How painful it is for families where a person has a mental health problem that features in a media report, particularly when violence and murder are involved. No wonder people hide their illness if they can be identified with, or identify themselves, as potential perpetrators.
The facts are different. You are 400 times more likely to be murdered by your nearest and dearest than by someone with a mental illness. Mental illness should not be equated with violence.
People who are out of control are generally not mentally ill. Dramatic language can give an extreme impression of mental illness, when in fact extreme, violent behaviour by those with mental health problems is rare.
Learning to talk and write about a stigmatising topic like mental illness is full of pitfalls. The more politically correct the writing, the more stilted it becomes, so it comes across as patronising.
As a practising child and adolescent psychiatrist I have learnt better ways of talking with children, adolescents and their parents about their emotional, behavioural and neurodevelopmental problems. I am sure that over the years I have got it wrong and used words and ideas that were painful and distressing, leaving them feeling I was unsympathetic.
It is even more difficult to give an objective, neutral message when talking about mental illness to a public audience.
Psychiatrists are aware of the need to inform the general public about such matters, but apparently have been reluctant to do so. There are exceptions, such as Prof Anthony Clare, Prof Pat McKeon of the depression support organisation, Aware, and others who have educated us all in normalising mental illness, reducing fear and assisting people to seek help at an earlier stage.
As part of a destigmatising campaign the Irish Division of the Royal College of Psychiatrists monitored the reporting of mental illness in broadsheet and tabloid newspapers over the last year.
The tone of reporting has been mainly objective and sympathetic. Except in specific tabloids, pejorative words are no longer used but in all newspapers people continue to be identified by their illness, labelled, for example, as schizophrenic, depressive or autistic, rather than a person who has schizophrenia or whatever illness.
Increasingly, journalists are refusing to interpret someone's illness as the cause of their actions. A recent tragic event, in the early stages of reporting, implied that the person's known psychiatric history was causative, and it was identified in conjunction with the event. This may be seen as mitigating the tragedy, but until the facts are clear, why mention it at all?
People are more informed and inquisitive about mental health as they wish to empower themselves, so their health and their family's health is in their hands rather than those of experts. In the recent past cancer was a taboo subject, and TB before that. It is no longer stigmatising to admit to having cancer or TB, and people are willing to talk about their experiences.
People with mental illnesses and their families are going through the same process today of wanting to be part of a more open society, where personal suffering is met with compassion rather than judgment.
But mental illnesses are still difficult to accept in oneself. People are vulnerable when confronted by any illness, but can also become isolated if they cannot talk about what is happening to them. The response is to shy away from overexposure.
Some doctors are sensitive to the needs of the people they meet and treat. If I speak about a particular illness, such as schizophrenia, I am conscious of the individual I am conversing with, but if I speak publicly I am unaware of the response to my language and content.
I am aware that people I have dealt with professionally, including the families of patients, are potentially responding differently to what I say than those who have had no contact with a mental health professional. People look for themselves in statements about health. Yet they need to be informed on many levels, personal, public and political.
Mental health services are poorly funded. Their development has been thwarted by failure to resource and pay attention to the needs of people with mental health problems. As services are neglected, personnel become disheartened and new, innovative ideas and techniques are lost. We all need to find a way to talk which forces us all to face our demons. Schizophrenia Ireland and Aware have brought those issues into the public domain.
People with mental illness are beginning to inform us about their needs. If you are disempowered, disembodied, you are voiceless. If you are unsure and apprehensive of the public's response to your admission of illness, you fall silent. I have heard many stories of discrimination in workplaces and socially. To improve standards of care, the public and professionals need each other's support. The media are a valuable resource in highlighting need, but there are inherent problems in campaigning through the media.
It is the nature of newspapers to emphasise conflict and human interest when looking for a story angle. Reporters need to be sensitive to the importance of looking at the whole picture, while the print media and mental health professionals need to build a relationship of trust, to open up and destroy the myths of mental illness.
Dr Kate Ganter is chairwoman of the public education subcommittee of the Irish Division of the Royal College of Psychiatrists