An Open Letter to Highlight Crazy-shaming in Media

Going public about one’s mental illness is a double edged sword, as evidenced always. While it has helped millions of mentally ill people to look up to celebrities who are as human as they are, fighting the same demons every single day, it has also caused unfortunate consequences. People like Sinead O’Connor have recently been ridiculed or forced into silence.

Her fourth letter, which is an exceptionally poignant and sensitive document that highlights the importance of mental health awareness and it being a human rights issue, is sadly brushed aside by even a venerable newspaper like the Independent. And it misses the point. Even when October 10th was the World Mental Health Day. Before we judge Sinead O’Connor’s lengthy letters, one must really understand the context of her rage and begin to question why this situation could so easily have been avoided.

As she rightly questions in her 4th letter, what example is Miley Cyrus really setting to her young fans, who probably now think it is OK to ridicule a person who is vocal about his or her mental illness in school? What message does it send to people who dislike the way they look and are depressed about it? What message does it send to cutters who hide their scars behind full sleeved shirts? What message does it send to people who suffer from various mental health issues? That it is shameful to seek mental health treatment?

The international coverage makes no mention of the nonchalance of people when it comes to crazy-shaming. Just like slut-shaming, crazy shaming is real and far more dangerous. Crazy-shaming can cause deaths. People who are depressed and do not seek treatment are at an increased risk of committing suicide. And we have all read about people attempting/committing suicides because they were ridiculed. It is a tragedy that one cannot still talk about mental illness without losing one’s credibility or putting oneself in harm’s way.

All these letters and the much-written about feud are less about nudity and commercialization of music. They are more about shaming mentally ill people into silence or worse, being nonchalant to their suffering while engaging in bored ridiculing. Sinead O’Connor’s repeated requests for apology must be seen as a genuine concern for millions of mentally ill people who hide their issues and not seek treatment out of fear of being ridiculed.

And they are very smart and deserve to be listened to, hung out with and respected for the extraordinarily intelligent and useful contributors to society they can be.

What is ‘sane’ anyway? And are media ‘sane’? No. Very far from it

― Sinead O’Connor in a post on my Facebook Timeline on 11th October, 2013 when I told her about my plan to write this blog post. 

Media portrayals of mental illness is negative and offensive

A look at some of the published studies about media portrayals of mental illness reveals a very bleak picture. Stuart (2006) described the dominant media portrayals of mental illness and what the usual consequences are. Both the news media and entertainment provide distorted and overwhelmingly dramatic images of mental illness and those who suffer from mental illness. These images emphasize unpredictability, criminality and dangerousness.

The author notes that most people model negative reactions to mental illness and the mentally ill, and the reactions include ridicule, derision, fear and rejection. The researcher further notes that such negative and biased portrayals in the media and consequent negative reactions from people impair mentally ill people’s help-seeking behavior, medication adherence, self-esteem and overall recovery. The study further noted that most mental health advocates blame the media for stigmatizing and discriminating mentally ill people.

O’Connor’s help-seeking behavior was ridiculed, two years later

When Miley Cyrus retweeted 2-year old help-seeking tweets of Sinead O’Connor, stigmatization of the mentally ill reached an unprecedented level. In her tweets, Sinead O’Connor had asked her followers if they could direct her to a good psychiatrist near her, as she feared she was at risk of harm. Help-seeking behaviors such as these save lives and to ridicule such behavior is nothing but pushing a person into not seeking treatment. Sinead O‘Connor has noted several times that it is murder to do so.

(When I spoke about my plans to write this post, she made it clear that I must mention it is murder to ridicule and shame mentally ill people. I agree with her and I feel it is even worse when the rest of the people and media just ignore the hurt and harm caused to the mentally ill, as a result of that shaming and ridiculing. )

Disappointing portrayals of the mentally ill pervades television and newspaper

An Australian study (Henson, Chapman, McLeod, Johnson & Hickie, 2010) found that portrayal of youngsters with mental illnesses in Australian television news is mixed. 10 of the items studied (29%) were positive, 13 items were neutral (37%) and nine items were negative (26%), when it came to media portrayal of young people with mental illnesses. Though adults fared slightly better, the study suggested there was still room for improvements. Yet another study analyzed the content of 83 newspapers articles published between February 1992 to January 1993 and it found that the mentally ill were viewed as being unpredictable and violent, stereotypes that hold good even in 2013 (Williams and Taylor, 1995).

A British study (Dickens, 2008) found that portrayals of mental illness in English media can be grossly negative and stigmatizing. The study recommends nurses to be aware of the different ways the media frames mental illness and challenge inaccuracies each time they occur. Similarly Harris (2004) notes that despite organizations campaigning to reduce stigma against the mentally ill, there is still a long way to go.

Italian newspapers used a significantly higher number of stigmatizing words and language along with accompanying photos when describing acts of violence committed by the mentally ill. Carpiniello, Girau and Orru (2007) noted that the media reports acts of violence committed by the mentally ill as if they should be viewed in a totally different light, adding to the existing stereotypes.

Sufferers of schizophrenia fare the worst

Persons suffering from schizophrenia seem to suffer even more stigma and prejudice than other mental disorders such as depression, anxiety or bipolar disorder. Hocking (2003) notes that even healthcare workers stigmatize patients of schizophrenia, causing a real barrier to recovery. The same study encourages educational campaigns aimed at media personnel so that mental illnesses are demystified and media can become allies instead of unfortunately acting as an adversary. The study implies that media personnel need to be educated first so that they can stop and reduce offensive portrayals of people with schizophrenia.

Lack of respect for privacy, pejorative portrayals and teachers bullying students

A New Zealand study found that the issue of human rights of the mentally ill was fragmented in the source material and when utilized, it undermined the legitimacy of the patient’s right to privacy. The study noted that a positive discourse about mentally ill people’s human rights was not enough by itself. A lot more than that needs to be done (Nairn, Coverdale and Claasen, 2001).

103 newspaper reports from eight major Canadian newspapers selected randomly revealed that these newspapers essentially portrayed mental illness and the mentally ill in a pejorative manner in the popular print media (Day and Page, 1986). And it is not necessarily only the peers who bully the mentally ill youngsters, but also their teachers. A study (Monsvold, Bendixen, Hagen & Helvik, 2011) found that youngsters with personality disorders were more likely to be bullied by their teachers.

Psychoeducation and media lobbying to stop the bullying of the mentally ill

Stuart notes that mental health professionals, activists and advocacy groups should take to media lobbying and press liaison to speak out for the mentally ill, who may not be able to speak out for themselves. The researcher also notes that public education and awareness needs to be improved and media should be used to help the mentally ill and not to put them in harm’s way by perpetuating same old myths and stereotypes.

If Miley Cyrus had ridiculed any other minorities for seeking help, she would have been thrashed not only by mainstream media but also by their respective advocacy groups and she probably would have had to apologize or pay compensation. Unfortunately, the mentally ill do not have a voice, even in 2013.

Seeking mental health treatment must remain a top priority, and when a person like Sinead O’Connor can start or be a spokeswoman for mental health advocacy groups that fight against suicides and help increase awareness about what bullying does to both healthy and unhealthy people, a lot can come out of this.

On her Facebook account, Sinead O’Connor expressed her wish to consider this episode as an opportunity to increase awareness about the consequences of negatively stereotyping the mentally ill and how publicly shaming those who seek help can increase the risk of suicides. She noted that no other minority is allowed to be discussed in terms that would encourage them to kill themselves or crate a circumstance where it is more likely to happen. She noted that the mentally ill have very few people to voice their concerns.

Certainly, the mentally ill are the most marginalized group in the world today. Human rights lawyers and mental health advocates who want to work with her and make mental health rights a human rights issue may follow her on Twitter at @SineadIsClothed.


  1. Carpiniello, B., Girau, R., & Orrù, M.G. (2007). Mass-media, violence and mental illness. Evidence from some Italian newspapers. Epidemiologia e psichiatria sociale, 16(3), 251-255.
  2. Day, D.M., & Page, S. (1986). Portrayal of mental illness in Canadian newspapers. Canadian Journal of Psychiatry, 31(9), 813-817.
  3. Dickens, G. (2008). Portrayal of mental illness and special hospitals in the UK press. British Journal of Nursing, 17(16), 1058-1061.
  4. Harris, G. (2004). Media representation of people with mental health problems. Nursing Times, 100(34), 33-35.
  5. Henson, C., Chapman, S., McLeod, L., Johnson, N., & Hickie, I. (2010). Room for improvement: mixed portrayal of young people with mental illness on Australian television news. Australian & New Zealand Journal of Psychiatry, 44(3), 267-272.
  6. Hocking, B. (2003). Reducing mental illness stigma and discrimination – everybody’s business. Medical Journal of Australia, Suppl. 178, 47-48.
  7. Monsvold, T., Bendixen, M., Hagen, R., & Helvik, A.S. (2011). Exposure to teacher bullying in schools: a study of patients with personality disorders. Nordic Journal of Psychiatry, 65(5), 323-329. doi: 10.3109/08039488.2010.546881.
  8. Nairn, R., Coverdale, J., & Claasen, D. (2001). From source material to news story in New Zealand print media: a prospective study of the stigmatizing processes in depicting mental illness. Australian & New Zealand Journal of Psychiatry, 35(5), 654-659.
  9. Stuart, H. (2006). Media portrayal of mental illness and its treatments: what effect does it have on people with mental illness? CNS Drugs, 20(2), 99-106.
  10. Williams, M., & Taylor, J. (1995). Mental illness: media perpetuation of stigma. Contemporary Nurse, 4(1), 41-46.
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