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Vol.22, No.3, March 2006 - Depressed youth influenced by films depicting mentally ill

Exposure to films depicting characters failing to seek help for mental health disorders could have long-term effects on depressed or suicidal adolescents, according to new study results. Patrick E. Jamieson and colleagues examined whether exposure to films featuring mentally ill or suicidal persons support the belief that suicidal youth doubt the effectiveness of professional mental health treatment.

The study was carried out through a U.S. nationwide telephone survey from May to June 2002. Following telephone screening of 8,517 households, approximately 19% of households (1,595) had an eligible respondent. The survey results are based on the responses of 900 youths (ages 14 to 22 years) who completed the interviews.

To identify respondents vulnerable to suicide, the survey included questions from the Youth Risk Behavior Survey, asking about recent depression or suicidal thoughts, feelings of sadness or hopelessness for 2 or more weeks that led to stopping routine activities, serious contemplation of suicide, or making plans about how to commit suicide. All respondents were asked if they had ever heard of the term "major depression." If so, they were asked if they thought that people their own age with major depression could get help from their doctor or a counselor.

A list of 18 films was included in the questionnaire. Embedded in the list were 3 films featuring mentally disturbed individuals and ineffective mental health treatment (The Virgin Suicides; Girl Interrupted; A Beautiful Mind);3 films depicting suicide not associated with mental illness, but which presumably would not influence a vulnerable respondent's perception of the efficacy of professional mental health care (Armageddon; Crouching Tiger Hidden Dragon; The Patriot); 3 thrillers that featured multiple homicides and fighting to end conflict (Pulp Fiction; The Matrix; Get Shorty);and 3 comedies which if containing violence, only did so in a humorous context (American Pie; There's Something about Mary; Four Weddings and a Funeral).To determine the likelihood of vulnerable individuals watching movies, respondents were asked to indicate how frequently they saw films in the cinema, on TV, or on DVD or video.

The survey results indicated that 24% of the respondents reported feeling hopeless for at least 2 weeks or suicidal in the last year. A total of 64 (7.1%) reported having considered suicide, of whom 31 (3.4%) had made plans to kill themselves.

Vulnerable respondents were significantly less confident in the efficacy of treatment for depression (p<0.001), with approximately 12% believing doctors to be ineffective, and 10% viewing counselors similarly. This last finding appears to be "strongly related" to exposure to films featuring mentally disturbed characters, say Jamieson and colleagues, and not related to films in the other categories.

As exposure to the films increased, vulnerable respondents reported less confidence in treatment. "At the highest level of exposure," say Jamieson and colleagues, "vulnerable youth reported more than twice the rate of treatment inefficacy as those who saw none of the films in the category [depicting persons with mental disorders]." Among the respondents who were not vulnerable, there was no relationship between perceptions of mental health treatment and film exposure. There were no significant interactions for any film category between gender and vulnerability status.

Portraying completed suicide in a film already suggests the failure of available assistance, say Jamieson and his team. If the plot then explicitly portrays inept mental health professionals, then that message clearly reduces the likelihood of seeking help. Greater efforts may be needed, they say, to encourage young people to seek effective treatment from appropriate mental health practitioners for suicidal ideation and depression.

Jamieson PE, Romer D, Jamieson KH: Do films about mentally disturbed characters promote ineffective coping in vulnerable youth? J Adolesc 2006; E-pub ahead of print: doi:10.1016/j.adolescence. 2005.11.007.

The Brown University Child and Adolescent Behavior Letter, March 2006
Reproduced with permission of John Wiley & Sons, Inc.
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