The Disclosure of Celebrity Major Depressive Disorder Diagnoses in Hong Kong: Its Effects on Public Awareness and Understanding Toward the Illness
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Community Mental Health Journal (2019) 55:120–128 https://doi.org/10.1007/s10597-018-0274-4 The Disclosure of Celebrity Major Depressive Disorder Diagnoses in Hong Kong: Its Effects on Public Awareness and Understanding Toward the Illness Vivienne S. Y. Leung1 Received: 22 May 2017 / Accepted: 19 April 2018 / Published online: 21 April 2018 © Springer Science+Business Media, LLC, part of Springer Nature 2018 Abstract This paper aims to examine consumer perception toward celebrity diagnoses of major depressive disorder (MDD) in Hong Kong and to provide insights into the effect of various factors on the persuasive effectiveness of MDD communication. A total of thirty-five interviews were conducted in April 2015. Interviewees in general are aware of celebrity MDD diagnoses, but they do not deem MDD as a threat to themselves. Hence, they are not motivated to learn more about the symptoms. Responses to celebrity MDD diagnoses are mixed. Many interviewees are sympathetic toward ill celebrities diagnosed with MDD, but some of the interviewees are dubious about the true intention behind disclosing their diagnoses to the public. Compared to non-fans, fans reported a greater increase in the level of knowledge of MDD after reading related media sto- ries about celebrity MDD diagnoses. Source credibility is perceived as an important factor in MDD communication. This research suggests that the government or NGOs may use credible celebrities whose image can be associated with MDD and cooperate with fan clubs to spread health-related information. The paper represents the first attempt to investigate the effects of celebrity disclosure of MDD diagnoses on the mental disorder-related perceptions of the general public in Hong Kong. Keywords Celebrity · Depressive disorder · Attitudes · Health communication · Hong Kong Introduction effects of the celebrity disclosure of MDD diagnoses on the mental disorder-related perception of the general public. It is Celebrity plays an influential role in health communication, expected that increased exposure to publicity about celebrity as celebrities are effective in raising public awareness of a MDD diagnoses may lead to increase awareness and under- particular disease, affecting consumer behaviour, and even standing of the disease. changing public perceptions toward the disease (e.g., Pol- lock III 1994; Kelaher et al. 2008; Hilton and Hunt 2010). This paper recognizes the power of celebrities in health Literature Review communication and aims to assess their potential impact in the area of major depressive disorder (MDD). MDD is Potential Impacts of Ill Celebrities in Health a prevalent and serious mental disorder, which is signifi- Communication cantly undertreated and stigmatized globally (World Health Organization 2008, 2012). According to previous studies, Celebrity is perceived as one of the effective tools in rais- highly publicised illnesses may affect the public’s awareness ing consumer awareness of a particular disease (Chapman and behaviour (e.g., Kalichman and Hunter 1992, p. 1374; et al. 2005, p. 247; Alonso 2006, p. 30; Hilton and Hunt Kelaher et al. 2008, p. 1326). This paper will examine the 2010, pp. 1–2). Celebrity is an attention-gathering mecha- nism that can attract media attention and focus the spotlight on a particular issue. For example, after Kylie Minogue’s * Vivienne S. Y. Leung breast cancer diagnosis went public, a 20-fold increase in [email protected] news coverage of breast cancer occurred (Chapman et al. 1 Department of Communication Studies, Hong Kong Baptist 2005, p. 247). The intensive media coverage may lead to University, Kowloon Tong, Hong Kong an increase in concern about the disease and interest in Vol:.(1234567890)1 3 Community Mental Health Journal (2019) 55:120–128 121 acquiring more information about it (e.g., Kalichman and actress),4 Sammi Cheng (a famous local female singer),5 Hunter 1992, p. 1374; Kelaher et al. 2008, p. 1326). Simi- Fiona Sit (a famous local female singer) and others. In addi- larly, basketball star Earvin Johnson disclosed his HIV sero- tion to sharing their stories about fighting depression, some positivity, and there were significant increases in interest of them are actively involved in helping other sufferers and in in AIDS information and concern about AIDS among the educating the public. For example, Lam Kin-ming founded respondents (Kalichman and Hunter 1992, p. 1375; Kalich- the Joyful (Mental Health) Foundation in 2004, which aims man et al. 1993, p. 888). to spread correct information about mental illness and sup- Celebrities’ effect on raising public awareness also port mental patients in Hong Kong (Chow 2005a). Sammi applies in the field of mental illness. Due to the social stigma Cheng recorded a theme song for the HK Familylink Mental of mental illness, MDD has been underdiagnosed and under- Health Advocacy Association to help increase public aware- treated, and a majority of sufferers choose to remain silent ness of mental illness and to raise funds for the organization. or even refuse to admit their internal distress (Capriotti Since research findings about the impact of ill celebrities 2006, p. 241; González et al. 2009, p. 37; Fujii et al. 2012, and the related media stories of their diagnoses have been pp. 235–236). Media stories about celebrities revealing their mixed in the past, this notion prompts the first and the sec- own histories of depressive disorders challenge the norm of ond research questions. hiding the shame of mental illness and may encourage men- RQ1: In general, is the general public aware of celebri- tally distressed people to seek help (Alonso 2006; Capriotti ties who are diagnosed with a serious illness? What specific 2006, pp. 241–242). Harper (2006) believes that audiences kinds of information interested them the most? may express sympathy for mentally distressed celebrities, RQ2: Would media stories that report information about and this type of compassionate identification with the media a celebrity’s diagnosis induce positive attitudinal changes stories may help to destigmatize mental illness. Their public toward the ill celebrity? disclosure of their own stories may also initiate a public discussion of mental suffering (Alonso 2006, pp. 30–31).1 Factors Affecting a Celebrity’s Persuasive Leslie Cheung, a renowned Hong Kong celebrity, who had Effectiveness in MDD Communication been suffering from depression, committed suicide in 2003. Cheung’s death illuminated the seriousness of MDD to Though celebrities are in general effective endorsers in the the public and motivated those of his fans who also suf- field of mental illness, there are certain factors that may fered from depression to seek help (Chow 2005b). Moreo- mediate their degree of effectiveness. An industry survey ver, the Mood Disorders Centre of the Chinese University reported that credibility is an important factor in celebrity recorded an increase in inquiries from potential patients endorsement of pharmaceutical products (Moynihan 2004). after Cheung’s death (Chow 2005b), thus proving celebrity’s According to the source credibility model, the expertise and great influence on public awareness of mental illness. trustworthiness of the source may affect message effective- In recent years, the topic of mental illness has become ness (Hovland et al. 1953; Hung et al. 2011, pp. 609–610; increasingly prominent in society, and media stories of men- Ohanian 1991; Lafferty et al. 2002, p. 3). Similarly, a celeb- tally distressed celebrities also proliferate (Harper 2006). In rity who is perceived to be trustworthy and knowledgeable Hong Kong, mentally distressed celebrities were increas- about the medical condition is more effective in spreading ingly willing to talk about their health conditions after the the message about the mental illness or the pharmaceutical death of Leslie Cheung, including2 Albert Leung (Lin Xi) products (Moynihan 2004, pp. 102–103). (a local renowned lyrist),3 Lam Kin-ming (a local female In addition to credibility, source attractiveness is another theoretical framework for endorser effects in advertising. The components of source attractiveness include likability, 1 Leslie Cheung Kwok Wing was a Hong Kong singer-songwriter, actor and film director. He is considered as “one of the founding familiarity and similarity. The more attractive a source, the fathers of Cantopop” in Hong Kong entertainment business. He com- more effective the message (Hovland et al. 1953; McGuire mitted suicide on April 1, 2003, by leaping from a Hong Kong hotel while suffering from depression (Billboard 2003). 2 Albert Leung, under the pen name Lin Xi, is a renowned, award- winning lyricist based in Hong Kong. He previously suffered from 4 Sammi Cheng is a renowned Hong Kong Cantopop singer and anxiety problems, and he was reluctant to undergo therapy to treat his actress. She is one of the most prominent female singers in Hong problem (China Daily 2006). Kong. She battled serious depression for 3 years starting in 2005. She 3 Lam Kin Ming is a actress in Hong Kong. She once suffered from has spoken publicly about her battle with the disease and cites it as a depression and anxiety disorders. She established the Joyful (Mental life-changing experience (Lollipop 2013). Health) Foundation in 2004. The aim of the Foundation is to promote 5 Fiona Sit is a Chinese Cantopop singer and actress in Hong Kong. awareness of mental health in the community and to avoid misun- She exhibited signs of severe depression as early as 2008. She slashed derstanding and discrimination regarding the disease (Joyful Mental her waist and became obsessed with suicide. She recovered after she Health Foundation 2004). found strength in God (Jayne 2012). 1 3 122 Community Mental Health Journal (2019) 55:120–128 1985). A celebrity with personal experience of the medical depressive disorders and gained favourable responses and conditions about which he or she speaks is usually a more evaluation (Clark 2008, p. 452). Harper (2006) observed effective messenger in health communication (Moynihan that, in contemporary Western culture, the Greco-Roman 2004, p.