing. It is hard not to be empathic with the mother as she has last someone who she loved dearly, but her words express some ignorance to the situation and the process to be followed after Li is declared not criminally responsible. At the end of the article, the author describes the process that Li has undergone with his mental condition and the problems that occurred in the health care facility where Li was taking his treatment. The last statements clearly show that Li did not receive the optimal level of health care based on his condition. The article has several elements that contribute to the stigma that our society has attached to mental illnesses. Similarly to movies and television shows, this news article depicts a person suffering from a mental disorder as a cold-blooded, murderer and cannibal. The language used in the article may be accurate to describe the scene but it is unnecessary for the effects of reporting the news. Also, the author of the article minimizes the effects that a mental illness could have had on the events that occurred in that Greyhound bus. It is clear that Li was not effectively treated at the institution where he was as he could escape and the institution did not seem to try to locate him to be returned to the hospital and continue his treatment. Instead of criticizing the health care system for not being proactive at treating a person that was having auditory hallucinations, the author focused on the tragic events for which Li was held responsible and that he carried them out when he was acutely ill. Also, the article shows the opinion of the

Media Critique 6 victims mother, which makes evident that she clearly is unaware of the forensic mental health system. She is seeking for revenge, as she explicitly states, for a crime that was committed against her son. She recognizes that Li was suffering from a mental illness, but she does not show any empathy towards him. Her words are reflected on the comments of other people that have posed responses to this article in different websites. Responses like these are the biggest concern to society as it creates a ripple effect and people believe that patients suffering from mental illnesses are fully responsible when they commit a crime. Society does not benefit from the stigma that gets generated from media. People fear patients with mental disorders because they feel they may act like Li. Society often adds a label of dangerous and unreliable to all patients suffering from mental conditions (Crisp, Gelder, Rix, Meltzer, & Rowlands, 2000). The stigma often comes with actions that for the most part are negative. The stigma that society places on mental health patients reduces access to employment, health care, and housing (Corrigan, 2004). To society, this means that a person suffering from a mental illness that is stigmatized will likely be driven to commit other crimes to survive. In addition, the same rejection from society would make the people feeling stigmatized less likely to look for treatment and to stay complaint with it. Also, the families of these patients are affected by stigmatization (Moses, 2011). The perception of the illness generally creates feelings of sadness, worry, guilt, and other negative feelings associated with the mental disorder. These feelings would also have an effect on the patient as sometimes the families having these feelings would isolate from the patient and create an extra burden to the patient. To this matter, society would benefit greatly from changing the perspective of the stigma associated with mental illnesses. First, it would reduce the isolation and aggression that patients receive from the public. Second, it would generate more opportunities of employment and appropriate housing for people

Media Critique 7 suffering from mental illnesses, which will increase their overall quality of life. Last, it would create an overall sense of acceptance that ultimately will improve the outcome of treatments and therapies. At the end of the note, the author notes the mistakes that occur in the treatment of Li. The article states that the patient was hospitalized in 2005 and diagnosed with schizophrenia. During his stay in the hospital, Li refused to take treatment for his condition. Doctors in this mental health hospitals detected that Li had auditory hallucinations and tried to establish a treatment without success. The article also noted that Li left the hospital without permission or supervision. The first mistake was to allow Li to leave without treatment. Li should have been tracked by the health care system to monitor his condition and prevent the occurrence of violent events. Also, the doctors should have worked with his family and the social work system to create a strategy to give Mr. Li an effective treatment. The author of the article makes note of the mistakes that occurred in the mental health hospital, but fails to criticize or assign some responsibility of the crime to these mistakes. The author uses the comments on the article to assign indirectly full responsibility to Li of what occurred in that Greyhound bus. However, it is clear to a professional of the medical field that the case is full of opportunities for improvement. To society as a whole, it is important to understand that stigma affects the patients and their functioning on society that ultimately will affect the entire society. The stigma associated with mental illnesses increase the economic and labour costs produced by the disorder alone. Part of the stigmatization that remains in society has been created by the health system itself. When the mental illnesses are described as any other illness, the public considers these mental illness to have the same symptoms overall just like physical illness do. This will include the component of violence and aggression that some patients that suffer from mental illness exhibit.

Media Critique 8 The mental disorder models that use the biological basis of the condition to explain the etiology of it, increase the stigma associated with the condition by essentialist assumptions (Howell, Weikum, & Dyck, 2011). To prevent this from happening, a social-cognitive model has been proposed to bring awareness to the public (Riskind, Bombardier, & Ayers, 2006). When the families of adolescents suffering from mental illnesses were studied, Moses (2011) found that families that refer to the condition of their family member in more psychiatric terms had a tendency to view the condition as permanent and without control. The study also found that families that did not use psychiatric terms to refer to the illness were using this strategy as a defence mechanism against the loss they were experiencing (Weller, Calvert, & Weller, 2003). Patients suffering from mental health illnesses often report low self-rejection from society (Verhaeghe, Bracke, & Christiaens, 2010). This rejection often results in lower treatment outcomes and thus, less satisfaction about the treatment. This also produces a reduction in compliance with the therapy that will further decrease satisfaction creating a downward spiral of treatment failure. Personally, I feel that articles such as this one produce great fear in the society towards mental illnesses and the people that suffer from them. The stigma that is created by irresponsible authors trying to sell an article fuels the fear that society exhibit in our culture. When a person that is suffering a mental illness commits a crime, media takes advantage of the situation and publishes articles and news that make the society alert to the mental illnesses. But these articles only create fear in the society by association. Society assigns the crime as a norm to the mental illness process. Behaviours tend to be associated directly to an illness when society sees that a specific behaviour is recurrently shown on a person with a mental condition (Moses, 2011). It is more common to see negative news related to mental illnesses than positive things. Even though

Media Critique 9 some movies have shown the positive aspect of mental diseases, such as A Beautiful Mind by Ron Howard describing a professor that suffers from schizophrenia, the vast majority of representations in media about mental diseases are negative. As a health care professional, I feel that the article published by the Associated Free Press hinders the efforts of the health care team to treat patients. The stigma that is associated to mental health through articles such as this, discourage the seeking of treatment (Martinez, Piff, Mendoza-Denton, & Hinshaw, 2011). I feel that the efforts that we do at the mental health system will not be sufficient if the stigma prevails in society. Many people suffering from mental conditions will not be treated and those patients would have the potential to commit other crimes that potentially can also be reported negatively on the news. This is vicious cycle that will exacerbate the stigmatization of the patients suffering from a psychiatric disorder. News articles as this one also has implications for the patients and their families. The patients often experience rejection from the society and sometimes from their families too (Link, Struening, Rahav, Phelan, & Nuttbrock, 1997; Moses 2011). The stigma associated with mental disorders affects the motivation of patients to seek treatment. In the United States, 28 percent of the population has a detectable mental condition, but only 8 percent looks for treatment (U.S. Department of Health and Human Services, 1999). In Canada, a similar situation is experienced as 20 percent of all Canadians will experience a mental illness (Health Canada, 2002). The lack of treatment affects personal and professional life of the patients and the families that suffer the mental condition. The families of mental health patients have economic and health complications when dealing with a mental disorder and the stigma associated with the condition increases the complications. Often, a family member is required to be a caregiver for the affected family member. This reduces the income that the family can perceive. If the costs of the treatment of

Media Critique 10 the mental condition is added to the reduce income, the economic burden will be multiplied. The health of the family members living through a mental condition is also affected. Their emotional suffering is great and it may affect their physical and mental health as well. Families need to receive therapy to diminish the impact of the mental condition and to reduce the suffering that may be experienced (Marshall, Bell, & Moules, 2010). If we consider that the stigma increases the effects of the condition and increases the pressure that the families endure during their care, the burdens of living through a mental health condition are exponentially greater. The stigma that is created through media exerts more pressure on the families by having a societal shunning. The patients and their families are often looked with inquisitive eyes and are not welcome on many social or public gatherings. Sometimes the pressure is so great that families decide to hide the family connections to someone that is suffering from the mental condition (Moses, 2011). In the particular case of Mr. Li, the news article could have done many things different to project a different perspective of the situation. To begin, the author could have stated the mistakes in the treatment of the condition of Li. The author could have assigned some responsibility to the mental health system where Li was being treated and their disregard, to some degree, of his auditory hallucinations. A person that is in an acute episode of his/her mental condition is not responsible of the actions executed. Therefore, the article should have assigned responsibility to the other parts implicated including family members and medical authorities. Also, the article should have omitted the explicit words of the judge and police officers describing the crime scene. To the effects of delivering a note, those comments are unnecessary and unfair to Mr. Li. I feel that words such as grotesque and the description such as lick blood from his hands predispose the audience to feel that Mr. Li is in fact a cold-blooded individual that deserves no sympathy. Also, the words of the mother reflect some ignorance and

Media Critique 11 should be appended with an explanation of what would happen to Mr. Li if he was found not guilty of the crime. Having only the opinion of the mother of the victim to judge what will happen to Mr. Li if he is found not guilty with grounds of his mental illness is incomplete and can many people upset by thinking that a person that perpetuated such crime could be released without any reform. In general, from the title of the article to the last period, this news article fuels the stigma that society has about patients suffering from mental health and does nothing but deter the treatment of many individuals like Mr. Li that urgently need treatment to prevent actions such as the one occurred in the Greyhound bus on July 30th, 2008.

Media Critique 12 Jaime Ulises Verastegui 72 William Stephenson Dr. Whitby, ON L1N 8R9 February 14, 2011 Associated Free Press 49 Elm Street Toronto, ON M5G 1H1 To the Editor, On the article titled Schizophrenic Canada bus beheading man found not guilty written by one of your columnists, there are several portions of the publication that increase the stigma that has been attached to mental health conditions. In a very irresponsible manner, the author of this article depicts the crime scene with unnecessary details that predispose the reader to have a negative frame of mind towards the perpetrator of the crime. Even though Vince Li was declared not guilty for having a mental condition that affected his judgement, the author of the article makes no comment about the future of Mr. Li or the problem associated with his condition. Also, this author makes emphasis of comments made by the judge of the case and the mother of the victim of the crime that increase the negative perception that one may have about Mr. Li. The problem with the stigma associated with mental disorders is that patients will be more resistive to seek for treatment (Martinez et al., 2011). In Canada, 20 percent of the population will suffer from a mental illness at some point in their lives. The different cases may not be as severe as with Mr. Li (Health Canada, 2002). However, if all those patients do not get effective treatment they may suffer profound complications. This will increase the cost that mental illnesses have. In 1993, it was reported that the cost of mental illness was at least $7.331 billion (Health Canada, 2002). Speaking of schizophrenia in particular, at least 1% of the population is affected by this condition (Health Canada, 2002). If we consider that Canada has a population of 33,739,900 individuals, then we can consider that we could potentially have

Media Critique 13 337,399 patients suffering of schizophrenia. In the last report of worldwide murder cases in 2002, Canada reported only 523 murder cases (United Nations Office on Drugs and Crime, Centre for International Crime Prevention, 2002). The cases of murder then cannot be attributed to patients suffering from schizophrenia alone. Otherwise, the number of cases will be significantly higher. By participating in the increase of the stigmatization, this article participates in the premature treatment termination of patients suffering from mental conditions (Sirey, Bruce, Alexopoulus, Perlick, Raue, et al., 2001). The lack of treatment will increase the incidences of cases such as this one. I suggest that you should include the medical perspective of a mental health professional to deliver accurate information to your audience.

Sincerely, Jaime U. Verastegui

Media Critique 14 References Corrigan, P. (2004). How stigma interferes with mental health care. American Psychologist, 59, 614-625. Crisp, A., Gelder, M., Rix, S., Meltzer, H., & Rowlands, O. (2000). Stigmatisation of people with mental illnesses. British Journal of Psychiatry, 177, 4-7. Health Canada. (2002). A report on mental illnesses in Canada. Ottawa, Canada: Health Canada. Howell, A.J., Weikum, B.A., & Dyck, H.L. (2001). Psychological essentialism and its association with stigmatization. Personality and Individual Differences, 50, 95-100. Lamb, H.R., and Weinberger, L.E. (1998). Persons with severe mental illness in jails and prisons: A review. Psychiatric Services, 49, 483-492. Link, B.G., Struening, E.L.. Rahav, M., Phelan, J.C., & Nuttbrock, L. (1997). On stigma and its consequences: Evidence from a longitudinal study of men with dual diagnosis of mental illness and substance abuse. Journal of Health and Social Behaviour, 38, 177-190. Marshall, A., Bell, J.M., & Moules, N.J. (2010). Beliefs, suffering, and healing: A clinical practice model for families experiencing mental illness. Perspectives in Psychiatric Care, 46(3), 197-208. Martinez, A.G., Piff, P.K., Mendoza-Denton, R., & Hinshaw, S.P. (2011). The power of a label: Mental illness diagnoses, ascribed humanity, and social rejection. Journal of Social and Clinical Psychology, 30(1), 1-23. Moses, T. (2011). Parents conceptualization of adolescents mental health problems: Who adopts a psychiatric perspective and does it make a difference? Community Mental Health Journal, 47, 67-81. Riskind, J.H., Bombardier, M., & Ayers, C. (2006). Perceiving normality in clients as a potent

Media Critique 15 social-cognitive treatment approach. Journal of Social and Clinical Psychology, 25, 249260. Sirey, J. A., Bruce, M. L., Alexopoulos, G. S., Perlick, D. A., Raue, P., et al. (2001). Perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression. American Journal of Psychiatry, 158, 479-481. United Nations Office on Drugs and Crime, Centre for International Crime Prevention. (2002). The Eight United Nations Survey on Crime Trends and the Operations of Criminal Justice Systems. New York, NY: United Nations Office on Drugs and Crime, Centre for International Crime Prevention. U.S. Department of Health and Human Services. (1999). Mental health: A report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services. Verhaeghe, M., Bracke, P., & Christiaens, W. (2010). Stigma and client satisfaction in mental health services. Journal of Applied Social Psychology, 40(9), 2295-2318. Weller, E.B., Calvert, S.M., & Weller, R.A. (2003). Bipolar disorder in children and adolescents: Diagnosis and treatment. Current Opinion in Psychiatry, 16(4), 383-388.