This slim volume, 175 pages of text
and 10 essays, serves as a good introduction to the consideration of the often
symbiotic and always involved relationships of the media, health practice and
representation. In the main the essays concentrate on the popular media,
television and newspapers in particular. The impact or relevance of film or
literature or fine art does not figure prominently, and this is explained as
being related to the available evidence. This is a little disappointing as the
representation of psychiatry in film has been well and extensively researched.

 The essays tend examine contemporary trends and do not offer much
in the way of historical background, although much of the analysis and
theoretical positioning of the authors is steeped in the precepts of critical
sociology, especially the work of Walter Benjamin and more recently, Stuart
Hall. Although the authors come from a number of different countries, it is a
fairly limited selection; the UK mainly, but also Australia, New Zealand and
one from Canada and one from the USA. The European or non-Western traditions
are not as well represented (although to be fair it is said that 15 abstracts
from other countries were submitted for consideration, but not included in the
final volume).

The book is clearly written for an
academic audience, and despite the fascinating central concept — how and why
do the mass media shape our perceptions of what health is, what we should
expect and desire? — there are few parts that would attract and engage the
less expert or more casual reader. The style is often dense in the way that
only sociological texts can manage, and there is no thematic development
through the book; it is a collection of essays.

The first question posed in the
collection is a central one: why should medical sociologists study the media?
We are to hope that this is rhetorical, but the essays do go on to examine, not
to say deconstruct, the main issues of production, representation and
reception. One concern that does emerge in a number of papers is that of the
‘informed consumer’. What characterizes this person, and where does this
information come from? How reliable is it? To what extent does it shape the
behavior of consumers and practitioners? Do we, because of popular television
shows like ER which tread that
delicate line between being factually based, but also fiction, think of
ourselves as being medically informed? It is curious to note how some academics
and health professionals recommend ER to
their students, not for its entertainment value, but for its information — and
personal experience confirms this. I have many times come into a classroom to
find students talking about what they saw on ER last night; "Did you see how they diagnosed that brain
hemorrhage (or whatever)? Wasn’t that cool?"

There is much to explore here, and only a little is
touched on. The nature of health care is responding to a media-informed imagination
that is at once saturated with fiction and selective with facts.

It is not without some irony that
the ‘informed consumer’ is both an aim and a problem to health providers. Being
informed is OK, but it really has to be the way I want you to be informed, not
in a way that is either misinformed or contrarily informed.

The topic of the collection seems
particularly interesting to those with an interest in mental health because of
the many common stigmatizing and flawed conceptions of the mentally ill person.
It is distressing enough to read newspaper headlines about "psychos"
and "schizos" and "split personalities". It is frustrating
to see in print deliberate misrepresentations from those who ought to know
better about the violently mentally ill. However, it also encouraging to note
how, often through soap operas, shows with perhaps the fewest intellectual
pretensions, storylines with mentally ill characters or mental illness as a
major theme are woven in and out of the representation of ordinary experience.
The beginnings of empathy are the key to overcoming stigma. Once an experience
is normalized it becomes more understandable, less fear-provoking and less
stigmatized. This is perhaps one of the most hopeful messages that can be
gleaned from studies of health within the media. This is something we should
all hope for.

© 2005 Mark Welch

Mark Welch, Ph.D. Assistant
Professor in the Faculty of Nursing at the University of Alberta, Edmonton,
Alberta and Co-Director of the PAHO/WHO Collaborating Centre for Nursing &
Mental Health.

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