Newspaper stories as measures of structural stigma.
OBJECTIVES: Structural stigma and discrimination occur when an institution like a newspaper, rather than an individual, promulgates stigmatizing messages about mental illness. This study examined current trends in the news media on reporting topics of mental illness. METHODS: All relevant stories (N=3,353) in large U.S. newspapers were identified and coded during six weeklong periods in 2002. Stories were coded by themes that fit into four categories: dangerousness, blame, treatment and recovery, and advocacy action (that is, calls for public policy and action that increase the quality of care or opportunities for those with mental illness). RESULTS: Thirty-nine percent of all stories focused on dangerousness and violence; these stories most often ended up in the front section. Few stories promulgated the idea that either the person or the family was responsible for mental illness (2 percent). Instead, stories about genetic or biological or environmental causation (for example, stress and trauma) were more common (15 percent). There were equal numbers of stories about biological and psychosocial treatments (13 and 14 percent, respectively). Four percent of all treatment-related stories addressed recovery. Twenty percent of stories contained themes that fell into the broad category of advocacy action. These stories addressed the shortage of resources in the public mental health arena, the need for better care, the absence of good-quality housing, and the goal of insurance parity. CONCLUSIONS: Data on how mental illness is represented in newspapers yield a useful perspective on structural stigma and the policies and standards that are applied by the news media. These findings have implications for influencing the press.