In most countries where trained mental health professionals are woefully inadequate, public perceptions and attitudes towards the mentally ill and mental illness are shrouded in strange myths and colored by stigmas. Public education and awareness assume tremendous importance in these circumstances to bring about psycho-socio-cultural changes in society.
The decades of 1980’s and 1990’s have been the decades of information technology making the whole world a global village. Technology is still growing by leaps and bounds. The challenge now is to connect local problems with global concerns and also connect local solutions to global response.
The Prevailing Attitudes differ from population to population and on who has become ill. Differences may be found among — Rich Vs Poor, Rural Vs Urban, Male Vs Female, Earning member Vs Dependent, Social support systems Vs None, Treated Vs Untreated and whether Awareness programs in the past has been carried out or not.
By and Large the attitudes and concerns are — Mentally ill are seen as aggressive, violent and dangerous; general public is largely uninformed about various aspects of mental health and lacks awareness about available facilities to treat mentally ill; defeatism about possible outcome after therapy and tendency to maintain social distance from mentally ill and to reject them. It is further worsened by irresponsible portrayal of the mentally ill as deranged, violent and dangerous stereotypes or alternatively as pathetic objects of ridicule by the entertainment industry, often using psychiatric terminology with scant respect to their actual significance and meaning. The media coverage of homicidal or suicidal acts committed by mental patients unfortunately focuses on sensationalism rather than sympathetic understanding or analysis of situation.
Mental illnesses form a large part of the total disability worldwide but each culture differs in its perception of this problem due to pre-conceived notions of causation, symptomatology and treatment modalities of the illnesses. Similarly, the available infrastructure and facilities for treatment and rehabilitation may vary widely within a country and across countries, due to diverse cultures, socio-economic status and systems of medicine apart from socio-cultural background.
As far as media is concerned, we must pray to be saved not only from ignorance experienced by the public, but also to be saved from over zealousness, smugness of knowledge and professional militancy shown by the professionals at times. The worst we can do under the circumstances is to try and superimpose the media strategy of another country.
It is in this context that realistic programs of changing public attitudes should be planned.
Mass media — The word media comes from ‘Medium’. Thus, a means of communication between two or more individuals refers to Media. That which reaches the masses is Mass Media. It encompasses any means of communication to a large number of people. Thus, it is not only national channels of televisions but also regional newspapers or community leaders that can be useful.
- The issues to be kept in Mind for utilizing the changing face of Media.
Become clear about new information/attitude/paradigm to be created.
Be aware of the old paradigm/attitude. It may or may not be used like — shattering a myth or allowing it to die its own death.
Set a target audience.
Identify resources (money, personal, type of media at disposal)
Set a time frame and informal plan of action.
Be brief and precise in information. Do not attempt many messages at one time. You must also be aware of the people’s or media’s agenda.
No media is too small or too prestigious. Each serves its purposes for certain target population as well as for type of messages to be given, or attitude to be changed. Be aware of which media you feel most comfortable.
Positioning (with events/other information/news)
Utilization of subtle means of communication (Music concerts/messages by celebrities/movies/talk shows/serials etc.)
Influence media or other personal when their near/dear one is suffering from the illness.
Consistency of information from multiple sources.
Not creating the demand without the necessary infrastructure specially of non-pharmacological means (rehabilitation, day care, behavior modification, family or group therapy etc.).
Some truths about Media: —
Each news competes with others (for space and positioning).
Each news agency tries to compete with other news agencies.
Each agency tries to provide most updated information.
Each agency is governed by its target audiences and controlling forces (owners, administrators, govt. policies, revenue generators) to decide the importance of an issue.
Social marketing is becoming an important force.
Personal crusades by mental health or media professionals can ensure success of a program.
The present reflections in the media and the possibilities in future are: —
I Television —
A. Terrestrial & Satellite — All countries have their own television networks which reach large populations in that geographical area serving the needs of that community. However, mental health does not find much direct or positive programing.
B. Foreign Satellite — BBC, Discovery, CNN, Doordarshan etc. The programming may be quite different, as would be the information, treatment facilities etc. and not very relevant to another country except for a small percentage in metros.
C. Cable — Local, specific, interactive, cost effective — The programming has been news stories, capsules of information, documentaries, infotainment including serials, talk shows, spots etc.
The programming, reach and time of telecast along with the willingness of the channel to produce the program/allocate funds sets the agenda and reach.
II. Movies —
Specific movies in mental health facilities or patient/doctor as a central character weaving in mental illnesses into a story without prejudice could have a wide reach as well as help the cause by role modeling of a character. It has been a mixed bag with some movies very sensitive and others bordering on absurdity. The lobby of psychiatrists should try to educate the producer/director, scriptwriter and actors about the trueness of the symptomatology, social impact and treatment of mental illnesses and mental health.
III. Radio —
Wide reach, relatively easy to be programmed as it is largely state owned with public service broadcasting as a goal and resurgence of radio listening, specially due to infotainment programs. The programming has been of public service messages, information capsules, specially woven information in entertainment programs, dial in phone services, ‘agony aunt/uncle’ programs, skits with socially relevant information as a sub theme etc. Some of the private radio channels are easier to get through and doing good service.
IV. Print —
Small (local)/Medium (state or regional)/National/International newspapers or magazines. The coverage includes—
A. Events (conferences, inaugurations, book release, National/ International day (Mental Health, Drug Abuse, WHO etc.)
B. News stories about mentally ill/mental health/distressed committing suicide/social impacts/interesting research etc.
C. News stories about new treatments/causation etc.
D. Interviews with National/International experts.
E. Public service advertisements by pharmaceuticals/NGO’s.
F. Agony aunt columns.
V. Internet —
Bewildering range of uncensored, at times misleading information. Specific websites can be created to cater to a select population about updated, precise culturally relevant and useful information about causation, recognition, course, treatments available etc.
VI. Govt./NGO’s Sponsored —
A. Street plays
B. Puppet shows
D. Talks and seminars
E. Pamphlets/booklets and Books
F. Information from and about Hospitals, Primary Health Centers and sub centers specially as part of National/Regional Mental Health Programs.
VII Others —
A. Folklore, folk music
B. Panchayat (village bodies), word of mouth
C. Opinion of leaders, doctors and religious heads
Each of these Media must be used by each professional working in the field of mental health, depending on his or her skills and opportunity. Each of these media are important and serve a purpose as well as a target population and is a piece in the larger picture of successfully integrating awareness, early recognition, treatment and rehabilitation for a stigma free society.
Dr. Avdesh Sharma, New Delhi, India
International Lead, Public Education Initiatives,
World Psychiatric Association (WPA)
Supported by Unrestricted Educational Grant by SUN Pharma
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