Are some pharmaceutical advertisements in APA's professional journals and in Psychiatric News feeding the stigma against mental illness?

That's what APA's Assembly asked last month in an action paper that calls on the Association to develop advertising principles regarding the ways people with mental illness should be depicted and to distribute these principles to all drug companies.

The action paper was brought to the Assembly by Mary Ellen Foti, M.D., of the Massachusetts Psychiatric Society. She said that patients and families are often negatively affected by depictions of the mentally ill in pharmaceutical advertising.

Foti told Assembly members that advertisements in APA's professional journals--and other places where advertisements for psychopharmacologic agents appear--often depict patients with severe mental illness as being "split" or "fragmented."

The advertisements, she said, contribute to the common misperception of schizophrenia as a disease of "split personality."

The advertisements, moreover, are seen by allied professionals and community support workers. In fact, Foti said she was moved to action when a nonpsychiatric community mental health worker saw an advertisement and asked, "When is something going to be done about this?"

Said Foti, "Our advertising principles need to be reconsidered and brought into line with current ideas about stigma."

APA has written guidelines for advertising, though they do not specifically address depiction of mentally ill patients or the possible stigmatizing effects of such depictions.

The action paper, still to be considered by the Board of Trustees, states:

"Drug companies tend to present mentally ill people in their advertisements as split, out of control, or disintegrated, sometimes with a follow-up picture presenting an annealed, controlled, or integrated person. Examples include the advertisement of Luvox in which a woman's face is divided lengthwise into black and blue halves; Depakote, which depicts a person [careering] on a rollercoaster; and Risperdal, which cuts a woman's face into 18 pieces and 'connects' them on the following page. Such images of the mentally ill are archaic and promote the stigma associated with mental illness."

The action paper was reviewed by Area 6, which declined to support Foti's motion, on the grounds that it was "not high enough of a priority." Nonetheless, the action paper attracted the support of a number of psychiatrists, including Assembly leaders, who stated that Foti had brought to their attention a worthy concern that had largely escaped notice.

Former Assembly Speaker Norman Clemens, M.D., hailed Foti for "educating" him about an issue he had not previously recognized. Clemens was echoed by former speaker Richard Bridburg, M.D., who said, "It's high time we did something."

(Psychiatric News, December 6, 1996)