Keeping Track Form

1. Name of TV show/newspaper article/magazine article/product advertised/etc.

______________________________________________________________________

2. Name of TV station/newspaper/magazine/etc.

______________________________________________________________________

3. Name of reporter/writer/host

______________________________________________________________________

4. Date of broadcast/publication

______________________________________________________________________

5. What's the problem?
* Objectionable terms used (i.e. "schizo", "loony-bin")
* Stereotypes depicted (i.e. person is violent/unreliable because of mental illness)
* Mental illness is unrelated to facts (i.e. "The accused, who has suffered from depression, was charged with fraud after forging 31 checks.")
* Incorrect or questionable facts given (i.e. "a person never really overcomes mental illness")

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

6. Any compliments?

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

7. Are there any facts in any of the sections that can help correct the incorrect information given?

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

 

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