Indeed, psychiatry may need to defend itself on the media witness stand. Psychiatrists also ought to seek to educate the public and reduce stigma. Let us seek more information about the harmful portrayal of psychiatry in media.
Media influencing minds and feelings
Media, in all forms, has played a very significant role in influencing the minds and feelings of people globally. Especially during COVID-19 times, with more access to content via OTT platforms, media has been more instrumental than ever in creating change.
Media portrayal of mental illness has been conventionally crude. The mere thought of mental illnesses conjures images of violent people, mental asylums, straight jackets and shock treatment. Although this has been true for a very long time, recently things are changing.
There is more emphasis on portraying the more common illness in psychiatry such as depression and anxiety. There is an emphasis of encouraging people to talk and to share and also to listen with intent. Recently a movie in Bollywood took a very close and personal look in counselling/talk therapy.
Media & the portrayal of mental illness disorders
Although all these aspects are encouraging, psychiatry is the only branch of medicine where media portrayal is not just about the illness and its symptoms, but also about its treatment. Most media portrayal of mental illness can be broadly sub-divided into 2 groups:
- either showing people in asylums in straight jackets, waiting upon to get shocks or
- people sitting or lying down on couches and “talking” about their issues.
This is not typically true for any other speciality. Take cardiology for example, people are aware of what a heart attack can look and feel like, but they are not aware of the treatment of the same. Whether it is managed conservatively or with an intervention is at the discretion of the doctor. The treatment protocol is usually suggested by the doctor and then the patient has the option to consent for it.
Unlike in psychiatry, whereby the diagnosis and treatment are both usually being suggested by the patients. If the patient feels sad, unhappy they suspect that they have depression, if the patient is anxious and is feeling uncomfortable, they suspect that they have anxiety. When they come to a doctor, they don’t come to understand this further, they usually come to either validate their suspicion or have someone dismiss it as being a trivial issue. As a psychiatrist interacting with patients on a daily basis, I find myself often in the position of justifying my diagnosis and convincing them of the severity of the illness, says Dr. Parth Goyal, Consultant Psychiatrist in Ahmedabad, Parth Hospital. They seem to have often made up their minds before coming to me for an opinion. If my opinion is similar to theirs, they are happy, but if it differs, they don’t like it.
Media & the portrayal of mental illness treatment
Same is the case for the treatment part of the consultation. Most people think that talking things out is sufficient, even more, it can be done in one simple session. They are not looking for a treatment but for a solution that we can provide to them to make their lives better. The issue here is that, for them my solution should be similar to the solution that they have in mind.
This behaviour has always surprised me and I have often found myself wondering upon the reasons for such a behaviour. Some of my patients have actually come to my cabin and asked me about the “COUCH” and have somewhat been offended by its absence. This was my first clue into understanding their reasons.
Of the many conversations that I have had with my patients, the main thing that stands out is that their view of what a psychiatric consultation should be like is being shaped by various television shows and movies, especially those on the OTT platform. The fact is that they take such portrayals on face value and believe it to be the only form of interaction with the psychiatrist. In most cases they are not even looking for a psychiatrist but infact looking for a psychologist. Let us clarify the difference here:
PSYCHIATRIST = Doctor who treats mental illness medically using a host of techniques (Medicines, neurostimulation and psychotherapy) depending on the patients need.
PSYCHOLOGIST = Professionals (not doctors) trained in assessment of various mental disorders and offering specialised psychotherapy services in liaison with a medical professional.
Wrapping Up…
Most media sources do not clarify this for a whole host of reasons, the most important being a) they are not all are documentaries and b) cinematic liberty.
But the fact of the matter is that it shapes perspectives which can be dangerous and could force the patient to go down a dangerous slope.
A psychiatric consultation is much more that sitting on a couch and talking. It’s about understanding if you have a mental illness or not and if so, what is the extent and the specifics of the same. It’s like any other branch of medicines where there are a lot of specifics that need to be evaluated. Treatment options are then decided from a patient-to-patient basis.
For everyone reading this, my only request and take-home message is that please don’t have a fixed opinion of what a psychiatric consultation is like before going to a psychiatrist.
Please don’t let your opinions be dictated by some tv show on some platform.
Psychiatry is like any other branch of medicine, where evaluation is performed rigorously, in a protocolised manner, with treatment options differing based on illness, severity and individuals.
