Stigmatising pharmaceutical advertisements

The general public holds stigmatising attitudes toward those with mental disorder, with schizophrenia being rated as highly associated with dangerousness and unpredictability (Crisp et al, 2000). The authors mention that health professionals may share some of these views. After reading their article, I was struck by a number of pharmaceutical advertisements elsewhere in the same issue of the Journal, that appeared to perpetuate a negative image of schizophrenia. My curiosity thus stimulated, I performed a cursory lunchbreak study examining the portrayal of people with mental disorder in pharmaceutical advertising in three recent issues of international psychiatric journals (Table 1). It was notable that all the advertising for antidepressants had positive imagery. Indeed this was also largely true for the ‘other’ category, with only one negatively rated advertisement.

Table 1 Pharmaceutical advertisements in three psychiatry journals

	British Journal of Psychiatry, July 2000	American Journal of Psychiatry, June 2000	Australian and New Zealand Journal of Psychiatry, June 2000
Antidepressants
No. advertisements	2	5	5
No. rated as negative	0	0	0
Example of imagery			Smiling woman
Antipsychotics
No. advertisements	5	3	2
No. rated as negative	3	0	0
Example of imagery	Wan young woman, dishevelled hair	Family photos of happy family	Attractive young woman putting lipstick on
Other
No. advertisements	1	5	0
No. rated as negative	0	1
Example of imagery		Smiling children (advert for stimulants)

By contrast, three out of five advertisements for antipsychotic medications in this Journal were negative. One was particularly striking, a fearful young man peering through a door, his house covered in foil. The copy included the following: “His parents have to withstand torrents of verbal abuse. And Constant threats of violence”. This small sample also suggests that there may be international variations in advertising in the field; what underlies this is unclear. It is intriguing, however, that the British advertising mirrors the attitudes of surveyed householders.

How can we expect the general public to have a rational and informed approach to people with schizophrenia when learned journals accept advertisements that promote a product through negative stereotyping? Perhaps our willingness to allow this to happen is in accord with work in the field which suggests that health professionals may have even more negative attitudes to mental disorder than the general public (Jorm et al, 1999). A public campaign to combat stigma is undoubtedly important, but perhaps we should be prepared to examine our own beliefs about serious mental illness as a prelude to changing attitudes in society at large.