The human society is made up of people who evolve rules and practices to conduct their affairs over time. These practices are all subsumed under the umbrella of culture, which is defined as a total way of life of the people, including the things we believe naturally without verification.
The central element of any culture, therefore, is value, which prescribes the behavioural attitude of the people.
Practice naturally derives from the traditional legal institutions of the society, which may take the form of bureaucracy or discourses when it assumes an intellectual status. The media in this context is a traditional legal institution that functions as a vehicle of values in the public discourse of mental health issues.
The media of course constitutes a collection that includes not merely television and radio, but the cinema, advertising, newspapers, magazines and pamphlets. Stigma derives from the Greek word that refers to bodily signs designed to expose something unusual and bad about the moral status of the signifier. Such signs were either ‘cut’ or ‘burnt’ into the body and advertised that the bearer was a slave, a criminal or a traitor, someone to be avoided especially in the public.
The sociologist Erving Goffman, in a classic book on stigma, points out that the person with a stigma is more often defined as somehow less than human and to justify the stigmatisation, human beings tend to construct a theory or ideology as a basis of explanation. The stigmatisation theory, most times, rests on the theories of moral weakness, dangerousness, contamination and culpability.
Most of us acquire our stereotypes of mental illness during childhood and while much of the imagery involved is spurious, such expectations and stereotypes are continually reaffirmed and reinforced in ordinary social interactions.
Much of the language of mental health has been absorbed into the public discourse in a manner that is explicitly stigmatising with the use of such terms as ‘psycho’, ’nutter’, ’maniac’, ‘schizo’, ’kolo’ to demean and denigrate the entire field of mental health. The political abuse of psychiatry has given psychiatrists cause to be alert to the professional danger of being misused as agents of social control and contributors to the process of stigmatisation of the mentally ill.
Some researchers have taken a conservative stance as it relates to the social order and some have argued that greater recognition be paid to the social and cultural assumptions on which much of psychiatry theory and practice are based, which is capable of contributing to subtle stigmatisation of the mentally ill within the mental health services.
A good number of our teachers insist that psychiatric units in our teaching hospitals should be located amongst other wards not somewhere in the backyard with minimal use of bars and iron gates. A substantial part of the history of psychiatry has been that of confinement and our images of madness derived from that history which powerfully reinforces the notion of mental illness as a state of incipient danger.
The word’ bedlam’ connotes, among other things, ‘a place of uproar’, which derives from one of the earliest psychiatric institutions, the Bethlehem Hospital. The growth of this hospital for the mentally ill was a spectacular phenomenon of the 19th century, which did little to reduce the fear and the ignorance surrounding the mentally ill.
The mental hospitals retained much of the aura of abuse, neglect, and cruelty surrounding the mad houses of earlier years. This may possibly be the drawbacks in the setting up of our ‘stand-alone’ psychiatric hospitals in Nigeria that have acquired popular stigmatising names like Aro, Yaba apa-osi and others. With the decline in the establishment of stand-alone psychiatric hospitals and the simultaneous development of the psychiatric units in the settings of the teaching hospitals, in addition to the rise of community psychiatry practice; hopes have risen that the stigmatisation of the mentally ill might be eventually eliminated.
However, this strategy requires the education of the general public and greater involvement of the mass media in positive portrayal of mental health issues. Since the cardinal contributory factors to stigmatisation are ignorance, fear and hostility then the antidotes will naturally be information, reassurance, and a vigorous anti-discriminatory campaign. This cannot be achieved without the involvement of the media.
Experience in the developed countries has shown that journalists and broadcasters need to be persuaded that inaccurate reporting, stereotyped portrayals and sensationalist use of discriminatory language and labels are no longer acceptable .On this note, due appreciation should be accorded to the management of The Punch newspapers as a leading media organisation in health advocacy in Nigeria through the daily Healthwise pages.
Our Nollywood producers need to appreciate their crucial role in modifying the attitudes of the people as they produce home videos that can portray the mentally ill in a positive light as our parochial values concerning them are critically interrogated.
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