Dollars and disparities: challenging news media's coverage of global mental health and its economics
The COVID-19 pandemic has led to a significant increase in mental health news coverage, indicating a growing public interest in the topic. A comparative analysis of global English-language media before and after the pandemic showed that the number of stories with mental health-related themes more than doubled in this period.
This surge in coverage presents an opportunity for the media to tell powerful stories on a subject that touches everyone. But it also raises thorny questions about the social role of mental health journalism and the current state of reporting on the topic.
Follow the money
A close study of the coverage reveals that, despite the increase in the volume of stories, there remains a critical missing theme in mental health journalism: the unjust economics of global mental health.
Global mental health is an emerging field that aims to alleviate mental suffering and promote mental health worldwide. It seeks to address the historical oppression and exclusion of marginalized communities from mental health care and advocates for equitable access to mental health resources, which are disproportionately controlled by rich Western countries.
An overemphasis on Western perspectives has erased the lived realities and needs of people in low- and middle-income countries (LMICs) — home to 80% of the global population, and by some estimates, 80% of people who live with mental illness. Consider that WHO reports more than 75% of people living in LMICs with mental, neurological, and substance use disorders receive no treatment at all. Or that low-income countries have fewer than two mental health workers per 100,000 population, compared to over 60 in high-income countries.
Unfortunately, the concept of equity at the heart of the global mental health movement has not translated into change on the ground, and the media has largely failed to keep up with this important story.
Ditch the dominant model
Instead, mental health coverage in the media has been dominated by the Western biomedical model, which, crudely put, views mental illness as an individual’s problem caused by imbalances in brain chemicals, despite increasing evidence challenging this theory. This perspective overlooks the deeper socioeconomic stressors such as poverty and inequality that contribute to mental health issues like depression — the leading cause of disability worldwide. It also leads to shallow policy approaches focused only on medical "cures".
When the Western media does cover health issues in LMICs, it often focuses on communicable diseases and "exotic disease, disaster, and despair stories", neglecting non-communicable diseases like mental illnesses and the glaring disparities between high-income countries and LMICs.
To be fair, the media faces several challenges when engaging with mental health and its economic aspects. The inherent complexity of mental health, lack of awareness among journalists, limited reliable data, and the prioritization of breaking news stories hinder comprehensive coverage of the economics of the mental health sector.
To rectify these historical omissions, I propose four foundational areas for the media to focus on: the flow of money into the mental health sector, who benefits from it, who is left out, and at what cost.
The full paper, available below as a PDF, includes four chapters that delve into these topics, including insights from key stakeholders such as reporters, editors, mental health funders, and academics studying global mental health.
For those without time to read the full paper, I highlight five lessons in improving mental health coverage.
Lesson 1: Reimagine mental health beyond healthcare
To effectively address any public health challenge, our conversations must extend beyond healthcare and encompass socioeconomic forces. The media can engage public health experts to explain how various systemic and structural factors, such as financial stress, housing crises, job insecurity, and the loss of green spaces impact mental health. Creating space for lived experience experts and promoting diversity within newsrooms are also essential for a nuanced understanding of mental health.
Lesson 2: Change the narrative and presentation of mental health stories
Avoid oversimplification when reporting on complex themes like mental health. Instead, embrace nuanced storytelling that shuns simplistic solutions. Present mental health stories on your platform in a way that reflects their cross-cutting nature, breaking free from traditional classification systems that limit their reach.
Lesson 3: Provide training to reporters and editors
Journalists covering mental health should have a basic understanding of business and economics, while those in finance or economics should familiarise themselves with the health domain. Interdisciplinary knowledge allows journalists to grasp the decision-making processes, budget allocations, and systemic deficiencies that influence mental health outcomes. Newsrooms should curate and provide easy access to relevant resources to support journalists in their coverage. (See Appendix 1 of the paper.)
Lesson 4: Look beyond large sums and glamorous characters
The media's penchant for big-dollar figures and big-name philanthropists investing in mental health can be limiting. Instead, investigate how funds are distributed and whether they contribute to sustainable reforms and capacity building. Newsrooms should emphasise the "why" and "how" of mental health funding rather than solely focusing on the “how much”.
Lesson 5: Prioritise inclusion and equity for scale and impact
The ultimate goal is to tell stories that drive home the urgent need for equity and inclusion in mental health. Emphasise the need for both more resources and their effective and equitable utilisation.
Better mental health journalism requires addressing the harmful history of coverage, challenging overly westernised and medicalised narratives, and foregrounding the socioeconomic factors that influence mental health.
By improving coverage, the media can play a crucial role in reforming public attitudes, reducing stigma, and promoting a more equitable and just approach to mental health worldwide.