Shine a light

Nichole Banducci was with her family when wildfire flames, fanned by Santa Ana winds, raced over the Santa Monica Mountains. As the deadly Woolsey Fire descended into Malibu in the early morning of Nov. 9, 2018, Banducci, her husband Brian, in-laws and three children prepared to evacuate. They loaded their dog, cat, rabbits and belongings into two cars, a van, a truck and their 1964 Shasta Oasis trailer, and headed out. Less than an hour later, flames ravaged Banducci’s Malibu Park neighborhood, destroying her home. The loss Banducci experienced with the Woolsey Fire not only challenged her physically and emotionally, but also served as a point of inspiration. Now, the wellness advocate and educator will debut a new online program in early 2020 called “Fortify Against Stress” that she developed to equip others with the tools they need to improve their well-being. 

When you experience a trauma, your body’s automatic response to stress causes heightened potential for anxiety and depression,” said Banducci, who earned her bachelor’s degree in public relations in 1993 and an MBA from USC Marshall in 2001. “The subsequent emotional, physical, and hormonal/chemical changes to your body set the stage for ongoing mental health concerns. I’m hoping I can help my clients better understand this.”

Banducci, along with other USC Annenberg alumni, faculty and students, are leveraging their expertise across communication, journalism and public relations to help advance the public’s understanding of and conversations about mental health. With one in five adults and one in six youth in the United States experiencing a mental illness each year, their work has perhaps never been more pressing.

Open conversations

 “It’s become more mainstream to talk about mental health, and I’d love to say that we — the media — have played a role in that,” said Jacqueline Howard, who earned a master’s degree in broadcast journalism in 2010 and is now a reporter for CNN Health. “Reducing the stigma attached to talking about mental health really is our responsibility as communicators.”

Over the course of her career, many of Howard’s reporting assignments have led her to delve into the complexities of mental health. One especially poignant series she co-wrote for CNN centered on the topic of suicide following the death of Anthony Bourdain, the host of CNN’s popular travel and food show Parts Unknown.

“What I’ve learned is that with every story related to, not just suicide, but mental health in general, you need to allow those affected to tell their stories their way,” Howard said. “I’ve realized we — the journalists — are just the avenue through which they can do that.”

Listening to and sharing the experiences of mothers like Timoria McQueen Saba, whose postpartum hemorrhage nearly killed her, drove another CNN article Howard wrote exploring rising maternal mortality rates following childbirth.

In addition to highlighting how black women are disproportionately more affected than women of other races by pregnancy mortality, Howard explored how Saba was eventually diagnosed with post-traumatic stress disorder in the aftermath of the hemorrhage.

“[Saba] stayed awake at night with images of the blood flashing in her mind,” Howard wrote. “She now knew the feeling of her ‘body losing life,’ she said, and she couldn’t stop thinking about it.”

Howard continued to chronicle Saba’s healing process as she connected with a social worker who devised a treatment plan that combined therapy and restorative yoga.

As a 2019-20 National Fellow at USC Annenberg’s Center for Health Journalism, Howard is continuing this investigation into rising maternal mortality as well as the role of postpartum mental health care in preventing suicide, which studies have shown is a leading cause of death for women during this period.

“In today’s world, where news can come at you so fast, the fellowship allows me to really dig into some of the biggest challenges in health and health journalism in a way that I can’t do in a breaking-news environment,” she said.

Michelle Levander, the center’s founding director, believes that reporting such as Howard’s is vital because it allows expert storytelling to affect community and societal change. She noted that investigations related to mental health make up a significant number of the projects currently underway at the center, which marked its 15th anniversary in 2019.

In keeping with the Center’s “Impact Reporting” model, those projects have changed policy around mental health in communities across the country, bringing new resources for trauma-informed approaches and programs.

Supported by an “impact reporting” model, the center’s fellows have helped change policies around mental health in communities across the country, bringing new resources for trauma-informed approaches and programs.

“Mental health has traditionally been something of a ‘news desert’ topic,” Levander said. “While the center has supported a number of projects related to mental health, I feel there’s way more to be done.”

Into the spotlight

Hollywood A-listers are one group that has played an integral role in helping to fill this gap in the media’s coverage, Howard noted.

“We are seeing a major shift in lifting the stigma as celebrities talk publicly about their mental health,” she said. “I think journalists and news outlets are seizing this opportunity, too, as they seek to connect with their audiences on a more personal level.”

Yet, even with actors such as Kristen Bell, Gina Rodriguez and Jon Hamm increasingly opening up about their own struggles, a recent landmark study by the USC Annenberg Inclusion Initiative (AII) revealed that few of the characters they portray across popular film and TV series exhibit mental health conditions and those that do are routinely dehumanized.

Conducted in partnership with the American Foundation for Suicide Prevention (AFSP), and funded by the David and Lura Lovell Foundation, the study examined 100 top-grossing films and 50 popular TV series to evaluate the prevalence of mood disorders, anxiety, PTSD, addiction, suicide and autism spectrum disorders, among other conditions. Results showed that fewer than 2 percent of all film characters and roughly 7 percent of TV characters experience mental health conditions on screen.

Dr. Stacy L. Smith, AII’s founder and director and the study’s lead author, said the entertainment industry continues to be out of sync with reality despite close to 20 percent of the U.S. population experiencing some form of mental health condition or illness per year, according to a recent National Institute of Mental Health report.

“The prevalence of mental health conditions among the audience far outpaces the characters they see on screen,” said Smith, associate professor of communication. “This presents a distorted view of the world for those who live and thrive with mental health conditions, but never see their stories represented in popular media.”

Beyond the results, the report provides strategic tools and solutions to help entertainment professionals write more authentic depictions.

For example, only 5 percent of film and 9 percent of TV characters were shown in treatment, while 22 percent of film characters and 62 percent of TV characters were shown in or mentioned therapy. By incorporating depictions of treatment and different kinds of therapies for mental health conditions, content creators can help advance an important message to audiences that effective treatments are available.

“Most Americans understand that mental health is a critically important part of their overall health. And yet, mental health literacy among the general public remains low,” said Dr. Christine Moutier, AFSP’s chief medical officer. “By showing audiences people who live with and manage their mental health in an authentic way, we can encourage people, and those who surround them, to be more sophisticated in managing their mental health.”

Wellness through community

One group that the AII study discovered is virtually absent from media portrayals of mental health conditions is the LGBTQ community. There were no LGBTQ film characters with a mental health condition across the 100 top films of 2016 and only eight TV characters across 50 popular shows in 2016-17. The lack of LGBTQ characters shown in this capacity is striking, as the National Alliance on Mental Illness indicates that mental health conditions are nearly three times more likely to occur among members of the LGBTQ community.

Hoping to identify ways to better serve those who identify as LGBTQ, doctoral student Traci Gillig focused on the interventions, interpersonal relationships and structural factors that influence their health and well-being — and the well-being of those who are part of other marginalized groups.

She partnered with a nonprofit called Brave Trails, which launched in 2014 as the first leadership camp in the western United States for LGBTQ youth, to conduct her dissertation research. 

“Their programming is part traditional summer camp — hiking, arts and crafts,” said Gillig, who has worked with Brave Trails since its founding. “They also offer resources and activities that pertain specifically to the campers’ LGBTQ identities, helping them navigate the stressors that can come from that.”

She first met the camp’s founders when she was volunteering at the Los Angeles LGBT Center. As she worked with them, she saw an opportunity to connect their new camp with research. What started as a small project eventually grew in scale and spanned five years, becoming the foundation for her dissertation.

“As the sense of community at Brave Trails continues to grow, the question becomes, what sort of outcomes does that have for youth, and how can we learn from what they’re doing and offer up information that applies to other efforts?” she said.

“The fact that we found significant reductions in depressive symptoms over time was evidence for the benefit of programming that’s not explicitly therapy, but that helps affirm people’s identities in other ways,” added Gillig, who is now assistant professor of communication at Washington State University.

Her latest line of research looks at how people outside of marginalized populations perceive marginalized groups and will offer more insights on how to use media portrayals and other interventions to help shift attitudes, while also generating understanding and supportive policies.

Gamifying healthy behavior

For nearly three decades, Lynn Miller, professor of communication and associate dean of research, has also been working to develop intervention tools that can help improve the well-being of those in the LGBTQ community.

Her chosen medium, however, might not be what you’d expect. Miller and her team have designed an interactive video game that aims to prevent risky sexual behavior in men who have sex with men.

Using an innovative approach, which they call Socially Optimized Learning in Virtual Environments (SOLVE), the game immerses players in an interactive world in which they go on a “virtual date.” Real-life challenges like whether to ask a partner to use a condom are simulated, while interventions embedded throughout encourage players to change decisions to reduce risky sexual behaviors. Players also have the option to make the same choices again.

One of the game’s goals is to normalize a player’s desire to have sex, thus reducing shame associated with the desire, Miller explained. Studies have found, she added, that shame can often be a contributing factor in depression, anxiety and low self-esteem. While research has also shown that people who harbor shame are less likely to make healthy choices, Miller’s game offers a possible way to rewire this dynamic.

Over the last year, Miller and her team have begun exploring how the gaming tools they have developed can be adapted to target those suffering from depression and social anxiety.

“One thing we’re trying to emphasize is normativity,” said David Jeong, who earned his PhD in communication in 2017 and is now a postdoctoral research scholar in Miller’s lab. “I think this is something that could be applied to any type of health issue, including mental health, in which some sort of shame-type element is involved.”

In one game, a person with social anxiety enters a crowded bar and makes choices about who to interact with — or not. Such virtual experience, Jeong maintained, could help that person cope better in the real world.

“Many depressed or anxious individuals see things differently, and we’re trying to capture, in a game, how they understand the world and what affects their reactions,” Miller said. “Once we understand that, we can fine tune the game to encourage these individuals to adapt and to grasp what a life without depression might look like.”

Telling the story of mental health

Understanding the world of “Generation Z” — usually defined as people born since 1997 — has also become increasingly urgent. According to a recent Pew Research Center survey, 70 percent of U.S. respondents ages 13 to 17 indicated anxiety and depression were major issues among their peers. And Centers for Disease Control data shows that the suicide rate for Americans between 15 and 24 has reached the highest rate since 1999.

For Kaleigh Finnie, her struggles with mental health began in her teens. Her father, Shaun, said that despite Kaleigh’s bubbly outward appearance, his daughter could be moody and had received some counseling for anxiety. By her senior year of high school, she seemed to have improved significantly. Yet, unbeknownst to everyone, Kaleigh continued to struggle with mental health issues throughout her freshman year at USC Annenberg, and in the summer of 2015, while back home in the Houston area, she took her own life.

As the family came to terms with their loss, they eventually decided to partner with USC Annenberg to establish the Kaleigh Finnie Memorial Endowment, which was launched in September. The merit-based fund provides scholarships and awards to USC Annenberg undergraduate and graduate students who hope to contribute critical research and generate important conversations around mental health.

In October, students submitted 25 proposals, from which a committee selected six to receive funding this Spring.

“As part of their applications, several of the recipients bravely shared their own personal struggles with mental health,” said Suzanne Alcantara, assistant dean of student services. “Their ideas for how to begin to turn the tide for their generation were incredibly inspiring.”

Senior public relations major Joelle Ferguson plans to use the support to help USC continue to improve their communication strategies around mental health awareness and resources on campus.

“I, along with so many other students, can identify with Kaleigh’s experience,” Ferguson said. “During my senior year of high school, I lost both my mother and grandfather, and by my sophomore year at USC, I developed symptoms of depression.”

Her project, which begins with holding a town hall to focus on students’ perspectives on wellness and campus resources, will culminate with the development of a university-specific online course that seeks to inform students about self-care and resources beginning at orientation.

Other award recipients include Daric Cottingham, who is pursuing a master’s in specialized journalism. He plans to create a podcast called Smile and Wave to provide a platform for individuals to share their own stories and feel less isolated. Andrea Moore, who is earning her master’s in communication management while working as a staff member within USC Student Health’s Office for Health Promotion Strategy, will build a social media marketing campaign aimed at educating USC faculty on how to adopt best practices in addressing student mental health in their classrooms.

Senior journalism major Dan Toomey’s proposal to establish a health and wellness desk in USC Annenberg’s Media Center will also receive support. As a managing editor for culture and outreach at Annenberg Media, Toomey said the funding will bolster the recruitment and training of student journalists specifically focused on mental health. He sees this not only as a chance to create internal workplace change within the media center, but also an external impact for the entire USC campus.

“I’ve conducted interviews with dozens of students, professors, administrators and parents around mental health issues,” Toomey said. “Each of these talks has conveyed to me the same message about mental health: We need more communication.”