Knocking Bruno when he is down
Authors: R. Persaud
Journal: BMJ (2003)

The term stigma derives from the ancient Greeks, who used it to refer to bodily signs designed to expose something unusually bad about the moral status of the possessor. The signs were cut or burnt into the body, advertising that the bearer was a blemished person, to be avoided, especially in public places.

Last week the UK tabloid newspapers went out of their way to ensure that the ancient Greeks would have felt right at home in 21st century Britain. In their 23 September editions, they raced to cover the “sensational” story that national hero and boxer Frank Bruno had been admitted, under a section of the Mental Health Act, to a psychiatric hospital.

The Sun led the way with the front page lead headline “Bonkers Bruno locked up,” while the Daily Star opted for “Sick Bruno in siege drama.” Following a storm of protest from many mental health charities, the Sun toned down its headline in later editions the same day to “Sad Bruno in mental home.”




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But it was still sobering to mental health professionals that Goodmayes Psychiatric Hospital, the institution to which Bruno was admitted, should be referred to as a “mental home” after the Sun had thought long and hard about trying not to offend.

The next day, back-pedalling furiously, the Sun had joined forces with the mental health charity SANE to launch a campaign to raise money for people with mental health problems. Now a model of political correctness, on 24 September the Sun announced, “Frank Bruno is neither mad, bad or even sad—like many thousands of other Britons recovering in psychiatric units, Frank is simply ill.” By Thursday, Sun readers were being told, “Boxer's children praise our fund for mentally ill. Here's how you can support the Sun's campaign to help people suffering mental health problems...”

Because SANE—which stands for Schizophrenia a National Emergency—had changed the Sun's reporting style, and had even got the paper to help raise funds for mental health, it might seem that there are signs of progress in the battle against the stigma surrounding mental illness. However, the Sun's initial readiness to express deeply hurtful attitudes about mental illness suggest that the coals of stigma are still glowing, ready to be fanned into flame by a media eager to pander to the prejudices and fears of their audience.

Jo Phelan, of the Columbia University School of Public Health, New York City, has presented data to the Annual Meeting of the American Sociological Association, which, along with other research, suggests that negative public attitudes to people with mental illness are worse today than they were in the 1950s. One theory is that this is partly because the modern media's representation of mental illness remains, at best, medieval.

While the ire of the charities might have focused on the tabloids, the UK broadsheets were actually adding their own more sedate but substantial contribution to stigma. They presented an endless parade of evidence for Bruno's recent “instability,” little of which amounted to symptoms of mental illness. There was also an intimate raking over of Bruno's personal life in order to assemble a cascade of “causes” and “diagnoses.” Twenty-eight days are allowed under the Mental Health Act to form an assessment, but most journalists can complete one by the editor's afternoon deadline.

Particularly troubling was the implicit notion that people with mental illness have some deep character flaw, which is the true cause. An example of this was an article in the Sunday Times, headlined “The big fight: a troubled man against himself.” None of the hundreds of column inches suggesting that Bruno's illness was linked to marital problems, retirement, or the loss of the media limelight seemed to show any awareness of recent medical research evidence that repeated blows to the head in numerous sports are associated with depression.

Dr Stephen Pereira, consultant psychiatrist in charge of the intensive care unit at Goodmayes Hospital, told me that central to the media response seemed to be the idea that being sectioned was something awful. For him, this illustrated the widest chasm between mental health professionals and the public. He argued that there was a sense in which it could be construed that being sectioned was a benefit: it meant that someone was finally going to get help. Much worse was the prospect for those whose psychiatric problems remained undiagnosed or untreated.

Arguable though that may be, no one can dispute that having a television crew waiting outside Frank Bruno's home as the police escorted him away to hospital must have been horrific for him and his family. Someone must have tipped the media off for cameras to be there before he got to hospital. Doctors and psychiatrists, as advocates for their patients, should campaign against this aspect of media intrusion. However, it remains charities such as SANE that are at the vanguard of this kind of fight, with doctors usually nowhere to be seen.