Mental Illness Narratives Research Articles

Narratives of Mental Illness and Well-being: A 6-Week Course Aiming to Improve Medical Student Empathy and Resilience Through the Creative Arts.

Narratives of mental illness and well-being are difficult to communicate in medical education. The arts convey these narratives and may strengthen medical student capabilities. This study evaluated the efficacy of a 2021 6-week seminar-style course for medical students focused on five mental states through the lens of visual arts, film, and literature to impact student capabilities. Pre- and post-course administration of standardized rating scales, including the Jefferson Scale of Empathy Medical Students (JSE-S), the Groningen Reflection Ability Scale (GRAS), and the Connor-Davidson Resilience Scale (CD-RISC), measured course impact on medical student empathy, reflective functioning, and resiliency, respectively. Administration of these scales on a matched control group of students not enrolled in the course served for comparison. Pre- and post-course survey data demonstrates that the course improves at levels of statistical significance medical students' empathy (JSE-S score 77.50 SD = 15.76 improving to 93.80 SD 20.92, p = 0.0068, t = 4.19, df = 4) and resilience (CD-RISC score 65.83 SD = 14.36 improving to 78.60 SD = 10.92, p = 0.0137, t = 4.19, df = 4), but not reflective functioning (GRAS score 91 SD = 9.14 improving to 95.20 SD = 10.06, p = 0.1444, t = 1.81, df = 4). The control group showed no statistically significant differences pre- and post-course. Limitations notwithstanding, this study suggests that the analysis of film, literature, and visual art may improve medical students' empathy and resilience. Future studies may explore reproducibility among larger sample sizes at differing institutions and curricula as well as downstream effects on patient care and well-being.

Unstable states and the biologization of mental illness

We critically examine how biological narratives of mental illness mediate relations between personal experiences and socio-structural conditions of distress in crisis contexts. Using three case studies of contemporary crises in Russia, the Republic of Cameroon, and Bangladesh, we showcase the ways in which biological meanings of mental illness carry political and structural significance as authorities employ “biologization” for political ends. In Russia, biologization is strategically useful to authorities seeking to control a populace, as chronic “conditions” can be “treated” indefinitely. In Cameroon, state psychiatrists in Yaoundé incentivize patient citizenship through biological frameworks of illness and intervention. In Bangladesh, the embodied presence of Rohingya refugees is a medium by which they can engage politically; therapeutic intervention becomes a site of political consensus in which Rohingya enact a “fictive biological citizenship.” Biologization of mental illness forms a basis for reinforcing or challenging the power of the state and the meaning of citizenship in distinct ways across these three contexts, highlighting the importance of attending to its political implications as it is invoked in frameworks of diagnosis, explanation, prognosis, and treatment in global contexts of ostensible crisis.

Physiological stress responses to mental illness narratives.

Physiological stress responses to mental illness narratives.

Playing with the Narrative of Mental Illness : Communication Beyond Serious Empathy games

This essay focuses on the implicit narrative of mental illness communicated through the cultural rhetoric of serious games and empathy games. Games about mental illness are seen to promote a change in behavior and foster greater understanding by breaking down the boundary between the neuro-non-normative avatar and players. However, rather than cultivating empathy, these games reinforce notions of mental illness as the unknowable Other. Using Infinite Fall’s Night in the Woods (2017), this essay demonstrates how the use of non-serious elements, changes to the narrative premise, and limited insight into the avatar’s mind create a new communicative situation. Oscillating between sameness and difference, the game shows mental illness as a normal part of life, of growing up and getting to know yourself and the people around you.

Nemone Lethbridge’s play Baby Blues on BBC television: maternal mental illness narratives, stigma and support in 1970s Britain

ABSTRACT In December 1973, the BBC aired Nemone Lethbridge’s auto-fictional play Baby Blues as one of their influential ‘Play for Today’ (PfT) series (1970–1984). This article explores the impact of Lethbridge’s controversial television play, which drew attention to taboo topics, such as infertility, caesarean section childbirth, infanticide, suicide, and, separately, motherhood ageism and dismissive medical professionals. It will illustrate how Lethbridge’s play Baby Blues was part of a broader change in discussing maternal mental illness and creating support for women experiencing postnatal depression and psychosis, instigated by the Women’s Liberation Movement (WLM). The article situates Baby Blues within the wider history of the PfT series, with its focus on socio-political issues, and highlights the challenges Lethbridge faced in bringing the play to production. It analyses the mixed responses to the play, many of which were critical, and how this led to Lethbridge’s launching of a grass-roots self-help group, Depressives Anonymous (DA), in 1974, which was—and still is—a long-lasting legacy of Baby Blues. The article builds on the history of maternal mental illness as explored in women’s narratives and its association with stigma, support and feminism, alongside the British Broadcasting Corporation’s television series PfT, in 1970s Britain.

The Effects of Peer Mental Illness Narratives on Reducing Stigma Among U.S. Marginalized College Students

ABSTRACT Mental health stigma remains a significant barrier to accessing mental health care and treatment, particularly among racial, ethnic, gender, and LGBTQIA+ underrepresented groups in the United States. This study aimed to investigate the relative persuasiveness of mental health narratives featuring both marginalized and non-marginalized characters in reducing stigma among college students. We conducted an online between-subjects experiment with a sample size of 292 participants to explore the impacts of message format (narrative vs. non-narrative), narrative point of view (first-person vs. third-person), and character similarity (marginalized vs. non-marginalized voices) on the persuasion process, specifically targeting the reduction of stigma and changes in attitudes toward those seeking mental health services. Findings revealed that the use of narrative messaging had no effect on reducing mental health stigma or treatment attitudes, but narrative campaigns featuring members of underrepresented groups did enhance one’s perceived similarity with mediated characters, which in turn resulted in more support for seeking mental health treatment. These findings have implications for the design of social media-based anti-stigma interventions and narrative persuasion in mental health research.

The Thematic Evolution of Sports Journalism’s Narrative of Mental Illness: A Little Less Conversation

The Thematic Evolution of Sports Journalism’s Narrative of Mental Illness: A Little Less Conversation

Marginalization and the Construction of Mental Illness Narratives Online: Foregrounding Institutions in Technology-Mediated Care

People experiencing mental illness are often forced into a system in which their chances of finding relief are largely determined by institutions that evaluate whether their distress deserves treatment. These governing institutions can be offline, such as the American healthcare system, and can also be online, such as online social platforms. As work in Human-Computer Interaction (HCI) and Computer Supported Cooperative Work (CSCW) frames technology-mediated support as one method to fill structural gaps in care, in this study, we ask the question: how do online and offline institutions influence how people in resource-scarce areas understand and express their distress online? We situate our work in U.S. Mental Health Professional Shortage Areas (MHPSAs), or areas in which there are too few mental health professionals to meet expected needs. We use an analysis of illness narratives to answer this question, conducting a large scale linguistic analysis of social media posts to understand broader trends in expressions of distress online. We then build on these analyses via in-depth interviews with 18 participants with lived experience of mental illness, analyzing the role of online and offline institutions in how participants express distress online. Through our findings, we argue that a consideration of institutions is crucial in designing effective technology-mediated support, and discuss the implications of considering institutions in mental health support for platform designers.

Supplemental Material for Physiological Stress Responses to Mental Illness Narratives

Supplemental Material for Physiological Stress Responses to Mental Illness Narratives

Personal Narratives of Mental Illness: From Hostage to Survivor

This study has delved into personal narratives extracted from online blogs to build a systematic view of mental illness trajectory through the portrayal offered by bloggers. One hundred and thirty-three blogs were reviewed and narrative analysis was used to interpret a final sample of 12 blogs. The results offer two main narratives—the hostage and the survivor—which illustrate, within the context of social and self-stigma, the need for an identity reformulation in order to reach recovery. The two narratives also led to the design of a model for mental illness trajectory (MMIT). The breaking down of mental illness trajectory into phases could be advantageous to promoting tailored interventions for specific stages of recovery. The importance of referring to lived experience when trying to understand and develop better treatments for mental illness has been well established. This study contributes to the growing body of research that includes the voice of the person with mental illness offering not only a vivid portrayal of life with mental health issues but also an understanding of the trajectory to recovery.

‘Fog of Medication’: psychiatric drugs, neurochemical selves, and graphic medicine

ABSTRACT The mental illness narratives in graphic medicine navigate us through the experience of the patients and caregivers and complement the clinical perspective. These illness narratives showcase distinct challenges the patients face through the various phases such as diagnosis and treatment, including medication and institutionalisation. The neoliberal market advances in medicine have promoted indiscriminate commercialisation in healthcare. As the medical speciality dealing with mental illnesses, psychiatry’s increasing affiliation to chemical cure has realigned the treatment system in the latter half of the twentieth century towards increased pharmaceutical consumption. Graphic pathographies, Clem Martini and Olivier Martini’s Bitter Medicine, Rachel Lindsay’s Rx, and Tatiana Gill’s Head Meds and Other Stories explore the experiential aspects of mental illness emphasising the authors’ predicament with psychiatric drugs. Drawing theoretical insights of Nikolas Rose and Elizabeth Freudenthal, this research article examines the impact of relentless commercialisation of pharmaceuticals and its impact on individuals with mental illness as visually deliberated in the above graphic memoirs. By closely reading several instances from the texts, the present article highlights the complex networks of biomedicine, commercialisation, and contested selfhood.

Towards a systematic description of distance in autobiographical narratives of mental illness

Towards a systematic description of distance in autobiographical narratives of mental illness

On graphic mental illness narratives: an interview with Clem Martini, Tatiana Gill and Tyler Page

ABSTRACT Mental illness continues to be the most stigmatized medical condition across cultures. Autobiographical accounts on affective disorders/mental illnesses such as schizophrenia, bipolar disorder and depression among others not only foreground the distinctive circumstances of one’s suffering but also poignantly portray what it means to undergo the disquieting phases of treatment (such as drug therapy and institutionalisation). As such, these narratives open up dialogues about mental illness which otherwise remain stigmatised and thus contribute to overcome discrimination associated with mental illness. Of late, graphic medicine, one of the burgeoning genres of comics, have widened the scope of such first-person accounts of mental illness. Coined by a British physician and comics artist, Ian Williams in 2007, graphic medicine, typically narrated by patients, (professional) caregivers or physicians, refers to the intersection of comics and healthcare. Prominent graphic mental illness memoirs include Darryl Cunningham’s Psychiatric Tales (2010), Ellen Forney’s Marbles: Mania, Depression, Michelangelo & Me (2012), and Rachel Lindsay’s Rx (2018). In their mission to counteract medicine’s dogmatic and reductionist approaches, these visual memoirs foreground a plethora of subjective experiences as they also expose and change the current mental health procedures for the better. Taking these cues and in the context of deteriorating global mental health prompted by COVID-19 pandemics, three authors, Clem Martini, Tyler Page and Tatiana Gill, in an email interview share their views on mental illness, graphic medicine, identity crisis, stigma, and, the larger systemic challenges of mental illness treatments and care-giving. The interview consists of two parts. In the first part Drawing Mental Illness the authors respond to questions common to all of them and in the second part Greater Choice, Better Care each of them answer specific questions pertaining to their respective memoir.

Reducing mental illness stigma: What types of images are most effective?

Public stigma against mental illness is a barrier to treatment and recovery. Research into the design of anti-stigma messages has focused heavily on text; there is limited information on what types of images are most persuasive in eliciting anti-stigma outcomes. This is important to study because the type of image used to depict an illness can influence how the illness is perceived, which in turn can affect how people with the illness are treated. Through an online experiment with 162 American adults, this study investigated whether mental illness narratives about depression illustrated with photographs are more effective than those illustrated with cartoons at reducing stigma. It was found that the illustrated narratives, whether with photo or cartoon, produced more anti-stigma effects than the text-only narrative (control). Further, the photographic narrative was more effective than the cartoon narrative in eliciting closeness to the story protagonist and willingness to donate to mental health services. The study’s findings indicate that images should be used in anti-stigma messages on depression; further, regarding image type, photographs should be considered over cartoons as they are more effective in eliciting certain anti-stigma outcomes. Implications for Practice This study suggests that images have strong anti-stigma effects and that photographs are sometimes more persuasive than cartoons. These findings can inform best-practice guidelines for designing anti-stigma messages, created and disseminated by organisations such as the United States’ National Alliance on Mental Illness and Mental Health America. Images in these messages should be selected carefully as they can influence how people with mental illness are perceived and treated.

Personal Narrative of Mental Illness within the Family: A Mental Health Professional’s Autoethnography

Personal Narrative of Mental Illness within the Family: A Mental Health Professional’s Autoethnography

Graphic illness memoirs as counter-discourse

ABSTRACT Medical and popular discourses often perpetuate stereotypes of the mentally ill that essentialize them as imbecile and violent, which in turn trivializes their voices and perspectives. Because of this, stereotyped representations of mental illness mediated through films, fiction, or pedagogical texts often follow a pattern of exclusion. Personal narratives of mental illness, on the contrary, restore the language of mental illness as experienced by the mentally ill and therefore challenge and subvert the dominant representations. In this context, graphic memoirs of mental illness are a cultural resource in redeeming the identity and truths of those suffering from mental illness. The genre takes effect rhetorically through stylistic techniques and metaphors that critique normative conceptualizations of the behavioural patterns of the mentally ill. Taking these cues, the present essay explores the diverse ways in which graphic memoirs on mental illness construct a counter-discourse by challenging and subverting the stereotypical representations of mental illness. Specifically, through a close-reading of Ellen Forney’s Marbles: Mania, Depression, Michelangelo, and Me (2012) and of Rachel Lindsay’s Rx: A Graphic Memoir (2018), which deftly describe the subjective realities of bipolar disorder, this essay investigates the role and function of metaphors (visual/verbo-visual) as a tool of counter-diagnosis.

Sense-making, Socialization, and Stigma: Exploring Narratives Told in Families About Mental Illness

ABSTRACT Guided by Communicated Narrative Sense-making Theory (CNSM), the current study investigated mental illness (MI) narratives told within families and the lessons younger members learned from these stories. Individual, semi-structured interviews with young adults (N = 24) revealed that family members, mainly parents, share stories about the MIs of individual family members and narratives reflected themes of struggle and caution. Participants reported learning important lessons from these MI narratives (i.e., MI awareness, importance of understanding MI). Findings illuminate the ways family narratives about MI teach younger members lessons and expectations for managing MI despite sometimes reinforcing MI stigma. Limitations, future directions, and implications for narrative interventions are also discussed.

The “madness” of market logic: mental illness and late capitalism in The Double and Nightcrawler

ABSTRACTThis paper examines representations of mental illness in popular film, particularly Richard Ayoade’s The Double and Dan Gilroy’s Nightcrawler. As I argue, both films trouble typical Hollywood narratives of mental illness by situating schizophrenia and psychopathy, for instance, within a socioeconomic context, specifically relations of production under late capitalism and the unfettered self-interest of neoliberalism. If mental illness is a product of the postindustrial workplace in The Double, it becomes a prerequisite for success in Nightcrawler, providing a cinematic depiction of mental illness at odds with the “personal pathology” paradigm that dominates the current neoliberal landscape.

The Picture of Madness–Visual Narratives of Female Mental Illness in Contemporary Children’s Literature

This article analyses a selection of contemporary children’s visual texts (for economy and specificity ‘contemporary’ is taken to mean the current century), covering a cross-section of age demographics to better understand how the texts depict female characters suffering with mental illness. It examines these primary texts not only to see how such characters are represented but also to see whether they either bolster or challenge the idea of the female being viewed as the male's ‘Other’. A brief historical and cultural contextualisation of the relationship between mentally ill females and the male-centric profession of modern psychiatry is followed by a close analysis of four primary texts, analysing visual narratives of mentally ill female characters in two picture books, an illustrated book and a graphic novel, noting how contemporary visual depictions contrast with early ideas and images supporting the nineteenth-century feminisation of madness. The conclusion is that, from the limited selection of texts analysed, contemporary children’s visual texts represent a clear contrast to the historical image of the frail and winsome madwoman. The findings are that they do not uphold the image of the female madwoman as Other.

Being open in academia: A personal narrative of mental illness and disclosure

Key Messages Personal narratives offer insight into daily battles of those with mental health issues. Those with mental health issues often struggle with productivity. Some recommended strategies could help with life in academia.