Mental Health

More Realistic Physical Representations in Media Will Support Youth Mental Health

More Realistic Physical Representations in Media Will Support Youth Mental Health

For many years, parents, child advocates, and mental health professionals have expressed their concerns about the influence of mass media on children and adolescents’ perceptions of body image, body satisfaction, and self-esteem. Over the past decade, with the rise of digital media and young people’s nearly constant engagement with media and technology, there has been an increasing alarm. Sadly, the media is filled with unrealistic representations of what our bodies should look like and do not accurately reflect the range of body shapes we see within our society—female characters and models often have bodies that are smaller and thinner than average, and males are often shown as physically strong and muscular. On top of this, these characters are often portrayed as being successful, accepted, sexually desirable, and happy while overweight characters are commonly used as comic relief, are often ridiculed in social situations and regarded as unattractive. 

recent report looking at children’s television in both the US and Canada showed that the majority of human characters in children’s television, especially females, were portrayed as thin or very thin. In addition, female characters were nearly twice as likely to be sexualized in the US based on factors such as revealing or flattering clothing, long eyelashes, and sensual lips. 

While many things can contribute to one’s body satisfaction (or dissatisfaction) and self-esteem, several research studies have established that children and youth are indeedvulnerable to mass media images and messages that encourage and reinforce distorted body images and unhealthy perceptions about dietary health. 

In one striking example, a landmark study over the period that television was introduced to a community in Fiji demonstrated the dramatic effect these images had on young adolescent girls, showing how they internalized the Western images of beauty, resulting in disordered eating habits and patterns. Moreover, a meta-analysis of 25 experimental studies examined the immediate effect of exposure to a variety of images and found that body image, especially for females younger than 19, was significantly more negative after seeing thin media characters than after seeing average or plus-size media characters or inanimate objects. 

Exposure to hundreds and thousands of these inaccurate and unrealistic images over time sends the message that they are common and normal within society, when in fact, they are difficult if not impossible for most people to achieve. In fact, these images are almost always digitally manipulated, modified and enhanced to achieve this ‘ideal’ body image, creating an even larger gap between reality and what we see in the media. The impact of not being able to look like these characters in the media is associated with decreased self-esteem, body satisfaction, depression, and eating disorders.

Moreover, exposure to sexualizing media leads to self-objectification in both men and women – which feeds a destructive cycle of measuring self-esteem by physical appearance. At a time when rates of anxiety, depression and suicide are on a steep rise, especially among young women and girls, putting a stop to these distorted media representations is long overdue and more important than ever.

While the problem remains significant, we have seen some positive improvements in advertising and marketing campaigns in recent years. For example, Aerie, the lingerie retailer, created a campaign, #AerieREAL, which intends to promote body positivity by using raw, unretouched images that feature models of different racial backgrounds and body types and more recently, models with disabilities and other medical issues. Similarly, Dove’s Girls Self Esteem campaign has a similar mission. Many popular retail brands, such as Target, Old Navy, Nike, and Forever 21, have followed suit by incorporating a diversity of body types and/or scaling back on re-touching photos in their advertising. 

In TV and film, avoiding these distorted physical stereotypes is still the exception, not the rule. There are a handful of shows making a solid effort to promote more “body positivity” through inclusion of a variety of body types and characters, but they are unfortunately few and far between. We need to see much more of this – and urgently – especially for any hope of stemming the tide of rising rates of anxiety, depression and suicide among our youth. 

Inclusive and realistic portrayals can promote body acceptance and reinforce self-esteem – and wellness should be prioritized over ratings. If done well, the ensuing culture shift should open the door for a new era of creative, representative content that viewers can relate to and embrace. 

To contribute to positive body diversity in media, here are some actionable insights for content creators:

  1. Offer more realistic cultural standards of beauty through a diversity of body types and experiences.

  2. Avoid characters fixating on weight loss and beauty. 

  3. Create characters who model body positivity and acceptance. 

  4. Deviate from cultural norms of women needing to be slender and men, strong and muscular.

  5. Offer an alternative narrative to one featuring women and girls as sexual objects and men as fixated on female physical characteristics above all others.

  6. Show characters who deviate from the cultural norms of beauty as romantically desirable and socially accepted, not just as sidekicks or comic relief. 

Vicki Harrison, MSW

Program Director, Center for Youth Mental Health and Wellbeing

Stanford Psychiatry Center for Youth Mental Health & Wellbeing

Adrianna Ruggiero

Senior Research Coordinator for CSS

Avoiding Mental Health Stigmatizations & Encouraging Help Seeking Through Entertainment Media

Avoiding Mental Health Stigmatizations & Encouraging Help Seeking Through Entertainment Media

Mass media have the power to shape our perceptions, attitudes and beliefs toward certain groups, issues and individuals. For better or worse, most forms of media, including entertainment media, serve as primary sources of information for many viewers, influencing our understanding of those around us and in turn, our future behaviors and actions.

Unfortunately, for those struggling with mental illness, the depictions of characters with mental health issues often focus on negative and extreme stereotypical traits that portray these individuals as a danger to society and themselves. These depictions are not only inaccurate and unrepresentative of the millions of people worldwide who face mental health challenges, but they also reinforce preconceived stigmatizations which can lead to diminished self-esteem and social exclusion

Mental health professionals are often portrayed as odd, unhelpful, unrelatable and/or unavailable, which can have major consequences on those affected by mental illness. These negative portrayals can interfere with help seeking behaviors and prevent individuals from receiving treatment due to factors such as fear, shame, embarrassment and discrimination. A startling two-thirds of individuals with a mental health disorder never seek professional help.

Too often, entertainment programs portray mental illness as something that destroys lives and fail to show viewers that mental illness is common and treatable. By depicting treatment and recovery, the media can help normalize mental health issues, fight stigma, offer hope, and connect viewers with resources for themselves or loved ones.

In a survey commissioned by the mental health organization Mind, based in the UK, findings showed that after seeing a news report or drama involving a character with mental health challenges, more than half of the respondents expressed that it had improved their understanding of mental health issues and a quarter said it had inspired them to start a conversation about mental health. Furthermore, out of the respondents affected by mental health issues, one third were encouraged to seek professional help and get assistance. 

Several other studies have highlighted the power of the media to reduce stigma, increase understanding of mental health and increase help-seeking behaviors. For example, one study found that participants who watched a film depicting an accurate portrayal of an individual with schizophrenia, were less likely to endorse stigmatizing attitudes toward individuals with the illness compared to participants who saw an inaccurate portrayal of schizophrenia. Another study found that having a strong relationship to the main character of a television series who had obsessive compulsive disorder (OCD) was associated with lower OCD stereotypes and greater willingness to seek and disclose mental health treatment specifically among participants with a mental illness. 

It is clear that the media have the power to influence our perceptions, attitudes and beliefs about individuals living with mental illness and also to help those affected. Therefore, it is in the best interest of millions of viewers and their loved ones for content creators to portray characters with a mental illness accurately and positively.

Here are some actionable insights for storytellers: 

  1. Avoid perpetuating stereotypes about mental illness that may be stigmatizing and harmful. 

  2. Avoid including stigmatizing language in scripts, such as “crazy,” “psycho,” “looney,” “wacko,” etc.

  3. Avoid making mental illness the defining feature of a character’s personality. 

  4. Introduce likeable and relatable characters who also might happen to encounter mental health challenges. 

  5. Portray doctors and therapists as helpful and supportive rather than incompetent or unavailable.  

  6. Model help-seeking behaviors such as talking to therapists, talking to trusted friends/adults and calling/texting helplines. 

  7. Model help-seeking behaviors not only for serious or diagnosable problems but also for common challenges such as stress, divorce and death. 

  8. Show supporting cast characters modeling supportive behaviors and describing options for seeking help. 

  9. Insert message of mental health treatment, hope and recovery. 

Vicki Harrison, MSW

Program Director, Center for Youth Mental Health and Wellbeing

Stanford Psychiatry Center for Youth Mental Health & Wellbeing

Adrianna Ruggiero

Senior Research Coordinator for CSS

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