The Picture of Mental DISORDERs in

1

• The Picture of Mental DISORDERs in
• Czech, Slovak and Croatian
• Printed Media
• (pilot project)
• Alexander Nawka Tea Vukusic Rukavina

2
Outline

• Research team members
• Theoretical background
• First steps
• Workshop in Berkeley
• Research question and expected outcomes
• Preparation phase
• Workshop in Varna
• The Coding manual
• Data collected
• Results
• The problems and possibilities to discuss here
• Further development of the project

The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
3
Research team members
Czech Republic Tereza Danecková, Lucie Nawková,
Petra Vondrácková, Michal Miovský Slovak
Republic Alexander Nawka, Martin Klus, Bibiana
Bednárová, Svetlana uchová Croatia Tea
Vukusic Rukavina, Martina Rojnic Kuzman, Nikolina
Jovanovic Senior advisors Howard Goldman,
Steve Hinshaw, Jirí Raboch, Petr Háva
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
4
The vicious cycle of stigmatization
Marker
Loading
Less resistance
Problems of knowledge ignorance

• Home life
• Work life
• Social life

Problems of attitudes prejudice
Stigma
Problems of behaviour discrimination
Greater disability
Discrimination
Exclusion
Less self-esteem
Disadvantages
Sartorius 2005 Thornicroft 2006
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
5
Media and the vicious cycle
Loading
1. Previous knowledge
2. Personal experiences
Stigma
3. Information obtained through the media
Sartorius 2005 Thornicroft 2006
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
6
Initial thoughts

• There is high stigma of Mental Illness in our
  three countries
• Media coverage contribute to increase the stigma
• To improve media messages we need to influence
  editors and journalists
• We need specific data about current media
  practice in our countries

The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
7
Workshop in Berkeley, January 2008
GO BEARS!!!
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
8
Logical Modelling

• INPUT OUTPUT
  OUTCOMES

• Short-term
• Press conference,
• Peer reviewed article

• Money
• Time
• Technology
• Background knowledge
• Initial disscusion
• with journalists

• Developing
• the instrument
• Verifying the
• coding system
• Report on the
• current situation

• Medium-term
• Influencing - headline writers,
• editors, reporters, advertisers,
• politics, related stakeholders

• Long-term
• Improve media coverage
• and discrimination practices
• Increase help seeking
• behavior

The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
9

• Research question
• What is the content of the media messages about
  Mental Illness in Czech, Slovak and Croatia in
  terms of stigma?
• Expected outcomes
• To develop and verify the instrument for coding
  media messages featuring the topic of mental
  illness.
• To prepare a report on content of media messages
  in Czech, Slovak and Croatian printed media with
  preliminary results as a basis for future
  longitudinary monitoring in these countries.

The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
10

• In the meantime we have also
• had a seminar on the topic at the Psychiatric
  Clinic, 1st Faculty of Medicine, Charles
  University
• established links with the journalists from the
  most widely read newspapers and magazines in
  Czech republic
• published an article in the most widely read
  magazine Rytmus ivota and also in the most
  widely read broadsheet Mladá fronta dnes
• established links with Czech legislators, Boris
  tastný the Vice-chairperson of the Committee on
  Health Care in the Parliament of the Czech
  Republic
• presented our results at the biggest national
  Psychiatric Congress in pindleruv Mlýn and
  published one short paper in the Czech
  Psychiatric Journal
• submitted an abstract to the European
  Psychiatric Congress that will be held in Lisbon,
  January 24.-28.1.2009
• opened a discussion in the Czech psychiatric
  society on the topic Psychiatry and the media

The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
11
Workshop in Varna, June 2008
GO WINE!!!
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
12
Methodology

• Selection of research sample
• Media messages from 6 most widely read daily
  periodicals and from 6 most widely read weekly
  periodicals.
• Time period
• 5 weeks randomly select from year 2007 (12, 13,
  26, 38 a 49)
• Key words
• KW 1 Neutral terms - psychiatr,
  psychiatric facility, mental illness,
  hallucination,
• psychotherap, psychologist, dementia,
  schizophreni, psychosis, depression, depressed,
  
• antidepressant, maniodepressive,
  mania, anxiety disorder, anorexi, bulimi,
  retardation,
• narcomaniac, PTSD (posttraumatic
  stress disorder)
• KW 2 -Labeling terms (mental illnesses
  are used as labels) schizophrenic, neurotic,
• psychotic, alcoholic, anorectic,
  bulimic used as nouns not as adjectives.

• Main topic One of the main topics of the
  article is psychiatry or mental Illness.
• Associated topic The main topic is different and
  topics of psychiatry is included as secondary.
• Occasional reference The main topic of the
  article is not related to psychiatry topics, but
  there
• are some mentioning of psychiatrist, psychiatric
  ward etc.
• Transferred meaning Psychiatric term is used in
  different connotations.
• Life-style Article is related to lifestyle and
  mental health issues.

The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
13
Methodology
Descriptive characteristics
CODING MANUAL
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
14
Methodology
Descriptive characteristics
CODING MANUAL
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
15
Methodology
Content characteristics (1)
CODING MANUAL
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
16
Methodology
Content characteristics (2)
CODING MANUAL
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
17
Methodology
Content characteristics (3)
CODING MANUAL
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
18
Methodology

• Each article was coded by 3 separate coders,
  after which consensus was reached about the
  final coding for the article.
• On-line data base http//www.horook.hr/coding/log
  in.php
• was developed, with on-line
• questionnaires according to
• coding manual, enabling each
• coder to fill in his/her data,
• using triangulation and
• consensus to choose the
• final code and to transfer all
• data collected in to excel
• or SPSS program.

The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
19
Data collected
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
20
Articles on cover
RESULTS
x215,284, df2, p0.001
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
21
Sensation seeking content
RESULTS
?210.888, df2, p0.004
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
22
Sensation seeking form
RESULTS
x276.983, df2, plt0.001
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
23
Aggressive behavior
RESULTS

• aggressive behavior

• if yes

x224.111, df6, plt0.001
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
24
Aggressive act
RESULTS
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
25
Disorders mentioned
RESULTS
x251.718 df16, plt0.001
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
26
Global impression text
RESULTS
x215,236, df6, p0.018
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
27
Global impression text and media type
RESULTS
x249,505, df6, plt0.001
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
28
Global impression and information source
RESULTS
x243,095, df9, plt0.001
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
29
Global impression and aggressive behavior
RESULTS
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
30
Global impression and disorders mentioned
RESULTS
x269,488, df24, plt0.001
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
31
Global impression and mean words number
RESULTS
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
32
Preliminary conclusions
RESULTS

• statistically significant differences in the
  distribution (among 3 countires)
• media type,
• the position of articles (covers),
• style (number of words, sensation seeking in form
  and content, source of information),
• aggressive acts associated with psychiatric
  patients, stigmatizing headline and psychiatric
  diagnoses

The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
33
Preliminary conclusions GI
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
34
Preliminary conclusions GI country specific
predictors
The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
35
Assessment of current status

• development of the final version of the coding
  manual
• on-line data base, data entry completed by
  December 1st 2008
• preliminary statistical analysis
• not finished the inductive qualitative analysis
  of the positive and negative statements and
  publication activities...

The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
36
The problems and possibilities to discuss here

• To describe the statistically evaluated results
  and select methodology for inductive qualitative
  analysis of positive/negative statements with our
  faculty advisors
• further development of the project and work on
  the proposal for the project extension in the
  next 2 years.
• Three different ways to broaden our project.
• 1. broaden research area (new countries f.e.
  Slovenia, Poland, or new media (TV, internet)
  and new time frame more weeks,
• 2. to compare public opinions related to stigma
  before and after an intervention campaign we
  would implement (3).
• 3. idea for intervention to have either in
  Slovakia or Czech, course similar to Croatian
  course Media and health, with emphasis on stigma
  of mental illness in media.
• Discuss the possibilities where and when we will
  publish the results from the pilot project.

The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
37
Plan for this year

• To publish the results from the pilot phase in a
  journal with impact factor
• To publish a review paper in a journal with
  impact factor
• To publish the results in national journals
• To present the results at the national and
  international psychiatric congresses (Luhacovice,
  Karlovy Vary, etc.)
• To continue with presenting new results in the
  newspapers, magazines and in the radio
• Lucie Nawková will moreover work with this data
  as a part of her PhD thesis
• To present the results at the traditional course
  Media and health in Croatia, June 2009
• Prepare the proposal for the project extension in
  the next 2 years jointly with our faculty
  advisors

The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009
38

• Thank you for your patience

The Picture of Mental Disorders In Czech, Slovak
and Croatian Printed Media (pilot project)
Finance and Delivery of Mental Health Services in
Central and Eastern Europe Research Training
Workshop January 5-7, 2009