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. 2023 Mar 21;3:100204. doi: 10.1016/j.ssmmh.2023.100204

“It’s important to manage our stress”: Mental health advice in the Australian print news media during the COVID-19 pandemic

Grace Horwood 1,∗, Martha Augoustinos 1, Clemence Due 1
PMCID: PMC10029348  PMID: 36974336

Abstract

The COVID-19 pandemic has heightened existing concerns about mental health and illness in Australia. The news media is an important source of health information, but there has been little research into how advice about mental health is communicated to the public via the news media. In this study, we examined how advice about building and maintaining mental health was discursively constructed in the news media during the COVID-19 pandemic. A discourse analytic approach informed by critical discursive psychology was employed to analyse 436 articles published in daily newspapers in Australia between 1 January and 31 December 2020, which contained references to mental health and the COVID-19 pandemic. Three main interpretative repertoires were identified – negative emotions are a risk to mental health and must be managed; risky emotions should be managed by being controlled (based around a ‘border control’ metaphor); and risky emotions should be managed by being released (based around a ‘pressure cooker’ metaphor). This study demonstrates that, amid the COVID-19 pandemic, advice constructed negative emotions as risky and problematic; and normalized the habitual management of emotions by individuals through strategies of control and release. Potential implications of such discourses for goals of improving population mental health are discussed.

1. Introduction

According to the World Health Organization (“WHO”) mental health is “a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community” (WHO, 2022). Within the field of wellbeing research, mental health and mental illness are mainly conceptualised either as two separate, albeit related, unipolar continua (Keyes, 2005); or as opposite ends of one bipolar continuum (Huppert and So, 2013). In either case, mental health and mental illness are understood as distinct, separately measurable states. There is, however, much ambiguity in public and academic discourse between the terms mental health and mental illness, with the term mental health commonly used as a euphemism for mental illness (Huppert, 2014). For the purposes of this article, we use the term ‘mental health’ to refer to the positive state of mental wellbeing as defined by WHO; and the terms ‘mental illness’ and ‘mental disorder’ to refer to a clinically diagnosable disorder, whether diagnosed or not. We use the broader terms ‘mental distress’ and ‘mental ill-health’ to refer to any form of sub-optimal mental health, which may or may not include a diagnosable disorder.

Mental ill-health has for some time been the subject of concern in Australia, due to persistently high, or rising, rates of mental illness and distress. In Australia, the 12-month prevalence of mental disorder (as measured by the CIDI - Composite International Diagnostic Interview) has remained stable since 1997, at around 20 percent of the population (Australian Bureau of Statistics, 2021; Korten and Henderson, 2000; Slade et al., 2009). Meanwhile, the prevalence of high or very high psychological distress among the population (as measured by the K10 scale) increased significantly between 2001 and 2018 (Enticott et al., 2022). This is despite per capita expenditure on treatment for mental illness more than doubling between 1999 and 2016 (Meadows et al., 2018). Until recently, positive mental health has not been systematically measured in Australia, however, recent research grounded in a dual continua model showed that, in 2019, on the positive mental health continuum, 70 percent of respondents were classed as flourishing, 29 percent as moderate and 1 percent as languishing (Be Well Co, 2022).

The worldwide COVID-19 pandemic, declared in early 2020, heightened concerns around mental health and illness in Australia. The pandemic impacted upon mental health directly, through fears of infection and increased uncertainty; and indirectly through the social isolation, job losses and financial hardship associated with lockdowns and other measures (Botha et al., 2022). Surveys in Australia early in the pandemic found heightened levels of depression, stress and anxiety among the population (e.g., Rossell et al., 2021). During the pandemic, 17 percent of Australian adults saw a health professional regarding their mental health, and 61 percent used at least one strategy, such as exercise, positive thinking or activities they enjoy, to help manage their mental health (Australian Bureau of Statistics, 2021). Nevertheless, the prevalence of psychological distress rose significantly during the pandemic (Biddle and Gray, 2021; Botha et al., 2022); and levels of mental health and wellbeing also dropped significantly. For example, among young people, 50 percent reported that the pandemic had impacted negatively upon their mental health and wellbeing (Filia et al., 2022). In 2020, the percentage of those classed as flourishing fell to 48 percent; and the percentage of those languishing rose to 6 percent (Be Well Co, 2022).

Given that previous efforts to improve mental health and reduce rates of mental illness such as increased provision of treatment, mental health literacy campaigns (Jorm, 2012) and the implementation of positive psychological approaches (Rusk and Waters, 2013) appear to have had little effect on rates of mental ill-health (Jorm, 2019); and given the added impact of the pandemic, there is a need for further critical reflection on current approaches to improving population mental health. The use of discourse and language is a key way in which the status quo in health is perpetuated (Lupton, 1994). How concepts of health and illness are constructed through language and discourse influences how health and illness states are understood; and how people who occupy certain states of health or illness are viewed by others, and view themselves (Sontag, 1978). Despite the public often being urged to talk more about mental health, to date there has been little critical debate or analysis around what should be said about mental health or what language should be used (Hess et al., 2016).

1.1. Mental health and the news media

The news media are important discursive sites in society for the negotiation of meaning, and for mediation between experts and the public (Fowler, 1991). The mainstream news media has long been recognised an important site for the social construction of meanings and beliefs around health and illness (Hodgetts and Chamberlain, 2006). 95 percent of Australians view or read news media content at least once per week; with television the most common way news is accessed, followed by online news websites or apps, social media, radio, online search engines, print newspapers and podcasts (Rapsey, 2022). Traditional news media outlets still tend to be seen as more credible sources of health information than social media, which is often seen as rife with misinformation (Lupton and Lewis, 2021); and dependence on the mass media for information is theorised to increase during unexpected events and in times of societal instability (Ball-Rokeach and DeFleur, 1976). Advice from experts about mental health relayed via the news media may therefore have been especially influential during the COVID-19 pandemic.

News media coverage has played an important role in earlier campaigns in Australia aiming to raise awareness of common mental illnesses (Hickie, 2004); and the passive psycho-education of the public has previously been identified as a cost-effective way to improve population mental health (Donker et al., 2009). There is a substantial body of research analysing the coverage of mental illness in the news media, which has highlighted the role of the news media in contributing to stigma through associating mental illness with dangerousness and violence. A smaller number of studies have analysed the coverage of mental health and wellbeing in the news media; in particular examining recovery messages (Atanasova et al., 2019). However, there has been little research to date analysing how advice about mental health is constructed in the news media; either prior to or during the COVID-19 pandemic. In the context of the COVID-19 pandemic, research on news media coverage and mental health has mainly focused on the negative effects of news consumption on mental health (e.g., Strasser et al., 2022) rather than on the potentially productive use of the news media for information or advice about mental health. One exception is a study by Caicedo-Moreno et al. (2022), who performed structural topic modelling to analyse the mass media framing of psychology and mental health during the first months of the pandemic in America and Europe. Topics found to be most prevalent were: the risk to mental health posed by the pandemic, the importance of seeking mental health care, and behavioural changes that can help mitigate stress and anxiety. Overall, they found that psychological expertise in the media was related mainly to an individual level, and seldom to larger social issues such as inequality and prejudice.

The present study aimed to address the above gap in the literature by focusing on the positive state of mental health only; and by performing a finer-grained analysis of how advice about improving and maintaining mental health was discursively constructed in the news media in Australia during the COVID-19 pandemic.

2. Data

The data for this study was news articles published in Australia in 2020, the period covering the first and second waves of the COVID-19 pandemic in Australia. Ethics approval was not required as all data had already been published in the news media and was available in the public domain. Articles were sourced via the Australia and New Zealand Newsstream database, and publications were selected for inclusion based on readership ranking. The eight most widely read daily print newspapers in Australia in 2020 were, in descending order: Herald Sun, The Australian, Daily Telegraph, Sydney Morning Herald, The Age, West Australian, Courier-Mail and Advertiser 1 . There was a significant readership gap between Advertiser and the next-ranked publication; and accordingly, this was chosen as a convenient cut-off point for inclusion. West Australian was excluded as it was not available on the Australia and New Zealand Newsstream database, leaving seven included publications. Also included in the data was the online-only ABC News 2 website, which was the most widely read of any digital or print news source in Australia in 20203 . These eight publications represent diversity of ownership, with five newspapers owned by News Ltd., two newspapers owned by Nine Entertainment Co. Pty Limited; and the ABC News website being government-funded.

Print newspaper articles, and ABC News website articles, were used as the basis for this study as these were the only news articles archived on searchable databases. Whilst newspaper circulation rankings are based on sales of the daily print edition, it is noted that most or all print news articles were also published online via the websites or apps of their respective publishers. As such, in this study, ‘print’ news encompasses news accessed online - the second most common way news is accessed in Australia - as well as news accessed via a physical newspaper. Search parameters were: articles published between 1 January 2020 and 31 December 2020, containing anywhere in the record the phrases mental∗ health∗, mental∗ well∗, emotional∗ health∗, emotional∗ well∗, psychological∗ health∗, psychological∗ well∗, social∗ health∗, social∗ well∗, spiritual∗ health∗ OR spiritual∗ well∗, AND coronavirus, COVID∗ OR pandemic. News stories, editorials, opinion pieces, commentaries, advice columns and published transcripts of interviews or podcasts were included, but letters to the editor or correspondence were excluded. The initial search based on the above parameters returned 4667 results. These were all viewed by the first author and exclusion criteria were applied, namely articles not related to the Australian context; and articles not primarily about mental health (e.g., only mentioned mental health in passing). After application of these criteria, 436 articles remained, which comprised the final data set.

3. Methodology

In this study, analysis primarily drew upon the ‘synthetic’ approach to Discursive Psychology elucidated by Wetherell (1998), also known as Critical Discursive Psychology (Edley, 2001). Critical Discursive Psychology is a valuable methodological approach in health psychology as it combines the fine-grained analysis of how actions are performed through talk in its immediate interactional context; with consideration of the wider socio-cultural, discursive and historical context in which talk occurs (Locke and Budds, 2020). Analysis in Critical Discursive Psychology is often structured around the concepts of interpretative repertoires, which have been described as “cluster(s) of terms, categories, and idioms that are closely conceptually organized … typically assembled around a metaphor or vivid image” (Potter, 2021, p. 127); and subject positions, which are the identities or vantage points produced or made relevant for people by certain interpretative repertoires (Davies and Harre, 1990).

Analysis in this study also incorporated insights from Conversation Analysis regarding advice-giving. According to the classic definition of Heritage and Sefi (1992, p. 368), advice is something which “describes, recommends, or otherwise forwards a preferred course of future action”. Two key characteristics of advice have emerged from previous research – firstly, advice entails an epistemic asymmetry, frequently warranted by institutional role, constituting the advice giver as more knowledgeable and competent in the topic at hand than the advice recipient; and secondly, advice has an essentially normative (and thus potentially moral) dimension, constructing the recommended course of action as beneficial and desirable, that is, as something the advice recipient should do (Shaw et al., 2015). In interaction, advice-giving will often be preceded by the establishment or elicitation of a problem, in order to create a context in which advice-giving then becomes relevant (Heritage and Sefi, 1992). During the analysis of the data in this study, sections of newspaper article text were deemed to constitute ‘advice’ about mental health if they displayed the key dimensions of asymmetry and normativity.

Analysis in this study was carried out in several stages consistent with the steps outlined by Locke and Budds (2020). First, the data was read and re-read repeatedly by the first author to build familiarity. Numerous categories, codes and themes were inductively generated and refined and built upon with each re-reading. Second, similar ways of talking about the research topic, including associated key words, figures of speech and metaphors, were grouped together, with a focus on what the observed patterns of language were ‘doing’. Third, building upon the first two steps and upon continued engagement with the data, three main interpretative repertoires were identified. Fourth, we considered how advice givers and recipients were positioned through the interpretative repertoires identified. Fifth, extracts were purposefully selected which best exemplified each interpretative repertoire; and then these extracts were analysed in detail as to how discursive and rhetorical devices were deployed to construct advice in certain ways. Finally, the patterns observed, including what alternative accounts were absent or minimal, were considered in light of the wider cultural, economic, historical and ideological context, and what dominant accounts might be achieving in that context.

In Critical Discursive Psychology, validity is primarily demonstrated through showing how analytic results were derived from the data, and reliability through a detailed explanation of how data was collected and analysed; meaning that readers can assess findings and conclusions for themselves (O'Reilly et al., 2021). To this end, we have presented our analysis alongside empirical extracts from the data, and have made our full data set available to the public via an online data sharing repository.

4. Results

In the data set, no significant differences were observed in how mental health advice was constructed between different types of article format, nor between different publishers. In the news articles that formed the data set, the epistemic authority of certain groups regarding mental health was routinely assumed. Advice was most often sourced - and usually quoted directly - from experts, such as psychiatrists, psychologists, academic researchers or people working in mental health promotion. In some cases, entire articles were authored by psy-professionals. Advice about achieving or maintaining mental health was constructed through the use of three main interpretative repertoires. These are detailed below, along with representative extracts.

4.1. Repertoire 1 – Negative emotions are a risk to mental health and must be managed

In the newspaper articles analysed, there was wide agreement that the COVID-19 pandemic and associated measures, especially lockdowns, had caused an increase in negative emotions among the population. These emotions were typically portrayed as understandable, but also as risky; and readers were advised that there was a need to manage their emotions, as exemplified in Extract 1:

Extract 1: Willis, O., ‘Coronavirus anxiety: Recognising the impact a pandemic can have on your mental health’, ABC Premium News, 30 March 2020.

  • 1.

    The coronavirus pandemic has profoundly disrupted the ways in which we live and work, and

  • 2.

    many of us are feeling understandably stressed, confused and frightened.

  • 3.

    All of this is completely normal, said Olivia Fisher, a mental health researcher at Queensland

  • 4.

    University of Technology.

  • 5.

    “It's important to remember we're human, and most of us haven't dealt

  • 6.

    with something like this before,” Dr Fisher said.

  • 7.

    Feelings of worry and unease can be expected during a stressful event, but it's important to

  • 8.

    manage our stress before it turns into more severe anxiety or panic.

  • 9.

    “If you're really overwhelmed or feeling anxious more days than not, that's when you need to

  • 10.

    be seeking some support,” she said.

In this extract, expert (ll. 3–4) concern is focused on the negative emotions of stress, confusion and fear (l. 2) and “worry and un-ease” (l. 7) felt by the public as a result of the pandemic. In the circumstances of the pandemic, these emotions are described as “understandable” (l. 2), “completely normal” (l. 3), “human” (l. 5) and “expected” (l. 7). However, at the same time, the word “important” is used in relation to emotions and their management (l. 7), conveying the expert's concern about the risks attached, despite reassurances that they are normal. The reader is urged not to be complacent about “normal” emotions, but to be vigilant, as negative emotions can turn into a more severe negative psychological state (l. 8). That is, negative emotions in response to stressful circumstances are normal, but so is their continuous management by individuals. As another article said, “the anxiety many of us are feeling in response to the pandemic is an appropriate response because a lot of people are going to die. It's a question of how to manage it” (Gorman, 2020).

The phrase “before it turns into” (l. 8) indicates a script formulation (Edwards, 1994) constructing events as following a known order. The script formulation in this case is conditional (Connabeer, 2021), implying that if you manage your emotions appropriately, then they will not turn into a more severe condition; thus, tacitly attributing responsibility for mental health outcomes to individuals. However, it is unclear exactly where the line is between normal feelings of stress, confusion and fear (l. 2) and the also relatively vague states of “feeling really overwhelmed” and “feeling anxious more days than not” (l. 9). This means that the judgement about when to seek help (and accountability for it) is largely left with the individual. Despite this, the advice to seek help when needed is highly normative - “you need to” (l. 9). The responsible citizen (Petersen, 1996) is thus one who independently and pro-actively manages their own relationship to the risk of mental ill-health.

Repertoire 1 plays a critical role in setting the scene for the remaining two repertoires, in that it constructs the individual's negative emotions as a problem requiring management in order to avert the risk of escalation into a more severe condition. Repertoires 2 and 3 are the two main techniques or strategies which readers were advised to use in order to manage their negative emotions.

4.2. Repertoire 2 – Risky emotions should be managed by being controlled

A basic metaphor around which both Repertoires 2 and 3 were structured was the mind as container (Lakoff and Johnson, 1980). Container metaphors function to highlight the discrete, bounded nature of an object or area (Charteris-Black, 2006). Metaphorically, the perforation or penetration of a container usually denotes a loss of control of some kind, and is associated with an inflow or outflow of matter (Charteris-Black, 2006). In the dataset for this study, for example, articles described how “dark thoughts” began to “creep into” a person's mind (Squires, 2020), or spoke of how the virus had “seeped into” another person's “usually positive mindset” (Digirolamo, 2020a). According to Repertoire 2, emotions should be managed by being controlled. In particular the focus was on regulating the borders of the mind - preventing the inflow of negative influences from without, and cultivating positive emotions within. In particular, individuals were positioned as responsible for controlling their emotions through a specific two-part structure, which occurred repeatedly throughout the data in different contexts. Extract 2, which cites a media personality with a mental health podcast, contains a typical example of this:

Extract 2: Adams, C., ‘Osher provides peace of mind’, Daily Telegraph, 13 April 2020, p. 20.

  • 1.

    After a summer where episodes

  • 2.

    centered around climate change and bushfires, Gunsberg is now helping listeners deal with

  • 3.

    the mental health challenges thrown up by COVID-19 and the resulting isolation.

  • 4.

    “There is so much that we can't control,” he notes. “I can't control economic policy or how

  • 5.

    quickly our country clamped down on social distancing or why you're still allowed to have a

  • 6.

    haircut. I can control how I feel about them though. For some people, it might be the first

  • 7.

    time this concept has been brought to them – if your brain is healthy, you can choose how

  • 8.

    you feel about things. There are techniques we can explain.

A two-part contrast structure occurs in lines 4–6 of this extract. The first part of the structure lists multiple things “we” (the individual) cannot control - economic policy, social distancing and pandemic restrictions (ll. 4–5), and the second part, marked by a contrastive conjunction – “though” (l. 6), lists one thing the individual can control – their own feelings (l. 6). This is an example of a rhetorical device known as a two-part contrast structure in the form of a contradiction, i.e., not this but that (Heritage and Clayman, 2010). In public speaking, two-part contrast structures are often used to signal the completion of a point being made, with the second part typically echoing the first part but with one element changed (Atkinson, 1984). This helps the audience to anticipate an upcoming conclusion or punch line, and therefore ensures audience response (e.g., applause) at the appropriate time. In rhetoric in general, the effect of a two-part contrast structure is to place greater emphasis on the idea contained in the second half (Heritage and Clayman, 2010). Thus, the contrast structure in this extract functions to make the second part - control over one's feelings - more impactful and memorable than the first part – one's circumstances. Exercising personal control over feelings, through learning “techniques” (l. 8), is the only solution to the problem of mental health challenges (l. 3) allowed for by this specific two-part contrast structure; implying that it is the only feasible response, and thus where attention should sensibly be focused. Because emotions are said to be within the power of the individual to control, how one feels becomes a matter of personal choice, as stated explicitly in lines 7–8.

While in Extract 2 the techniques that can be used to control one's feelings are not specified, in the data, one of the main ways in which individuals were advised to manage their emotions was by making lifestyle choices which increased positive emotion and/or reduced negative emotion. The main example of this, which came up repeatedly in the data, was controlling one's intake of negative news coverage, as illustrated in Extract 3, from an article authored by a psychologist:

Extract 3: Manning, J., ‘How to cope with anxiety and stay positive’, Sydney Morning Herald, 24 March 2020, p. 21.

  • 1.

    Never before has the adage “take it day by day” been more relevant. A healthy state of mind

  • 2.

    includes to capacity to move “outside” of yourself and thereby broaden your perspective on

  • 3.

    your thoughts, emotions and life in general. An activity such as playing with your pet,

  • 4.

    gardening, knitting, meditating or playing a musical instrument can help you to become

  • 5.

    present in the moment, to observe the flow of your mental and emotional activity but not be

  • 6.

    pulled into it.

  • 7.

    Taking time to be present through the pandemic will be crucial for positive mental health.

  • 8.

    Limit your social media and silence your phone for periods through the day and listen to

  • 9.

    soothing or uplifting music instead.

  • 10.

    Consuming the rolling COVID-19 coverage increases the production of stress chemicals

  • 11.

    (adrenalin and cortisol) and can cause your brain to go into “fight or flight” mode which

  • 12.

    increases your anxiety …

In this extract, to have “a healthy state of mind” (l. 1) is to have the ability to observe one's thoughts and emotions as if looking on from the outside (l. 2); to not allow oneself to be drawn into them (ll. 5–6), but instead to “broaden one's perspective” on them (l. 2). The mentally healthy individual is thus positioned as one able to take on the role of a psychologist of the self – both “the one who gazes and the one who is gazed upon” (De Vos, 2013, p. 9). If high levels of negative or otherwise unhelpful thoughts and emotions are observed, then the healthy individual rationally increases their engagement in activities that encourage positive thoughts and emotions, such as listening to soothing music (l. 9), and/or decreases their engagement in activities that increase negative thoughts and emotions, such as using social media (l. 8). Another article said, “focusing on an endless stream of distressing news reports, social-media feeds, or what you cannot have or cannot do, will evoke different emotions to focusing on what you are grateful for” (Nehmy, 2020). In Extract 3, the intake of news into the mind is compared to the intake of food into the body through being described as “consuming” news (l. 10). In other newspaper articles, there were references to one's ‘information diet’ and the need to ensure that this was as healthy as possible. According to this account, the main problem is not the impact of the events of the pandemic, or sensationalist journalism, or social media algorithms designed to keep users scrolling constantly; but individuals choosing to consume too much negative news coverage – that is, failing to monitor the borders of their mind appropriately.

4.3. Repertoire 3 – risky emotions should be managed by being released

Repertoire 3 was also based upon the metaphor of the mind as a container. However, unlike Repertoire 2, Repertoire 3 viewed problematic emotions as arising from within the self, rather than as infiltrating from without; and accordingly, the solution suggested was release of emotion, rather than control. Repertoires 2 and 3 may appear contradictory, but in the data, they were not presented as such. Although most articles drew primarily on either one repertoire or the other, neither repertoire was argued against. Instead, as illustrated below in Extracts 4 and 5, Repertoire 3 was invoked in much the same way as Repertoire 2 – as a regular habit necessary for the maintenance of mental health and the prevention of mental illness.

The main rhetorical device used to construct release as necessary for the management of mental health was the metaphor of the pressure cooker. The metaphor of strong emotions as hot fluids within a sealed container is well-known (Lakoff and Johnson, 1980); and functions to emphasise the uncontrollable, and therefore dangerous, nature of such emotions (Koevecses, 2000). The pressure cooker metaphor also draws upon Romantic and psycho-analytic ideas concerning the harmful effects of the repression of emotions. In the data, it was said that build-up of internal pressure and risk of an explosion could be reduced by releasing negative emotions, typically by talking about them. This process was often described metaphorically as opening up, indicating the purposeful relaxation of the borders of the mind-container to allow greater outflow.

The use of the pressure cooker metaphor is illustrated in Extract 4. This article discussed a mental health program aimed at young people called Outside the Locker Room (“OTLR”), which was already in place before the pandemic, but which under pandemic restrictions was being delivered through an app. Extract 4 quotes the founder of the program, who was formerly a professional football player.

Extract 4: Davies, H., ‘Kicking the stigma’, Courier-Mail, 4 July 2020, p. 10.

  • 1.

    “I think it's starting to become more acceptable to talk now. It used to be if you had a

  • 2.

    problem you put your head down, bum up and worked your way through it, but history

  • 3.

    shows that's not the right way to get past it and when people have an issue and talk

  • 4.

    about it to a friend or family member they always feel better.

  • 5.

    “Kids need to understand that people are willing to listen and we aim to teach them to

  • 6.

    have the courage to speak up.

  • 7.

    “I really enjoy being part of OTLR because it teaches kids this from an early age so they

  • 8.

    don't let their feelings get on top of them and then explode.

  • 9.

    “The bottom line is kids need to open up.

  • 10.

    “Anyone who has been through depression and mental health issues knows how

  • 11.

    important it is to talk.”

While this extract discusses young people (who were the focus of most concern regarding mental health during the pandemic), similar patterns of language occurred in the data set in relation to all age groups. According to Repertoire 3, as exemplified here, problematic emotions will never be resolved until the individual releases those emotions by talking about them to another person (ll. 3–4, 9–11). If this is not done, then negative emotions will continue to build until eventually a catastrophic explosion will occur (l. 8). In contrast to Repertoire 2, negative emotions are constructed as powerful and uncontrollable – it is simply not possible for the individual to prevent an explosion through attempting to control them. As emotions arise organically from the inside, border control is also futile. The only way an eventual explosion can be avoided is by negative emotions being released or let out. Repertoire 3 thus creates a subject position for the advice recipient as a patient talking to a therapist.

In this extract, it is presented as common-sense knowledge which nowadays everyone knows that an approach of “put your head down, bum up and work your way through it” (ll. 2–3) does not work, whilst talking to someone “always” results in a person feeling better (l. 4). This focus on individual, internal emotions as central to mental health reflects a largely Western-centric bio-psychological paradigm; as cross-culturally, social networks and a sense of community are generally more important for mental and emotional health than whether people talk about emotions arising from traumatic experiences or not (Junger, 2015; Summerfield, 2000). Nevertheless, in the newspaper articles in the data set, it was typically constructed as the responsibility of individuals to create regular opportunities to talk to others about their feelings, as illustrated in Extract 5:

Extract 5: Hooper, J., ‘5 iso habits that you should NOT break’, Herald Sun, 5 July 2020, p. 8.

  • 1.

    Before lockdown, busy schedules

  • 2.

    distracted most of us from what we were really thinking and feeling. Being forced to slow

  • 3.

    down and literally stay in one place gave us all an opportunity to reassess the state of

  • 4.

    our mental health.

  • 5.

    “Emotions that were stored in the subconscious rose to the surface and people had to

  • 6.

    unpack those things,” Sokarno tells Body ​+ ​Soul. “You might have realised you don't like

  • 7.

    your own company or that you overthink things, and you had to work through that.” To

  • 8.

    ensure you don't fall back into the old habit of suppressing your feelings, Sokarno

  • 9.

    recommends scheduling regular chats with friends and family to de-stress, journaling

  • 10.

    about the things that trouble you, or spending 10 ​min a day practising mindfulness.

In this extract, which cites a psychologist, the repression of one's feelings is referred to as an old, and undesirable, habit (l. 8). The reader is advised to establish new and better habits including “regular chats with friends and family” (l. 9). Such chats are said to have the effect of de-stressing, indicating that feelings of stress and anxiety can be released in this way. The language of “habit” (l. 8) suggests that individuals have a moral responsibility to ensure that they do this regularly. Importantly, the release of emotion through talking to others is constructed in this extract as something which does not just happen naturally and spontaneously, but which all individuals are responsible to pro-actively and regularly schedule (l. 9) as part of their daily life. Periodically purging the self of negative emotions by talking to others is to be practised deliberately and habitually, among a suite of other responsible personal habits, in order to maintain mental health. Thus, as Furedi (2004, p. 37) observes, opening up becomes a moral obligation: “The act of acknowledging one's feelings and by implication, an openness to seeking help, is culturally represented as virtuous behaviour.”

5. Discussion and conclusion

In this study, we examined how advice about building and maintaining mental health was constructed in newspaper articles in Australia in 2020, during the first two waves of the COVID-19 pandemic. While our focus was on the positive state of mental health, we found that in the data the term mental health was more often used in reference to threats or risks to mental health, and the prevention of mental ill-health. We found that advice about maintaining mental health, and preventing mental ill-health, was constructed through the use of three main interpretative repertoires.

Repertoire 1 constructed mental health as at risk from negative emotions, and positioned individuals as responsible for managing their emotions to mitigate risk. In the data, the dominant conceptualisation of mental health was a single, bipolar continuum with mental health at one end, mental illness at the other, and negative emotional states in between. Negative emotions were commonly constructed as warning signs of a concerning trajectory away from mental health and towards mental illness. As one expert said, “While the rise in anxiety in the face of COVID-19 is certainly not mental illness per se, it does represent a major new risk factor for the later onset of new illness, especially depression” (McGorry, 2020). Readers were typically advised that early intervention to address negative emotional states was therefore crucial for the prevention of mental illness. Another article stated, “Early intervention is the key. When people develop persistent symptoms of anxiety, sadness, sleep disturbance, lethargy, difficulty concentrating and avoidance from others – which can be some of the warning signs – they must seek help” (Digirolamo, 2020b). Continuum conceptualisations (as opposed to categorical conceptualisations) work to blur the boundary between mental health and illness; normality and abnormality. While this can have benefits, such as being associated with lower mental illness stigma (Peter et al., 2021); on the other hand, McGuire (2017) argues that the rise of spectral thinking has had the effect of ‘de-regulating disorder’ and of rendering all of us mentally unwell most of the time; opening up new forms of governance and new obligations for individuals of constant self-surveillance and self-work.

According to Repertoire 2, negative emotions should be managed by being controlled. In particular, common advice was to focus one's energies on things one can control (one's own feelings and responses), rather than on external factors one cannot control. This ‘dichotomy of control’ originates with Stoic philosophy (Durrant, 2023); and that it is still popular today indicates that it has real practical usefulness. The COVID-19 pandemic and initial government responses were factors that individuals could not control, and as such, this advice likely helped people to cope, by offering a form of secondary control (Rothbaum et al., 1982). However, this common contrast structure could have some less productive effects in a larger and longer-term sense, which warrant consideration when designing future mental health communications.

Firstly, this contrast structure positions individuals as lone actors who must face problems by themselves, and not as members of a group who can act on problems together. This reinforces a neoliberal ideology of individual responsibility and autonomy whilst diverting attention from social and structural determinants of mental health. Secondly, this contrast structure constructs negative feelings as a problem needing to be solved; when in most cases these are healthy responses that will likely resolve with time or changing circumstances; but if not, that could, if allowed to persist, provide motivation for action towards change, such as increased civic and political engagement (Degerman, 2019). Thirdly, this contrast structure constructs a simplistic binary in which things are either uncontrollable, or controllable; when, in reality, most things are partially controllable. Adoption of this false dichotomy could have the effect of weakening individuals’ sense of personal and political efficacy (Crawford, 1980), and increasing passivity in the face of social and interpersonal problems (Durrant, 2023). For example, in the data, there was widespread application of this two-part contrast structure to factors of a more social, structural or political nature. Factors impacting on mental health, but described as unable to be controlled, included climate change, economic policy, misinformation, the beliefs of others, and racism – all things that potentially could be influenced, at least partly, by individuals, or groups working together.

According to Repertoire 3, negative emotions should be managed by being released, primarily through talking with others. While talking with a sympathetic other is undoubtedly usually helpful, this repertoire once again locates the root problem behind mental ill-health with the individual (albeit mediated by social norms), namely, a reluctance to talk or open up. However, it is possible that the problem for many people may not be unwillingness to talk, but other factors external to the individual. One such factor may be a lack of someone to talk to. In Australia, a quarter of young people feel lonely all or most of the time (Tiller et al., 2021); and almost one in five adults rarely or never have people that they can talk to (Australian Psychological Society, 2018). Accessing talking therapy with a professional is often difficult, especially for people living in disadvantaged and remote areas (Meadows et al., 2015). Dominant language may be another factor affecting willingness to “open up” for some people. For example, the language of ‘mental health’ has been cited by men in particular as a deterrent to talking about their personal struggles or seeking help, due to a wish to avoid being labelled as mentally ill (Sharp et al., 2022). Such factors require collective structural, institutional and social responses; and encouraging people to open up may be at best a partial solution to addressing mental distress.

As can be seen, Repertoires 2 and 3 construct advice about managing mental health in different ways. This likely indicates the continued cultural influence of the two most dominant psychological paradigms of the twentieth century – the psycho-analytic, focusing on the exploration of the subconscious and cathartic release of repressed emotion; and the cognitive-behavioural, focusing on the modification of undesirable thoughts, beliefs and emotions through the application of evidence-based techniques (Shachak, 2018). Ordinarily, the presence of two different interpretative repertoires can suggest the presence of an ideological dilemma (Wetherell et al., 2015). However, what is noteworthy in this data is that, despite indications of an ideological dilemma between control of emotion and release of emotion, Repertoires 2 and 3 were not set against one another as being in conflict. Thus, it seems that both therapeutic approaches have been co-opted into the neoliberal project of self-governance. As Rose (1990, p. 246) writes, “Each therapeutic system … has its own particularity. But what unites them is the calculated attempt to bring the subject from one way of acting and being to another”. Both control and release were normalized in the data, usually via the advice of experts, as complementary ‘techniques of the self’ (Rose, 1990) that everyone should implement habitually and regularly in order to maintain mental health and reduce the risk posed by negative emotions during the COVID-19 pandemic.

Potter (1996, p. 186) has observed that “one of the powers of descriptions often lies in what they fail to describe, what is ignored or left out”. It was notable than an alternative account which had a minimal presence in the data was one which constructed negative emotions as healthy and non-problematic in the circumstances, and which advised readers to simply sit with, feel or accept negative emotions rather than trying to fix or change them. Whilst there were exceptions - for example, one article said “uncomfortable feelings are the price of admission to a meaningful life. It is really uncomfortable now. That's OK … when we accept the difficult feelings, they become less powerful” (Adams, 2020) and another spoke of “accepting what you're thinking, feeling, experiencing and not boxing away uncomfortable experiences” (Lambert, 2020) - the three repertoires described above were by far the most dominant in the data.

Overall, the results of this study suggest that caution is needed in future mental health promotion and communication efforts to avoid the problematisation and/or medicalisation of non-disordered emotional distress; as this may have effects contrary to aims of improving population mental health. In the short term, it may foster in the public an intolerance to negative or uncomfortable feelings, reducing resilience (Doblyte, 2022; Jones and McNally, 2022). Recent analysis indicates that, although psychological distress did increase in Australia during the pandemic, most distress was transitory once lockdowns ended (Botha et al., 2023). In the longer term, it may detract attention from the impact of social and structural factors on mental health, and weaken motivation and a sense of interpersonal, collective and political efficacy to influence these.

Our findings broadly reflect those of Caicedo-Moreno et al. (2022); however, the discursive approach adopted in this study adds to existing literature by providing an in-depth, micro-level analysis of how advice about mental health was constructed within news articles. This study examined how advice was constructed during the COVID-19 period only, and as such, we are not able to provide a broader commentary on how mental health advice is constructed in the news media outside of that context. Another limitation of this study is that our data was confined to print and online news articles available on a searchable database, and there is the possibility that results may have been different had more diverse online sources and publishers been included. Similarly, our findings may not apply to other forms of media such as television news, or news accessed via social media.

Funding

This research is supported by an Australian Government Research Training Program (RTP) Scholarship.

Data availability statement

The data that support the findings of this study are openly available in figshare at https://doi.org/10.25909/20115503.v1.

CRediT authorship contribution statement

Grace Horwood: Conceptualization, Formal analysis, Investigation, Data curation, Writing – original draft, Writing – review & editing. Martha Augoustinos: Supervision, Writing – review & editing. Clemence Due: Supervision, Writing – review & editing.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Handling Editor: Dr E Mendenhall

Footnotes

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The data that support the findings of this study are openly available in figshare at https://doi.org/10.25909/20115503.v1.

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