Mental Health Stigma in 2021

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March 5, 2021

Writer: K Ballesteros
Researchers: Azie Marie Libanan, Alvin Joseph Mapoy
Graphics: Tobey Calayo
Moderators: Richardson Mojica, Ian Stephen Velez, K Ballesteros

 

The Commission on Human Rights of the Philippines (CHR) released a strong statement about the “Tililing” poster bearing an image that relies on negative perceptions of Filipinos living with mental illness. The image was first circulated in mid-February 2021. According to the CHR, “marami nang miskonsepsyon na bumabalot sa usapin ng mental health at hindi makakatulong kung makakahon ito sa misleading na pagtingin” (Mercado, 2021). 

The Commission was not alone in slamming the image for its irresponsible portrayal of Filipinos with mental health problems.

The Philippine Psychiatric Association (PPA) likewise released a statement in defense of people with mental health problems, claiming that Filipinos have the right to live free of stigma (Baron, 2021). The PPA also emphasized how the media may become a strong ally in raising mental health awareness (Baron, 2021). 

The Philippine Mental Health Association (PMHA) also stated that media organizations have the responsibility to help cultivate an environment where people with mental health concerns are supported (Baron, 2021). Given that “news media…are among the most frequently identified sources of mental health information” (Stuart, 2006, p. 101) these platforms have the scope and platform to either dispel “inaccurate and stigmatizing stereotypes” (Stuart, 2006, p. 101) or to perpetuate the same harmful representations. The PMHA also emphasized that “stereotyped and negative portrayal[s] of mental illness in the media have ‘profound implications’ for persons suffering from mental illness” (Baron, 2021). The most recent image slots neatly into the tradition of media organizations producing “largely inaccurate and negative” (Stuart, 2006, p. 101) representations of mental illness.

Any form of oversimplification or exaggerated portrayals of mental illnesses, and the people who live with them, can distort and misrepresent a vulnerable community. Misrepresentation, or distorted portrayal, is not only incorrect and erroneous but “damaging” (Saleh, 2020). According to Heather Stuart’s 2006 study, Media Portrayal of Mental Illness and Its Treatments, characters portrayed as having mental illnesses on both television and film are often “the objects of fear, derision or amusement; and verbal references to mental illness are used to denigrate, segregate, alienate, and denote another character’s inferior status” (p. 100). 

Because this issue is vast and multifaceted, this article will focus on describing stigma and the environments that allow the stigmatization of people living with mental illness to continue; and some of the dangers of misrepresenting mental health issues in the media. 

Stigma & where it lives

The call to end the stigma references the phenomenon wherein certain individuals are denied full social acceptance (Saleh, 2020). A 2018 study on the stigma experienced by people with mental health problems and epilepsy in the Philippines described public stigma as the “general public’s reaction toward a group” (Tanaka, C., Tuliao, Tanaka, E., Yamashita, & Matsuo, 2018). The study defined ‘stigma’ as a phenomenon composed of three distinct elements: a collection of negative beliefs about the stigmatized group; an emotional reaction which becomes prejudiced behavior; and the behavioral manifestation, which then becomes discrimination (Tanaka, C. et al, 2018). 

Stigma, therefore, encapsulates the emotional reaction to and the behavior against certain groups of people. Stigmatizing vulnerable communities begins long before any outward behavior occurs; in fact, stigma begins with collectively held beliefs and ideas about how mental health illnesses manifest. 

Stigmatization relies on an environment where misinformation, distorted media representation, and the lack of proper representation pervade. Part of this environment is entertainment and news media’s focus on “the individual with mental illness rather than framing mental illness as a societal issue” (Saleh, 2020) where systematic, economic, and socio-cultural factors–including widespread poverty–contribute to restrictions in accessing support (Tanaka, C. et al, 2018). 

People with mental health problems (PMHP) and other vulnerable communities, including women, children, and those who live beneath the poverty line’s experience of stigma may vary in terms of frequency and kind and may compound depending on individual situation. Participants of the 2018 study shared experiences that were the result of stigma, including: psychological abuse, physical restraint, being taken advantage of, and neglect (Tanaka, C. et al, 2018). A reading of negative media representation along class lines likewise reveals how these representations work to further alienate those who live in precarious situations: “if people in power understand mental illness to be an illness that strikes only disenfranchised peoples, it will continue to be viewed as something that affects only a small minority of other people, and that therefore is not noteworthy enough to warrant appropriate levels of funding for research, treatment facilities, and community resources” (Edney, 2004, p. 6; Edney, 2004, p. 8). 

‘Deliberately sketchy & generic descriptions’

According to Dara Roth Edney’s Mass Media and Mental Illness: A Literature Review (2004), false images perpetrated by media organizations wield have undue influence, not only on public opinion, but on government response, and the systems built to offer support and protection that respond to the false information and misconceptions surrounding PMHP, instead of their true needs and issues (Cutcliffe & Hannigan, 2001; Rose, 1998 as quoted in Edney, 2004, p. 1).   

One of the foremost issues surrounding media representation is linked to the way media had been built. According to Stuart, media narratives are written to “require the reader to employ negative cultural stereotypes and common sense understandings of what it means to be mentally ill, to interpret story material and co-create the message” (Stuart, 2006, p. 101). The “Tililing” poster released by Darryl Yap works similarly: as a singular image, it draws on “deliberately sketchy or generic depictions” (Stuart, 2006, p. 101) and encourages viewers to read the image according to prevalent stereotypes.  

Another aspect of misleading representation concerns health workers–psychiatrists, psychologists–and even mental health treatments, which are likewise negatively portrayed (Edney, 2004, p. 5), further entrenching misconceptions surrounding mental health as a whole. The most insidious effect of these representations is their effectiveness in infiltrating the attitudes of even trained practitioners. Edney (2004) emphasized that even leading healthcare practitioners may also treat PMHP according to their established negative attitudes (p. 8).  

The cult of beautiful sadness

In 2013, The Atlantic published Anne-Sophie Bine’s Social Media is Redefining Depression, a piece investigating select social media platforms like Tumblr where teenagers engage in sharing content that glamorizes mental health illnesses, including depression, eating disorders, and OCD. According to Bine, content on Tumblr is easy to produce: “anyone can take a picture, turn it black and white, pair it with a quote about misunderstood turmoil, and automatically be gratified with compassion and pity” (2013).  

Bine’s article described communities acting as echo chambers, where adolescents earn support by mirroring content and assimilating similar, self-destructive behaviors: “communities are set up all around affinities, designed around developing homogenous social groups” (2013). Here, adolescents may acquire a warped world view, where like-minded peers can offer understanding and acceptance (Bine, 2013). The lure of these online groups for adolescents is in their sense of community and shared spirit, which are also what these teenagers stand to lose should they choose to exit their communities. Bine described the “Silver Bubble Problem” which “makes it difficult for those inside the community to see the outside world in the first place” (2013) which means that these echo chambers insulate their members from thinking and acting differently. 

Similar behavior–termed “Tribal Marketing”– is an effective technique used to initiate conversations among users who display similar values, and interests, to promote products or services (Jadayel R.E, Medlej, & Jadayel, J.J., 2018, p. 467). As in Bine’s older study, Mental Disorders: A Glamorous Attraction on Social Media (2018) describes how disinformation and misconceptions have been weaponized: “nowadays, anorexia nervosa, self-harm, depression, anxiety disorders, and many other mental health disorders are being glamorized, romanticized, and consequently promoted” (Jadayel R.E. et al, 2018, p. 468).

“A Filipino term for someone who is not sane”

Faced with the backlash, “Tililing” director Yap’s response further endorses the film, claiming that “watching the movie would give answers to the choice of movie title and poster” (Mercado, 2021) adding that the director is himself a mental health advocate. In another article, Yap claimed that “the script, the whole story was written a decade ago, and it is with pride and bravery to claim that — you haven’t seen anything like this before” (Baron, 2021). But given the media landscape that is the inheritance of a progressively more image-driven environment, PMHP and their own experiences and stories are still “rarely included as sources for news items” (Stuart, 2006, p. 101) and mental health professionals have avoided media contact (Stuart, 2006, p. 102). 

In Yap’s 2019 interview about “Tililing”, the director defended his choice for a title: “it’s a Filipino term for someone who is not sane. And ako when I write gusto ko yung madaling ma-digest ng tao” (Rappler, 2019). 

Although Yap declared that “members of the cast dealt with their own struggles that reinforced their mental health, which is why they would not accept the project if it contradicted their beliefs and personalities”, this lands as brutally short-sighted, misguided, and misinformed. The 2019 interview actor Baron Geisler attempted a summary of the plot: “you’ll see how papaano yung condition or paano ipakikita ang mga nurses sa lente nila or paano ikukuwento yung buhay namin” (Rappler, 2019), which may or may not play into yet more erroneous and dangerous misconceptions about nurses who work closely with PMHP.  

Propagating negative media images continue to dehumanize the people who must live with mental illnesses everyday, distress their family members, and further cement damaging public opinions. 

Join us on #UsapTayo this Wednesday, March 10, as we talk about media portrayal of mental health. Let’s continue to promote mental health awareness, champions!

Questions

  1. How can films become more inclusive of mental health problems?
  2. What can be considered as a piece of art that promotes accurate representations of mental health? How do we properly portray mental health disorders in media? 
  3. How do we, as members of the public, hold media organizations and content creators accountable?

Works Cited

Mercado, N.A. (2021). “‘Stereotypical, discriminating’: CHR slams ‘Tililing’ movie poster”, Inquirer, 14 February. Available at: https://newsinfo.inquirer.net/1395658/stereotypical-discriminating-chr-slams-tililing-movie-poster (Accessed: 03 March 2021).  

Commission on Human Rights of the Philippines [CHR] (2021) 13 February. Available at: https://www.facebook.com/chrgovph/posts/3547026868747166 (Accessed: 03 March 2021). 

Baron, G. (2021). “Mental health orgs react to ‘Tililing’ poster”, Manila Bulletin, 11 February. Available at: https://mb.com.ph/2021/02/11/mental-health-orgs-react-to-tililing-poster/ (Accessed: 03 March 2021). 

Manila Times (2021). “Darryl Yap returns to directing with ‘Tililing’”, 3 March. Available at: https://www.manilatimes.net/2021/03/03/lifestyle-entertainment/show-times/darryl-yap-returns-to-directing-with-tililing/846745/ (Accessed: 03 March 2021).

San Juan, R. (2021). “Darryl Yap defends ‘Tililing’ after psychology major Liza Soberano criticizes movie poster”, Philippine Star, 8 February. Available at: https://www.philstar.com/entertainment/2021/02/08/2076232/darryl-yap-defends-tililing-after-psychology-major-liza-soberano-criticizes-movie-poster (Accessed: 03 March 2021). 

Rappler (2019). “Darryl Yap’s ‘Tililing’ won’t be restricted to just one genre”, 6 November. Available at: https://www.rappler.com/entertainment/movies/darryl-yap-says-tililing-movie-does-not-have-specific-genre (Accessed: 03 March 2021). 

Stuart, Heather. (2006). Media Portrayal of Mental Illness and Its Treatments: What Effect Does It Have on People with Mental Illness?. CNS drugs. 20. 99-106. 10.2165/00023210-200620020-00002. 

Edney, D.R. (2004). “Mass Media and Mental Illness: A literature review.”, pp. 1-27. Available at:  https://ontario.cmha.ca/wp-content/files/2012/07/mass_media.pdf.

Tanaka, C., Tuliao, M., Tanaka, E., Yamashita, T., & Matsuo, H. (2018). A qualitative study on the stigma experienced by people with mental health problems and epilepsy in the Philippines. BMC psychiatry, 18(1), 325. https://doi.org/10.1186/s12888-018-1902-9

El Habbal Jadayel, Rola & Medlej, Karim & Jadayel, Jinan. (2018). MENTAL DISORDERS: A GLAMOROUS ATTRACTION ON SOCIAL MEDIA?. International Journal of Teaching & Education. 7. 465-476. 

Bine, A-S. (2013). “Social media is Redefining Depression”, The Atlantic, 28 October. Available at: https://www.theatlantic.com/health/archive/2013/10/social-media-is-redefining-depression/280818/ (Accessed: 03 March 2021). 

Saleh, N. (2020). “How the Stigma of Mental Health is Spread by Mass Media”, Very Well Mind, 02 June. Available at: https://www.verywellmind.com/mental-health-stigmas-in-mass-media-4153888 (Accessed: 03 March 2021). 

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