lexicon international media guide for mental health_final_lexicon
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International Media Guide for Mental Health
LEXICON
www.forum4mentalhealth.com/lexicon
This project was supported by an educational grant rom AstraZeneca
We all contribute to the stigmatisation of people who, if they had aphysical problem, would receive our sympathy and support. Yet, withmental illness we so often turn away and hope someone else will cope.
Living with mental illness is tough enough, without having added to theburden of illness, the pain of rejection and stigma.
John Bowis MEPEuropean Parliament
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Contents
Foreword 3
IntroduCtIon 4
theLexICon 6
overvIewoFmentaLILLness 8
LexIConoFmentaLILLness 9
howtoIntegratetheLexIConIntoworkIngpraCtICe 11
ContaCts 12
resourCematerIaLs 14
reFerenCes 15
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Foreword
Firstly, because seven advocacy groups one global, two
European and our national agreed to collaborate on its
production and each will probably use it in their uture
work. Collaboration between advocacy groups is rare, at
times only declarative, despite the act that their goals are
oten similar and that in many situations joint eorts would
be much more likely to produce results. It is to be hoped
that the joint eort o producing and using the Lexicon
will be a stimulus or urther collaboration between the
organisations on new projects likely to be immediately
useul, as the Lexicon undoubtedly will be.
The second reason is that the Lexicon is produced with
the active involvement o communication proessionals
and o the general public. Nongovernmental and
intergovernmental organisations rarely rely on top-
level proessionals in the media or the presentation and
distribution o their ideas; as a consequence many o
their excellent achievements vanish without making the
impact that their quality or importance deserve. It is to be
hoped that the participation o the writers o the text and
o the advisors to this project in the work o advocacy
organisations will continue and be expanded. This
should help to beat the inertia, lack o interest and rank
opposition o many o those who should be interested in
promoting mental health and improving care or people
with mental illness, but who do little to help either pursuit.
The nal reason to welcome the Lexicon is that it has
been long awaited by many o those who wanted to dosomething specic to beat the stigma o mental illness, or
prevent its growth and devastating consequences. The
Lexicon by its structure and content is likely to be both
useul or that purpose, and used by many people. I hope
that it will be translated into many languages with the
help o people who have mental illness and their amilies,
because both are extremely well placed to identiy words
that hurt and destroy, which could be replaced by words
that tell the truth and help.
I also hope that the publication o the Lexicon is the rst
step to its continuing growth and to its use in dierent
languages and in dierent parts o the world. This will
be the best reward or those who produced it. More
importantly, however, its use might make the lie o people
with mental illness and their amilies improve in quality,
and might help them deal with mental illness reed rom
the terrible burden o stigma that mental illness and its
consequences can create or all those involved.
Professor Norman Sartorius, MD, PhDPresident of the Association for the Improvement of MentalHealth ProgrammesPast Director of the Mental Health Programme of the WorldHealth Organization and past President of the WorldPsychiatric and the European Psychiatric Organization
There are at least three reasons to be delighted by the publication o this Lexicon.
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Mental illness doesnt always elicit sympathy/concern;
it may be hard to see, so its oten hard to understand.
However, one in our people experience a period o
mental illness at some stage in their lives,1 and by 2020
depression alone will be the second largest cause o
disability in the world ater heart disease.2
Most mental illness can be successully treated. Those
aected can and do recover, going on to lead productive,ullling lives. However, ewer than 20% o people with
mental health problems manage to work because they
are so stigmatised. Stigma is a key part o many o the
diculties aced by people with mental illness, preventing
many rom living rewarding, productive lives. In addition,
it hinders people rom seeking help, reduces access to
treatment, and leads to discrimination. More than 80% o
people with mental health problems identiy stigma as one
o the main barriers to recovery.
A common public misconception is that many people
with mental illness are somehow dangerous or capable
o violence. In act, only about 50 o the 600 murders
committed annually in Britain, or example, are carried
out by people with a mental illness, and o those, only ve
involve attacks on strangers.
The rising economic cost o mental illness to the European
economy is currently estimated at Euros 436 billion, morethan twice the GDP o Austria. Absenteeism associated
with depression and anxiety alone, eats up Euros 77 billion
o this total.
It is vital not just or the well-being o individuals but
also or national economies that members o the
media do not contribute to this stigma by perpetuating
negative stereotypes o people with mental illness as
being aggressive and dangerous, or weak-willed and
unreasonable. Instead, the media have a signicant role
to play in providing accurate and air representations o
mental illness.
Advocacy groups working with people with mental illness
have long been concerned about these issues and have
produced media guidelines with the help o journalists.
This international Lexicon is a collaboration between
leading national and international advocacy groups,people with personal experience o mental illness,
mental health experts and senior journalists, to collate
inormation into a centralised and multilingual ormat.
Building on previous work, the hope is to oer a resource
to support accurate and air coverage o mental illness by
the media.
IntroduCtIon
This international Lexicon is intended to be a major step in the global eort to transorm perceptions o mental illness by promoting
responsible and accurate coverage by the media.
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Personal details
David Wetherill aged 41 years Diagnosed with schizophrenia at 22 years o age Previously received hospital treatment three times,
most recently 18 months ago ater an attempted suicide
No previous history o violence Treated in the community with occasional visits to the
hospital outpatient unit
Treated with antipsychotic medicationIncident details
David had misplaced his medication some time in theprevious week
Unable to get an appointment or a repeat prescription Attended a psychiatric unit on the morning o the
incident but was turned away as not seen as a threat
to himsel or the public
Experienced a paranoid delusion on busyshopping street
Apprehended by police in changing rooms o apopular clothing shop
Shoppers were let shocked and upset as schizo David
Wetherill, 41, went mental during one o the busiest shoppingdays o the year. Wetherill, known to health services or
20 years with a history o aggressive behaviour, yesterday
charged through crowds o terrifed onlookers, knocking some
into the busy road. During the rampage, Wetherill threatened
several small children who he believed were telling him to
push people in ront o buses. It is thought that the madman
had ailed to take his medication and earlier that morning
reused help at a psychiatric clinic. Wetherill later stormed
into a popular clothing shop, locking himsel in the womens
changing room where he was apprehended by police,
preventing urther threat to the public.
Nutter goes berserkoN citys favouriteshoppiNg street.
Major questions need to be answered ater a man with a history
o mental illness was reused medication yesterday. DavidWetherill was diagnosed with schizophrenia aged 22 and has
been receiving antipsychotic treatment since then. Now 41,
Wetherill recently lost his prescription, and realising that his
health was suering sought help at both his general practitioners
surgery and at a local mental health clinic. However, he was
deemed not to be a risk to himsel or the public and was sent
away. Ater the visit to the clinic, Wetherill suered a paranoid
delusion on a busy city centre street, a place that he generally
tries to avoid. In his haste to fnd a sae place, Wetherill knocked
several people into the road beore seeking sanctuary in the
changing rooms o a clothing shop. Although no one was hurt
in the incident, police were called and attended the scene.Wetherill then let quietly with police and social workers and is
now receiving treatment or his condition.
QuestioNs askedafter meNtally illmaN is refused help.
CasestudY
Media reporting o issues surrounding mental illness is highly variable. Below are two contrasting examples o how the same story could be covered. First, the acts o the story:
Example1: Example 2:
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theLexICon
ai
Mental health problems are complex issues that can oten be dicult to report accurately, and mental health advocacy groups around
the world have reported concerns with the way some members o the media report stories involving mental illness. Many articles and
headlines reinorce inaccuracies and prejudice towards people with mental illness in ways that are unacceptable in public discussions
o people with disabilities, or other previously stigmatised groups.
The aim o the Lexicon is to be a useul and helpul resource or journalists. It is an attempt to highlight some o the inaccurate and oensive slang terms oten seen in the media, to
provide practical denitions, and to encourage the media to report on mental illness accurately and in context.
The intention of this new Lexicon is that it will lead to:
aCCuraCY cibiccilciiiiillilill;
reCognItIon cllill;
understandIng lilliiclcii,,lillcbiy,icl
cyliiy;
BaLanCe icliciiilliiilill;
Context ciiiiiillillic,blblicbiilc;
approprIateness lyilciiylybliy,ilblclbccly
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theLexICon
wylyc?3
Il. One in our people will experience a mental health problem Iicl.Mental health is now an important priority on the agendas o policy-makers, healthcare providers, and responsible businesses tyic. Many people with personal experience o mental health problems have valuable contributions to make
The Lexicon will be translated and distributed across the world. It is designed to be incorporated into media style guides in the hope that it will help to end the use o language that
reinorces public prejudice, promotes inaccurate inormation, and in many cases contributes to private pain.
SiegemaniacdeStroySbuilding.
Using language like this helps perpetuate the myth that all
people living with mental illness are violent.
psychogirlfrieNdfromhell.
Calling someone a psycho creates ear and adds to the
misconception that people with mental health issues are
dangerous and unpredictable.
dadappeals
toluNaticsoN.
This headline is insulting to both the ather and the son and
has ailed to describe the sons condition in a medically
accurate way.
depreSSedpeopleShouldgetoverit.
This statement is inaccurate rom a medical perspective
and illustrates a lack o understanding o the seriousness
o depression.
schizophre
Nic
iNvolvediNcrash.
It is degrading or an individual to be described as
their illness. It is more accurate to say man/woman with
schizophrenia.
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overvIewoFmentaLILLness
BIpoLardIsorder(formerly known as manic depression)
Someone diagnosed with bipolar disorder may swing rom moods
o deep depression to periods o overactive, excited behaviour
known as mania. Between these highs and lows, patients oten
remain stable. Most people will experience a number o
episodes, with each lasting three to six months, although some will
experience only a single mood episode. Some people also see
or hear things that others around them do not (known as having
visual or auditory hallucinations or delusions).
Prevalence: 0.61.2%1
depressIon (unipolar disorder)
Depression is a common mental disorder that causes people
to experience depressed mood, loss o interest or pleasure,
eelings o guilt or low sel-worth, disturbed sleep or appetite,
low energy, and poor concentration. I depression becomes
chronic or recurrent, it can cause considerable impairments in
the ability to take care o daily responsibilities.
Depression occurs in persons o both genders, and all ages
and backgrounds. It aects approximately 121 million peopleworldwide and is a leading cause o disability. Depression can
be reliably diagnosed and treated in primary care. Although
depression can be successully treated, ewer than 25% o
aected individuals have access to eective treatment.
Prevalence: 7.49.2%1
eatIngdIsorders(i/blii/bii)5
The term eating disorder is applied to a wide range o
disturbed eating behaviours. However, ocial classications o
eating disorders include three conditions: Anorexia Nervosa,
Bulimia Nervosa and Binge Eating Disorder.
Eating disorders are complex conditions that can be lie-
threatening. Aected individuals can recover i they receive
appropriate treatment. Eating disorders can aect anyone
and it is thought that both environmental and genetic actors
contribute to their development.
Prevalence: 0.20.6%1
personaLItYdIsorder6
A group o conditions characterised by an inability to get on
with other people and learn rom experience. People with a
personality disorder may nd that their belies and attitudes are
dierent rom those o most other people. Others may nd their
behaviour unusual, unexpected or perhaps oensive.
Personality disorders usually become apparent in adolescence
or early adulthood, although they can start in childhood. Peoplewith a personality disorder may nd it dicult to start or maintain
relationships, or to work eectively with others. As a result, many
may eel alienated and alone. The risk o suicide in someone with
a personality disorder is about three times higher than average.
Prevalence: Up to 13% o the population are aected7
sChIzophrenIa8
Schizophrenia is a serious mental illness characterised by
disturbances in a persons thoughts, perceptions, emotions
and behaviour. It usually becomes apparent in adolescence
or early adulthood, but can also occur later in lie. Symptoms
are typically divided into two groups, active symptoms (also
reerred to as positive or psychotic symptoms) that refect
new or unusual orms o thought and behaviour, and passive
symptoms (also reerred to as negative symptoms), which
refect a loss o previous eelings and abilities.
Prevalence: Approximately 1% o the population is aected9
sChIzoaFFeCtIvedIsorder
A condition eaturing symptoms o mood disorders such as
depression or bipolar illness, and also o schizophrenia.
Prevalence: Approximately 0.3% o the population is aected10
dii,ciic
The Lexicon ocuses on the ollowing key disorders, and the behaviour associated with them:
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10
LexIConoFmentaLILLness
sometermstousethatdonotenCouragestIgmatIsatIon: Mental ill health Mental health problems Person living with a mental health condition
nutter slblcicccliicliii,iiblb
psYChopathIC aicilliyi;iiblciilbiillybli.sllybi
bliclii
psYCho mili..yc/ycic.Iicciiilc,ilbcy
bccll.Ii,cciiclbllb.
alily,iycicbi
psYChotIC scicllyibiliyiiiliyy.Iiblillybiyci
bi
sChIzo Iiciilbill
sChIzophrenIC Iiciilbill
sICko alyil,bi
spLItpersonaLItY diciii.tilillicicii,biicii
suFFerer tbi.ui
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11
howtoIntegratetheLexIConIntoworkIngpraCtICe
The intention o the Lexicon is to encourage better coverage in newspapers and media read or seen by the general public by
stimulating journalists to ask themselves a ew more questions:
1. abiicc,illlccyc?
2. Illlbi?
3. Illily,iclibccllcil,iiillii
ilill,iiciliiilli?
4. hbjcilybcciciby?
5. Clcyliiiiilciilliic?
Editors and sub-editors could also consider the packaging o the story:
1. Ijci,ili,lilycic?
2. hybiclcciiy,ilcbyiilciicici
iicl?
3. Iilyillcii?
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1
ContaCts
The press oces listed here can provide advice on covering mental health issues, as well as access to inormation, research,comment and spokespeople.
accyiiiil
illblc
euFamI (European Federation o Associations o
Families o People with Mental Illness) is an organisation
registered in Belgium with an ongoing commitment to
improving care and welare or people aected by
mental illness. EUFAMI has a number o programmes
supporting people aected by severe mental illness andthe organisations representing them across Europe.
Tel: +32 16 74 50 40
www.euami.org
FCamh (Finnish Central Association or Mental Health)
Finnish Central Association or Mental Health consists
o some 150 local, regional and national mental health
associations rom all over the country. The members o
these associations are people with personal experience
rom mental problems and various mental illnesses. The
membership also includes patients relatives, psychiatricnursing sta and other volunteers willing to contribute to
mental health work.
Tel: +358 9 5657 730
www.mtkl.
FeaFes (La Conederacin Espaola de Agrupaciones
de Familiares y Personas con Enermedad Mental) is a
Spanish national membership organisation ounded in
1983 and led by amilies and people with mental illness.
Its mission is improving the quality o lie o people with
mental illness and their amilies, deending their rights and
representing the advocacy movement.
Tel: +34 91 507 9248
www.eaes.com
gamIan-e (Global Alliance o Mental
Illness Advocacy Networks) is an international, non-
prot, ederation comprising users and consumers,
amily members, careers, health care proessionals,
representatives o government bodies and agencies, and
other concerned parties who support or are interested in
issues aecting those who suer rom a mental illness.
Tel: +356 994 73489
www.gamian.eu
namI (National Alliance on Mental Illness) is the USAs
largest grassroots mental health organization dedicated
to improving the lives o individuals and amilies aected
by mental illness. It has an organization in every state and
in over 1100 local communities across the country who
work together to meet the NAMI mission through support,
advocacy, research and education.
Tel: +1 703 524 7600
www.nami.org
sciiIl is the national organisation
dedicated to upholding the rights and addressing the needs
o all those aected by enduring mental illness including,but not exclusively, schizophrenia, schizoaective disorder
and bipolar disorder, through the promotion and provision
o high-quality services and working to ensure the continual
enhancement o the quality o lie o the people it serves.
Tel: + 353 1 860 1620
www.sirl.ie
www.recover.ie
wFmh (World Federation or Mental Health) is an
international membership organization ounded in 1948 to
advance, among all peoples and nations, the preventiono mental and emotional disorders, the proper treatment
and care o those with such disorders, and the promotion
o mental health.
Tel: + 1703 313 8680
www.wmh.org
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1
ContaCts
uknIl
dhl Inormation about policy and
government initiatives.
www.dh.gov.uk/mentalhealth
hl(iql) is the principal organisation
in Wales, United Kingdom, working with individuals
recovering rom severe mental illness and their amilies.
Haal delivers a range o services to people with
severe mental health illness including direct support and
advice, support in a crisis, contact with others by phone,
advocacy, support in a group setting, introductions or
beriending, and employment and training projects.
Tel: +44 (0) 1792 816 600
www.haal.org
mdFtBiloii is a user led charity
with a network o sel help groups in England and Wales
or people with Bipolar Disorder (Manic Depression) and
their carers.
Tel: +44 (0) 8456 340540
www.md.org.uk
mlhlFi is a leading advocacy grouphelping people survive and recover rom mental health
problems.
Tel: +44 (0) 207 803 1130
www.mh.org.uk
mInd is the leading mental health charity in England
and Wales. It works to create a better lie or everyone
with experience o mental distress by: advancing the
views, needs and ambitions o people with mental health
problems, challenging discrimination and promoting
inclusion, infuencing policy through campaigning andeducation, inspiring the development o quality services
which refect expressed need and diversity, achieving
equal rights through campaigning and education.
Tel: +44 (0) 845 766 0163
www.mind.org.uk
rethInk provides expert advice and inormation on
issues that aect the lives o people coping with mental
illness.
Tel: + 44 (0) 845 456 0455
www.rethink.org
sane was established in 1986 to improve the qualityo lie or people aected by mental illness. It provides
support, inormation and advice or anyone aected by
mental health problems
Tel: + 44 (0) 845 767 8000
www.sane.org.uk
shIFt is a Department o Health unded campaign to
tackle the stigma and discrimination associated with
mental illness.
Tel: +44 (0) 20 73072447
www.shit.org.uk
sisB is a bank o people with mental
health problems who are willing to talk to the media
about their experiences.
Tel: + 44 (0) 1273 463 461
www.shit.org.uk/speakersbureau
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1
resourCematerIaLs
Canadian Mental Health Consumer/Survivors Lexicono Recovery
Commissioned by the National Network or Mental Health
http://www.likeminds.org.nz
EU High-Level Conerence on Mental Health
Brussels, 13 June 2008
http://ec.europa.eu/health/ph_determinants/lie_style/
mental/mental_health_en.htm
Guide or Journalists & Broadcasters Reporting on
SchizophreniaPrepared by Schizophrenia Ireland, Lucia Foundation
www.sirl.ie
Hacked O A Journalists Guide to Disability
Prepared by National Union o Journalists
http://www.nuj.org.uk/
Health and Community Care Research Programme Research ndings
The second national Scottish survey or public attitudes
to mental health, mental well-being and mental health
problems
Prepared by the Scottish Executive
www.seemescotland.org
Mind Out or Mental Health
An active campaign to stop the stigma and discrimination
surrounding mental health
Commissioned by the Department o Health in the UKwww.mindout.clarity.uk.net
NAMI Newsroom Resources or media proessionals
Prepared by the National Alliance or Mental Illness
(NAMI)
www.nami.org
Opening Minds Opening DoorsHow to make a dierence when reporting on Mental
Health Issues
Prepared by the World Federation or Mental Health
(WFMH)
www.wmh.org
SHIFT Report Whats the Story?
http://shit.org.uk/~mediahandbook.html
Patient Health International International website
or patients and carershttp://www.patienthealthinternational.com
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1
reFerenCes
1. Wittchen HU, Jacobi F. Size and burden o mentaldisorders in Europe - a critical review and appraisal
o 27 studies. Eur Neuropsychopharmacol
2005;15(4):35776.
2. World Health Organization. What is depression?
Available at: http://www.who.int/mental_health/
management/depression/denition/en
3. Mindout or mental health. Mindshit: a guide to open-
minded media coverage o mental health. Available at:
http://mindout.clarity.uk.net/p/mindshit.pd
4. Mind, Understanding bipolar disorder (manic
depression), 2006. Printed copies can be purchased
rom Mind Publications (email: [email protected].
uk, telephone 0844 448 4448) or you can read Minds
and purchase Minds inormation booklets online at:
http://www.mind.org.uk/Inormation/Booklets
5. Bodywhys - The Eating Disorders Association oIreland. About Eating Disorders. Available at:
http://www.bodywhys.ie/t.php?c=about_eating_
disorders/general.html
6. Mind, Understanding personality disorders, 2007.
See above or details about how to access Minds
inormation booklets
7. Winship G, Hardy S. Perspectives on the prevalence
and treatment o personality disorder. J Psychiatr Ment
Health Nurs 2007;14:14854
8. Schizophrenia Ireland. Available at: http://www.sirl.
ie/schizophrenia.php
9. Mueser KT, McGurk SR. Schizophrenia. Lancet
2004;363:206372
10. Perl J, et al. Lietime prevalence o psychotic andbipolar I disorders in a general population. Arch Gen
Psychiatry 2007;64:1928.
acl
Headline: The National Media Monitoring Programme
or Mental Health and Suicide (Ireland). Available at:
http://www.headline.ie
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This project was supported by an educational grant from AstraZeneca