A 10-year examination of people with psychosis in American television programing: are representations improving over time?

Background: Media portrayals inform understandings of mental illness; yet little research has investigated representations of characters with psychosis in fictional television programming.

Aims: This study examined the valence and trends regarding representations of people with psychosis in popular fictional television programing in the United States, one of the most influential markets in the world.

Methods: A content analysis was conducted of the 50 most-watched American primetime fictional television shows from 2011 to 2021. Two raters independently coded characters in three domains pertaining to: demographics, life-status, and - most importantly - character framing. The Cochran-Armitage and Jonckheere-Terpstra tests were used to determine potential changes over time.

Results: Regarding valence, characterizations were more positive than negative. Trend analysis revealed few changes regarding demographic or life status variables, but a different picture emerged with the character framing variables. Over the course of the decade, characters with psychosis were progressively less likely to be depicted as formerly incarcerated, engaging in criminal activity, and as villains, and more likely to be portrayed as victims, protagonists, attractive, and having a positive effect on society.

Conclusion: The study findings are encouraging although additional efforts are needed to ensure media representations accurately reflect the demographic characteristics of people living with psychosis.