Exploring Changes in the Portrayal of Mental Health on Wikipedia

For this project, I wanted to see how the ways in which we talk about mental health have changed over time, as well as how our diagnoses of mental illness and approach to treatments have developed. I am a psychology major and an intern for Richmond’s Counseling and Psychological Services office, so mental health is a topic that really interests me. In particular, I am interested in how much change surrounding the topic of mental health and our perceptions of mental disorders has occurred in just the past decade or two.

I began my analysis with the page titled ‘mental health’ and there were two findings that really stood out to me. First, the term “unmet” is consistently one of the top words from 2011-2018. However, it disappears from the lists of top words for every year before 2010. Most of the “unmet” terms on the mental health page are in the section discussing the World Mental Health survey initiative, which was created initiated the World Health Organization. The WHO’s big takeaway from this survey is that mental disorders are the leading cause of disability across the world, but the needs for treatment are often unmet. The survey is not mentioned at all in the 2010 page and there was actually a lot added to the mental health page between 2010 and 2011, signaling a huge bump in our knowledge surrounding mental health and healthcare. Not coincidentally, the article cited for the survey initiative is an article published to PubMed Central (a well-known archive of primary research articles) March 30, 2010.

Second, since I have a background in Positive Psychology, I noticed that the way in which mental health was defined in the first paragraph changed in an important way. In 2004, mental health was simply the “absence of mental illness.” Interestingly, the last sentence on the page notes that mental health can be thought of as more than the absence of a mental illness, yet the first sentence on the page defines mental health using only the idea of an absence. However, the Positive Psychology movement began in 1998 when Martin Seligman was selected as the head of the APA. The premise of Positive Psychology is that well-being is more than an absence of bad, it’s also a presence of good. The 2006 version of the “mental health” page is the first to acknowledge this emerging field of psychology. Interestingly, the first paragraph for this year states that “there is no one ‘official’ definition of mental health” and that “‘mental health’ and ‘mental illness’ are not opposites.” Perhaps due to the growing influence of Positive Psychology, the definition of mental health changed in 2007 to “either a level of cognitive or emotional wellbeing or an absence of a mental disorder.” Though today’s definition of mental health is still likely to vary based on culture, education, and individual opinions, it is interesting to see how Wikipedia’s definition has expanded and become more inclusive over time.

After checking out the mental health page, I then wanted to take a step back and look at how the field of psychology was represented over time. To this day, psychology is often not thought of as a “hard science” and so I wanted to look at how the field of psychology was perceived at different points in time. Interestingly, the term “philosophy” was a top word in the years 2001-2003. The 2001 version notes that psychology was thought of as a branch of philosophy, but then spends one of the five paragraphs that make up the entire page discussing psychology’s stem from philosophy. The current page on psychology still discusses the field’s roots in philosophy, but while the 2001 says “Most universities, journals, and researchers today treat psychology as among the experimental sciences and not as a branch of philosophy,” the 2018 page does not suggest anyone “treating” psychology as anything but a science. In fact, the term “science” doesn’t even appear in the 2001 version until the fourth (second to last) paragraph, while the 2018 version’s first sentence reads, “Psychology is the science of behavior and mind…”

Next, I wanted to look at the “mental disorder” page. I started with the 2002 page, which blew my mind because the first paragraph claims that most mental illnesses are attributed to “organic/neurochemical causes” and treated with medication. It fails to mention any developmental or social factors that might contribute to the onset of a mental illness. Similarly, another aspect of the “mental disorder” page that I thought was really interesting was that the 2003-2006 versions contain a section titled “Controversy over the nature of mental illness,” most of which is absurd considering what we know today about all the factors that can contribute to the development of mental illness. The paragraph begins with “The subject is profoundly controversial…” and then continues on to state “It is important to note that the existence of mental illness and the legitimacy of the psychiatric profession are not universally accepted.”

Furthermore, one large controversy throughout the history of mental illness diagnosis was that homosexuality was once considered by the APA as a mental illness. The 2003 page addresses this, writing “homosexuality has been considered such an ‘illness’ from time to time, and obviously this perception varies with cultural bias and theory of conduct,” which almost suggests that this notion comes and goes and isn’t completely ruled out. The 2004 page was edited to: “homosexuality was once considered such an ‘illness’ (see DSM-II), and this perception varies with cultural bias and theory of conduct.” I thought it was really interesting that even within one year, the way in which we talk about homosexuality changed from the notion that it may still be reasonably considered a mental illness to the fact that this was once accepted and no longer should be.

Another interesting finding was how the “major depressive disorder” page has changed over time. The first thing I noticed was the Change of a “treatment” section to a “management” section between 2008 and 2009. This is likely because when you talk about seeking out mental health aid, it’s important to remember that a mental disorder is a part of the person and though they won’t be cured of a disorder, there are many options to manage it. This is important because when someone goes on medication such as an antidepressant, they will likely have to take it for the rest of their lives, so the language we use surrounding mental aid is important to give a promising and realistic view of how aid works to help a person. Furthermore, the 2003 ‘treatment’ section is 6 sentences (2 very short paragraphs) long, while the 2018 ‘management’ section is much longer. Clearly, our understanding of major depressive disorder has grown quite a lot since 2003.

Similarly, the page for schizophrenia has changed a lot over the years. The 2002 version has one sentence under the “Causes” section: “While most researchers and clinicians believe that schizophrenia is caused by some malfunction of the brain, there is no direct known cause for the illness.” We literally had no idea what factors may contribute to the development of schizophrenia and this was 2002. In contrast, the 2018 version has a whole section with subsections (broken down into genetic and environmental factors), as well as a link to a page specifically on the ‘Causes of Schizophrenia.’ Interestingly, the page “Causes of Schizophrenia” didn’t even come about until 2007. It’s hard to believe that my brother is only 17 years old and in his lifetime we have gone from having no clue what may impact the development of schizophrenia to a much greater understanding of the multiple factors.

Another page that has altered its language over time is the “ADHD” page. There was (and is) still a lot of controversy as to whether ADHD can be considered a “real disease.” In fact, the 2002 version had a section titled “Evidence for ADHD as a real disease.” This is changed in the 2003-2005 versions to “Evidence for ADHD as an organic phenomenon.” The use of the term “organic” suggests that people are still trying to prove ADHD is a real, naturally-occuring disorder and not just something made up by psychiatrists. On the other hand, the 2018 version still addresses controversies surrounding ADHD validity but the page focuses less on defending ADHD as a real disease compared to earlier versions of the page.

After this focus on the linguistic content of my pages, I wanted to analyze other important aspects of the pages. Glancing over the first images that the pages in my corpus contain, I noticed three things. First, many pages do not contain any images. These tended to be concepts that are less concrete, such as mental health, causes of schizophrenia, social stigma, quality of life, and sanity. Second, many of the pages’ first images included heads, probably because they related to psychology or the mind. Even the “mental disorders” page’s first image is a word cloud in the shape of a head. Third, I thought it was interesting that a couple of the mental disorders were portrayed through art, including major depressive disorder, schizophrenia, and PTSD. I’m not sure why this is but my guess would be it’s hard for an image to express a complex idea like a mental disorder (you can’t really show what the experience of schizophrenia looks like in one image) so art is a platform to better express those experiences.

I was also really interested in how the pages in my corpus would cluster. My process of grabbing pages from Wikipedia for my corpus followed a rough pattern: I started with the page on mental health and looked at all the links contained in that page. Through this process, I added any pages I thought were relevant or I was interested in. I then did this for the mental disorders page to gather more information on specific disorders, their diagnoses, and treatment. The clusters worked really well because I created enough (12) to allow them to be pretty small and specific. When I was deciding which pages to include in my corpus, I grouped them on the “page-names” text file in order of how groupings made sense to me. Consequently, the order of my documents follows the order of the groups I came up with. Interestingly, I grouped my pages into just 5 clusters: (1) mental health and mental disorders, (2) negative stereotype and dangerous history, (3) types of therapy, (4) positive psychology, and (5) legal understanding of mental illness. When I tried using python to create 5 clusters, though, the program came up with completely different groupings of pages. One cluster felt like a catch-all cluster while the others were quite specific. Therefore, I increased the number of clusters from 5 to 12. Examples of the potential names of these clusters might include: Schizophrenia (C0); relaxation self-help (C1); types of therapy (C2); legal understanding of mental health (C3); types of psychology (C4); Depression (C5)... Altogether, these were much easier to name because they were smaller and more specific.

This project emphasized how much change can occur over short periods of time regarding our knowledge, as well as how we talk about mental illness and related controversial or sensitive topics. Psychiatric facilities were once called lunatic asylums, homosexuality was once considered a mental illness, and 16 years ago we had no idea what caused schizophrenia. As our knowledge around a topic changes and grows, so does the language we use to discuss that topic. This is why the top words for just about any page in my corpus changes over the years. The words we use not only reflect our level of knowledge but also our opinions and values, which is why popular websites used to gather and disseminate information must choose their words carefully, as well as continue to make revisions as our culture’s knowledge and values change over time.