1

p t s d
MINDSET Reporting on
Mental Health
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FOREWORD

STIGMA AND MENTAL ILLNESS

By André Picard, Health Columnist, The Globe and Mail

There is no question that stigma has an impact

on the lives of people living with mental illness.
Negative stereotypes and prejudicial attitudes
help create an environment that can dissuade
people from getting help, impact their medical
treatment, interfere with their ability to get
work, undermine their human rights, destroy
relationships with family and friends, and even push people to
take their own lives.

The media influence, to a perverse degree, public opinion and

public policies, both of which have the potential to improve the
care and the lives of people with conditions like depression,
schizophrenia, bipolar disorder, anorexia, addiction and other
brain diseases.

So what is the role of journalists and editors in tackling the

stigma that invariably comes along with these diagnoses?

Is our role to sit back, observe and report dispassionately on this

sad state of affairs, or to proactively set out to bring about social
change?

The short answer is: A bit of both.

The single most influential change that the media can (and
should) make is to start treating mental illnesses the way they
do physical illnesses: With curiosity, compassion and a strong
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dose of righteous indignation when people are mistreated or Things are changing, in the media and elsewhere, but not
wronged. quickly enough.

Journalists should be as willing to write about depression as For real, meaningful change to occur, we need to be conscious
breast cancer, as dogged and thorough in the reporting of of our failings, of the shortcomings in coverage of mental
advances and setbacks, and as determined to seek out patients health issues, and address them systematically.
to illustrate their stories. They should be no more forgiving of
long waits for a child to see a psychiatrist than they are of long It starts with language. We have to be conscious about the
waits for grandmothers needing hip replacements. They should impact of outdated, prejudicial turns of phrase – not saying,
cover suicides the same way they cover murders, seeking to find for example, that someone has “committed” suicide, which
answers about the causes, while mourning the dead, flaws and implies a crime has been committed. We need to do away
all. with euphemisms like “died suddenly” and “he snapped” and
use precise language like “took his own life” and “suffered a
Yet, all too often, we are too willing – subconsciously or psychotic episode.”
otherwise – to accept this second-class status for mental health
issues as the norm. We also need to clean the slate of assumptions, like people
with mental illness are less intelligent or more artistic. Instead
The media have also allowed certain quirks to shape coverage of fueling the notion that people with mental illness are violent,
of mental health issues. We rarely write about people with we should provide context, that they are, in fact, many times
severe mental illness unless they experience a psychotic episode more likely to be victims of violence.
and perpetuate some gruesome act like beheading a stranger
on a bus. When we do features on patients who have overcome Then comes the hard part: Equality – treating mental health like
mental illness, we treat them as objects of pity, rather than other health and social issues.
beneficiaries of treatment. As for suicide, there are longstanding
taboos that lead us to turn away in shameful silence. It’s the process the media has followed, at varying speed, in
writing about every major social change, from the abolition of
Some of this can be explained. In the media, we cover the slavery to the emancipation of women and beyond.
unusual, not the mundane; we tend toward the black-and-white
rather than the grey; and we shy away from the inexplicable. Writing about mental illness in all its richness, and with all its
challenges, need not cause stigma. Rather, it provides us with a
Yet, when it comes to mental health, these approaches serve to rare chance to bring about meaningful social change alongside
perpetuate stigma. a golden opportunity to better journalism.

In recent years, mental health has come out of the shadows.

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TABLE OF CONTENTS

Foreword: André Picard................................................... 3

Introduction: What’s It All About? ................................ 8
Chapter 1: Understanding Stigma............................... 10
Chapter 2: One Size Doesn’t Fit All............................. 13
Best Practice Checklist......................................... 14
Quick Reference .................................................. 16
Chapter 3: Treatment Issues......................................... 19
Chapter 4: Interviewing................................................ 21
Interviwing Dos and Donts................................... 24
Chapter 5: Mental Illness & The Law.......................... 25
Best Practice Checklist......................................... 29
Chapter 6: Covering Suicide......................................... 30
Suicide Dos and Donts......................................... 31
Language Best Practice........................................ 32
Background Facts................................................. 33
Chapter 7: Mental Illness and Addiction..................... 34
Addiction Checklist.............................................. 35
Website information...................................................... 36
Quick Reference Compendium..................................... 37
Publication information................................................. 42
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INTRODUCTION FOREWORD
It’s not about self-censorship, or changing the definition of news.
It’s about getting the facts right, exploding myths and placing
WHAT’S IT ALL ABOUT? stories in proper perspective.
Almost everyone in Canada is affected in some way by It’s also about alerting ourselves to stories we may be missing
mental illness. Statistics Canada estimates that 20% of the - stories that probe issues, successes and shortcomings in
population has some form of mental disorder each year. Canada’s fractured and sometimes fractious mental health
system.
Some suffer in silence, too afraid to seek help. Up to 30% of
Canadians will receive a mental illness diagnosis in their lifetime. After all, these are stories about us. All of us in time are likely
It’s a surprising figure - and one that incidentally underlines the to slide back and forth along the continuum between mental
broad range of illness and disorder that falls under the heading health and mental illness.
of mental illness.

As some recover and others fall sick, and as family and friends
become involved, there’s no longer any ‘them’ and ‘us’. Mental
illness becomes an issue for all. Yet fear and negative feelings
for people who are mentally ill are persistent and pervasive.
Public attitudes aren’t determined by any
Stigma often flies in the face of facts, which should make it a
means exclusively by the media, but the media
natural concern for journalists. One in five journalists know this has a very big impact on public attitudes and
all too well, because they are currently battling mental illness on the ability to change public attitudes for the
themselves. Journalists are not immune. better or for the worse. I think that journalists
have a huge role to play in moving mental
Many who experience mental disorders lead useful and illness from kind of a concept to something
productive lives, either in full recovery or by managing their at the real individual, personal level. And only
symptoms through medication, therapy and other means. journalists can do that because they have the
reach.
The Hon. Michael Kirby
Very, very few of those affected by mental illness will pose any Former Senator
threat to others. People who are mentally ill, in general, are Founding Chair, Mental Health Commission
of Canada
far more likely to become victims rather than perpetrators of President, Partners for Mental Health
violence. But that’s not what our gut tells us.

This guide will explore why that is so, how the news media
may unintentionally or otherwise contribute to such a false
impression, and what we as journalists can do about it.
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CHAPTER 1
We live with illnesses, but as people we
UNDERSTANDING STIGMA are so much more and many of us are very
productive people, who live next door
As many as two thirds of Canadians who suffer some form to you. By recognizing this, I believe the
of mental disorder avoid seeking treatment, for fear of how media could go a long way to reducing
they will be perceived and how their lives might be affected. the stigma attached to people who live
Under-reporting leads to under-provision of mental health with a mental health condition.
services, making the situation even worse. Rick Owen, Journalist,
Kirkland Lake, Ontario
(Diagnoses: Depression and Addiction)
With so many people going without help, we see less evidence
of recovery, so that prejudices against people with mental illness
are reinforced.

Discrimination feeds on misinformation. Way down at its root,

when it comes to mental illness, lies our deep-seated fear of
unpredictable, horrific violence. And it is those violent stories
that take a great deal of our attention, because they are not simply to reinforce or feed on society’s prejudices.
newsworthy.
This guide is based on three propositions which we found were
But to blame journalism for creating this situation is both unfair widely supported by mental health professionals we consulted
and pointless. More useful questions to ask are: or interviewed:

• To what extent does journalism compound the problem? • The lion’s share of stigma is generated and reinforced by
very rare, highly shocking, well-publicized instances of
• What can we add to stories involving violence that puts violence by people affected by very serious untreated
them in perspective? illness.

• What is journalism doing to throw light into the dark • Attempts to counter the emotional impact of such stories
corners of mental illness and the mental health system, to by generating more positive news about mental illness are
help vanquish enduring myths? commendable, but unlikely to succeed on their own.

Much excellent journalism has been done in this area by • Censoring or playing down coverage of major incidents of
Canadian newspapers, radio and television. Many journalists, we psychotic behaviour leading to death or serious physical
believe, entered the business with a desire to make a difference, harm is not an option in an open society.
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So what can journalists who recognize the problem actually do CHAPTER 2

to make a real difference? We arrived at two broad answers:

• Journalists should train some of their investigative skills ONE SIZE DOESN’T FIT ALL
on mental heath issues with persistence, fearlessness and
vigour. Ultimately, the best way to reduce the number of Treating mental illness as a single category is a big part of
stories about horrific acts by people in psychotic episodes the problem.
is to probe why these incidents continue to occur.
With physical health, we routinely differentiate, for example,
• In all their work, reporters and editors should be aware between infections, heart problems and cancer. When it comes
of the damage that can be done by reinforcement of to mental health, however, much tends to become conflated.
stereotypes and strive to minimize it. And so unreasonable fear produced by extreme cases of
psychosis rubs off on a much larger range of people with anxiety
The purpose of this guide is to give you some tools and ideas disorders and the like.
about how to do just that, and to do smarter, better stories.
It’s worth repeating: With the exception of a tiny minority,
most people diagnosed with a mental illness are significantly
more likely to be the victims rather than the perpetrators of
violence. But this is seldom recognized by the public at large.
For decades, people with mental illnesses Vagueness only makes it worse. When dealing with stories
were subjected to one of the most intense
involving mental illness and violence, it’s important to be
kinds of discrimination in Canadian history.
specific. You should always seek authoritative confirmation of a
They were shoved into institutions or attics
or basements for years. We’re still dealing specific diagnosis. A police officer’s word or a neighbour’s vague
with the echoes of all that. Stigma is not assertion that someone in the news had ‘mental problems’
nearly as bad as it was, people are talking, but can be problematic and contribute to stigma. Besides, it’s not
50% of Canadians who have a mental illness accurate.
or have it in the family will still not reveal it
publicly. Journalists can help by bringing more Even within schizophrenia - potentially the most severely
understanding to the table. challenging of mental illnesses - there is no uniformity. People
Lloyd Robertson, CTV News
may have mild, medium or severe forms of the disorder. They
may or may not hear voices, and those voices may or may not
present real dangers. Indeed, not everyone who hears voices fits
the rest of the criteria for a diagnosis of schizophrenia. Nor does
every person with schizophrenia become violent. Once again,
journalists need to exercise professional caution.
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Don’t just associate mental illness with

While full recovery (meaning a return to their state before the terrible crimes. Write about it in another
illness struck) in people with schizophrenia is rare, as many as way, not necessarily more positive, but in
65% do, with treatment, achieve a degree of control over their a framework that better represents reality.
symptoms and some hold down jobs - even in at least one case Ninety-seven percent of people with
as a neuroscientist. Thus the stigma generated by high-profile schizophrenia never commit crimes. You
acts of violence by people in psychosis caused by untreated have to be very careful not to let mental
schizophrenia is a significant problem for others under treatment illness become synonymous in the public
for the disorder, as well as those with less disabling diagnoses. mind with violence.
Katia Gagnon, La Presse
Consider adding some of these facts to provide context to your
stories.

➤ BEST PRACTICE CHECKLIST

✓ Don’t reinforce stereotypes (especially in headlines).

✓ If violence is involved, put it in context: Violence by

people with mental illness is rare.
The first thing we have to do is talk about
mental health challenges. We have to part
✓ Don’t imply all people with schizophrenia are violent. the curtain. What we’ll find is an illness,
not a moral failure. Once we start sharing
✓ Avoid referring to people with schizophrenia as our stories, we will take the charge out
“schizophrenics”. Generally speaking, labeling someone of talking about it. If we all do this, it will
by the name of their disease is not a good idea. be as easy as talking about any illness. It’s
important to know that we aren’t alone in
✓ Strive to include quotes from those affected or others this. Not by a long shot.
like them. Shelagh Rogers, OC
CBC radio host/producer
(Diagnosis: depression)
✓ Be careful and specific about diagnoses.

✓ Include professional comment / seek professional advice

when needed.
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➤ QUICK REFERENCE Anxiety Disorders: A range of conditions affecting about 12%

of Canadians. These include Obsessive Compulsive Disorder
Schizophrenia: A serious, chronic but treatable brain disease and Post Traumatic Stress Disorder. Generalized Anxiety
affecting about 1% of the population. Onset usually occurs in Disorder is characterized by chronic worry, fear and panic
adolescence or young adulthood. Patients may hear command interfering with ordinary living and social interaction. Treated by
voices and lose touch with reality (psychosis). A small proportion counseling, group therapy and medication.
of people with untreated schizophrenia may become violent
during psychosis. Treatments include psychotherapy, awareness Personality Disorders: These disorders involve inflexible
therapies and anti-psychotic drugs. Although schizophrenia behaviours outside social norms, persisting to the point of
is often seriously debilitating, treatments can deactivate making ordinary life difficult. May be caused by trauma in
symptoms and enable patients to work and relate well to others. childhood. Treated by psychotherapy.
Schizophrenia does NOT involve ‘split-personality’.
Obsessive Compulsive Disorder: Characterized by repeated
Bipolar Disorder: Sometimes called manic depression. Patients and ritualistic behaviours, such as repeatedly carrying out
cycle between depression and hyperactivity, sometimes actions in a set order, repeated hand washing or counting.
accompanied by recklessness and unrealistic belief in their
abilities and importance. A small minority of patients may Attention Deficit Hyperactivity Disorder: The most common
become psychotic and violent. Treatable with therapy and behavioural disorder occurring in childhood. Children with
drugs. ADHD have difficulty concentrating, and they become restless
and distracted. Children with ADHD may be prone to impulsive
Depression: A debilitating disorder involving loss of motivation, outbursts of speech or behaviour.
lethargy, anxiety, feelings of worthlessness, insomnia and
general hopelessness. Interferes with a person’s ability to Eating Disorders: Among all mental illnesses, these have the
cope with daily life. Some may become suicidal. Treated with highest mortality rate. About 10-20 per cent of patients die from
medication and therapy and may be managed by therapy and the disease or from complications. These disorders are more
self-help techniques. common among females than males and usually relate to issues
of self-esteem.
Post-Partum Depression: One of the most common
complications following childbirth, characterized by an intense Recovery: Professionals use this term in different ways. The
sense of inability to cope with the baby’s needs. Accompanied important thing to stress in order to provide context and a
by tiredness, irritation and loss of appetite. Untreated, it can complete picture is that many people with a mental illness
lead to suicide and infanticide. who receive treatment can recover. There are two main ways
professionals use the term recovery. They mean different things
so it’s important to check what they really mean:
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Recovery in Mental Illness: When someone with a chronic CHAPTER 3

mental illness can manage the symptoms and return to some
quality of life, although not the same as before the onset.
TREATMENT ISSUES
Recovery from Mental Illness: Also referred to as clinical
recovery. This means returning to the state one was in before Even before psychiatry expanded the definitions of
the onset of the condition. mental illness with the publication in 2013 of the DSM-5, a
diagnostic classification tool, recorded incidence of mental
illness had been on the rise worldwide. That may be because
of improved detection and broader research, rather than
increased occurrence. Rates of schizophrenia and bipolar
disorder, two of the most serious mental illnesses, are
generally steady.

Among those who believe mental illness to be broadly

increasing, opinion is divided as to the relative roles of
biological and social factors. Some argue that the pace and
stress of 21st century life renders many more susceptible to
disorders such as anxiety and depression.

Beginning in the 1960s, many countries adopted a policy

I think the key is to think of them as if of increased care in the community. The move followed the
they were from your family. Don’t think of development of the first anti-psychotic and anti-depressant
them as a label, a patient, or as someone drugs. Many mental hospital beds were closed, usually without
with schizophrenia. Think of them as a sufficient funding being transferred to community services. This
person, talk to them like they are our
resulted in spiking rates of homelessness, unemployment, self-
people, as indeed they are.
medication with alcohol and street drugs, and petty crime.
John Kastner, director of documentaries
NCR: Not Criminally Responsible
and Out of Mind, Out of Sight MENTAL HEALTH ACTS
Every province in Canada has its own Mental Health Act. They
lay down, among other things, the conditions under which a
physician can prescribe treatment against the patient’s will. For
some patients with psychotic illnesses, symptoms can include a
lack of insight into the fact of their own illness.
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The patient has a right to a hearing, with legal representation, CHAPTER 4

within seven days to dispute any doctor’s treatment order.
The appeal is heard by an independent three-person board,
consisting of a psychiatrist, a lawyer and a member of the INTERVIEWING
public.
Stories about people with mental illness should include the
voices of those people. Giving a voice to the people who
SOURCES OF TREATMENT
are actually living the experience makes for better story
A shortage of psychiatrists in Canada and their concentration in telling, and better journalism. Including people with mental
major urban areas means patients seeking voluntary treatment illness helps break the myth that they are “not like us” when
may have to wait a year to see one. in fact they are in the mainstream.

Some patients with minor disorders are treated by general Psychotic behaviour - by someone who is out of touch with
practitioners. Some also pay for counseling, outside provincial reality - is easily recognizable. No one should attempt an
health programs, by clinical psychologists. interview with a person in that state. People with personality
disorders such as psychopathy, involving impulsive anti-social
A variety of self-help groups for various conditions is also behaviour, may also be dangerous. Otherwise, there is no
available. Some of these groups style themselves “consumer/ physical danger to the reporter.
survivors” and may be opposed to standard psychiatric
methods. The real danger lies in distorting news coverage by ignoring
the voices of 20% of the Canadian population. Very often, news
TREATMENT ISSUES reports talk about people with mental illnesses as though they
Some civil liberty groups oppose forced treatment in any were outside normal social interactions - a throwback, perhaps,
circumstances, arguing that people have a right to be sick. to times when mentally ill people were locked up and forgotten.
A challenge to Ontario’s Mental Health Act on that basis was
rejected by the Ontario Supreme Court in September, 2013. If you were writing a story about dealing with a broken leg, the
first thing you would do would be to speak to people in that
On the other hand, some psychiatrists believe mental health situation.
acts should give doctors more latitude, when making treatment
orders, to consider what they are told by family members about Ignoring the voices of mentally ill people also runs the risk of
a patient’s behaviour. In British Columbia, the law now allows alienating one-fifth of your readers, listeners or viewers.
this in the case of a family member who is a care-giver. Most journalists have learned to change their approach when
they switch from interviewing powerful people to vulnerable
A lack of forced treatment has been a factor in well-publicized ones: Being friendly, taking time, asking open-ended questions,
criminal cases involving pleas of Not Criminally Responsible. taking care not to push too hard or to re-traumatize, but still
(See Chapter 5.) seeking clarity and insight.
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of recovery, especially in connection with serious illness, is a

case in point.
I report on mental illness - depression,
schizophrenia - and I am aware that in these
cases the journalist must use his power with As with physical illness, many people with a mental illness who
a lot of discretion. It’s understood that receive treatment can recover. Reporters and editors who bear
I will recognize the limits imposed by the this in mind can help reduce stigma.
person’s illness and their fundamental
right to respect. Among those whose illness is chronic, some are able, with
Michel Rochon appropriate treatment, to manage their symptoms and
Health & Science Journalist substantially improve their quality of life. This is sometimes
Radio-Canada
called ‘recovery in mental illness’, as opposed to ‘recovery from
mental illness’, or clinical recovery, defined as returning to the
state the person was in before the illness occurred.

When interviewing professionals who cite recovery rates,

journalists should determine which definition is being used and
report accordingly.

Demonstrating empathetic interest helps. Assuming you know

how the person feels or ought to feel doesn’t.
See them as a person, not a diagnosis.
Take care to ensure that the interviewee understands that his There’s no reason to fear. Not only ask
or her name and diagnosis will be made public, and that the them about their experience of what it’s
person is in a proper emotional state to give informed consent. like to have schizophrenia... you need to
ask them what has helped or hindered
If the person is not in such a state, ask if you can return at a later you in your recovery? What has helped
time to include their words in a follow-up story, if there will be you to have some quality of life? So
one. Leave a phone number so that they can initiate contact interview that person just like you would
when they are ready. For today’s story, try talking to a mental interview a person who has Parkinson’s
disease.
health professional instead.
Chris Summerville
CEO, Schizophrenia Society of Canada
DEFINITIONS OF RECOVERY
Reporters should be aware that mental health professionals may
hold differing views about aspects of mental illness. The matter
24 25

➤ INTERVIEWING DOS AND DONTS CHAPTER 5

MENTAL ILLNESS AND THE LAW

Do talk to people who have mental disorders and include what
Very few of the seven million Canadians with mental
they say in your stories.
disorders ever come into conflict with the law. Those
most likely to do so are the ones whose illness leads to
Do remember these are people who naturally deserve respect. homelessness, addiction and petty crime or breaches of
public order.
Do demonstrate empathy, ask open-ended questions.
Until fairly recently, such people were generally dealt with
in the regular court system, waiting for weeks or months for
Do ensure the person understands the implications of being
medical assessment, clogging courts and jails that were ill-
interviewed and gives informed consent. equipped to deal with them, receiving little or no treatment
during incarceration, having no follow-up treatment arranged
after release, and consequently often repeating the cycle with
depressing regularity. The cost to the legal and penal systems
Don’t re-traumatize by pushing too hard. was substantial.

Don’t interview people when they are out of touch with reality Most major cities now have diversion courts, sanctioned by
or psychopathic. the Criminal Code, many of which deal exclusively with low-
risk cases in which the accused appears to have a mental
illness. These courts are oriented towards treatment rather than
Don’t be scared: Outside those rare conditions, people with punishment. Their repeat-offender rate is impressively lower
mental disorders are harmless. than that in the regular court and penal system, and strain on
the public purse is significantly reduced.
Don’t assume you know how the person feels or thinks.
Cases are selected for diversion by the Crown. Both judge and
Crown have special training and legal personnel are usually
Don’t imply their illness is incurable.
outnumbered by dedicated mental health and social workers.

Typically the accused is medically assessed - often on site the

same day - acknowledges the offence, agrees to court-ordered
treatment, and has his or her charges withdrawn when it is
satisfactorily completed.
26 27

Treatment orders are issued by mental health courts with the

patient’s consent (albeit under circumstantial duress) and so do I always have a bit of a knot in my stomach
not have to conform to the restrictions of the provincial Mental when one of these (high profile) cases
Health Act for involuntary treatment. However, where the comes up, because I’m wondering how
accused is ‘unfit to stand trial’ the court may impose involuntary we’re either going to be set back or
treatment for up to 60 days. Court proceedings are open to the advanced by how the media cover it.
media, but few of the cases handled, by their nature, generate Hon. Justice Richard D. Schneider
much news. Chairman, Ontario Review Board

FITNESS TO STAND TRIAL

The Criminal Code provides that if a mental disorder makes
an accused person unable to conduct his defence or instruct
counsel, he is ‘unfit to stand trial’. The prosecution is held in
abeyance and a provincial or territorial Review Board assumes
jurisdiction. It decides where the accused is to be housed, under
what conditions, reviewing the matter not less than once a year.

NOT CRIMINALLY RESPONSIBLE

‘GETTING AWAY WITH IT’
When a trial proceeds, either in mental health court or in
superior court in the case of serious offences requiring a jury, Another popular misperception is that those found not criminally
there is provision in the Criminal Code for pleading that an responsible for murder are effectively let off. This view is
accused person is not criminally responsible for the act they often taken by members of a victim’s family, and repeated in
committed. It involves showing, on a balance of probabilities, news reports. The reality is that most people found NCR and
that the accused was ‘suffering from a mental disorder that committed for treatment will lose their freedom for longer than
rendered the person incapable of appreciating the nature and they might if they had simply pleaded guilty. Furthermore, with
quality of the act or omission or of knowing that it was wrong.’ treatment comes belated, life-long appreciation of the enormity
In other words, the person was psychotic at the time of the of their acts.
offence. This is known as the NCR defence.
REVIEW PROCESS
When such a defence is initiated, the judge will usually order a When a jury finds someone not criminally responsible, the case
number of psychiatric evaluations to be carried out by experts is referred to the provincial or territorial review board. Typically,
he or she chooses. It’s a common misconception that the the board will lock the person up in a secure mental hospital
prosecution and defence lawyers can ‘shop around’ for experts to and order treatment, reviewing their progress at least once a
support their case, though they may ask the judge to commission year. Members of the victim’s family usually attend each review,
extra evaluations if they aren’t satisfied with the first results. frequently generating further newsworthy outbursts of rage,
28 29

once again reported alongside - or sometimes above - the

medical evidence presented. It’s an opportunity to take some social
responsibility, which I think most reporters
CHANGES PENDING feel. I think that’s why they’re reporters in
The Harper government introduced legislation in 2013 called the first place.
Heather Stuart, Ph.D.
the Not Criminally Responsible Reform Act. It would formally Bell Mental Health and Anti-Stigma
enshrine public safety as the paramount consideration for review Research Chair, Queen’s University
boards, build into the Criminal Code a definition of ‘significant
threat to the safety of the public’ - the phrase which governs a
Review Board’s jurisdiction over a mentally disordered person -
and allow judges to designate some mentally ill people found
NCR as ‘high risk’.

Such people could not then be granted conditional or absolute

discharges, and would be eligible for reviews only once in three
years. The designation could be revoked only by a court after
recommendation by a Review Board. Access to treatment would
not be affected. ➤ REVIEW BOARD HEARING BEST PRACTICE CHECKLIST
Some judges have expressed doubt whether the proposed ✓ Be clear that the patient is not a criminal.
legislation would have had any impact on most of the high
profile cases of recent years. It has also been criticized by mental
✓ A review hearing is not a re-trial: Focus your story on
rehabilitation, not vengeance.
health professionals. At the time of publication, this legislation
had not yet become law. ✓ Check the ‘facts’ contained in statements made outside the
hearing.

✓ Carefully consider the fairness of relaying characterizations of

the patient made outside the hearing.

✓ Don’t reproduce offensive language that casts stigma on people

who are mentally ill unless it is critical to the story.

✓ Consider doing a more in-depth follow-up story which may

generate more light than heat.

✓ Editors should review this checklist before writing headlines.

30 31

CHAPTER 6 SUICIDE DOS AND DONTS

COVERING SUICIDE Do consider whether this particular death is newsworthy.

RECONSIDERING THE TABOO
Do look for links to broader social issues.
Some news organizations still have policies against covering
suicide - policies that are often broken when newsworthy
suicides occur. This traditional taboo is now out of step with Do respect the privacy and grief of family or other ‘survivors’.
recommended practice.
Do include reference to their suffering.
Suicide is the ninth leading cause of death for Canadians of all
ages and the second biggest killer of adolescents between the
ages of 15 and 19. The suicide rate among teens, however, is Do tell others considering suicide how they can get help.
static. There is a strong, but not universal, connection between
suicide and mental illness.

Studies have suggested that adolescents in particular may be Don’t shy away from writing about suicide.The more taboo, the
susceptible to ‘suicide contagion’. Yet suicide prevention experts more the myth.
now advocate open discussion and do not oppose sensitive
reporting of newsworthy deaths by suicide. This is especially Don’t romanticize the act.
important in the age of social media, when false information and
rumour may be rampant.
Don’t jump to conclusions. The reasons why people kill
themselves are usually complex.
How we report newsworthy suicides matters. Here is a brief
guide to what reporters and editors need to know to cover
suicide deaths responsibly: Don’t suggest nothing can be done because we usually never
know why people kill themselves.

Don’t go into details about the method used.

32 33

➤ LANGUAGE BEST PRACTICE BACKGROUND FACTS

Although much attention is focused on suicide by the young,

Do use plain words. Say the person ‘died by suicide’, ‘killed killing oneself intentionally is more common among men who
herself’, or ‘took his own life.’ are elderly or middle-aged. Canadian men are three times more
likely to die by suicide than Canadian women. This has been
Don’t say the person ‘committed suicide’. It’s an outdated a long-term trend. Married people are the least likely to die
phrase implying illegality or moral failing. by suicide compared with those who are single, divorced or
widowed.
Don’t call suicide ‘successful’ or attempted suicide
‘unsuccessful.’ Death is not a matter of success. About 90% of people who die by suicide in Canada have some
mental or addictive disorder. The most common of these is
Don’t use or repeat pejorative phrases such as ‘the coward’s depression (around 60% of cases).
way out’ which reinforce myths and stigma.
Tim Wall, executive director of the Canadian Association for
Suicide Prevention, says: “Suicide is a very complex issue
and there are many things that will contribute to someone
getting to the point in their life where their sense of hope is
completely overwhelmed by feelings of despair and pain and
hopelessness.” Stigma is thought to be among the contributory
causes.
Media attention to the issue of bullying The overall suicide rate in Canada peaked in 1983 at 15.1 per
- linking it to suicide - is one example of
100,000 deaths. By 2009, the rate had declined by 29% to 10.7.
how suicide has been oversimplified.
Tim Wall Suicide today represents an increasing proportion of deaths
Executive Director
Canadian Association for Suicide among adolescents, but only because the other most significant
Prevention cause of death - accidents - has been steadily declining, while
adolescent suicide rates have been essentially flat.

The most common means of suicide is by hanging (44%) but this

declines with age. Poisoning, including overdoses, is the second
most common at 25%. Suicide by gunshot (16%) increases with
age.
34 35

CHAPTER 7

MENTAL ILLNESS AND ADDICTION While psychiatry treats addiction as a mental disorder in its own
right, it frequently co-exists with others. Up to 80% of people
Some stories that don’t appear at the outset to involve diagnosed with schizophrenia, bipolar disorder or antisocial
mental illness, really do. Medicine considers addiction - to personality also have an addiction problem. Across non-
drugs, alcohol, cigarettes, gambling or anything else - to be addiction mental disorders as a whole, the ‘comorbidity’ rate is
a mental disorder. This often contrasts sharply with popular around 20%.
perception.

Journalists whose stories tend to echo the view that addiction

is a sign of personal weakness are ignoring facts known to the ➤ ADDICTION CHECKLIST
medical profession for more than half a century. Since journalists
themselves have a higher-than-average alcohol addiction rate,
some at least should have personal insight into the problem. ✓ Addiction results from physical changes in the brain,
and is considered a mental disorder.
Addiction changes the brain, altering the order in which it ranks
priorities, regardless of consequences. Dependence involves ✓ Addiction may co-exist with other mental disorders.
compulsive use, increasing tolerance and leading in turn to
further increased use. Such compulsive behaviour is also found in
other mental disorders. ✓ Addiction can also be associated with hereditary and
social factors.
The brain changes involved in addiction are difficult or
impossible to reverse. Consequently an alcoholic, for example, ✓ Medical science says people with addictions are ill.
may - through treatment or willpower - stop drinking. But Respect the person, understand the behaviour.
recovery in the sense of returning to ‘normal’ or ‘acceptable’
drinking patterns is extremely rare.
✓ Stigmatizing people with addictions can adversely
The underlying reasons why some people appear to be more affect their prognosis.
prone than others to substance abuse disorder are subjects of
debate. Some research suggests a genetic component may be at
play. Some psychologists observe that addiction often arises in
response to stress, and shape treatments accordingly.
36 37

I can absolutely guarantee that in most

QUICK REFERENCE COMPENDIUM
of the crimes that are committed by
addicted and mentally-ill offenders, ➤ BEST PRACTICE CHECKLIST
there’s no element of wanting to do that.
There’s no joy from it.

Chris Curry, former addict and ✓ Don’t reinforce stereotypes (especially in headlines).
journalist, turned alcohol & drug
counsellor
✓ If violence is involved, put it in context: Violence by
people with mental illness is rare.

✓ Don’t imply all people with schizophrenia are violent.

✓ Avoid referring to people with schizophrenia as

“schizophrenics”. Generally speaking, labeling someone
by the name of their disease is not a good idea.

➤ IF YOU WANT TO... ✓ Strive to include quotes from those affected or others
like them.
Delve deeper into issues raised in this guide
✓ Be careful and specific about diagnoses.
Consider other journalists’ thoughts and first-hand experience
✓ Include professional comment / seek professional advice
Hear the views of suicide preventionand mental health when needed.
specialists

Follow pertinent case studies

Start or join a discussion

Find useful contacts

GO TO OUR WEBSITE: www.mindset-mediaguide.ca

38 39

QUICK REFERENCE COMPENDIUM QUICK REFERENCE COMPENDIUM

➤ INTERVIEWING DOS AND DONTS ➤ REVIEW BOARD HEARING BEST PRACTICE CHECKLIST

Do talk to people who have mental disorders and include what ✓ Be clear that the patient is not a criminal.
they say in your stories.

✓ A review hearing is not a re-trial: Focus your story on

Do remember these are people who naturally deserve respect. rehabilitation, not vengeance.

Do demonstrate empathy, ask open-ended questions.

✓ Check the ‘facts’ contained in statements made outside the
hearing.
Do ensure the person understands the implications of being
interviewed and gives informed consent.
✓ Carefully consider the fairness of relaying characterizations of
the patient made outside the hearing.

Don’t re-traumatize by pushing too hard. ✓ Don’t reproduce offensive language that casts stigma on people
who are mentally ill unless it is critical to the story.
Don’t interview people when they are out of touch with reality
or psychopathic. ✓ Consider doing a more in-depth follow-up story which may
generate more light than heat.
Don’t be scared: Outside those rare conditions, people with
mental disorders are harmless. ✓ Editors should review this checklist before writing headlines.

Don’t assume you know how the person feels or thinks.

Don’t imply their illness is incurable.

40
40 41
41

QUICK REFERENCE COMPENDIUM QUICK REFERENCE COMPENDIUM

SUICIDE DOS AND DONTS
SUICIDE LANGUAGE

Do consider whether this particular death is newsworthy. Do use plain words. Say the person ‘died by suicide’, ‘killed
herself’, or ‘took his own life.’

Do look for links to broader social issues.

Don’t say the person ‘committed suicide’. It’s an outdated
phrase implying illegality or moral failing.
Do respect the privacy and grief of family or other ‘survivors’.
Don’t call suicide ‘successful’ or attempted suicide
‘unsuccessful.’ Death is not a matter of success.
Do include reference to their suffering.
Don’t use or repeat pejorative phrases such as ‘the coward’s
Do tell others considering suicide how they can get help. way out’ which reinforce myths and stigma.

ADDICTIONS CHECKLIST
Don’t shy away from writing about suicide.The more taboo, the
more the myth.
✓ Addiction results from physical changes in the brain, and
Don’t romanticize the act. is considered a mental disorder.

Don’t jump to conclusions. The reasons why people kill ✓ Addiction may co-exist with other mental disorders.
themselves are usually complex.
✓ Addiction can also be associated with hereditary and
Don’t suggest nothing can be done because we usually never social factors.
know why people kill themselves.

Don’t go into details about the method used.

✓ Medical science says people with addictions are ill.
Respect the person, understand the behaviour.

✓ Stigmatizing people with addictions can adversely affect

their prognosis.
42

Mindset: Reporting on Mental Health is published by

The Canadian Journalism Forum on Violence and Trauma, in
association with CBC News. It was made possible, in part, by funding from the
Mental Health Commission of Canada, provided to MHCC
by a grant from Health Canada. The Forum is solely responsible for the content.

© 2014. All rights reserved.

inside back cover

This field guide is made freely available to news organizations

and journalism schools. It may also be downloaded as a .pdf file from:
www.mindset-mediaguide.ca
More detail and discussion may be found on the same website.

_________

The Canadian Journalism Forum on Violence and Trauma is a federally-registered

charity primarily concerned with the physical and mental wellbeing of journalists,
their families and those they influence.

More information about the Forum is available through:

www.journalismforum.ca
[email protected]
(519)-473-6434

Aussi disponible en français – En-Tête: reportage et santé mentale

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