Sources of Stereotyped Images of the Mentally Ill

By

Stuart Fischoff, Ph.D.

Journal of Media Psychology, Volume1, Number 1, Winter 1996, 4-11

Introduction

The entertainment media of film, television and a variety of print outlets serve many functions for people including entertainment, information, and escapism.Ý One function less widely discussed is the formation of stereotypes for different classes of people, e.g., criminals, heroes, racial minorities and the mentally ill.Ý

Previous research has shown that the general public's images of the mentally ill derive from sources radically different from images held by mental health professionals.Ý Wahl (1993), for example, has noted that novels about serial killers are a prime information source for many people.Ý The novelists, Wahl argues, inaccurately suggest that serial killers tend to be psychotic and they present unrealistic composites of symptoms, which are likely to mislead readers about serious mental illness.Ý

Not the least of these misconceptions is that the seriously mentally ill are particularly brutal and dangerous.Ý According to a recent content analysis of prime time television dramas of the frequency with which both ìnormalsî and mentally ill are portrayed as violent, fully 70% of mentally ill are portrayed as violent, while only 42% of ìnormalsî are so portrayed.Ý This incidence of television violence among the mentally ill is hugely disproportionate to real numbers in society and contributes to the stigma of mental illness (Gerbner, 1993). Ý.

Most recently, Hollywood has purveyed images of serial murderers in films such as Seven (1995) and Copycat(1995), and murderous psychopaths in Casino (1995).Ý In the absence of personal experience with these "types" of people, the media-purveyed images become what psychologists call "typifications" or "prototypes," which means these screen images are brought to mind when someone mentions the subject of serial murderers.Ý

Similarly, when people are asked to imagine a person suffering from a multiple personality disorder (MPD), it is likely that visions of the actress Sally Field (Sybil, 1976) or Joanne Woodward (Three Faces of Eve, 1957) are conjured up.Ý After all, how many people have actually confronted someone suffering from MPD?Ý It is duly noted, however, that over the past five years, many self-described MPD sufferers have paraded across the stages of tabloid talk shows.Ý For many viewers, then, it is the talk show circus, not the theatrical or television motion picture that is the primary source of stereotypes of the mentally ill.

Research amply substantiates the importance of the role of the entertainment media in stereotype formation.Ý According to a 1990 Robert Wood Johnson Survey (as cited in Blanch & Penny, 1993), the public identifies the mass media as their major source of information on mental disorders.Ý Nancy Signorielli (1989), tracked the presence of the mentally ill on prime time television.Ý She found that 20% of the shows involved some depiction of mental illness and that the mentally ill were disproportionately involved as perpetrators or victims of violence.Ý Moreover, when depicted on television, the mentally ill were more likely to be portrayed as evil or bad and less likely to be portrayed as good than were ìnormals.îÝ From a different angle, research (Domino, 1983) showed that watching major motion pictures which featured characters who were mentally ill produced an increase in negative attitudes toward the mentally ill.Ý

Studies by Ed Tan (1992) and Dolf Zillmann (1991) indicate that, compared to textual presentations, movies are a more influential and largely non-cognitive source of information and emotionally arousing imagery.Ý Movies adhere more to the demands of dramatic license than to the pleas for accurate portrayals of mental illness.Ý It is not surprising then, that studies show that the mass media are highly influential in the formation of stereotypes of the mentally ill and that these stereotypes tend to be skewed toward inaccurate and negative characterizations.

The present study explored three questions:Ý

RQ₁: If college education is an antidote to ignorance, does exposure to more accurate information about the nature of mental illness and its diverse manifestations via classroom instruction offset distorting media impact?Ý

RQ₂: Are sources of information other than film and TV, viz., print and personal experiences, differentially important in terms of impact on stereotypes?

RQ₃: Insofar as serious mental illness is as uncommon in the lives of most people as felonious criminality, are the mass media more or less potent as a source of stereotypes of criminals as compared to stereotypes of the mentally ill?

Methodology

Subjects

Responses from 348 male and female students from Cal State University, Los Angeles comprised the database for the present survey.Ý Their ages ranged from 17-35 with a mean age of 27.4.Ý The subject population was 45% male and 55% female.Ý Respondents were students enrolled in undergraduate courses in psychology.Ý All had taken a course in Introduction to Psychology and were, at the time of the survey, enrolled in either a social, an abnormal or developmental psychology course.Ý The survey was conducted during the second week of the 1994 Winter Quarter.Ý

ProcedureÝ

Subjects were given an 11-item, open-ended survey, which had been pretested for clarity of understanding on a pilot sample of 100 respondents.Ý The subjects were asked to look at each type of category of person, conjure up an image in their heads of what this person looked like and then indicate the primary information source from which that image was derived.Ý The term stereotype derives from the notion that the images conjured up are pictures in one's head and serve as a prototype for such categories in the absence of a specific person as a stimulus object.

A content analysis sorted responses into one of three predetermined categories: Film/television, print media, and personal experience.Ý Print media included such information sources as newspapers, magazines, class texts or books read on one's own.Ý Personal experience included work settings such as hospitals or social service agencies, relations with family or friends or simply seeing people on the street discerned as criminal or mentally ill.

If respondents, as they occasionally did, listed more than one information source, only the first source listed was tabulated.Ý This held the number of responses/subject constant and was based on the assumption that the first source listed was the principal information source.

In order to contrast stereotypes of mental illness with other social stereotypes, in addition to the eight mental illness categories (schizophrenic, homicidal maniac, multiple personality disorder - MPD, obsessive-compulsive, mental patient, heroin addict and alcoholic) three more fairly common anti-social types were included: pimp, drug dealer and murderer.Ý Criminal types are frequently depicted in the mass media;Ý Does the media stereotype machine work harder on images of the mentally ill or on images of criminals?.

Results

Table 1

Sources of Stereotypes of the Mentally Ill and Criminals

Category Stereotypes		ÝÝÝÝÝÝÝ FILM/TV		ÝÝÝÝÝÝÝÝÝÝÝÝ PRINT		ÝPERSONAL EXPERIENCE		ROW TOTAL	CHI-SQUAREÝÝ
		#	Row %	#	Row %	#	Row %
Mental Illness
schizophrenic		164	0.47	80	0.23	104	0.30	348	32.28**
homicidal maniac		276	0.84	44	0.13	8	0.02	328	387.02**
MPD		176	0.51	112	0.33	56	0.16	344	62.88**
manic-depressive		128	0.40	100	0.31	96	0.30	324	5.63*
obs-comp		140	0.44	92	0.29	88	0.28	320	15.7*
alcoholic		60	0.20	4	0.01	236	0.79	300	293.12**
mental patient		184	0.55	24	0.07	128	0.38	336	117.71**
heroin addict		216	0.62	32	0.09	100	0.29	348	149.24**
Col Totals		1344	0.51	488	0.18	816	0.31	2648	422.62*
Criminality
murderer		292	0.86	16	0.05	32	0.09	340	423.62**
pimp		268	0.78	8	0.02	68	0.20	344	323.26**
drug dealer		180	0.53	8	0.02	152	0.45	340	150.31**
Col Totals		740	0.72	32	0.03	252	0.25	1024	769.34**
Grand Column Totals		3428		1008		1884		6320	1029.05**
% Total Responses		0.54		0.16		0.30		100
	**p < .001Ý * p < .05 for 2-tailed tests

Results of the survey (see Table 1 above) clearly indicate that there is a significant difference between informational sources for stereotypes of the mentally ill (MI), χ²=422.62, p < .001.Ý TV and Film are the most influential source of such stereotypes with Personal Experience (PE) and Print coming in 2nd and 3rd respectively.Ý Among individual categories of MI, it is also clear that stereotypes for manic-depressives and obsessive-compulsives are only slightly more likely to be influenced by Film and TV than by either PE or Print.

Interestingly, the only dramatic reversal of these source trends concerns the MI category of Alcoholic where PE was cited by 236 respondents (79%).Ý Content analysis of the responses indicated that 136 of these respondents (53%) mentioned family and friends as information sources while 100 (40%) mentioned observing people on the streets.Ý The remaining 7% derived from work settings.Ý Clearly reliance on the media for sources of stereotypes is diminished for so wide-spread a social affliction as alcoholism.

Results for sources of criminal stereotypes are even more dramatically skewed in the direction of Film and TV than they were for MI, χ² = 769.34, p < .001.Ý However, whereas stereotypes for murderers and pimps derive primarily from Film and TV, PE comes in a close second as an information source for drug dealers (53% and 45% for Film and TV and PE respectively).Ý As with alcoholics, drug dealers are hardly exotic, at least on the streets of major urban areas such as Los Angeles.

In terms of the differential importance of Film and TV to various stereotypes, results of additional chi-square analyses reveal that TV dominates Film as an information source across all MI categories (66% vs. 34% for TV and Film respectively, χ² = 82.01, p < .001).Ý This was true in all but three MI categories: schizophrenia, mental patient, and MPD, where the differences between the two media sources are negligible.Ý In all other categories of MI and criminality, TV holds sway, χ² = 112.09, p < .001.Ý It is worth noting that content analysis of responses revealed that stereotype images from TV predominantly come from talk shows such as "Oprah" or from TV news.Ý

Discussion

The results of the present survey on informational sources of stereotypes of both the mentally ill and criminals indicate that, in the vast majority of stereotypes people have about these social categories, TV and film are the dominant sources of information.

Data also suggest that the impact of TV and film is more potent for criminal stereotypes than for mentally ill stereotypes.Ý In part this seems to be due to the infrequency with which most people come in personal contact with criminals such as murderers and pimps, although personal contact does account for 45% of the stereotypes of drug addicts.

As regards stereotypes of the mentally ill, two out of nine stereotypes, for manic-depressives and obsessive-compulsives, the mean differences between information sources were less robust, suggesting that these types of mentally illness do not generate typifications as salient as they do for other MI categories.Ý The most dramatic stereotype of the mentally ill occurred for homicidal maniac, where 84% of the respondents indicated it derived from film and TV.Ý Paralleling this result for criminals, the category of murderer was also sourced most substantially from film and TV.

It is not surprising that the results of the present survey support both empirically-based (e.g., Gerbner, 1993; Roth & Wahl, 1982; Wahl, 1995) data and essays in persuasion (e.g., Fischoff, 1993) about the informational sources of stereotypes of the mentally ill.Ý What is surprising is, that for a college population of students in psychology courses, the impact of print and textbooks did not carry more weight.Ý This would suggest that for a non-college educated population, the results may be even more dramatically biased in the direction of film and TV as major sources for stereotypes about the mentally ill.Ý

What does a narrow source of stereotypes imply?Ý Concerns expressed about the misinformation film and TV disseminate are justified.Ý Two principal motives drive the entertainment mediaís use of stereotyped images.Ý One, obviously, is for dramatic interest.Ý The other is in pursuit of higherÝ television ratings.Ý This is, alas, frequently accomplished by ìfloggingî the events and lurid images surrounding sensational crimes such as those committed by Jeffrey Dahmer or Charles Manson and his ìfamily.îÝ This media hype inevitably contributes to fattening the collective repository of misinformation regarding mental illnessñand criminalityñthat is embedded in the American psyche.Ý

The present study did not ask respondents to describe the stereotypes they mentally generated.Ý Yet, it seems safe to assume that, since the stereotypes of the mentally ill are largely derived from film and TV, these images would be more exaggerated, more dramatic and less realistic than the actual people who are victims of such illnesses.Ý By the same token, when it comes to villains on screens, images will also be more dramatic and less realistic than those in the real world who are disposed to criminal behavior (Fischoff, 1995).Ý

Mental images created by film have been found to evoke more dominating responses than images evoked by text (Tan, 1992).Ý Emotions connected with these visual images lead to self-protective or self-interested behavior such as voting against or protesting halfway houses for the mentally ill in oneís own community (Bridge and Medvene,1990).Ý This reluctance to accept a halfway house in oneís neighborhood has come to be known as the NIMBY reaction (ìnot in my back yardî).ÝÝ

It seems richly evident that film and television portrayals of the mentally ill are more powerful than print information in generating and inculcating inaccurate cognitive stereotypes and defensive emotional cues for social perception and social acceptance of the non-violent mentally ill.Ý And, as the present results indicate this is true even for college students in psychology who ought to know better!Ý

In the end, when it comes to the battle between text and image, image bestrides the world like a colossus.Ý People will remember the image of a leering Jack Nicholson, a crazed, homicidal maniac, fire ax in hand, peering into the gape of a bathroom, quicker than some article in the New York Times chronicling the travails of the woebegotten psychotic street person on 43^rd street and Broadway who is more terrified of the world than the world should ever be of him.

References

Blanch, A., & Penny, D. (1993).Ý Countering stereotypes in the news media: People speaking for themselves.Ý Journal of the California Alliance for the Mentally Ill, 4 (1), 33-36.

Bridge, G.R., & Medvene, L. J. (1990).Ý Using television to create more favorable attitudes towards community facilities for deinstitutionalized psychiatric patients.Ý Journal of Applied Social Psychology, 20, 1863-1878.

Domino, G. (1983).Ý Impact of the film, ìOne Flew Over the Cuckooís Nest, ì on attitudes toward mental illness.Ý Psychological Reports, 53, 179-182.

Fischoff, S. (1993).Ý A reel take on mental illness.Ý The Journal of the California Alliance for the Mentally Ill, 4 (1), 17-20.

Fischoff, S. (1994).Ý Romancing the psychotic. L.A. PSYCHOLOGIST, May/June, 5., 9.

Fischoff, S. (1995).Ý Villains in Film: Anemic Renderings.Ý Popular Culture Review. V. 6, 1,Ý 45-52.

Gabbard, Glen, Gabbard, Krin, Psychiatry and Cinema, Chicago, University of Chicago Press, 1992, U.S.A., (2^nd ed.)

Gerbner, G. (1993).Ý Images that hurt: Mental illness in the mass media.Ý Journal of the California Alliance for the Mentally Ill, 4 (1), 17-20..

Hyler, S, Gabbard, G., & Schneider, I. (1991).Ý Movie Madness.Ý Hospital and Community Psychiatry, 42 (10), 1044-1048.

Roth, R. & Wahl, O. (1982).Ý Television images of mental illness: Results of a metropolitan Washington media watch.Ý Journal of Broadcasting, 26, 599-605.

Signorielli, N. (1989).Ý The stigma of mental illness on television.Ý Journal of Broadcasting & Electronic Media, 33, 325-331.

Tan, E. (1996). Emotion and the structure of narrative film: Film as an emotion machine.Ý Hillsdale, NJ: Lawrence Erlbaum Associates.

Wahl, O. (1995). Media Madness: Public Images of Mental Illness, New Brunswick, New Jersey, Rutgers University Press, U.S.A.,

Wahl, O. (1993).Ý Messages about mental illness from the serial killer novel.Ý Journal of the California Alliance for the Mentally Ill, 4 (1), 43-44.

Zillmann, D. (1991). The logic of suspense and mystery.Ý In Bryant & D. Zillmann (Eds.)Ý Responding to the screen. ÝReception and reaction processes (pp. 281-304).Ý Hillsdale, NJ: Lawrence Erlbaum Associates.

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