The extent and nature of coverage of mental health issues in printed media in India.

CONTEXT: The term media on a whole pertain to the main method of mass communication. The chief aim of the media is communication, with the objective of educating, informing, and entertaining the audience. It is unknown how accurately the media reports the topics related to mental health issues. AIMS: The aim of this study is to explore the extent and nature of coverage of mental health issues in printed media. SETTINGS AND
DESIGN: Data collection for the present study was conducted at the Library Gian Sagar College of Nursing, Ram Nagar, District Patiala, Punjab, in January 2017. A quantitative research approach with exploratory research design was adopted to explore the extent and nature of coverage of mental health issues in printed media. SUBJECTS AND METHODS: By purposive sampling technique, 923 printed media from which a sample of 839 articles was drawn, i.e., N = 839 (N 1 for newspapers, N 1 = 827 and N 2 for magazines, N 2 = 12) with the help of search terms which consisted of 32 general and diagnostic terms covering the full range of mental disorders. STATISTICAL ANALYSIS USED: Descriptive statistics were used.
RESULTS: One hundred and ninety-three (23%) articles on mental health issues appeared in the city/region section. Two hundred and one (32%) articles in newspapers did not mention the author. The most common theme of articles in newspapers was suicide 169 (25%) followed by substance abuse 209 (20%). The neutral description was used by 589 (71%) of all articles.
CONCLUSIONS: Majority of the articles appeared in the city/region section with neutral/nature. Copyright:

INTRODUCTION

The term media on a whole pertains to the main method of mass communication that is mainly can be in the form of Internet, television, radio, newspapers, magazines, newsletters, and various others forms of print. The chief aim of the media is communication, with the objective of educating, informing, and entertaining the audience. It is a reflection of the society and consequently affects the perception and behavior of individuals. Media and mental illnesses interact with each other in many complex ways. It may act as the primary source of information about mental illnesses and may shape the perceptions and attitudes about mental illnesses. Media portrayal may not only stigmatize mental illnesses but also act as a means of reducing inaccurate perceptions. It can also act as a risk factor for certain forms of mental illnesses. On the other hand, specific forms of media, especially films, can be used as a means of understanding psychiatric disorders and the treatment methods that are available.[1]

Quantitative investigations have revealed that media scope can negatively affect open states of mind toward individuals with emotional or mental wellness issues. The idea of such media scope, and how far it changes after some time, may in this way impact the effect of a simultaneous program against shame and segregation, for example that propelled in 2009 by Time to Change.[23] Newspapers are one of the initial communication tools of society. Formerly newspapers contained only news. However, now, they contain not only news but also views on various subjects. They have been the most usual and a generally received medium to be used in conveying the local, regional, international, and national news to readers. Ever since the beginning of society, newspapers were published to convey the latest happening in different parts of the world. They help in creating a common opinion and work as a corporate social responsible tool and fight for justice if needed.[4] In New Zealand, “Like Minds, Like Mine” was an expansive anti-stigma program, which began in 1996. An examination by the Mental Health Commission of New Zealand, utilizing orderly reviews of news sections >3 month time frames in 1997, 1998, and 2004, discovered changes in the path individuals with dysfunctional behavior were spoken to by the print media, and that there was a reliable reduction in negative revealing and an expansion in positive detailing of emotional well-being issues. One of the points of the battle was to teach print media staff about speaking to individuals with psychological sicknesses all the more emphatically, and this appears to have had some effect.[5] From the studies conducted by Nunnally,[67] of famous originations of mental health, many analysts have based on his work depicting print media portrayals of mental health issues.[89101112] One survey of such work[12] demonstrates that delineations of dysfunctional behaviors are moderately regular in the media that these portrayals are one-sided toward the more extreme types of psychological maladjustment, and go to excessively to unusual practices. Of most noteworthy worry to mental health experts is that numerous delineations pass on the impression of a solid relationship between mental illness and savagery.[81013] Until today, there are various methodological confinements in this area of work. Initially, there are issues with the representativeness of the subjects obtained.[671112] Second, numerous subjects were aggregated retrospectively.[81012] Third, things were chosen from a formerly existing database which implied that the creators were not able to work with their own particular meaning of mental issue, or to assess how vital dysfunctional behavior was to the occasions revealed.[810] Furthermore, fourth, none of the examples can claim to be a forthcoming national example. Different issues with these examinations are that they might not have satisfactorily searched for positive components in the portrayals of people with dysfunctional behavior. Further, there seems to have been little consideration given to who is giving the data about mental illness in the articles. It appears to be sensible to recommend that media portrayals would be more positive should people with a mental instability be straightforwardly cited or empowered to introduce their own particular stories.[141516] Considering these restrictions, the investigator set out to tentatively gather an extensive example of print media that delineated mental sickness. The aim of the present study was to find out the extent and nature of coverage of mental health issues in daily newspapers over a period of 6 months. To assess the extent of coverage of mental health issues, the number of times various mental health issue articles printed in the newspapers were counted in frequencies. To find out the nature of coverage, the essential objectives were as follows: (i) to scan for any positive portrayals of psychological sickness and (ii) to look for other (unbiased or negative) portrayals of dysfunctional behavior.

SUBJECTS AND METHODS

A quantitative research approach with an exploratory research design was adopted to explore the extent and nature of coverage of mental health issues in printed media. The study was conducted in the Library of Gian Sagar College of Nursing, Ram Nagar, District Patiala, Punjab, India. The investigator referred 905 printed media from which a sample of 827 articles was drawn with the help of search terms which consisted of 32 general and diagnostic terms covering the full range of mental disorders. One of the essential objectives was to discover constructive portrayals of people with mental illnesses. Before breaking down individual items a rundown of conceivably positive and negative delineations was made. This rundown was created from before investigations of characters with a mental issue in film[1718] and daily papers,[8910] and in addition from investigator's own encounters. Everything was fundamentally perused and specific topics whether positive or negative were recognized and grouped. Purposive sampling technique was used to draw a sample from the target population. Five newspapers, i.e., The Tribune, The Hindustan Times and The Times of India; The Daily Ajit and Dainik Bhaskar were selected for the present study. Articles related only to mental health issues were included in the study. Printed media such as Research Journals of all medical specialties were excluded from this study. A self-structured observational checklist was developed and used for data collection. It had two parts: Part A and Part B. Part A (a) for newspapers consists of article identification categories such as articles on various sections of newspapers (front page, city/region, nation, global/international, editorial/correspondence, sport, etc.), any diagnosis mentioned and author of the article. Part A (b) for magazines which consisted of article identification categories such as article on various sections of magazines (cover story, drama in real life, book bonus, fashion and beauty, cookery/food, health, etc.), any diagnosis mentioned and author of the article, etc. Part B: this part consisted of the article analytical categories for individual article identified with various sub headings, i.e., language used for the articles (positive/negative/neutral), aggression in the article present, and cause of mental illness mentioned. Approval from the Institutional Research and Ethical Committee Gian Sagar Medical College and Hospital, Ram Nagar, Rajpura was granted for the study before starting the study.

RESULTS

For analysis, raw data were arranged in master sheet and the analysis of data was performed in accordance with objectives of the study. A total of 905 printed media were referred and a sample of 827 articles. Data were analyzed using descriptive statistics (frequency and percentage distribution). Table 1 depicts that out of the 827 newspaper articles on mental health issues identified during the study period, most belonged to the Tribune 250 (30%), followed by those belonging to Hindustan times 221 (27%). Minimum 79 (10%) articles identified during the study period belonged to The Daily Ajit. Figure 1 reveals that the majority 193 (23%) of the articles containing the search terms appeared in the city/region section. The entertainment section of the newspapers reported the second highest number of articles on mental health issues 165 (20%) followed by 141 (17%) on the front page. The sports section had the lowest 5 (1%) number of articles on mental health issues. global/international sections and editorial/correspondence sections showed somewhat similar number of articles on mental health issues. Figure 2 reveals frequency distribution of articles printed on different sections of each newspaper. It shows that majority, 70, of the articles in the Tribune were printed on the entertainment section, followed by the city/region section, 61. It is observed that the Ajit had only 1 article published on the front page. Figure 3 depicts the extent of coverage of mental health issues by different themes/diagnosis identified in newspapers. It was seen that the most common theme was suicide 209 (25%); the second most appearing theme was substance abuse 169 (20%). Other themes that were identifies were stress 98 (12%) and sexual abuse 77 (9%). Another mentionable theme was anger/aggression 81 (10%). Other mental health issues that were identified were childhood psychiatric disorders 65 (8%) and depression 37 (4%). Themes such as mania, mental health law, organic brain disorders, parental burden, sleep disorders, and personality disorders were (1%). Thus, it was concluded that the majority of articles on mental health issues in newspapers were on the theme suicide and substance abuse. Table 1 depicts maximum 261 (32%) of the articles did not mention the author of the mental health articles printed. Articles that had been written by a journalist were 157 (19%), whereas many of the articles 195 (24%) were reports of associated press/reuters. On the other hand, articles that were written by a mental health professional were 47 (6%) N1= 827. Articles written by freelance writer/celebrity were 105 (13%) and about 9 (1%) articles were appeals by politicians. Furthermore, it was seen that 36 (4%) articles were advertisements/promotional articles. Figure 4 reveals that 589 (71%) of all articles on mental health issues in newspapers described a person(s) with a mental illness/or a mental health issue article using neutral descriptive language followed by positive descriptive language 198 (24%). By contrast, only 40 (5%) of news stories used negative descriptive language to describe a person(s) with a mental illness in a news story/or a mental health issue article.

Table 1

Frequency and percentage distribution of extent of coverage of mental health issues by author of the article printed in newspapers (n=827)

Author of the articles identified in newspapers	Number of articles, frequency (%)
	The Tribune	The Times of India	Hindustan Times	The Daily Ajit	Dainik Bhaskar	Total
Mental health professional	17 (7)	15 (8)	11 (5)	1 (1)	3 (3)	47 (6)
Associated press or reuters	84 (34)	45 (24)	45 (20)	11 (14)	10 (11)	195 (24)
Journalist	20 (8)	30 (16)	65 (29)	15 (19)	27 (30)	157 (19)
Editor/letter to the editor	30 (12)	3 (2)	12 (5)	0	0	45 (5)
Freelance writer/celebrity	12 (5)	11 (6)	9 (4)	0	2 (2)	105 (13)
Appeal by politicians	2 (1)	2 (1)	2 (1)	1 (1)	2 (2)	9 (1)
Advertisement/promotional article	8 (3)	12 (6)	6 (3)	0	10 (11)	36 (4)
Not mentioned	77 (31)	70 (37)	71 (32)	51 (65)	35 (39)	304 (37)

Figure 1

Frequency and percentage distribution of article printed on different sections of newspapers

Figure 2

Frequency distribution of articles printed on different sections of each newspaper

Figure 3

Percentage distribution of different themes/diagnosis identified in newspapers

Figure 4

Percentage distribution of nature of coverage of article identified in the newspapers

DISCUSSION

The study findings are supported by a study conducted by Kranke et al. (2010) in which articles were more frequently identified in the broadsheet (59.4%) than in the tabloid newspapers (40.6%). Only (6%) of the articles were featured on the front page, of which a significantly greater number were from the tabloid newspaper.[19] Front page articles frequently focused on forensic psychiatric issues (69.5%). Mental health professionals (psychiatrists n = 6, psychologists n = 13, psychiatric nurses n = 2) were the authors of only (5.5%) of all the articles, of which a significantly greater number were featured in the broadsheet newspapers (P < 0.05). The results are supported by studies by Morse F (2013) and Stuber J (2015) to describe the association between psychiatric disorders and aggression in the printed media shows that the proportion of articles depicting psychiatric disorders together with either self or other directed aggressive behavior were 31.2%.[2021]

CONCLUSIONS

The following conclusions were drawn from the study:

The study reveals that the majority of the articles appeared in the city/region section. The present study shows that most of the articles pertaining to mental health issues are of neutral language/nature not stigmatizing any group of people. The opinion of a mental health professional was sought in less than a third of cases and was associated with a more positive language/nature use overall.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.