“From what I’ve seen”: Attitudes regarding mental health service access and the influence of popular media depictions

Abstract

Mental health and mental illness is a complex issue that has been depicted in all forms of media, including popular fictional media such as film and television. Alongside depictions of mental health issues there are commonly depictions of mental health services. While there has been extensive research on the stigmatizing effects of negative representations of mental illness, there has been much less exploration of the impact of media depictions of mental health services on viewers. Even rarer is the exploration of the ways in which depictions of mental health services may influence viewer’s attitudes towards and willingness to use mental health services. The aims of this research project were to gain understanding of the attitudes people hold regarding access to mental health services, primarily therapeutic relationships, and to understand the influence popular media depictions of such mental health services may have on those attitudes. Semi-structured interviews were carried out with seven women who were attending or had recently attended university. The interviews were designed to ask participants about their attitudes towards therapeutic relationships as well as towards mental health services in general. Participants were also asked to identify and discuss examples of popular media texts that depicted mental health services. Verbatim transcripts of the interviews were then analysed using Interpretative Phenomenological Analysis (IPA). IPA produced four master themes related to what participants knew and understood about accessing mental health services and the factors that influenced their willingness to access mental health services. These were: the importance of experience, barriers to access, elements of therapeutic relationships, and realistic media portrayals. A description of these master themes and the related subordinate themes is presented. IPA revealed that the most significant factor to participants’ attitudes to mental health services was shown to be their personal experiences and the experiences of those they knew. Structural barriers such as cost and availability were also important factors in participants’ willingness to access mental health services. Following these factors, media depictions had an impact on participants’ attitudes towards mental health services by perpetuating negative stereotypes about mental health services, or mental health service users. In the cases of participants with little or no personal experience with mental health services, media depictions were reported as having a greater impact on the understanding of mental health services. The media that participants engaged with, including fictional, non-fictional, and online media, were shown to help shape the expectations participants had of mental health services. Comparison of the themes produced from the IPA to the themes identified in the media review showed that certain themes were significant in influencing participants’ attitudes towards mental health services and in the media with which they engaged. Themes such as boundaries and willingness to participate overlap directly and shared similar terminology. Other themes contain shared ideas, such as power dynamics identified by participants, and issues of forced participation, honesty, and friendship identified from the media texts. The findings from this research project provide insight into how individuals understand mental health services and the factors that affect those attitudes. It will also show the potential effect media depictions can have on those attitudes. These findings are important in a culture where media content, both fiction and non-fiction, has a growing role in our lives every day. Understanding the key issues that affect access to mental health services, and how media depictions of mental health services may contribute to peoples’ willingness to access mental health services can contribute to the growing field of knowledge regarding access of mental health services. Over time, a greater understanding of these issues could ultimately contribute to policy changes that have potential to improve overall access to and utilisation of mental health services.