Mental Health and Communication Difficulties.

Commical – Episode title: Mental Health and Communication Difficulties

Published 01/06/2021 on Chasing Albert website, spotify and apple podcasts.

Marie 00:00

You might have noticed a shift in the way the media reports on mental health, specifically a shift in the language used around suicide or the circumstances under which schizophrenia is discussed. It's not by accident. Dr Elizabeth Paton is Project Lead on Everymind's Mindframe program. Mindframe supports safe media reporting, portrayal and communication about suicide, mental ill health, and alcohol and other drugs. She joins me today to talk about how safe media reporting can reduce stigma around mental ill health and increase the likelihood of help-seeking for those experiencing it.

Marie 00:00

Oprah, Steve Jobs, Andrew Denton - to me, these guys are masters of communication. The rest of us, well, mainly you, because I'm a pro, fumble our way through. Commical examines this funny little thing called communication that can either tear us down or make us soar. Join me, an amateur comedian and a communication expert, as we listen, learn and laugh through the experiences of my very talented guests.

Marie 00:00

Hi Elizabeth, thank you for joining me.

Guest 00:00

Hi Marie, thanks for having me.

Marie 00:00

An absolute pleasure. Really excited to talk to you today about Mindframe and the great work you're doing. I wanted to start by kind of understanding how many people suffer from mental illness in Australia.

Guest 01:21

The research that we have at the moment is that approximately one in five Australians will experience a mental illness in any 12-month period. Across our lifetime, almost 45% of all Australians will experience mental illness of some kind. That's a lot of Australians. But I think what's important to remember is that we really don't know who those Australians are. It could be someone you know. It could be people in your family. So it's important to consider.

Marie 01:53

Do you think there are some people who themselves don't know that they're suffering from a mental illness?

Guest 01:59

Yeah, it's possible. Some people may have symptoms, but not necessarily of a great enough severity that they might meet the criteria of a diagnosable mental illness. But they may still have mental health problems that can affect their lives in some way.

Marie 02:14

And how would you say mental illness is currently portrayed in the media or in popular culture?

Guest 02:20

I think portrayals of mental health and mental ill health have been improving, particularly over the last 10 to 20 years. We've definitely seen more of an emphasis on wellbeing and taking care of your mental health. But unfortunately, we're still working to reduce stigma and stereotypes around mental illness, and also to increase positive representation, particularly for things like complex or severe mental illness. We recently released a new set of guidelines on media reporting of severe mental illness in the context of violence and crime because, unfortunately, there's still an imbalance in representation of mental illness, like schizophrenia for example, that doesn't really accurately match prevalence within communities.

Guest 02:20

What does that mean? It means that the only time we really see schizophrenia, for example, in the media is usually when there's a murder trial or violence and crime in the news. But we know there are many people living with schizophrenia who are not at all violent. If we only ever see those kinds of representations, that can have an impact on how the community feels about people living with a mental illness. They'll make assumptions that all people with that diagnosis are going to be violent, and that's really inaccurate and harmful for people in those communities.

Marie 03:46

So what would the ideal scenario look like then?

Guest 03:49

I think having better representation - not just focusing on negatives like crime or violence - but increasing ways of including people living with a mental illness in news reporting and in our television and film. People who live well with their illness, who may be receiving treatment and managing their symptoms. It shouldn't always be the extreme cases we see in our representation.

Marie 04:19

When a celebrity reveals that they have experienced a mental illness, or are living with - how would you phrase that?

Guest 04:26

So, living with a mental illness.

Marie 04:30

Yep. When they reveal that, it helps to destigmatise mental illness. However, does the rest of us need to share or disclose that we have a mental illness - say, to our employer?

Guest 04:41

Taking a step back, I think celebrities sharing their experiences can be positive and can open up space for people to talk about their own experiences. But it really depends on how it's reported in the media and how it's discussed on social media. If you think of recent examples where celebrities have talked about their own mental health or mental illness, how has that been treated? How was it reported on? Were they made fun of? Did they get accused of making it up for attention? That kind of media attention can increase stigma and make it more difficult for people to talk about it.

Guest 04:41

Talking about your own mental illness is a really personal decision - whether you want to share that and where you feel comfortable to do that. If we have these celebrity stories where people are not being believed or are being ridiculed, then that's obviously going to have an impact on people wanting to disclose their own information. It is a very personal decision, and I think each person needs to think through that for themselves: what the consequences might be, whether that's positive or negative.

Guest 04:41

It may be a really good opportunity to educate people or debunk some stereotypes or myths about what it's like to live with a mental illness. It may impact their work and family. We still have stigma about mental illness in our community. Will this disclosure open them up to potential stigma and have an impact on their life in some way? Could it have an impact in a positive way - for example, disclosing that you have a mental illness because you need extra support, or need to be cut some slack, or take some time off, or whatever it might be?

Marie 06:47

If someone was to do that, what kind of language would they be using?

Guest 06:52

Again, it's going to be really context dependent. We have speaker guides on our website for people who are going to be sharing their lived experience publicly, whether that's talking to the media about their experience or speaking to a community group, for instance. We've got some language guides there, making sure that the language they use about their own experience isn't going to create negative stigma for others who may have a similar diagnosis.

Guest 06:52

There are ways to do it safely and ways to talk about mental health that can help increase help-seeking when people need it, or increase awareness and affect community attitudes. Sometimes that's as simple as just changing your language. Stop using colloquialisms, for instance - things like 'a nutter' or 'a psycho'. Pulling that kind of really casual language out of our conversations can be helpful. Often that kind of language is inaccurate and out of context. But the impact of those things is that people living with a mental illness may feel like they won't be taken seriously. If people are throwing around language in a negative way or in a joking way, how will they be treated if they do disclose? So we recommend reducing that kind of really jokey, casual language where possible.

Marie 08:01

Speaking of jokey language, is there a role for comedy here? A role in perhaps advancing education on mental illness?

Guest 08:11

Well, I think there is and there isn't. Comedy is a really subjective area, and there's a lot of potential for stigma to be increased. A lot of comedy, for example, is around exaggeration and stereotypes, and when we're talking about mental illness that can be quite harmful, particularly for people living with a mental illness. But we also know that people use humour to get through difficult situations - that's how they cope - and comedians, I think, need to be mindful about translating that into their work.

Guest 08:11

If they want to share their own lived experience as material, that's entirely up to them. But how it's delivered will make a difference to whether it educates people and encourages help-seeking, or whether it creates more stigma and stops them from feeling like they could reach out for support.

Marie 09:05

Is achieving one of them okay? So, for example, if it were to inspire people to get help but also did play on stereotypes and took us back a step from a stigma point of view, would that be acceptable? Or are we aiming for both here?

Guest 09:20

Well, aiming for both ideally. But again, I'm not sure they balance each other out. We know in media portrayals, for instance, that most media about mental illness is negative, and it's really difficult to counterbalance that. You can't just put up one positive article and suddenly the stereotypes are gone. You're working against the weight of a big history of negative portrayals. So I think comedy needs to do similar work and think about whether it's just adding to that enormous weight of stigma and stereotypes, or whether it's actually moving us towards more positive representation or a space where people feel able to go and get support when they need it.

Marie 10:08

You've got your work cut out for you, don't you? The size of this is huge. How are you tackling this? For example, how are you educating the media? And how do you know if you're engaging enough people or making enough of a difference? Are you literally listening to media and analysing coverage? Is that the way it works?

Guest 10:27

The Mindframe program works in a couple of ways. Our primary target sector is the people who communicate publicly the most and with the most people, so that's the media. It's also other communicators, so it might be a public relations person or a comms person embedded in another organisation. We also work with stage and screen creators, so we work across both fictional and factual representations.

Guest 10:27

We do a lot of proactive work with them. We engage, we go out to them and offer training and support, and we do get journalists and other creators coming to us to help support their work. For instance, we might get a call saying, 'I'm doing this story on mental illness. Can you have a look and make sure this is okay?' So we do that before things go out.

Guest 10:27

We also work reactively as well. If there are stories that do go out live or to the public that have problematic content, we do get in touch and work with journalists or editors to potentially edit that work or remove content that's problematic, but also then to upskill them so that if they are doing more of these types of stories, they have the skills to be able to do it well.

Guest 10:27

We also work in pre-service training, so we get to journalists and PR students in universities before they even get into their newsrooms or businesses, which is really great because it builds those skills up early. Then we also work with anybody who might be a media source - people who are sharing this information with the media and supporting them through this process. That might be someone from the mental health sector, a community group, people with lived experience, governments - anybody who might be interacting with media in some way. We aim to get them across the guidelines so what they're sharing is safe, and they can also remind journalists to keep their reporting safe as well.

Guest 10:27

All of that adds up to reaching a lot of media and public communicators, and hopefully we are seeing continued improvements. Over the last 20 years you've probably seen some of those. You might have noticed that we're increasingly seeing things like help-seeking information attached to stories or content warnings.

Marie 12:58

How long did that take you? That's fantastic. You won't see many stories these days that don't have a trigger warning, or that reminder statement they put after most stories now with a link to or a phone number for Lifeline or Beyond Blue, or whatever it might be. Is that a result of the work of organisations like yours? And how long did that take? Because seemingly it happened overnight.

Guest 13:21

It's been part of what we've done. I think this shift towards including help-seeking has happened over the last 10 to 20 years, and that's matching a couple of things. We've started to get more research that says news stories can have an impact on people, and the content they're sharing can have an impact. So we've strengthened the evidence base behind what we do, but we've also seen social shifts as well - that there's more content about mental health and mental ill health in the media, and we're continuously improving that. Including help-seeking is one of the guidelines that we promote in Mindframe. But I think it's certainly been a group effort across the whole community to have that increase over the last decade or so.

Marie 14:11

What about the change in language around the reporting of suicide? It used to be 'committed suicide', and now the language you start to see more and more is 'died by suicide'. That to me seemed to happen overnight, like something I've just seen in the last six to 12 months. I'm assuming a lot of work went into making that shift, right?

Guest 14:28

Yeah, again, it's been a slow process, and probably over the last 10 years I would say that shift has started to happen. But I think it's evolved from the fact that we've started to see more lived experience stories - people who have a direct experience of suicide, whether that's their own behaviour, or caring for someone, or they've been bereaved by suicide and someone they love has died by suicide. We're hearing more and more from them that some of this language is stigmatising.

Guest 14:28

If we think about the word 'commit', for instance, commit refers to crimes or sin. Associating suicide or suicidal behaviour with crime or sin makes people afraid to talk about it - worried they'll get in trouble, for instance - and suicidal behaviour is no longer a crime in Australia and a lot of other countries. They might be worried they'll get shunned by their religious community. If we keep those associations together through our language, that doesn't encourage people to seek help if they're worried they're going to get in trouble or won't be taken seriously.

Guest 14:28

So that shift towards more neutral language - away from that value judgement in the word 'commit' to 'died by suicide' - helps separate those things and destigmatise talking about suicide and getting help when you need it.

Marie 15:56

If I have my own business or I'm working in a company, how do I ensure that the people in my organisation are using the kind of language that creates a psychologically safe and healthy environment?

Guest 16:07

I think there are a few things you can do. One of them is to proactively encourage and show that you value good language, and that can be through modelling that behaviour yourselves, having key individuals - maybe the boss or key influencers - model that behaviour within an organisation. It can be providing resources, providing training to show that you value that good behaviour, and incorporating good language into behaviour standards, for instance.

Guest 16:07

One of the other programs that we have here at Everymind is the National Communications Charter, and that's a unified approach to language and messaging around suicide, mental health, mental ill health and social and emotional wellbeing. That kind of acts as a pledge to use better language. Organisations can sign up to the charter and also work on implementing the charter throughout their business practices as well.

Marie 17:11

Where do they learn the language? Is there a document they can download that says, 'Hey, this is the language you should be using day to day in the company'?

Guest 17:20

Yeah. The National Communications Charter has some language guides included in its implementation guides as well, and really easy things that organisations can do to help encourage their use. We also have language guides in the Mindframe program. As part of our guidelines, we have guidance around using words like 'commit', but then sharing alternative language or preferred language that people can use instead. We take a look at the potential impact language can have and then offer some alternatives.

Marie 17:58

And are these things they can use in everyday scenarios? For example, if someone might have taken some sick leave, or if something's occurred on the team, or someone's noticed something about a team member - how is it used? In what kind of scenarios would they use it day to day?

Guest 18:14

In terms of using language guides, if our everyday language is safe, sensitive and appropriate, that creates an atmosphere where people feel able to talk about what's going on and seek help when they need it. If you're in a scenario where you notice that someone is distressed, or their behaviour has changed, or you think they may be experiencing a mental health issue, there are certainly guides available for how to have those conversations.

Guest 18:14

Then we're talking not just about language, but actual ways to be able to have those conversations. For employers or managers, Heads Up has a range of online resources, guides and fact sheets to help them support someone with a mental health condition. But I think it certainly helps to encourage people to be aware of these things as issues, to increase their knowledge about different mental illnesses and what their symptoms are, so that if you do see a sign or a symptom you know, okay, now's the time that I might need to reach out to support someone.

Guest 18:14

It can also help, I think, to drive organisations to be ready to support someone if they need it. Signing up to the National Communications Charter, for instance, one of the steps there is having your resources available within your organisation to support someone. So putting up a poster that says, 'If you are experiencing mental ill health, here are ways that we can support you.' That might be tools or resources. It might be what your organisational help-seeking options are. A company, for instance, might have an EAP, like an employee assistance program, that their employees may not know about. Making those things public and sharing them proactively goes a long way to supporting employees.

Marie 20:20

What happens in a scenario where somebody accidentally uses negative language unintentionally in the workplace? How are those scenarios best handled?

Guest 20:31

I would always advocate for a prevention-first focus and doing the work, particularly in an organisation, to set people up for success where possible.

Marie 20:44

But it doesn't always happen, right? Because we're human and we make mistakes.

Guest 20:48

It doesn't. But I think if people are aware of appropriate language to start with, you've got a place to go from. Most organisations will have their own standards of behaviour and how they deal with things like that. In a social setting, it can be really hard to call out negative language, but it can be useful to do that. You'd obviously need to think about whether it's safe to do that, but often people don't realise that their language may be impacting others, and a quick pull-up can be enough to change their behaviour.

Guest 20:48

To say, 'Hey, that language is actually quite stigmatising towards people with a mental illness. How about you either cut that language out, or here's an alternative?' It can be an opportunity to talk through that - 'My friend has a mental illness, and I'd appreciate it if he didn't have to hear that kind of language.' Things like that can help change behaviours. It can be just a simple pull-up. It doesn't need to be a big confrontation. It can just be part of a conversation, I think.

Marie 21:48

So, what's the big goal for you guys at the moment? Do you have something in particular that you're working towards?

Guest 21:54

Oh, that's a big question. Our overarching goal is obviously to be a part of mental illness and suicide prevention. We want to make sure there are reduced rates of distress in our communities, and safe language and the work that we do at Mindframe is just one component of that. There are a lot of other things that need to happen to go into reducing those rates, but we're working towards that as our overarching goal.

Guest 21:54

Ideally, we'd love to see public communication - whether that's news or the stories we share in film and television - show better representation, less stigmatising content, and more of a prevention focus, or content that encourages people to seek help.

Marie 22:43

One of the things I wanted to ask you - you mentioned that when you pick up on the use of negative language or unhelpful language in the media, you often reach out to see if the journalist or the editor will change the content of that copy. What's the reception like, typically, when you do that?

Guest 22:59

It's usually pretty good. I think we all are good humans, or we try to be, and if something is pointed out to you that's potentially hurting someone, we usually try to adapt and reduce that behaviour. It's the same with journalists. They obviously have a job to do, but sometimes they're just not aware of the potential impact their writing or their film may have. Usually, once they are aware of that potential impact, they're quite willing to work with us, whether that's to edit something, to get in touch and work with us on future stories, or to do some training with us.

Marie 23:39

Yeah, because I think sometimes once the article has been published, if it's already had its big impact and you're working with them subsequently, even if there's a change, from a mainstream perspective it goes unnoticed. But I guess on a micro level, the journalist - you've progressed, you've educated one more person, one more journalist who next time, when they're writing a story, might apply that new learning so they're not making the same mistake again.

Guest 24:02

Yeah, I think too we also end up with champions within media organisations. They've had some new learnings in this area and then spread that or share it with their colleagues. We end up with situations where we go in and train whole newsrooms and editorial teams because one journalist has made a change, they're really supportive of the guidelines, and they want to share those. So generally, within those media organisations, we've had some really great reception.

Marie 24:35

Well, thank you so much for joining me today. I've learned a lot. I have a lot more to learn, I'm sure a lot of people do, but good luck with all the amazing work that you're doing today and in the future.

Guest 24:45

Thanks very much. We're here to support people to communicate well about these topics. It can be difficult, but we are here to support them if needed.

Marie 24:55

Well, it's mindframe.org.au, right, for more information?

Guest 24:58

It is, yes.

Marie 25:00

Perfect, and we'll include links in the description as well.

Guest 25:03

Thanks very much for having me.

Marie 25:05

Thanks so much. All the best.

Marie 25:08

And that's Commical for this week. If you'd like to join the show, suggest a topic or ask me a question, hit me up on Instagram at @mariediggle, or email me at comicalpodcast@gmail.com. Thanks so much for listening. See ya.