Four Things the Media Got Wrong About Mental Illness This Year

Mentally ill person asking for help.

Mental illness was in the news more this year than in recent memory. Until 2020, many people were unaware that calling for help in a mental health crisis summons a police officer instead of an ambulance. After the shooting of Daniel Prude, similar stories emerged, putting mental illness and crisis response in the national spotlight.

News stories also focused on the devastating toll of the coronavirus on our mental health–the so-called “fourth wave” of the pandemic. The public learned that the mental health system is ill-equipped to meet the needs of those feeling the effects of social isolation, economic uncertainty, fear of the virus and loss of loved ones. 

Both of these narratives offered an opportunity to delve into the inadequacies of our broken mental health care system and educate the public about the need for reform. Instead, news stories focused little attention on how the system has failed to help the most severely ill for decades.   

Most of the reports this year served only to perpetuate misunderstandings about mental illness. As a result, we are left with short-sighted solutions that fail to address the underlying problems in treating the mentally ill.  

Here are four things the media got wrong about mental illness this year.

Conflating Mental Health With Mental Illness

This year, news stories focused more on those with mental health concerns brought about by the pandemic than those with serious mental illness. I don’t mean to minimize the effects of the coronavirus–many people are hurting, and the pandemic may indeed lead to more depression, anxiety and substance use disorders. However, no one is talking about helping the most severely mentally ill who have long been suffering. 

The Pandemic Relief Bill will offer increased access to counseling to help those with mental health needs. But it will not bring more hospital beds nor eliminate discriminatory laws that prevent access to treatment for people with mental illness. The needs of the most severely ill continue to be ignored.

Part of the problem is that the public conflates mental health with mental illness. The media and even some mental health organizations perpetuate this misunderstanding. On one side are the worried well–those with anxiety and low-grade depression–and on the other are people with severe, disabling brain illnesses. 

People with mental health issues are able to care for themselves and meet their basic needs. On the other end of the spectrum, people with severe mental illness–schizophrenia and other psychotic disorders–suffer chronic, unrelenting symptoms that cause devastation to the lives of the sufferer and those around them. Their rational minds are subsumed by delusions and disorganized thoughts.

People with mental health issues can be helped through counseling and self-care. People with severe mental illness need a full continuum of services–from long-term inpatient care to step-down units, intensive outpatient services, community programs, housing and supportive services. This continuum of services does not currently exist, but the media did not cover this angle.

Attributing Police Shootings of the Mentally Ill to Race

A spate of coverage in police shootings this year highlighted the mistreatment of people suffering mental health crises. For the most part, the news media framed this mistreatment as a race issue. However, discrimination against the mentally ill crosses all races. 

Statistics show that people with mental illness who died by police gunfire since 2015 were mostly white, accounting for 58 percent of deaths, with Blacks at 16 percent and Latinos at 13 percent. While racism may play a role in some cases, the common factor in all of these deaths is the presence of untreated or inadequately treated severe mental illness. 

These individuals were in crisis because of the failure of our mental illness treatment system. When police arrive on the scene, they naturally expect the individual to comply. But if you are experiencing psychosis, your illness may prevent you from obeying commands. 

You are not likely to comply if you are suffering from delusions–for example, if you know with every fiber of your being that you are the only one who can save the universe. These delusions are a symptom of brain illness. For the mentally ill, their delusions are every bit as real as the air we breathe. No calming voice, no attempt at reasoning can convince them otherwise.

People with mental illness who encounter police are indeed the victims of discrimination. But their disability is the root of this discrimination, not race.

Trying to Fix the Mental Health System by Improving Crisis Response

Crisis response received national attention this year. Proposed solutions to police shootings of the mentally ill centered on increased training for police and adding social workers to crisis response teams. While a non-law enforcement response is certainly ideal, better crisis response will not solve the problem. Instead, we need to address the root causes of a person devolving into crisis in the first place.

We need a more effective, compassionate system of care for people with brain illnesses. Right now, we have a shortage of inpatient beds, psychiatrists, housing and community services. But beyond that, we have systemic discrimination against people with these disabilities. 

We discriminate against the mentally ill by denying treatment until it is too late. To have a person hospitalized, in many states, they are required to meet a standard of dangerousness. By denying them treatment, we are forcing people to deteriorate while their illness goes untreated. As Rep. Tim Murphy says in this wonderfully informative Zoomcast by Healing Minds NOLA, you wouldn’t say to a person with heart disease: we can’t treat you now–come back when your heart stops pumping. 

Framing Treatment of Mental Illness As a Choice

Mental illnesses are disorders of the brain–the organ responsible for decision-making, reasoning, daily functioning– everything. Psychosis causes disordered thinking and delusions because it is a brain disease. Yet for some reason the public cannot grasp this concept.

We have no problem understanding that if someone has a broken leg, they will not be able to walk. If someone has a lung disease, it is no surprise that they get short of breath. Yet if someone has untreated schizophrenia–more accurately, an illness that affects the organ that allows us to think–we expect them to be able to think clearly and make rational decisions.

In a recent interview with Terri Cheney, author of the bipolar memoir “Manic,” the interviewer starts a question with, “Some people have someone they love who refuses treatment for their mental illness,” and goes on to ask how to help someone in denial.  

But denial is not the problem. Blaming someone with a brain illness for refusing treatment shows a complete lack of understanding of the illness. The inability of a person to perceive their own illness is a common symptom of severe mental illness.

When my brother began his descent into psychosis, he truly had no idea he was ill. He believed at various times that he was a famous basketball player, a doctor and a gifted musician. No amount of reasoning could have convinced him that these were delusions. His reality was as real as yours and mine. That is why he refused my family’s pleas to see a psychiatrist. It was never a question of denial.  

Lack of insight, known clinically as anosognosia, is a symptom not only of untreated schizophrenia and bipolar disorder, but also brain injury and stroke. Like a person who suffers a stroke and believes they are fine, so too, a person with psychosis believes they are sane. We do not let a person who suffers a brain injury or stroke refuse treatment. It should be the same for mental illness. Allowing them to refuse treatment is immoral. 

Will 2021 Be Different?

As 2020 showed us, there is no telling what the coming year will bring. But I hope 2021 will finally be the year that legislators, the media and the public finally begin to focus on meaningful change for people with mental illness. If not, we will continue to see police shootings, criminalization of the mentally ill, homelessness, and suffering.   

20 thoughts on “Four Things the Media Got Wrong About Mental Illness This Year”

  1. I’m so happy to come across your articles! We need your work to inform the creation of mental illness policies.

    I’m hoping that you will also examine the negative impact of the disability rights movement. Because the psychiatric survivor movement usurped the right to speak for all people with ‘mental health issues,’ the wrong policies have become even more entrenched. We need decision makers to understand that these groups do not represent the best interests of our community of people dealing with severe mental illnesses.

    I discuss some of the problems with disability rights leadership in this article; when I wrote it, the Democratic platform mirrored the platform of Bernie Sanders – it supported denying access to involuntary treatment. Fortunately, after Kamala Harris was selected, the problematic statements disappeared:

    1. I completely agree with you that the disability rights movement has been catastrophic for people with serious mental illness, and I plan to write about this in the future. Allowing people to deteriorate in the name of protecting their civil rights is cruel and immoral. I read your article and it is spot on. I look forward to reading more of your work.

  2. Excellent article. Very clear and well written with just enough of your story about your brother to get a reader’s attention and keep it. I’ve been waiting until after Christmas and New Year’s to try to get in touch with you. I’d like to know more about what you and what you are doing and the outcome of the call that I was supposed to be on with you.

  3. Perfectly said, so perfectly mapped out.
    We must stop trying to improve the jail and give law enforcement classes some are not really interested in.
    We need to build communities who want to be a part of helping , making a place where our SMI loved one’s would begin to trust and reach out for some help before they go into deep psychosis. Train willing Officers, Social Workers ,Case Managers and others to be available 24/7 for the needs to be met.
    Just a taste of some ideas.

  4. Excellent, comprehensive essay, Kristina. The reason people cannot grasp that these are diseases of the brain is in large part because of how they have been presented, inaccurately, over the decades as “behavioral” problems. Our laws governing treatment protocols are based on outdated concepts, not current scientific knowledge, and are relegated to lawyers, judges, law enforcement, legislators—not to doctors and the medical community like all other illnesses. Until we change this paradigm we will not see the change we know is needed in the perception and treatment of people with these serious brain diseases.

  5. Well said, Kristina! Thank you calling out the discrimination against people with serious psychiatric brain illnesses.

      1. I will follow you… Your words are expertly crafted and get at intimate spots of need. How do we turn the freighter in the right direction when it’s path is deeply groved? Fear and exhaustion are barriers with discrimination perpetuated. Your voice is making a difference. Thank you.

        1. Thank you for your comment. Your analogy is apt – it does feel like trying to turn a freighter going down a grooved path. Sometimes trying to speak out and make a difference feels futile (and exhausting), but your words have given me encouragement. Thank you.

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