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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
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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
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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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Civil liberty row on mental health law, The Guardian, 9/12/98, p14, continued
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
23
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Civil liberty row on mental health law, The Guardian, 9/12/98, p14, continued
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
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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.
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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.
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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.
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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.
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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
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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,
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