Sir: I would be interested in the College's view on pharmaceutical advertising in relation to the current campaign to reduce stigma in mental illness. I have recently been struck by the increasing use of negative images by some of the atypical neuroleptic manufacturers.

The black and white images with stark lighting and plenty of shadow seem designed to provoke feelings of fear and menace. Photographing patients as gaunt almost lupine individuals with sunken eyes, angular cheekbones, long hair and humourless, irritated expressions all seem to emphasise the perceived ‘differentness’ and threat of people with severe mental illness. Likewise ‘case histories’ laced with suggestions of suicide or danger to emotive groups such as children alongside pictures of a young woman mutilating herself or a frightened girl huddling behind her mother seem to play on misunderstanding and prejudice about schizophrenia.

The risks of alienation, marginalising and stigmatising people suffering with a severe mental illness by using adverts to shock and raise fears about dangerousness seem clear. It is particularly concerning when they occur in journals aimed at a wide variety of health professionals in a way likely to reinforce preexisting negative stereotypes about the mentally ill.

Mental health care organisations are striving to take on board high quality risk management and evidence based strategies in planning care for the severely mentally ill and advertising gimmicks that owe more to Poe and Hitchcock than to an informed balanced view of mental illness appeal to the irrational antithesis of this approach. It is not much of a partnership if drug companies use adverts that would cause distress to anyone suffering from schizophrenia or members of their families.