Independent Studies Feb 2000

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Sharyn Hyde Independent Studies, February 2000

The Social Construction of Newspaper Representations of Mental Illness

Sharyn Hyde

Undergraduate Independent StudiesUniversity of Derby

February 2000

Abstract

Introduction

Method

Analysis

Discussion

References

Appendix

Abstract

Research into media representations of mental illness has consistently reported on the

negative representations given across a variety of media forms. It has typically looked

at peoples attitudes to mental illness and how these are affected by such

representations. This perspective is problematic for a variety of reasons and removes

the focus from the people who are being represented. This study is an analysis of

English national newspaper representations of mental illness. The method of analysis

used was critical discourse analysis. In line with previous research, it emerged that the

majority of representations of people with mental illness were negative and linked

mental illness with violence, criminality and amorality. The shift in focus of this

research meant that it was possible to look at what such representations do rather than

just count and measure them. People with mental illness were positioned as out group

members with very little power in comparison to people positioned as in group

members. It is argued that these representations have the rhetorical function of

supporting the ideological position taken in the text.

Introduction

Representations of mental illness occur frequently in the media, and several studies

have shown that such representations are frequently unfavourable. It has been

suggested that people with mental illness are often portrayed in the media as being

different in terms of physical appearance and moral capacity from normal people. In

addition, they are treated as objects of humour and derision whilst at the same time

represented as dangerous in terms of violence towards others (Wahl, 1995). This is a

finding that has been consistent over the last five decades or so (see Wahl, 1992) and,

although representations have been shown to be less negative in more recent times

(Shain & Phillips, 1991), the majority of portrayals of people with mental illness inthe media are negative.

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The issue of dangerousness and unpredictability is one that has received most

attention because of the way such representations are held to affect peoples attitudes

towards people with mental illness (Wahl, 1992, 1995; Borinstein, 1992; Philo, 1993).

Attempts to provide people with more balanced information have not been

particularly successful, and it has been suggested that this may be related to fear and

mistrust (Shain & Phillips, 1991). Philo (1993) noted that media representations ofmentally ill people as violent and unpredictable were more influential on some

peoples expressed views than direct experience was.

Representations of people with mental illness are relatively common in the media

(Allen & Nairn, 1997; Wahl, 1992) and studies have suggested that the majority of

information that people receive relating to mental illness comes from the media

(Borinstein, 1992; Philo, 1993). When this is assumed to be an important influence on

peoples views, it is understandable that research has focused on attitudes. However,

there are several problems with looking at peoples attitudes. One of these was

evident in Philos study (1993) when he found that some people talked about people

with mental illness as generally dangerous but did not apply this to persons that they

had known with mental illness. Labelling peoples expressed opinions as attitudes is problematic as it assumes a fairly fixed opinion. This cannot account for

inconsistencies in peoples talk and may result in the over simplification of much

more complex issues.

A further problem with looking at attitudes is that it reduces the issue to the

individual. This ignores the wider context of society and locates problems within the

individual. Although attempts have been made to locate problems at a societal level

(Hannigan, 1999) the focus still returns to the effect that societal practices may have

on attitudes.

A more useful approach would be to look at the way in which such representations are

constructed by people and through media practices. A constructionist approach does

not have difficulty with explaining the variations in what people say as these are

expected to occur. This is because it is held that language (spoken and written) is not

about providing information but serves a rhetorical purpose and is used to perform

social actions (Potter & Wetherell, 1995). Language is dynamic, not static, and people

construct different versions of the world, drawing on various resources, in order to do

things with their talk. The focus shifts from attempting to define what is in peoples

heads to their discourse what it is that they are doing with their talk and how they

are doing it. From this perspective, it is apparent that looking at attitudes is

problematic for several reasons. As has already been noted, explaining things in terms

of attitudes cannot account for people giving inconsistent and sometimes

contradictory accounts. There is also the problem of the assumption that there issomething fixed and residing in the individual, ignoring the social context in which

the person is operating. In addition, labelling an attitude as a thing and describing it is

the role that the researcher has and this implicitly denies that the concept of an

attitude is a hypothetical construction and the specific definition of that attitude is the

constructed version of the researcher. Potter and Wetherell (1987) have noted three

main points in this process that are problematic. These are: defining the subject of the

attitude (a complex issue which involves categorisations which are not neutral and are

defined by the researcher), the researchers interpretations of the participants answers

and the transformation of the participants answers into something assumed to be

fixed and stable an attitude.

Another problem with the implications of the majority of the research in this areaentails the presentation of current psychiatric talk relating to mental illness as

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representing the truth about mental illness. Some researchers attempt to put

representations of mental illness into a historical context (Monahan, 1992). Although

the point is made that the way in which mental illness is represented is historically

and culturally specific, this is not extended to contemporary Western descriptions of

mental illness. These are taken for granted as true with no regard for the historical

and cultural specificity of such representations, which are perpetuated and maintainedas much through the rhetoric of the medical discourse that is used to create them as

they are by the mass media (Parker, Georgaca, Harper, McLaughlin & Stowell-Smith,

1995). It should be noted that the term discourse does not just relate to spoken and

written language. It is also used to refer to a systematic, coherent set of images,

metaphors and so on that construct an object in a particular way (Burr, 1995, p184).

The mainstream approach to research into mass media depictions of mental illness has

one other major failing. By concentrating on how such representations affect peoples

attitudes, there is an omission in that the research never deals directly with the people

whom it affects those who have been labelled as mentally ill. Parker, Georgaca,,

Harper, McLaughlin & Sowell-Smith (1995) note the way in which people with

mental illness are positioned by the language that is used to describe them. Overrepresentation of people from certain demographic groups such as women, people

from certain ethnic groups and people from working class backgrounds may not

reflect differences in the incidence of mental illness but more the way in which the

description and classification of mental illness pathologises reactions to the situations

that people are positioned into. This is exemplified by the attempts to create new

categories for versions of DSM and ICD (the American and European manuals used

to describe categories of mental illness and to inform diagnoses). Kutchins & Kirk

(1997) describe how a (failed) attempt to create a new disorder (masochistic

personality disorder) pathologised behaviour that is often a feature of reactions to

abusive relationships and is also similar to the traditional role of the female. They

note that the creation of diagnostic categories is often motivated by political and

financial issues as opposed to scientific inquiry, resulting increasingly in the

pathologising of everyday behaviour.

The use of discourse relating to science implies that there are real things out there to

be discovered and denies that these categories are actually constructed. The way in

which these categories are constructed and used is of key significance to the way in

which people who are given these labels are positioned in society. The problem with

much of the research into media depictions of mental illness is that it does not analyse

how these representations are operating and how they position those that are being

talked about. The focus of the research is moved from those who have the label to

others, and relates to what is assumed to exist in their heads rather than what their talkdoes in terms of positioning those with the label of mental illness.

Constructionist approaches to newspaper texts

There is very little research that looks at the area of mental illness in the media in

relation to discourse and the way that it is used. One study that does take a more

constructionist position to media representations of mental illness (Allen & Nairn,

1997) argues that negative depictions of people with mental illness are used not

because of lack of alternative versions on the part of the journalists or because of

sensation selling more newspapers. These depictions are used as part of media

practices aimed at engaging the reader with the text. This serves a function of

maintaining interest in the story. The use of case studies in the newspaper analysedwere worded in such a way that a lot of information was not explicit and forced

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readers to draw on common sense knowledge. Allen and Nairn maintain that this has

the effect of enlisting readers as co-creators of the text. This is supportive of the

stance that people do not use language passively to describe things but use it as a form

of social action.

This relates in part to the position taken by Scollon (1998) when he argues against a

traditional sender receiver model approach to media study. He maintains that mediadiscourse is a form of social interaction, with a focus on practices both between and

among media personnel and audiences.

Fairclough (1995) also focuses on interactions between media producers and

audiences. He asserts that there are two main tensions affecting news discourse. One

relates to the tension between public and private, in which public affairs are mediated

in private settings and private moments are made public by the use of mass media.

The other relates to the tension between providing information and entertainment in

telling news. He argues that there is an increasing move towards entertainment as

news telling has become more marketised. These tensions can be seen in the reporting

of stories related to mental illness, in the focus on national legislation and policy,

stories relating to individuals, the provision of explanatory details and the focus ondangerousness and criminality. It is important to look at these with regard to how

events and relations are represented, the identities that are set up in the text and the

relationships that are set up. By using this framework it is possible to see how people

with mental illness are represented and positioned in relation to others and what

purpose these representations may be fulfilling within the text. Another important area

to bear in mind relates to ideologies that may be implicitly or explicitly supported by

the stories (van Dijk, 1998). Van Dijk maintains that often it is as revealing of

underlying ideology to consider who is not represented and what is not stated in the

story.

This analysis was motivated by the current lack of research from a constructionist

perspective in this topic area. No specific hypotheses were formed, but an analysis

was done based around the following issues. The research focused on the

representations, identities and relations that were set up in the stories, with regard to

omissions and implicit as well as that which was explicit in the text. The words that

were used and the discourses that are operating were examined. All of these aspects

were considered in the context of what function they have in the text.

Method

This study is an analysis from a constructionist perspective of English nationalnewspaper representations of mental illness. The data that was used for analysis

consists of eight articles from five different newspapers relating to two stories. The

papers used were The Guardian (a left wing broadsheet), The Times (a conservative

broadsheet), The Mirror (a Labour supporting tabloid), the Sun (a Labour supporting

tabloid that publicly changed allegiance from the Conservatives during the 1997

election campaign that resulted in Labour gaining power) and The Daily Mail (a

conservative tabloid). The descriptions of these papers are not definitive my

intention is to provide background information on the subjects of analysis.

The process of selecting the articles for analysis over and above other articles

comprised several stages. The first stage involved a search on a cd rom database at the

British Newspaper Library. The keywords that were used to identify relevant articleswere mental illness, schizophrenia, depression and psychopath. Although I am

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aware that the term psychopath is not necessarily related to mental illness from a

psychiatric perspective, this term and various derivatives of it (for example psycho)

are often treated as synonymous with mental illness in the media and is therefore a

necessary inclusion. All of the stories were selected from the latter six months of

1998. The only paper that was not subjected to a database search was the Sun, for

which a manual visual search was conducted.From the results of this search, those stories that appeared in most of the papers were

selected. The rationale for this was to allow a comparison across newspapers of the

same stories. At this point there were six main stories and approximately 50 articles.

However, in order to conduct a feasible analysis, the amount of stories was reduced to

two, with four articles on each story. The rationale for the story selection was that one

related to people with mental illness as a group and the other related to an individual.

I selected these so that the approaches to each story in terms of the way in which

identities, relations and representations operated in the texts could be looked at with

regard to similarities and differences.

The method of analysis that I used was critical discourse analysis, mainly based on

Faircloughs (1995) approach to this, but drawing also from van Dijk (1998, 1991),Bell (1998) and Kress & van Leeuwen (1998).

Language is seen as having a dialectical relationship with sociocultural issues. This

means that it both shapes these issues and is shaped by them. Fairclough asserts that

any text is always constitutive of social relations, social identities and systems of

knowledge and belief. This is an important issue to consider in analysis how these

are operating in the text and whether the use of language is conventional or creative

(Fairclough, 1995). There is also concern with what Fairclough terms orders of

discourse, meaning this to be the various ways that discourse occurs in a particular

social domain or institution. He asserts that attention to the extent to which there are

differences and overlaps both within a set and between orders of discourse is an

important topic for analysis as social change is often manifested through the

redrawing of boundaries.

The relationships between three dimensions of a communicative event are important.

These are the sociocultural practice that a communicative event is part of and

embedded in this is the discourse practice which relates to media production and

consumption. Analysis of discourse practices involves intertextual analysis which is

more interpretative and looks at what processes have informed the text production and

what traces of these are left in the text. The text is in turn seen as embedded in

discourse practices and analysis of this is more descriptive, focusing on vocabulary,

syntax and semantics. Textual analysis informs intertextual analysis. Discourse

practices mediate between the text and sociocultural practices. It is at the level ofdiscourse practices that the communicative event draws from and affects the order of

discourses. Sociocultural contradictions that manifest in the text can be seen as

indicative of social change or unrest as the media texts are seen to be sensitive

barometers of cultural change (Fairclough, 1995, p60).

The focus that Fairclough puts on representations, identities and relations is

complemented by van Dijks stance (see van Dijk, 1998). This is a similar approach to

Fairclough, but with more of a focus on cognitive processes. Van Dijks approach is

relevant to this study because of his reference to the ideological square, which

functions to polarise in groups and out groups and to position these so that the in

group is seen in a favourable light and vice versa. This is important because of the

negative way in which people with mental illness are often positioned in the media.Van Dijk suggests that it is important to look at the background and context of the

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communicative event and to look at the ideological categories and the polarisations

that occur and to analyse what is implicit in the text. Attention to the formal structure

of the text is also necessary.

I have also drawn from Bells (1998) approach to analysis because of the attention to

specific detail here. This complements the approaches of Fairclough and van Dijk but

can be applied to the text very systematically. Bell recommends attention to events,relations between various aspect of the text, attributions, news actors, places, times

and background history.

It is necessary to consider the visual layout of a newspaper article for the purposes of

analysis and, where this was relevant, the approach taken by Kress & van Leeuwen

(1998) was considered. This was mostly related to the salience of an article for this

study as many of the stories were simple in terms of layout. Kress and van Leeuwen

maintain that aspects affecting salience, such as use of foregrounding, size and tonal

contrasts do not just play an aesthetic role but are vital in aiding the structuring of the

message.

These approaches to analysis all informed this research as, despite similarities, there

are subtle differences which were useful to consider when analysing the texts. As thefocus of this research is on representations of mental illness, the analysis is organised

around themes that arose from representations. I concentrated on what identities were

set up for people labelled as mentally ill and how these related to other identities in

the text. The focus is on how these representations are constructed and how these

constructions position the people in the stories. In addition to the critical discourse

analysis approach, I have also looked at the way certain discourses may be operating

in the text (Parker, 1994) and what these do in relation to the social positioning of

people with mental illness. This is an important issue to consider. For example, the

use of discourse relating to institutionalised medicine often operates to disempower

those who receive treatment (Fowler, 1991).

Analysis

Two main themes emerged in relation to the ways in which people with mental illness

were represented. These were the social construction of people with mental illness as

amoral, violent and criminal and the disempowerment of people with mental illness.

Both of these themes demonstrate that the construction of the representations of

people with mental illness was almost without exception negative, although varying in

the degree to which this negativity was explicitly or implicitly expressed. Although

the themes have been separated for the purposes of clarity, in the newspaper texts theyare not as discrete as this and are frequently interrelated.

There are also several means by which these themes are built up in the text which

recur throughout the extracts used. The most frequent are: language relating to

dangerousness and incapability of people with mental illness, the use of medical

discourse, the implicit and unquestioned assumption of the right to detain people with

mental illness and the way in which these rhetorical devices are used so that the

reader has to draw on commonsense knowledge and thus become involved in co-

creating these representations.

The social construction of people with mental illness as amoral, violent and criminal.

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A common theme with the stories is that they construct a representation of people

with mental illness as being dangerous, with specific reference to violence and

criminality. With some of the tabloid newspapers, this was also very strongly tied to

issues of morality, as demonstrated by the language that was used to describe the

people concerned. The first extract is an example of the way that language is used to

represent an individual and also demonstrates the way in which the construction of avictim identity and the use of her account in the text is used to support the

representation of the person concerned as amoral, violent and criminal and to polarise

his position as a member of an out group.

Extract 1: Use of language in creating representations and the construction of

the victim in support of the representation (from the Sun, 22/8/98, p9)

1. SOBBING Pamela Anderson lookalike

2. Perry Southall told of her terror last night

3. after the psycho who has made her life

4. hell was deemed TOO MAD to lock up.5. The stunning blonde, 22, gasped in court

6. as crazed stalker Clarence Morris was told

7. he could walk free. Later she wept: Im

8. afraid hes out to kill me.

9. The amazing ruling came after a psychiatrist

10. pronounced the convicted child-rapist untreat-

11. able. Exasperated judge Peter Fingret said that

12. meant he was powerless to send Morris to an

13. asylum. As MPs and victims groups last night

14. blasted the astonishing loop-

15. hole that let the fiend back on

16. the streets, Perry said: Do I

17. have to be murdered before

18. the lesson is learned?

The most immediately noticeable thing about this text is the identity that is set up for

the person with the mental health problem. The words that are used to describe him

(Morris) are overtly negative, emotive, slang and typically relate to his mental state.

Examples in this extract specifically relating to mental illness are psycho (line 3),

TOO MAD (4) and crazed stalker (6). These are also linked by association with

words used to describe his criminality convicted child-rapist (10) and to commenton his morality fiend (15). Here identities are polarised, with Morris positioned very

much as part of an out group, both by the words that are used to construct his identity

and by associations with out groups. Various other identities are used to support this

polarisation, for example the judge in charge of sentencing, MPs and victims groups.

This use of language continues throughout the rest of the story (see appendix, pages

39-42). This type of language is often used in the tabloid press to vilify someone and

their mental health status is often referred to through the use of derogatory

colloquialisms. This can be seen in terms of discourse practices and is a fairly typical

feature of the genre of popular tabloid newspaper reports.

The topic of the story relates to criminal activity by Morris and so a representation of

him as criminal is appropriate to the context of the story. However, the choice oflanguage used here is deliberately emotive and links his criminality with his mental

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illness and, ultimately, with a moral judgement on his character. These three forms of

representation are used to build a highly emotive and negative identity for Morris.

This is used in support of the implied position that the only way in which Morris

should be treated is to lock him away. This position is treated as taken-for-granted

knowledge, appealing to a view of common sense. This is demonstrated at lines 9:

amazing ruling, 11: Exasperated judge and 14-16: astonishing loophole that letthe fiend back on the streets. At no point in the text does it explicate the use of the

words amazing, exasperated or astonishing, this position is taken as self

evident. This again relates to discourse practices where the discourses drawn on in the

production of the text are discernible and also require the reader to draw on an

understanding of such discourses in order to understand the position taken.

In contrast to the representation of Morris but used to support this representation, is

the social construction of the victim, Southall. The identity that is set up in the text

for her is polarised in relation to that of Morris, with Southall positioned as a member

of an in group, both as a member of the public and as an attractive female. She is

compared to Pamela Anderson in the first line (a TV actress whose attractiveness was

often commented on in this paper) and described as a stunning blonde at line 5. Thisfocus on her attractiveness in addition to the familiarisation created by referring to her

by her first name (16) (a strategy which continues throughout the article) are both

devices used to elicit sympathy and identification with the victim from the reader,

which aids in the representation Southall as a member of an in group.

The polarisation of Southall as an in group member as opposed to Morris is further

emphasised by the representation of her as a damsel in distress which is used to

elicit sympathy for her on the part of the reader. Her emotions in relation to the news

of Morris release are focused on and emphasised in terms of distress and fear. The

words sobbing (1), made her life hell (3/4), gasped (5) and wept (7) all give

weight to the notion of her distress as a result of Morris release. The possible

consequences of his release are built up through the use of hyperbole both in

describing her fear and through quoting Southall herself. For example, terror (2),

Im afraid hes going to kill me (7/8) and Do I have to be murdered before the

lesson is learned? (16-18) all support the construction of Morris as a person to be

feared and the position that he should not have been released through use of emotive

language and expression of worst case scenarios. Discourses that are drawn on relate

to fear of mad people and public safety. These serve to account for the stance taken

by the story by evoking a common cultural stereotype relating to mental illness and to

make the issue of relevance to the reader.

However, this is a relatively obvious example of the way in which language is used torepresent people with mental illness. Another example, from a broadsheet newspaper,

demonstrates that this type of representation is not restricted to the tabloid

newspapers. Here the representation is also negative, with implied reference to

criminality and amorality and specific reference to mental illness with the inference

that this is an a priori reason to detain someone indefinitely.

Extract 2: use of medical discourse and comparisons to construct a

representation (from the Times, 22/8/98, p7)

134. After the case the Probation

135. service began to look for136. somewhere for Morris to live

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137. where he could be supervised.

Morris cannot be sent to a

139. psychiatric hospital because,

140. Although he can be treated

141. with medication, he cannot be

142. cured. He is in a similar143. position to paedophiles who

144. are classified as bad but not

145. mad, suffering from person-

146. ality disorders that do not

147. qualify them for compulsory

148. admission to Rampton or

149. Broadmoor or to regional

150. secure units.

This extract also represents the identity of the person concerned as mentally ill,

criminal and amoral, and although there is less reference to dangerousness here, this isa theme that runs throughout the article (see appendix, pp 33-36). There is not as

much polarisation of in groups and out groups in this article, although Morris is

definitely positioned as an out group member. Morris is positioned here as a problem,

in that detention in hospital is explained as not being an option, so this creates a

problem as the text implies that detention is the only commonsense option. This is

done through mentioning that Morris needs supervising (line 137) and then explaining

why he could not be sent to hospital (138-142). Here, a medical discourse is used, as

exemplified by the use of words such as treated (140) and cured (142). This usage

does several things in the text. Firstly, by using terms relating to medical practices,

the tone of being an informed source is maintained. More subtly, this use also draws

attention to the representation of Morris as being mentally ill, most notably in the

phrase although he can be treated with medication (140/1).

The link with mental illness and criminality and amorality is made at line 143 when

Morris is related to paedophiles. This is an extremely emotive comparison to make.

The label paedophile is linked both to criminal activity and amorality. The link

between this and mental illness is fairly explicit, due to a shift in footing from the

singular to refer to Morris to the plural to refer to paedophiles (143/4). Whilst using

this shift in footing to talk more generally about paedophiles, the phrase bad, but not

mad (144/5) is used, which constructs the issue in terms of morality, but the link

with mental illness is still there despite the statement not mad. This is due to the

continued use of medical discourse when referring to the specific label assigned tothese people: suffering from personality disorders (145/6). Here both the words

suffering and disorders belie the medical language used to talk about such issues

and place them firmly in the context of mental illness, with a specific link to a group

of people considered to be both criminal and amoral.

Again, although this relates to a certain extent to the specific details of the story, there

is still the link between mental illness, criminality and amorality. The identities that

are set up and the way in which these are related create this link. This is done in a

slightly more subtle way than in extract 1, where the words used were specific labels

applied to an individual. Here, the same position is maintained through comparisons

and the use of medical discourse. It can be seen that different discourse practices in

terms of text production are operating in comparison to extract 1, but the underlyingideological position is the same in the two texts. The different resources that are

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drawn on have a similar function they serve to account for the ideological position

taken in the story.

The issue of mental illness being linked to violence and criminality in the press is not

limited to specific people though. Extract three demonstrates that this link is applied

more generally to a group of people and again the assumption that it is right andnecessary to incarcerate people underlies these representations and is supported by

them.

Extract 3: the construction of people with mental illness as violent and inherently

criminal applied to a group identity (from the Times, 9/12/98, p2)

14. The proposals, drawn up jointly with

15. the Home Office, are the result of increas-

16. ing concern about the number of violent

17. crimes committed by people with person-

18. ality disorders who are considered danger-19. ous but who do not respond to convention-

20. al treatment with drugs or with therapy.

21. The new measures will close a loophole

22. in the law that, at present, makes it impos-

23. sible to send these people to hospital

24. against their will or to imprison them un-

25. til they have committed a crime.

Here, the phrase violent crimes (16/7) is used in direct relation to people with

mental health problems. The identity in this case does not refer to an individual but to

a group of people and the representation of this group is very negative. Again, people

with mental illness are positioned as members of an out group through the

representation of them as violent and criminal. Although the phrase personality

disorders (17/8) is used, which in terms of psychiatric definition is not a mental

illness, this distinction is not made in the article (see appendix, pages 25-26) and the

terms are used in a way that does not make the issue any clearer. The use of language

relating to treatment with drugs or with therapy (20) draws on medical discourse,

and by implication relates people with personality disorder to illness. The link with

violence and crime is emphasised as a problem by use of the phrase increasing

concern (15/6) (which is general and not attributed to anyone) and is related to action

regarding this concern (14). The issue of criminality is raised again at line 25 but thistime it carries an implication that it is inevitable that people with mental illness are

criminal. This is done through the use of the word until, which implies that if this

group of people have not already committed a crime then they will at some point in

time. This is also supportive of the supposition that people with mental illness should

be detained by placing this action in the context of a preventative measure. The use of

these representations to support the ideological position taken reflects the discourse

practice here. Existing cultural stereotypes are drawn on but these are then used

creatively to inform the reader in combination with use of medical language.

The ideological position that it is necessary to lock people away is evident by use of

the word loophole (21) to refer to the impossibility of the action of sending these

people to hospital against their will (23/4). By placing this impossibility in thecontext of a loophole, it is implied that detaining people with mental illness is the

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right way to deal with them regardless of their say in the matter. Inability to take this

course of action is problematised. This position is supported by the previous

representation of people with mental illness as violently criminal and, as neither the

ideological position regarding what action is appropriate nor the way in which this

position is supported by the prior construction are explicitly stated, this requires the

reader to co-create this reading of the text. This is where the discourse practicesmediate between sociocultural practices popular sociocultural representations or

discourses relating to people with mental illness were drawn on in the production of

the text, but they also require the reader to draw on the same discourses to inform this

reading.

In the first three extracts it has been seen that similar ideological positions have been

maintained through the use of different discourse practices. This applies to both the

representation of individual identities and of people with mental illness as a group.

Whilst the Sun used emotive and derogatory language and the extreme polarisation of

identities, the Times used the positioning of an identity as an out group and the

official sounding language of medicine to support the ideological position taken. Boththe papers drew on popular stereotypes of people with mental illness as violent,

dangerous and criminal, with extracts one and two also representing people with

mental illness as amoral. This demonstrates the use of sociocultural practices in

relation to discourse practices both in the production of the text and the way in which

the text is read by the audience.

The disempowerment of people with mental illness.

So far it has been demonstrated how negative representations of people with mental

illness are employed in some texts to support the underlying ideological stance.

Closer analysis of some of the methods that are employed shows how people with

mental illness are positioned into a role that disempowers them in relation to other

identities whilst at the same time being blamed for problems relating to violence.

Extract 4: disempowerment of people with mental illness through the use of

medical discourse. (from the Guardian, 22/8/98, p11)

20. Under the law, only those

21. with treatable mental dis-

22. orders can be detained in hos-

23. pital. Morris, from Poplar,24. east London, who has a psy-

25. chopathic disorder, is deemed

26. untreatable, and so was

27. released despite psychiatrists

28. ruling he posed a high risk

29. of future violence.

In extract three, the same ideological position is taken as in the first three extracts in

that Morris is represented as someone who should be locked away. This is an example

of the way in which medical discourse is used to support this position. The use of thisdiscourse has implications of disempowerment for people with mental illness because

11


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of the way it positions them in relation to other identities who are afforded much more

status and power.

This extract explains why Morris was not locked away through the use of providing

information in a medical context. The position that he should be locked away is

implicit through use of the explanation for why he was not. The rhetorical function of

this explanation is both to provide information about the story and to support theideological position. The existence of an explanation implies that there was a question

to answer.

Although the text refers specifically to one person, Morris, the use of this explanation

provides a norm for what happens to people with mental illness and relates this to

legal issues (line 20). The order of information is important. By invoking the issue of

law, the status of the following information relating to medical discourse is

legitimated and raised through association with another high status official institution.

The way in which people with mental illness are represented demonstrates a complete

lack of personal identity they are referred to by the impersonal pronoun those

(20). This is in contrast to the identity given to psychiatrists as a group of people (27).

There is implicit positioning of in groups and out groups here as psychiatrists areafforded power by the position that they hold. The action, ruling (28), that they take

in the text is supportive of this conventional representation. In contrast, people with

mental illness are those that have things done to them and this is demonstrated by the

reference to detention in hospital (22).

The discourse practice of employing the rhetoric of medicine (with the vastly unequal

power relations inherent in orders of discourse relating to medical institutions (see

Fowler, 1991)) has the effect of positioning people with mental illness as

disempowered. This is related to the legitimisation of detention and to the lack of

personal identification of people with mental illness as a group, except through

negative association with Morris. Using a medical discourse denies alternative

versions which may be less negative and disempowering.

The following extract also demonstrates the way in which medical discourse is used

in discourse practices and the way in which some people are afforded expert status

whilst others are not. It is also illustrative of another rhetorical practice that has the

effect of disempowering people with mental illness and also legitimates the expert

status given to others. This is the practice of representing people with mental illness

as incapable.

Extract 5: disempowerment of people with mental illness through

representations of incapacity (from the Daily Mail, 7/12/98, p16)

23. Legal changes will be made allowing the

24. recall of patients who are clearly not coping in

25. the outside world.

26. And the Government is keen to extend the

27. Mental Health Act to cover untreatable dis-

28. orders. Currently only treatable cases can be

29. kept in hospitals a loophole which allowed

30. Michael Stone, the killer of Lin and Megan

31. Russell, to be discharged.

32. Mr Dobson will say public confidence in33. Care in the community is at an all-time low.

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34. Too many vulnerable people have been left

35. to cope on their own. Some have become a

36. danger to themselves, their relatives and the

37. public. Care in the community has failed. I

38. will not tolerate that failure. Currently only

39. patients in hospital can be made to take med-40. ication. If they are released and psychiatrists

41. discover they are not taking the drugs, this

42. alone is not grounds to section them take

43. them back into hospital or keep them there

The use of medical discourse is far more apparent in this article than the one in extract

three. It extends to the way in which a whole group of people are labelled and

positioned within the boundaries of medical institution. The language used to label

people with mental illness is almost exclusively medically orientated: patients (24,

39) and cases (28). This practice relates to the ideological position of the story,

which centres on medication and detention for people with mental illness (seeappendix, pp 28-9) and constructing the identity of people with mental illness from a

medical perspective supports this position. As noted above, it has the effect of

disempowering those who are categorised as having mental illness and other possible

versions which could be more positive are rejected in favour of one that supports the

ideological stance.

The other representation of people with mental illness that is presented in extract 5 is

that of being incapable. There are two references to an inability to cope (24, 35).

This has the effect of disempowering people with mental illness further, not just in

relation to the power structure of the institution but by suggesting that there is some

deficiency in the ability to live in the community. This representation has two

functions in the text. The first is that it implicitly justifies detaining people against

their will on humanitarian grounds. The other is that by positioning people as

incapable, it provides a gap for others to take over. This representation implicitly

supports representations of other authority figures as being able to legitimately talk

about and act towards those who have been positioned in this way, and this is what

does happen in this text. One of the references to an inability to cope is quoted as

coming from Frank Dobson, the health secretary at the time of the article. In this

quote, he also refers to people with mental illness as vulnerable (34). He is already

in a position of power because of his profession, but the representation of people as

vulnerable and unable to cope emphasises the power difference in relation to him and

legitimises his right to speak on this issue, all the more so because it is constructed tobe in the people who it affects best interests.

The inclusion of Dobson in the story and the quotes that are selected and attributed to

him support the position of the story and serve to polarise his identity to that of people

described as patients. His individual identity is in direct contrast to the identity

given to people with mental illness. For the most part no individual identity is

provided. The only person who is individually identified as part of this group is

Michael Stone (30), who is identified as a killer. This identification , along with the

presented need to detain people with an implicit relation to risk of violence (40-43) is

in opposition to the presentation of people as vulnerable and incapable and belies this

representation as part of a rhetorical practice that supports the ideological position

taken. The result of this dual representation is that people with mental illness are bothincapable and culpable.

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This is most evident in the headlines and photographs that are used in this story.

Visual layout is important in this story as the message from the second and largest

headline is related to the photographs showing people apparently killed by people

who were suffering from mental illness. This emphasis on dangerousness is not as

blatant in the text, but is actually of greater impact due to the visual salience of the

headline and photographs both in terms of size and contrast.The third headline Action over the schizophrenics who wont take their medicine

further implies culpability for violence committed by people with mental illness. The

use of the word wont puts the action in the context of wilfulness. The phrase take

their medicine has a double meaning. It used literally to refer to people with

schizophrenia who do not take prescribed anti psychotic drugs. It is also used with

reference to the now seldom used dictum take your medicine, which loosely means

face up to the consequences of an action. This part of the text clearly places

culpability for the action of violence with people labelled with mental illness. It can

be seen that the discourse practice relating to text production here uses several

methods with more than one representation of people with mental illness, all of which

are negative and have negative consequences for people with mental illness. There isa double bind in that the overall effect is that they are represented as simultaneously

irresponsible through vulnerability and indirectly wilfully responsible for violence.

This has the effect of disempowering them as a group by removing their right to speak

or have a say in what people decide about them by implying that they are not

responsible for their actions whilst blaming them for their actions.

The use of public figures to talk about those with mental illness may also have the

effect of disempowering them. This can be seen in the following extract, where a

public figure is quoted talking about legislation relating to the treatment of people

with mental illness.

Extract 6: the use of authority figures in the disempowerment of people with

mental illness (from the Guardian, 9/12/98, p14).

111. The schizophrenia charity,

112. Sane, also applauded the

113. strategy as better than ex-

114. pected. Marjorie Wallace,

115. the chief executive, said: We

116. must prevent the headline

117. cases by intervening earlier118. to protect the liberty of pa-

119. tients themselves, the fam-

120. ilies, the victims and the

121. public.

122. We therefore accept the

123. need that doctors should have

124. earlier powers to recall for

125. treatment people who are not

126. taking their medication and

127. deteriorating in the

128. community.

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Here the person talking about people with mental illness is identified as someone who

has entitlement to speak about this issue. First the organisation is identified as a

schizophrenia charity (111), although whom this charity represents is unclear. Then

the person is named followed by her job title that identifies her as a powerful member

of that organisation. Through the quote that is used, the position that is taken

represents people with mental illness in a very disempowered position. The use of thephrase recall for treatment (124/5) implies that treatment is not taken willingly, and

the responsibility for treatment is placed with doctors, who have powers (124) to

ensure that it is taken. There is an unequal power relationship set up by the

representation of figures within the institution of medicine and by the language used

to describe the relationship between them and people with mental illness. This whole

representation is justified by placing it in the context of a need (123). The

representation of this as a need is created in the previous paragraph. This is done

through identifying people with mental illness as headline cases (116/7) which is a

reference to acts of violence committed by people with mental illness. The action

towards them is placed in the context of prevention (116) and this is justified in terms

of protection of a variety of groups of people, including people with mental illness(118-121). This is similar to the incapable stance seen in extract 5. Although the

position is arguably not as strong here by allowing the possibility that dangerousness

only applies to certain people with mental illness living in the community (125/6), the

effect is the same. This is exemplified by the responsibility for prevention being

placed with the generic we (115). It is left unclear who we refers to, but it does

not include those who the legislation applies to.

It can be seen how a person with a certain power status can talk about people with

mental illness in a way in which perpetuates the disempowerment of them in relation

to what happens to them and their relationship to other groups. This extract appears in

the most positive article about people with mental illness from the extracts used (see

appendix, pp 21-4). It is the only article that questions the right to detain people

against their will, using discourse relating to civil liberty and human rights. It is also

the only article to present a positive individual representation of someone labelled as

mentally ill. This is done through the use of a photograph and the caption beneath it.

This representation is of importance to the story both in terms of the size, contrast and

interest due to the depiction of a human figure. However, there is no individual

representation of people with mental illness in the text and the photograph is not

referenced here. Overall in the texts that have been analysed, there has been no

representation of people with mental illness from an individual perspective unless this

was related to criminality and violence. This omission is as revealing of imbalances of

power as any of the strategies discussed so far, given the amount of individuals thatare identified in a capacity to talk about those with mental illness MPs, doctors,

psychiatrists, judges, victims, charity representatives anyone but those who are

being talked about. Although the article from the Guardian that the above extract is

taken from has a much more positive ideological position towards people with mental

illness than the other articles analysed, the imbalance of power is still there due to

who is allowed to talk about this issue and who is not.

The imbalance of power has been shown to be related in part to the way in which

people with mental illness have been positioned and talked about by others. It has also

been noted that this reflects discourse practices in text production used to support the

ideological stance. Often this ideological stance is related to the unquestioned right todetain people with mental illness against their will. Although this is a point that has

15


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been made several times throughout this analysis, it is a fundamental issue that is

worth of individual attention. The purpose of this analysis is not to question the

practice of detaining people, but to question the representation of this as the only way

to treat people and to look at the implications of this ideological stance for people

with mental illness. This relates to the discourse practices that are used to create this

representation and how they position people with mental illness in society.

Extract 7: the representation that people with mental illness need to be locked

away (from the Daily Mail, 7/12/98, p16)

12. He will acknowledge the failure of care

13. in the community, which led to a series of

14. tragedies after mental patients were

15. released on to the streets

Here the representation of people with mental illness as people who should be locked

away is fairly obvious. They are identified as mental patients, which identifies themin terms of their mental health status (implicitly deficient) in direct relation to the

medical institution. This is from the same article as extract 5 (see appendix, pp 28-29)

and refers to people with mental illness throughout the article using medical

discourse.

That people have been locked up as opposed to staying in hospital is suggested by the

use of the word released. This action is criticised through the linking of it with

tragedies and suggesting that failure occurred because of these tragedies. This

provides support for the practice of locking people away. That this stance remains

unquestioned implies that this is the only to treat people with mental illness,

especially when the relationship between this action and the action of release are

opposed through suggesting that tragedies occur as a result of release.

The discourse practice that results from adopting this ideological position above

others in terms of justifying this position is particularly deleterious for people with

mental illness in terms of the representation and identity that is assigned to them. This

is because in the majority of stories, people with mental illness are represented as a

faceless group with no individual positive identities provided. They are positioned as

members of an out group by representing them as violent, criminal and amoral. This

identity is polarised against people identified as members of an in group. In contrast,

typically these people are given an identity both by naming them and identifying them

in terms of their entitlement to speak. In none of the articles analysed is anyone

labelled as being mentally ill afforded entitlement to speak. The only individualrepresentations that are used highlight violence and criminality in mentally ill people.

Often the function of these representations is to justify the practice of locking people

with mental illness away, but in providing such a faceless group identity the many

individuals labelled with mental illness who manage to live without m/any problems

outside of hospital are denied identity and labelled as violent, amoral criminals.

The other effect of providing a general group identity representing people with mental

health problems is that the complexity and variance of such problems is not talked

about in newspaper stories. By adopting this version over others, many other versions

which would be less negative in the representation of people with mental illness are

denied.

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Discussion

The analysis has shown that the majority of newspaper representations of mental

illness are negative and position people with mental illness as members of an outgroup. As suggested by Fairclough (1995), discourse practices mediated between

sociocultural practices and the text in terms of the discourses that were drawn on in

media production and were required to be drawn on in reading the text. This is similar

to what emerged in Allen & Nairns (1997) analysis. However, I would argue that

maintaining reader interest in the story is only part of the reason why a strategy that

means a reader has to draw on some existing knowledge to make sense of the text is

used. The other function such strategies may serve is to engage the reader in

constructing versions that support the ideological position taken in the story in order

to elicit readers support for the position through their involvement with the text.

Discourse practices differ from newspaper to newspaper, often when the ideological

position is the same. For example, in support of the detention of people with mentalillness against their will the Sun used highly emotive slang words in the construction

of identity and the construction of a victim identity, the Mail used visual imagery,

medical discourse and references to incapacity and culpability and the Times used

medical discourse and comparisons with out groups.

That most of the representations of people with mental illness were negative has

emerged in every one of the extracts analysed. The use of identities was important in

terms of who was identified, whether they were given an individual identity and

whether they were given the right to speak. How people were set up in relation to

each other was of vital importance. People were positioned as either members of an in

group or members of an out group (usually those with mental illness) and these

identities were often polarised. The power relationships were highly significant in

terms of how these positioned people with mental illness. These identities and

relationships were used in support of certain representations of the world the

ideological position taken in the story. Often the consequences of such representations

were the disempowerment of people with mental illness both in terms of the right to

talk about the topic (which happened to be themselves) and to be placed in a position

where it was justified that they have things (treatment) done to them, possibly against

their will.

The emergence of such negative representations in the analysis in relation to how

people with mental illness are positioned in society at least by the media have

important implications for these people. The selection of this version of events andrepresentations suppresses other versions which could be more beneficial to people.

There are at least two points at which alternative versions are suppressed here. The

first relates to the use of medical discourse in support of the ideological position

taken. It becomes apparent that this discourse is used in support of the position when

considered alongside the representation of people with mental illness. As noted in the

analysis, they are frequently grouped together, but this denies the complexity and

variation in mental illness that is a feature of medical descriptions of mental illness (as

well as individual personal representations). The way in which certain parts of

medical discourse are utilised and others suppressed demonstrates the rhetorical

function of its usage.

The other point at which alternative versions are suppressed is in the representation ofmental illness via medical discourse at all. This relates to the broader sociocultural

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practice of talking about and acting towards people with mental illness and it is done

in a variety of official institutions by the Government, by the medical profession

and in law, for example. The pervasiveness of this way of talking about mental illness

does not alter the historical and cultural specificity of such representations, but it does

mean that it would be extremely difficult to talk about mental illness in any other way

which sounded credible to the majority of people.This analysis has demonstrated to a certain extent what representations of people with

mental illness are created in English national newspapers, how these are created, what

function they have in the text and what the implications of these are. This is in line

with a constructionist approach which suggests that language is not neutral but

performs social actions. This is perhaps a reason why there has been limited success

with investigations into attitudes and attempts to change these. Looking at attitudes

denies the constructed nature of representations and the function of these.

There is a lot of scope for more research into this area. The current study is quite

limited due to the constraints of length and time. It could be extended to include more

stories over a longer period of time and also to include comments and letters, which

may show very different representations. It could also be applied to regional papersand other forms of media such as radio and television. An alternative to looking at

peoples attitudes would be to look at peoples talk about mental illness. Given the

lack of representation that has been demonstrated in this area, it would be of worth to

study the talk of people who have been labelled as mentally ill and see how they

position themselves in society through their talk.

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Appendix

The Guardian, 9/12/98, p14

Civil liberty row onmental health lawDavid Brindle, Social

Services Correspondent

MINISTERS were1. last night squar-

2. ing up for a3. clash over civil

4. liberties after it

5. was confirmed that a 700

6. million overhaul of care in

7. the community would be bol-

8. stered by sweeping legal

9. changes to enforce treatment

10. of mental disorders.

11. Frank Dobson, the Health

12. secretary, promised that the

13. overhaul would mean more

14. secure beds for mentally ill

15. people and the creation of as

16. sertive outreach teams to

17. keep tabs on patients living

18. outside hospital. These moves

19. were broadly welcomed by

20. mental health groups.

21. However, he made clear

22. that the Government antici-

23. pated legal changes to en-24. sure compliance with appro-

25. priate treatment and was

26. also discussing with Jack

27. Straw, Home Secretary, plans

28. for a new form of renewable

29. detention for people with

30. personality disorders consid-

31. ered untreatable.

32. This follows the case of

Michael Stone, convicted of

33. the killings of Lin and Megan34. Russell. Stone had previously

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Civil liberty row on mental health law, The Guardian, 9/12/98, p14, continued

35. been deemed untreatable. The

36. proposed orders would apply

37. to those thought to pose a

38. grave risk to the public,39. regardless of whether any of-

40. fence had been committed.

41. The Government insists

42. that its measures will be ac-

43. ceptable to the European

44. Court of Human Rights, but

45. anxieties are already being

46. expressed.

47. Julia Neuberger, chief exec-

48. utive of the Kings Fund

49. health policy institute said:50. We are extremely concerned

51. about the human rights impli-

52. cations of some of the Govern-

53. ments suggestions.

54. We must have a balance

55. between securing public

56. safety and honouring the

57. rights of individuals

58. Simon Hughes, Liberal

59. Democrat health spokesman,

60. said: By forcing patients to

61. take their medication against

62. their will, some will be kept

63. drugged up to stop them caus-

64. ing trouble.

65. This is not treatment, but

66. incarceration.

67. The planned legal changes

68. were outlined in a document

69. setting out a strategy on men-

70. tal health, after what Mr. Dob-71. son called the failure of

72. care in the community.

73. Although the strategy had

74. been billed as the scrapping

75. of care in the community, it

76. will in reality shore it up. A

77. cumulative 700 million extra

78. will be spent over the next

79. three years by the NHS and

80. social services, at least 500

81. million of which will be ear-82. marked for specific, White-

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83. hall approved schemes.

84. Mr Dobson gave little fur-

85. ther detail. Decisions on legal

86. changes and expansion of se-87. cure bed provision remain de-

88. pendent on reviews still in

89. progress.

90. He stressed, however, that

91. the safety of the public must

92. be the prime concern..

93. The strategy was welcomed

94. by Jayne Zito, who founded

95. the Zito Trust to campaign on

96. the failings of care in the com-

97. unity after the killing by98. Christopher Clunis of her

99. husband, Jonathan.

100. The combination of new

101. money, mew resources and

102. new powers will go a long

103. way to repairing the terrible

104. damage inflicted by a policy

105. which was so ill conceived

106. and so badly implemented

107. that it quickly became disrep-

108. utable and dangerous.

109. The schizophrenia charity,

110. Sane, also applauded the

111. strategy as better than ex-

112. pected. Marjorie Wallace,

113. the chief executive, said: We

114. must prevent the headline

115. cases by intervening earlier

116. to protect the liberty of pa-

117. tients themselves, the fam-

118. ilies, the victims and the119. public.

120. We therefore accept the

121. need that doctors should have

122. earlier powers to recall for

123. treatment people who are not

124. taking their medication and

125. deteriorating in the

126. community.

127. The National Schizophre-

128. nia Fellowship, however, ex-

129. pressed deep disappoint-130. ment at the funding

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131. commitment, pointing out

132. that only 150 million extra

133. would be available next year.

134. Cliff Prior, the chief execu-135. tive, said: This is a package

136. with glossy wrapping, but

137. when you look inside its half-

138. empty. The charity had

139. called for an extra 1.5 billion

140. over three years.

141. Ethna Kilduff, co-chair of

142. United Kingdom Advocacy,

143. representing users of mental

144. health services, accused the

145. Government of double stan-146. dards in condemning the

147. stigma of mental illness, and

148. encouraging users to help

149. plan services, but the

150. launching a policy the pan-

151. ders to damaging popular

152. prejudice.

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The Times, 9/12/98, p2

New curb on mental patient riskBY ALEXANDRA FREANSOCIAL AFFAIRS CORRESPONDENT

1. MEASURES that will enable the authori-

2. ties to lock up mentally ill people who are

3. considered a severe risk to the public are

4. to be introduced by the Government as

5. part of a 700 million package of reforms

6. to the mental health services.

7. Announcing the first major changes to

8. the discredited care in the community sys-

9. tem since its introduction in 1980, Frank

10. Dobson, the Health Secretary, said that

11. he would create a renewable detention

12. for people with severe psychopathic disor-

13. ders who were considered untreatable.

14. The proposals, drawn up jointly with

15. the Home Office, are the result of increas-

16. ing concern about the number of violent

17. crimes committed by people with person-

18. ality disorders who are considered danger-19. ous but who do not respond to convention-

20. al treatment with drugs or with therapy.

21. The new measures will close a loophole

22. in the law that, at present, makes it impos-

23. sible to send these people to hospital

24. against their will or to imprison them un-

25. til they have committed a crime.

26. Although Mr. Dobson conceded that the

27. detention of people who had not commit-

28. ted any crime raised all sorts of ethical

29. and practical problems, he said that pub-30. lic safety had to be his prime concern.

31. People whose mental illness poses a

32. threat to others are a very small minority,

33. but we must be able to deal with them.

34. Their illness is often an even bigger threat

35. to themselves and our new system shall

36. be better both for them and the public, he

37. said.

38. Release back into the community from

39. a renewable detention order will depend

40. upon a rigorous assessment that the per-41. son no longer poses a severe risk to the

25


26/42


New curb on mental patient risk, The Times, 9/12/98, p2,continued

42. public.

43. Mr. Dobson also wants to give health

44. workers new powers to force mentally ill

45. people living in the community to take46. their medication.

26


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The Mirror, 9/12/98, p4

EVIL PSYCHOS WILLBE CAGED FOR EVER by JO DILLON

1. MURDEROUS psychopaths will be caged forever

2. under sweeping new mental health reforms

3. announced yesterday.

Other untreatable people who pose a grave threat

4. to the public will also be locked away.

5. Health Secretary Frank Dobson said the 500mil-

6. lion package was need7. because care in the

8. community had failed.

9. We need a law that

10. works in a crisis, not one

11. that fails in a crisis, he

12. told MPs.

The Government is

13. determined to prevent

14. more killings like the

15. unprovoked stabbing of

16. commuter Jonathan Zito,17. killed in 1992 by paranoid

18. schizophrenic Christopher

19. Clunis. The package will

20. provide:

21. NEW treatment and

22. NHS beds for the mental-

23. ly ill.

24. 24-HOURcrisis teams

25. to respond in emergencies.

26. MORE hostels and sup-

27. ported housing.28. IMPROVED mental

29. health training for GPs.

30. Mr Zitos widow Jayne,

31. who battled for tougher

32. laws after his murder,

33. praised the move.

34. she said there was a

35. sense of anger and relief.

27


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Daily Mail, 7/12/98, pp 16 & 17.

AS THE GOVERNMENT UNVEILS ITS PLANS TO TACKLE THE SCANDAL

OF CARE IN THE COMMUNITY, A DEVASTATING DOSSIER ON THE LIVESIT HAS CLAIMED

Danger patients gallery of victims

1.Action over the

2.schizophrenics

3.who wont taketheir medicine

4. By GABY HINSLIFF

5. Political Correspondent

6. SCHIZOPHRENICS who refuse to

7. take medication will be sent back to

8. hospital under plans to be unveiled

9. by Health Secretary Frank Dobson

10. tomorrow.11. He will acknowledge the failure of care

12. in the community, which led to a series of

13. tragedies after mental patients were

14. released on to the streets.

15. A key factor in many of the killings was that

16. outside formal hospital care, schizophrenics

17. stopped taking drugs which repress their

18. condition and doctors were powerless to act.

19. Under Mr Dobsons strategy 24-hour cen-

20. tres with beds for mental patients in tempo-

21. rary crisis are being set up nationwide.

22. Legal changes will be made allowing the

23. recall of patients who are clearly not coping in

24. the outside world.

25. And the Government is keen to extend the

26. Mental Health Act to cover untreatable dis-

27. orders. Currently only treatable cases can be

28. kept In hospitals a loophole which allowed

29. Michael Stone, the killer of Lin and Megan

30. Russell, to be discharged.

31. Mr Dobson will say public confidence in32. Care in the community is at an all-time low.

28


29/42


Danger patients gallery of victims, Daily Mail, 7/12/98, pp16 & 17, continued33. Too many vulnerable people have been left

34. to cope on their own. Some have become a

35. danger to themselves, their relatives and the

36. public. Care in the community has failed. I

37. will not tolerate that failure. Currently only38. incalculable suffering

39. of the families

40. patients in hospital can be made to take med-

41. ication. If they are released and psychiatrists

42. discover they are not taking the drugs, this

43. alone is not grounds to section them take

44. them back into hospital or keep them there.

45. Only once they reach the stage of being a

46. clear danger to themselves or others can such

47. powers be used- and then it is often too late.

48. The plan is expected to give doctors pow-

49. ers to force patients in other settings, such as

50. mental health hostels, emergency beds and

51. out-patient clinics, to take medication before

52. the become dangerous. Some psychiatrists

53. have called for emergency powers allowing

54. them to medicate patients forcible wherever

55. they are, but visions of nurses breaking down

56. doors to deliver injections outraged mental

57. illness groups.

58. The Department of Health is planning a59. middle way. This could involve a milder form

60. of sectioning, where the patient would be

61. obliged to visit or stay at the clinic, but stop-

62. ping short of forced confinement in a psychi-

63. atric hospital.

64. The campaigning group Sane said it sup-

65. ported powers to keep patients who do not

66. take medication in clinics. Chief executive

67. Marjorie Wallace said she had been warning

68. for 15 years that care in the community would

69. leave officials with blood on their hands,70. adding: Now they have a chance to reverse

71. the policy which led to hundreds of unneces-

72. sary deaths and incalculable suffering for

73. patients, their families and the public.

74. The scandal of care in the community was

75. first highlighted by the landmark case of

76. musician Jonathan Zito, stabbed on a Tube

77. platform by schizophrenic Christopher Clu-

78. nis in December 1992. These pictures, of Mr

79. Zito and 47 other victims of such tragedies,

80. are just some examples of the problem Frank81. Dobson is trying to solve.

29


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The Guardian, 22/8/98, p11

Legal loopholeFrees stalker

Sarah Hall

1. A PSYCHOPATH who2. stalked a woman who

3. resembled TV star Pam-

4. ela Anderson yesterday

5. walked free from jail after a

6. judge ruled he could not be

7. sent to a secure hospital be-

8. cause of a legal loophole.

9. Judge Peter Fingret said it

10. was regrettable the con-

11. straints of the Mental Health

12. Act prevented him dispatch-

13. ing Clarence Morris to Ramp-14. ton secure hospital for an in-

15. definite period.

16. Morris, aged 39, had sub-

17. jected Perry Southall to an

18. eight-month campaign of

19. harassment.

20. Under the law, only those

21. with treatable mental dis-

22. orders can be detained in hos-

23. pital. Morris, from Poplar,

24. east London, who has a psy-25. chopathic disorder, is deemed

26. untreatable, and so was

27. released despite psychiatrists

28. ruling he posed a high risk

29. of future violence.

30. Last night Miss Southall, a

31. 24-year old dental reception-

32. ist, told ITNs News at Ten: I

33. feel let down by the mental

34. health systemYou have

35. got all these psychiatrists and36. they have got the power to put

30


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Legal loophole frees stalker, The Guardian, 22/8/98, p11, continued

37. these people away and they

38. dont use that power.

39. Morris, who pleaded guilty

40. to causing her psychological41. actual bodily harm, was sen-

42. tenced to 46 months in prison

43. yesterday but released imme-

44. diately since he had already

45. spent 27 months in custody.

46. The Suzy Lamplugh Trust,

47. which advises on how to deal

48. with stalkers, called for the

49. legal loophole to be closed.

50. The Home Office said last

51. night ministers acknowl-52. edged there was a gap and it

53. was being urgently reviewed.

54. Southwark crown court n

55. south London was told Morris

56. had already spent 15 years in

57. jail for convictions including

58. rape, unlawful sexual inter-

59. course and indecent assault.

60. He bombarded Miss Southall

61. with womens underwear and

62. love letters after meeting her

63. in October 1995 when he en-

64. tered her surgery in White-

65. chapel, east London, for treat-

66. ment, it heard.

67. He continued writing to her

68. when in custody in Brixton

69. prison, south London, sent

70. her photographs of nude

71. women, and threatened to

72. attack her with a claw ham-73. mer and wallpaper scraper.

74. The campaign caused her

75. sleeplessness and to burst

76. into tears.

77. He was initially sentenced

78. to five years in prison in 1997,

79. but won a retrial, at which he

80. pleaded guilty, earlier this

81. year. At this hearing, a Ramp-

82. ton psychiatrist said he felt

83. Morris might qualify for84. treatment at the hospital,

31


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Sharyn Hyde Independent

Documents

Independent Studies Feb 2000