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Depictions of Mental Illness in Children's Media

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DOI: 10.1080/0963823031000118230

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Journal of Mental Health (June 2003) 12, 3, 249 – 258

Depictions of mental illnesses in children’s media

OTTO F. WAHL

George Mason University, Fairfax, USA

Abstract
Background: It has been suggested that media portrayals help to perpetuate the negative
perceptions and attitudes of the public toward people living with mental illnesses. Children
are significant consumers of mass media, and they may be learning about mental illnesses
from their exposure to media depictions of those illnesses.
Aims: This article is intended to explore how psychiatric disorders are portrayed in children’s
media.
Methods: Studies of the depiction of mental illnesses in children’s media are reviewed.
Results: Studies of television, films, cartoons, and other media suggest that images and
references to mental illnesses are relatively common in children’s media and that such images
are more often negative than positive ones. The image of persons with psychiatric disorders as
unattractive, violent, and criminal, for example, appears common in children’s media, and
references to mental illnesses are typically used to disparage and ridicule.
Conclusions: Although content analyses do not establish impact, it is likely that negative
stereotypes are being fostered and that children are learning to respond to people with mental
illnesses in avoidant and disparaging ways. Anti-stigma efforts that do not include children
and do not address the media images of mental illnesses that foster unfavorable stereotypes
may permit continued development of negative attitudes toward people with psychiatric
disorders.
Keywords: stigma, mental illness, mass media, children’s attitudes.

Depictions of mental illnesses in that the public holds inaccurate negative

children’s media
It is widely recognized that, as the US
Surgeon General has recently observed,
‘stigma tragically deprives people of their
dignity and interferes with their full
participation in society’ (US Department
of Health and Human Services, 1999, p.
viii). Decades of research has established
beliefs about those with mental illnesses
as dangerous, unpredictable, unattrac-
tive, unworthy, and unlikely ever to be
productive members of their commu-
nities (Farina, 1982; Fink & Tasman,
1992; Nunnally, 1961; Rabkin, 1974).
The self-reports of mental health con-
sumers have likewise verified the contin-
ued existence of negative public attitudes

Address for Correspondence: Otto F. Wahl, Department of Psychology, George Mason University, Fairfax
VA 22030, USA. Tel.: 703-993-1361; Fax. 703-993-1359; E-mail: owahl@gmu.edu

ISSN 0963-8237print/ISSN 1360-0567online/2003/030249-10 # Shadowfax Publishing and Taylor & Francis Ltd
DOI: 10.1080/0963823031000118230
250 Otto F. Wahl
and the significant impact that stigma has
on their lives and recovery (Wahl,
1999a,b).
Few, if any, of those concerned with
the problem of mental illness stigma,
however, would argue that the documen-
ted negative attitudes toward mental
illness emerge full-blown in adulthood.
Rather, it seems more likely that these
ideas and attitudes are acquired gradu-
ally over a lifetime and that their roots
are established in childhood. Indeed,
Scheff, one of the pioneers in the
investigation of the stigma of mental
illness, has suggested that these attitudes
are fairly well set by early childhood. In
fact, he suggests that ‘the literal meaning
of crazy . . . is probably grasped by
children during the first years of elemen-
tary school’ (Scheff, 1999, p. 74). A
recent review of the literature on chil-
dren’s views of mental illness supports
Scheff’s contention. Wahl (2002) identi-
fied and reviewed 13 studies completed
since 1980 in which investigators at-
tempted to assess children’s knowledge
and attitudes toward mental illness.
Although the wide variety of measures
used – which included questionnaires,
vignettes, interviews, projective draw-
ings, and storytelling – prevented confi-
dent generalizations, some consistency in
findings was noted. In particular, it
appeared that, while young children did
not have crystallized knowledge of men-
tal illness and its symptom manifesta-
tions, they nevertheless had already
acquired attitudes that recognized mental
illnesses as somehow less desirable than
other kinds of health conditions.
How children acquire their under-
standing of mental illnesses has also been
a source of speculation and research.
There are, of course, many socializing
agents – family, friends, and teachers, for
example. It is likely these people con-
tribute to children’s attitudes about
mental illnesses, just as they contribute
to so many other aspects of a child’s
development. Another of the sources
commonly implicated by theorists and
researchers is mass media. Scheff, in
articulating how the societal stigma of
mental illness is created and perpetuated,
for example, specifically singles out mass
media, asserting that ‘the stereotypes [of
mental illness] receive almost continual
support from the mass media’ (Scheff,
1999, p. 76).
It is clear from research that children
have extensive exposure to mass media.
Paik (2001), for example, reports a study
showing that, in 1995, 58% of children
6 – 14 went to a movie in the past 30 days;
more than a third (37%) went more than
five times during the past month (Paik,
2001). According to the Internet Movie
Database, three of the four top-grossing
films of both 2001 and 2002 were G or
PG-rated movies. It is estimated that one
quarter of children aged 12 – 14 listen to
music 5 h a day or more (Paik, 2001). At
least 70% of families with children have
personal computers in their homes, and
children reportedly have made The Kids’
Channel the fourth most trafficked chan-
nel on AOL (Tarpley, 2001). Children
spend additional hours playing video
games and reading books, magazines,
comic books, and daily comics.
Television is a particularly pervasive
(and well-studied) source of information
for children. Studies indicate, for exam-
ple, that television is one of the earliest
socializing agents to which children are
exposed. According to Paik (2001),
nearly one in four 2-year-olds and two-
thirds of 4-year-olds in this country
spend 2 – 4 h a day watching television.
Donnerstein & Smith (1997) have ob-

served: ‘Recent surveys have indicated
that nearly 98% of American households
have a television and many homes have
more than one set . . . Within these
homes, 2 – 11-year-olds have the TV set
turned on for approximately 28 h a week.
. . . It is now widely known that television
viewing occupies more time than any
other non-school activity. And among
children, it accounts for more than half
of all their leisure activities.’ (pp. 30 – 31).
Almost half of all children have a
television set in their bedroom, including
about 3% of pre-school children (Jordan,
2001). Mediascope (2000) calculates that,
over the course of a year, children will
spend roughly twice as much time watch-
ing TV as they do attending school. The
Federal Communications Commission
(1996) reported similar striking data
about youthful television viewing, noting
that: ‘Television reaches children earlier
and for more hours per day than any
other educational influence except per-
haps family. Many children watch tele-
vision before they are exposed to any
formal education. Nearly 70% of day-
care facilities have a television set on for
several hours each day. By the time most
American children begin the first grade,
they will have spent the equivalent of
three school years in front of the televi-
sion set.’ (p. 7)
That mass media are important
sources of information cannot be denied.
What is also important to recognize is
that they may be crucial sources of
information about mental illnesses, in
particular. Adults, according to a Robert
Wood Johnson Foundation survey, re-
port that they have gained most of their
knowledge about mental illnesses from
the mass media (DYG Inc., 1990).
Children, whose opportunities to en-
counter and learn about mental illnesses
Mental illness in children’s media 251
from other sources (higher education, job
experience, etc.) are far more limited than
adults, may be even more reliant than
adults on mass media. Indeed, adoles-
cents and college students, like adults,
have identified mass media as an im-
portant influence on their thinking about
mental illnesses (Granello & Pauley,
2000; Lopez, 1991). As Hinshaw &
Cicchetti (2000) argue, then, it is reason-
able – if not necessary – to look carefully
at what the media present about mental
illnesses to discover what attitudes to-
ward those illnesses are being fostered.
Depictions of mental illnesses in
children’s media
The majority of studies of media
depiction of mental illnesses have focused
on adult media. These studies have
established that such depictions are both
common and unflattering. Wahl & Roth
(1982), for example, found that 1 in every
11 prime time television shows contained
a character labeled as having a mental
illness. Numerous studies have estab-
lished a strong media link between
violence and mental illnesses. This link,
moreover, crosses international bound-
aries and has been found in media in
Canada (Day & Page, 1986), the UK
(Philo, 1996), and New Zealand (Wilson
et al., 1999), as well as in the USA
(Diefenbach, 1997; Signorielli, 1989;
Wahl & Roth, 1982; Wahl et al., 2002).
The depiction of people with mental
illnesses as different, unpredictable, un-
successful, socially unconnected, and
unlikely to recover has also been noted
(Gerbner, 1993; Signorielli, 1989; Wahl et
al., 2002; Wilson et al., 1999).
There is far less data available on
children’s media, but several studies give
a glimpse of what these media contain.
252 Otto F. Wahl
Gerbner (1993, 1995), as part of his
broader consideration of many aspects
of television programming, examined
samples of Saturday morning children’s
programs. In particular, he sampled nine
seasons of major network Saturday
morning (8 AM – 2 PM) programs – 394
programs altogether. Among the findings
reported by Gerbner were that mentally
ill characters on Saturday morning shows
fail (i.e., do not achieve their stated
goals) twice as often as they succeed
(similar to their fates in adult program-
ming). They are also, along with elderly
women, highly likely to be killed, injured,
or exploited, leading Gerbner to con-
clude that ‘at the bottom of fate’s
pecking order are characters portrayed
as old women and as mentally ill’
(Gerbner, 1995, p. 134). Specific figures
for failure and victimization rates for
characters with mental illness were not
reported, however.
Wahl, Wood, Zaveri, Drapalski, and
Mann (unpublished manuscript) have
recently completed a study of mental
illness depiction in children’s films. In
this study, three trained raters viewed
and rated 49 G and PG-rated films
released in 2000 – 2001. Twelve of these
films (24%) contained a character la-
beled, within the film, as having a mental
illness. A total of 14 characters with
mental illnesses were portrayed in these
twelve films. The majority of the men-
tally ill characters were male, Caucasian,
and single or of unknown marital status.
Although many of these characters had
positive attributes (e.g., were trustworthy
or helpful) and were often responded to
in relatively sympathetic ways by other
characters, they also tended to threaten
and frighten other characters. Two-thirds
of the mentally ill characters behaved in
violent or aggressive ways; other char-
acters showed fear toward nine of the 14
mentally ill characters (64%). Treatment
was provided for only four of the
characters, and only one seemed to
benefit from such intervention. Charac-
ters were seldom identified through
medical or professional labels; rather
they were usually referred to by slang
terms such as ‘crazy’, ‘psycho’, and
‘lunatic’. In addition, 21 other films
contained references to mental illnesses,
and those references tended to involve
use of psychiatric terminology to dispa-
rage the views or behaviors of others
(e.g., ‘You’re certifiable.’ ‘He’s not as
crazy as he looks.’ ‘Have you lost your
mind?’).
Beveridge (1996) looked specifically at
the films of Walt Disney for portrayals of
mental illnesses. Based upon a qualita-
tive, rather than quantitative, examina-
tion of these films, he observed that
references to ‘madness’ appear in Disney
films across a wide time span, from
Dumbo (1941) to Alice in Wonderland
(1951) to Mary Poppins (1964) to Beauty
and the Beast (1992). He noted further
that Disney films frequently feature a
hero who is initially vilified or ridiculed
for being mad but who is actually sane –
Belle, in Beauty and the Beast, Dumbo’s
‘mad elephant’ mother, Mr Banks, when
he deviates from his usual stuffiness in
Mary Poppins. Beveridge also suggests
that a major message of these films is that
‘madness is generally . . . something to
fear and something that needs to be shut
away’ (pp. 619 – 620).
By far the most detailed examination
of depiction of mental illness in children’s
television was conducted in New Zeal-
and. Wilson et al. (2000) sampled a full
week of television on two New Zealand
television channels during the early
morning (6:30 – 9 AM) and mid-after-

noon (2 – 4:30 PM) timeslots designated
for children’s programming. Altogether,
they examined approximately 58 hours
of children’s shows (128 programs). They
looked at both the attributes of the
characters designated as having mental
illnesses and the vocabulary used to refer
to those characters. Wilson et al. (2000)
reported that 59 (46%) of the episodes
contained one or more references to
mental illness, the majority of these (47)
occurring within animated cartoons
rather than in shows with human actors
(12). The most common terms for mental
illness were ‘crazy’ (28), ‘mad’ (19), and
‘losing your mind’ (13). Similarly dis-
respectful slang terms like ‘nuts’, ‘bana-
nas’, ‘twisted’, ‘deranged’, ‘wacko’, and
‘looney’ were also noted, as were stereo-
typic gestures for mental illness such as
twirling motions to the head.
Wilson et al. (2000) found six recurring
characters consistently identified as hav-
ing a mental illness. These characters
were identified by slang terms, as noted
above. Specific (professional) diagnoses
were not provided. Three characters
appeared in mainly comic roles, and
three were reportedly shown as evil
villains. All were male. These characters,
the researchers noted, often had distinct
(and unattractive) physical features, such
as rotting teeth, unruly hair, heavy eye-
brows, narrowed eyes, and bad breath.
Comic characters behaved in illogical
and irrational ways that were amusing
to other characters (e.g., hitting their
head with a hammer and interpreting
word expressions literally). Mentally ill
villains were ‘determined and obsessive’
and engaged in criminal acts such as
kidnapping and attempted murder. The
authors reported further that they
‘looked for, but did not find, any positive
attributes’ (p. 442). They noted also a
Mental illness in children’s media 253
lack of ‘any understanding of the suffer-
ing that mental illness involves’ (p. 442).
Wahl (1995) has included, in his
observations of media images of mental
illness, negative portrayals in books and
comic books, as well. Although his was
not a systematic examination of these
media, his examples speak to the wide
variety of children’s media that reference
and/or portray mental illnesses. For
example, he noted a children’s book in
which one character, seeing a man on the
street behaving strangely, cautions his
friends: ‘Crazy people are like dogs. If
they see you’re afraid they attack.’
(Rockwell, T., 1973, p. 20). To this book
might be added one from the enormously
popular Harry Potter series, in which the
young wizard is warned about an escaped
prisoner: ‘[Sirius Black] is mad. He’s a
danger to anyone who crosses him, magic
or Muggle.’ (Rowling, J. K., 1999, p. 38).
Wahl has noted also that comic book
villains are often portrayed as crazed
madmen. The May 2001 issue of Green
Lantern, for example, introduced Nero, a
villain who starts out in a psychiatric
hospital with a diagnosis of schizoaffec-
tive disorder. It is often communicated in
comics, furthermore, that madness is
what turns good people (e.g., scientists)
into villains. Batman’s nemesis, the
Joker, as portrayed by Jack Nicholson
in the 1989 film, is an example of this, as
is The Green Goblin in the blockbuster
2002 Spiderman movie.
People with psychiatric disorders are
also often the subject of published
cartoons available to children and adults
alike. The comic pages of newspapers, in
any given year, will likely reveal many
cartoon characters lying on couches for
analysis, being taken away in straitjack-
ets for unusual behavior, or dismissed by
other characters as ‘nuts’, ‘fruitcakes’,
254 Otto F. Wahl
and the like. Walter (2000) sampled
American cartoons from 1941 to 1990
and examined several facets of the 404
cartoons selected. He reported that the
majority of characters with mental ill-
nesses were male (56%), and none were
depicted in positive ways. Mentally ill
characters were instead depicted, accord-
ing to Walter, as ‘mad’, licentious, bored,
greedy, and sadistic. The most common
depiction of these cartoon characters was
as a source of ridicule, consistent with the
humorous intent of the cartoons. Walter
concluded that such depictions ‘enable
the public to deride and thereby distance
itself from people suffering from or
treating mental illness, that is the car-
toons facilitate stigmatization’ (p. 15).
As noted earlier, data on children’s use
of media identify music and the internet
as important to youth, as well. Indeed,
children and adolescents have reported
that popular music is as important to
them as television (Roberts & Christen-
son, 2001), and more than half of
children ages 2 – 12 are believed to be
regular users of the internet (Tarpley,
2001). Although these are media that also
have not yet been studied with respect to
mental illness content, anecdotal obser-
vations again suggest that they, too, may
contribute frequent representations of
mental illnesses. Wahl (1995) identified
many popular songs with titles and lyrics
referring to mental illnesses, often ones
referring darkly to threat and violence.
Mental health advocacy groups that
monitor and respond to media depictions
of mental illnesses have noted numerous
music videos that feature characters in
psychiatric hospitals, straitjackets, and/
or padded cells. The musical artists
contributing these depictions of mental
illness, moreover, vary widely, ranging
from hard rockers like The Ramones
(‘Psychotherapy’) to country singer Lari
White (‘Wild at Heart’) to pop stars
N’Sync (‘I Drive Myself Crazy’) to
current rap star Mystikal (‘Bouncing
Back: Bumping Me Against the Wall’).
Internet sites and video games have
likewise been observed to offer significant
mental illness themes. These include
websites such as Lunatix Online (in
which ‘players assume the role of a
mental patient locked away in a wacky
mental institution on a crazy quest to
escape’). There are also video games such
as American McGee’s Alice (which in-
vites players to ‘duel to the death with
psychotic renditions of characters from
the original Alice adventures’) and
Twisted Metal: Black (which features
inmates who have escaped from an
asylum – including Mr Grimm, who eats
human flesh). The specific nature of these
depictions has not been fully articulated,
but concerns expressed by advocates
indicate that mental illness is both
trivialized and ridiculed in many of these
games and music videos. Moreover, as
may be apparent from the examples
above, images of people with mental
illnesses as dangerous and in need of
confinement and restraint are common as
well.
Discussion
The first obvious conclusion from
these examinations of media depictions
of mental illnesses is that there is a great
deal of material within children’s pre-
ferred media from which children may
learn about psychiatric disorders. Images
of madness appear in a wide variety of
media directed to youthful audiences
and, in some of those media, appear very
frequently (e.g., one in every four G and
PG films). Even without including adult

fare, to which many children are also
exposed, there is considerable opportu-
nity for children to witness images,
themes, and references to mental ill-
nesses.
The depictions of psychiatric disorders
in children’s media, moreover, appear to
involve negative stereotypes similar to
those in adult media. The predominant
presentation of characters with mental
illnesses is as violent, aggressive, and fear
inducing. In addition, characters with
mental illnesses tend to be unattractive in
personal appearance, typically fail in life,
can look forward to being ridiculed by
others, and seldom benefit from treat-
ment. Children are also being shown that
the proper response to individuals man-
ifesting psychiatric disorder is confine-
ment and isolation rather than empathy
and treatment. The extensive use of
disparaging slang in reference to men-
tally ill characters, furthermore, provides
a threefold message to young audiences:
The first message is that such psychiatric
terminology is appropriately associated
with behavior that is objectionable,
foolish, devalued, and/or cruel. The
second is that slang reference to mental
illnesses (unlike slang reference to other
serious disorders) is a common and
acceptable part of conversational speech.
The last message is that these are the
terms one uses to disparage others and
indicate our low opinion of them.
Articulation of the nature of depiction
of mental illnesses in children’s media, of
course, does not establish impact. The
influence of images, such as those docu-
mented, on children’s behavior and
attitudes with respect to mental illnesses
has not been empirically established.
However, the general impact of extensive
media exposure on children’s beliefs
about the world has been widely dis-
Mental illness in children’s media 255
cussed and documented. Cultivation, or
cultural norms, theories suggest, for
example, that the mass media provide a
consistent set of images that are assimi-
lated by audience members and come to
define their social reality. As Dennis
McQuail (1979) explains this: ‘In effect,
the audience member learns about his or
her social world and about himself from
the media presentation of society (given
that most of the time, most of this is not
directly accessible). The media provide
the materials for responding to experi-
ence and these accumulate over time in a
long-term process of socialization’ (p.
76). George Gerbner has observed,
further, that entertainment media have
taken the place of families and tribal
storytellers as the conveyers of cultural
mores and attitudes to future generations
(Gerbner et al., 1980). Television viewers,
Gerbner has noted, are exposed to a
steady stream of deliberately homoge-
nous images many hours each day. The
result is that viewers’ notions of social
reality – of how dangerous the world is,
of what professionals are the most
common, of what proportion of our
population is elderly – become closer to
what is portrayed on TV than to real life.
Several studies of adult media have
demonstrated an association between
frightening media images of mental ill-
nesses and attitudes toward those with
psychiatric disorders (e.g., Granello &
Pauley, 2000; Philo et al., 1994; Thornton
& Wahl, 1996; Wahl & Lefkowits, 1989).
As noted earlier, children, whose con-
ceptions of the world are still developing,
would seem to be even more vulnerable
to the cultivation influences of mass
media. Indeed, a large body of empirical
research has verified the relationship
between media depictions and children’s
ideas about a wide variety of things –
256 Otto F. Wahl
from gender roles to cultural differences
to proper diet (e.g., see Singer & Singer,
2001). It is not much of a leap to predict
that similar ‘cultivation’ is occurring with
the frequent and homogeneous images of
mental illnesses presented in children’s
media. It seems highly likely, in fact, that
children derive much of their under-
standing of mental illnesses from the
images they encounter in those media.
And what they are likely to be learning
is cause for concern for those who wish
to see an end to stigma and discrimina-
tion. Pervasive images of people with
psychiatric disorders as unattractive,
villainous, and dangerous likely facilitate
the rejection of mentally troubled peers.
Media images also encourage insensitiv-
ity and lack of empathy, as children learn
from models who disparage people by
using mental illness labels and who freely
use offensive slang to refer to those with
psychiatric disorders. Furthermore, these
depictions give children an idea of the
hostile environment they may face if they
acknowledge mental health problems,
thereby undermining treatment seeking.
The depictions in children’s media also
lay the groundwork for the persistent
adult fears, avoidance, and disrespect
that are central to continued stigma and
discrimination toward people with men-
tal illnesses.
An important implication of findings
about the depiction of mental illnesses
in children’s media is that stigma reduc-
tion campaigns that focus on adults and
adult media may be limited in their
long-term effectiveness. With children’s
media filled with negative stereotypes of
mental illnesses, we cannot ignore the
likelihood that negative attitudes about
mental illnesses are being nurtured
among children who are not touched
(as they are not targeted) by our public
education/anti-stigma campaigns. Even
if we were to succeed in changing adult
attitudes, then, we would soon face a
next generation fully indoctrinated with
the negative images and attitudes of
their precursors. Greater attention to
children’s developing knowledge and
attitudes about mental disorders, and
to the media images that feed them, will
be necessary if lasting changes in under-
standing and acceptance of mental ill-
nesses are to occur.
Declaration of interest
No financial assistance was accepted
from any source for completion of this
paper. The author has no financial
relationship with the Journal of Mental
Health or its editors or with any of the
authors whose work is cited in the article.
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