“So, how does the media affect our views of mental health?”
When I introduce the elective recovery education course called In The Media, I don’t show any news clips or magazine articles. I don’t pull up any statistics or make any statements. I don’t offer any definition of stigma.
I just ask that simple question: “How does the media affect our views of mental health?”
Some students speak up immediately, while others settle back in their chairs to think and to listen. Some raise their hands a little, start to speak and then quiet down again.
“It’s like they make it out like your, like you’re…” The young woman studied the ends of her hair as she spoke, dark-lined eyes cast down.
“They make it like you’re crazy!” The older woman beside her exclaimed, her voice emphatic, exasperated, a little angry.
The young woman looked up, looked around at the class, “Yeah!” she said, “they make it look like you’re all crazy! Like you’re just some…I don’t know… crazy person!”
She smiled when she realized that she was in a room full of people who, in their way, understood exactly what she was talking about.
The students at the recovery education center where I facilitate classes have typically had less-than-average access to higher education. In general, many of the students at the state-funded center have had extensive trauma in their lives, compounded abuse and injury. It is not uncommon for students to have had dealings with law enforcement and child protection agencies. They have all survived a lot and, in recovery, are eager to explore the shrewd wisdom that is earned through learning how to staying alive and to live well on their own terms. For many, it has been years since they were invited to speak their mind and share their insights, years since anybody listened to them. It is remarkable how wise they are.
“The way they talk about it on the news makes you feel like some kind of freak!” The young man who spoke up hadn’t shaved in several days. Under the fluorescent lights he looked tired.
At the hospital, an involuntary commitment that followed an argument with his mother, he’d been put on four different psychiatric medications and was trying to figure out how to establish a self-directed wellness that didn’t require him to be on drugs that caused him to feel tired and slow, to gain weight and to have to contend with erectile dysfunction. He’d been told, on various occasions, that he had bipolar disorder, schizoaffective disorder, and borderline personality disorder, but the primary things that he had decided to work on at the REC were the flashpoint anger that is common in post-trauma disorders and exploring ways to cope with anxiety and low self-worth.
“They treat you like you’re…some kind of…like, psycho or something.”
He fell silent.
This past year has been a terrible year for mental health in the news and other media. The most prevalent and widely publicized messaging has been heartily encouraged by national lobbying groups that “advocate” for expanded treatment of what they have deemed “severe diseases of the brain.” These groups, such as E. Fuller Torrey’s Treatment Advocacy Center, Mental Health America, the National Alliance for the Mentally Ill, and the Balanced Mind Foundation are based on biomedical models and are funded, at least in part, by the pharmaceutical corporations that profit from mental illness.
These groups, along with commentators, public officials and families have been sharply critical of the “mental health system” lately, issuing a sustained outcry for more funding and more treatment availability. The type of treatment that is being suggested is not recovery education or Peer-run respite centers, it is not community support and wellness planning. Psychiatrists and proponents of the medical model are calling for what is basically a soft re-institutionalization of people deemed mentally ill, particularly those with diagnoses erroneously assumed to be unilaterally severe and “treatable, but not curable.”
“More longterm treatment! More access to hospital beds! More outpatient commitment laws! More closely monitored medication!”
This perspective is driven by fear and misinformation, fueled by the belief that struggle in one’s human experience is an illness that has the potential to drive people to commit heinous acts from out of nowhere.
The gains that have been made by anti-stigma campaigns are crumbling as I write this.
Then again, anti-stigma campaigns do not typically support recovery. In fact, anti-stigma messages are often framed in such a way as to communicate, “Hey, you do have a brain disease, and there is nothing you can do but seek treatment, but that’s okay.”
As a person who would be identified by medical model psychiatrists as having a severe and persistent mental illness, I have to say, “No. Actually, that’s not okay.”
“People with schizophrenia are unaware of how strange their thinking is and do not seek out treatment. At Virginia Tech, where Seung-Hui Cho killed 32 people in a rampage shooting in 2007, professors knew something was terribly wrong, but he was not hospitalized for long enough to get well. The parents and community-college classmates of Jared L. Loughner, who killed 6 people and shot and injured 13 others (including a member of Congress) in 2011, did not know where to turn. We may never know with certainty what demons tormented Adam Lanza, who slaughtered 26 people at an elementary school in Newtown, Conn., on Dec. 14, though his acts strongly suggest undiagnosed schizophrenia.”
The essay written by Dr. Steinberg completely disregards the many viable alternative approaches to healing what is clinically seen as schizophrenia. Instead, he took this approach, which is itself extreme:
“…greater insurance coverage and capacity at private and public hospitals for lengthier care for patients with schizophrenia; intense public education about how to deal with schizophrenia; greater willingness to seek involuntary commitment of those who pose a threat to themselves or others; and greater incentives for psychiatrists (and other mental health professionals) to treat the disorder, rather than less dangerous conditions. Too many people with acute schizophrenia have gone untreated. There have been too many Glocks, too many kids and adults cut down in their prime.
Well, yes, I would say so.
The perspective presented by Dr. Steinberg is, I believe, dangerous. It supports violence and abuse. It feeds fear and delusion.
It is not helpful.
Why then does the media persist in promoting the medical model of mental illness?
I’ll let you consider that for a moment, and draw your own conclusions.
I’d suspect that it has something to do with:
A) the cultural phenomenon of misinformation
B) pressure from moneyed and influential sources of misinformation
C) a taste for the drama of slow human tragedy
Regardless of how we personally choose to frame our understanding of human distress, it is likely that we can all agree that the media has a responsibility to accurately report all sides of the story and to be conscientious of the language that they use to describe the lives of millions of Americans.
Anyone who visits this site knows that there are alternatives, in both practice and perspective. I’d encourage us all to communicate with media outlets about the importance of offering fair coverage of topics relating to mental health in this country. We can do this through writing letters to editors, blogging, and use of social media. Below, I’ve copied the letter I wrote to the Op-Ed editor at The New York Times, regarding my concern over the paucity of alternative perspectives.
My hope is that even the smallest voices may help media outlets to realize their responsibility to not deny people perspectives that offer solutions and which support hope and community wellness.
If given access to healing resources, people do heal and it is important that the media acknowledge that fact.
That being said:
To Whom it May Concern,
I’d like to respond to your 12-25-2012 publication of the Op-Ed titled Our Failed Approach to Schizophrenia, by Paul Steinberg.
I understand that Dr. Steinberg is a psychiatrist and that the training and protocol of his profession support his perspective on schizophrenia and how it may best be intervened upon. However, I think it is well worth noting that there are many other approaches to the human condition that is clinically deemed ‘schizophrenia.’
Dr. Steinberg approaches schizophrenia as a biomedical disease, with distinct pathology and looming prognosis. We know that the condition that is called schizophrenia, and psychosis in general, does involve people’s brains, because our brains are an integral element in our experiencing of life, but people’s minds and hearts play a significant role in how human distress arises. One could say, depending on subjective experience, that the mind and the heart are far more important than the brain in determining what the outcomes and the effects of difficulty in coping may be.
There are good reasons for us to be concerned with the state of mental health in this country and in the world.
Nonetheless, the medical model of mental illness offers little more than a brutally reductionist framing of our humanity, one in which disease severely and persistently supersedes one’s rights and undermines one’s potential. Perhaps the failure we should be concerned with is the failure of psychiatry itself and the failure of the treatments prescribed. In the past century, we have seen the rates of “mental illness” skyrocket, doubling and tripling, ever-expanding to now include 1 in 4 adults and increasing numbers of children. 
This phenomenon is well-documented in Robert Whitaker’s book, Anatomy of An Epidemic, which examines the rise of mental illness in America as a product of the expansion of pharmapsychiatry. According to Whitaker, psychiatry itself may be perpetuating illness in such a way that human distress is exacerbated rather than healed.  This is not a radical or anti-psychiatry view, but a well-reasoned alternative explanation for what might be going so terribly wrong that federal and state government agencies are spending millions of dollars to fail, miserably and obviously, in meeting the mental health needs in this country.
I’m sure that a newspaper such as the New York Times is aware of the recovery movement, which supports empowerment, integrated community healing, education and self-determination in structuring one’s own wellness. This is not radical. In fact, in several states, public funds are used to support education centers and non-medical crisis alternatives, such as Peer-run respite houses. Peers are people with “lived experience” who now work in settings that support individuals in navigating their difficulties and strengths in ways that work for them.
Many of the approaches used in recovery education settings are evidence-based, which means that they have gained the approval of federal agencies as programs and practices that produce measurable rates of self-reported recovery. Common examples of non-medical evidence based practices are Dr. Mary Ellen Copeland’s Wellness Recovery Action Plan and Dr. Marsha Linehan’s Dialectical Behavior Therapy.  Another promising practice is eCPR, which stands for emotional CPR and is being developed by Dr. Daniel Fisher, who recovered from a diagnosis of schizophrenia and went on to become a psychiatrist who served on President Bush’s New Freedom Commission. It is worth noting that both Dr. Copeland and Dr. Linehan also have lived experience, as do many other leading professionals in conscientious and ethical mental health.
In addition to state-funded recovery resources, grassroots advocates have organized networks of community support to help people to live full and self-determined lives regardless of their mode of human experience. As a person who carries a diagnosis that identifies me as being on “the psychotic spectrum,” it was transformative and healing to come across the work of MindFreedom International, The Hearing Voices Network, and The Icarus Project, visionary grassroots organizations that seek to redefine what we mean by mental health and to offer people access to resources of support and information.
Why is it that the loudest voice in the room is the voice of biomedical psychiatry?
In many editorials and commentaries, people seem to acknowledge that something doesn’t seem to be working in the “here’s-a-label-and-a-pill” approach, and there is increasing concern over the correlational link between dangerous side-effects of pharmaceuticals (SSRIs, stimulants, and steroids in particular) and societal violence.
I am aware that many statements were released to the press following the Newtown tragedy and I have been saddened to see that the perspectives on mental health highlighted by the media are those which are rooted in disease-model language and practice. It has been well-established that there are alternative approaches to human distress and that people can, if empowered to do so, recover from even the most damning diagnoses.
Activists and advocates in the consumer/survivor/ex-patient movement, which is largely ignored by the press, are able to speak articulately about the harm that forceful and coercive treatment does. It has been well-established that many of the practices common to psychiatric intervention actually violate human rights as they are outlined in the United Nations’ Convention on the Rights of People with Disabilities. 
In spite of viable alternatives, the media would have us to believe that the only response to the mental health crisis in this country is to expand traditional mental health services and enforce further compulsory screening and treatment, regardless of the fact that many biomedical treatments do not support recovery, are costly, and may even be stigmatizing and traumatizing in ways that further human distress. It has been shown that Peer-driven mental health services and recovery education can be more cost-effective and tend to have better outcomes than biomedical interventions.
It is negligent of psychiatry to disregard the role of trauma in people’s experience of distress and while Dr. Steinberg did acknowledge that stress plays a role in the onset of disorder, he failed to indicate what, specifically, the stressors that lead to disordered experiences may be. Trauma, abuse, processing differences, individual personality structures, relational dysfunction…all of these things play a role in our ability to meet the expectations of “normal” coping and compliance placed upon us.
I do not believe that it is a disease if someone fails to have their human needs for affirmation, comfort, acceptance, and understanding met. I do not believe it is a disease if someone is hurt, confused, or angry. I do believe that it is a tragedy that our country’s mental health culture and practice is structured in such a way that these basic human needs are routinely denied in people’s seeking help and that, rather than being helped, people are frequently harmed by the mental health system.
I’d appreciate it if you would consider presenting more alternative perspectives on mental health, as it is important that people know that there are other approaches and, more importantly, that there is hope.
Thank you for your time in considering this perspective. Have a nice day.
Faith Rhyne, Certified Peer Support Specialist
References and Perspective Resources
National Institute of Mental Health http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml
 National Institute of Mental Health http://www.nimh.nih.gov/science-news/2009/national-survey-tracks-rates-of-common-mental-disorders-among-american-youth.shtml
 The National Association of Peer Specialists http://www.naops.org/
 Robert Whitaker, Anatomy of An Epidemic. http://robertwhitaker.org/robertwhitaker.org/Anatomy%20of%20an%20Epidemic.html
 Dr. Mary Ellen Copeland, Wellness Recovery Action Plan. www.mentalhealthrecovery.com
Dr. Marsha Linehan, The New York Times, Expert on Mental Illness Reveals Her Own Fight.
 The National Empowerment Center, www.power2u.org
 Dr. David Healy, Antidepressants and Violence: Problems at the Interface of Medicine and Law. http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.0030372
World Network of Users and Survivors of Psychiatry, United Nations Convention for the Rights of Persons with Disabilities. http://www.wnusp.net/UnitedNations_MMtmp03630c55/UnitedNationsConventionfortheRightsofPersonswithDisabilities.htm
Note: All anecdotes have been fictionalized due to sensitivity of confidential information and out of respect for individuals. However, they do reflect actual dialogue and circumstances that are commonly encountered in recovery education settings.
To be honest, I wasn’t entirely sure what Part 2 might entail. There are, after all, so many ways that popular media has failed to support an informed and compassionate understanding of madness and humanity.
I figured something would come up in the news and, lo and behold, something did.
Of course, it wasn’t exactly news. It was this:
“…the most seriously mentally ill who are not in treatment and are psychotic, delusional, or hallucinating, or are off treatment that has previously prevented them from being violent, are in fact more prone to violence than others.”
This statement was made by DJ Jaffe in an essay published by the Huffington Post just days after Dr. Paul Steinberg published his perspective on schizophrenia in the New York Times. Jaffe’s essay was, mysteriously, titled Why the Public Doesn’t Trust Mental Health Advocates.
In this recent post, published in the HuffPo Crime section, Jaffe is not saying anything that he hasn’t been saying for years as a lobbyist for expanded commitment laws in New York, California and beyond.
The way Jaffe makes it sound, people with what he terms “severe mental illness” are barely even fully human. In the comments section of his essay, Jaffe is telling people that schizophrenia causes brain loss.
The mind and free will are often seen as core components of our humanity. Concepts such as mental-illness-as-a-brain-disease and anosognosia inherently deny the viability of our minds and free will. Thus, the conclusion is that we can never know what is best for us, because it is assumed that we do not even have the capacity to know what is going on.
I am aware, as a person whose diagnosis and history places me in the worrisome “subgroup” that Jaffe has identified, and as a person who works in an open-access public mental health setting, that some people do have a tremendously difficult time with their experiences.
I also know that we, as human beings, have rights and that we, as human beings, all deserve access to our own full potential. We have the right to not be constrained by limitations in someone else’s understanding of what it means to be us and we have the right to not be harmed as a result of what other people may think about who we are and what we may, or may not be, capable of.
Sometimes human beings experience circumstances in which they have the impression that they are being threatened. Sometimes we become confused about what is and is not a danger to us.
Those seen as “severely mentally ill,” and thus commonly seen as dangerous and unpredictable, are routinely threatened with force and restraint, with punishment, and with ostracization.
Most human beings, when threatened, will seek to defend themselves. This is not merely a psychological phenomenon, but an innate feature of our animal mechanisms of survival.
Anybody who has experienced fear, which is anybody, can tell you that fear scrambles our thinking.
“What was that noise?”
“Wait…did you hear something?”
“Oh, my gosh! Something is totally out there!”
This phenomenon is easily observable in children.
Fear feeds the perception of threat and we do, it’s true, live in a very frightening society.
As Pat Deegan articulated in a recent reflection on Nonviolence and Recovery, all humans have the potential to be violent and many humans behave violently at some point in their lives.
We know that violence has never been a good cure for violence.
One day, I’d like to speak with DJ Jaffe, about intervention and education, fear and hope, neuroleptics and brain loss, reactive psychosis and recovery.
I know he’s heard it all before, but I guess he doesn’t trust the advocates, either.
It figures. After all, according to Jaffe, we couldn’t possibly know what we’re talking about.
By the way, I went back to check on Steinberg’s essay about schizophrenia and was pleased to see that several letters in response had been published. All of them, however, were written by psychiatrists.
1] Jaffe, DJ. Why the Public Doesn’t Trust Mental Health Advocates. Pub. 12/27/2012. http://www.huffingtonpost.com/dj-jaffe/why-the-public-wont-liste_b_2360876.html
2] Deegan, Pat. Nonviolence and Recovery. Video. http://www.madinamerica.com/2013/01/pat-deegan-on-recovery-and-nonviolence/. 01/01/2013.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
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