Kathleen M. Pike, PhD

When is a Picture Not Worth 1000 Words: The Damage of Mental Health Stereotypes

Optical illusions are a form of magic show. Part of the delight is that we know we are being fooled. In an optical illusion, the visual information somehow tricks the brain. We know it. We are fascinated by it. All in good fun. But what about the images we see that play with our brains without our knowing it?! When it comes to mental health and mental illness, I dare say we have something of an optical illusion. The same happens unconsciously with the images we are inundated with — images that claim to represent reality but are really optical illusions of another sort.

Stock photos that accompany blog posts, articles, and other online media populate our mental landscape of what mental illness is, reinforcing stereotypes, prejudice, and ignorance about what people with mental illness look like.

1. Mental illness is for white people. The models in stock photos for mental illness are disproportionately white. The unspoken message here is that individuals from other racial groups don’t suffer from mental illness. These images also set up a platform for the (faulty) logical leap that when individuals from ethnic minority groups have similar symptoms, it’s because of some inherent flaw in their character or disposition, while when white people have the same symptoms, it’s because they’re suffering from a mental disorder. It’s not their fault— just a fluke in their brain chemistry.

2. Only pretty people suffer from mental illness. Stock photos of mental illness tend to portray young, beautiful, and able-bodied people. In a way, this sanitizes the image of mental illness and subtly tells us that mental disorders, the kind that can be treated by capable doctors in white coats with little blue pills, are for pretty people. If we have something more complicated, if we’re not so neat and pretty, there’s little hope for us.

3. But wait, if not beautiful, people with mental illness are unkempt and sleeping on the church steps. Images that portray something unexpected or infrequently seen are more likely to catch our eye. So, it is not surprising that media images of mental illness are often one extreme or the other. If the person in the image is not beautiful, it is likely that he will be disheveled and surrounded by a broken shopping cart or a cardboard bed. Let’s be clear, the individual talking to herself of the street corner probably has a psychotic disorder, and the beautiful person may have depression. We need to remember that it’s everyone in between who make up the majority of individuals with mental illness.

4. Eating disorders are for girls, addiction is for boys. Gender biases in mental illness are reinforced by the images in the media. The majority of stock photos depicting eating disorders portray women, for example, and the majority of substance use disorders portray men. These images reflect some real gender differences, but in reality, men also suffer from eating disorders like Anorexia Nervosa and Bulimia and women suffer from addiction. A recent review of the scientific literature found no differences in eating disorder symptoms like binging, vomiting, or laxative abuse. These highly stereotyped images cloud people’s thinking about their own suffering and potentially interfere with seeking treatment.

5. Mental illness is shameful. Images of people with their heads in their hands and with their faces obscured convey the message that if you have mental illness you should be ashamed. The image also infers ‘don’t look anyone in the eye and don’t let anyone know.’ These messages promote isolation at a time when social support and community are all the more important. These images are part of the messaging that results in people waiting and hoping that their mental health concern will go away on its own. The problem with that strategy is that waiting has the potential to give the mental health problems longer to take root and make the course of recovery protracted and more difficulty when they finally seek help.

In this era of visual imagery everywhere – from online and print media to Facebook and Snapchat – we need to pause and rethink what our images communicate about mental illness. Considering that one in four of us will have a mental illness over the course of our lives, it might be useful to estimate that one in four images that we see anywhere is someone living with mental illness.

Picture of Kathleen M. Pike, PhD

Kathleen M. Pike, PhD

Kathleen M. Pike, PhD is Professor of Psychology and Director of the Global Mental Health WHO Collaborating Centre at Columbia University.

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