Comparing Images of Depression in Mass Media and AI-Generated Pictures: Mixed Methods Study.

Background: Images play an important role in reducing stigma related to mental health, which often is distorted in the media. In recent years, generative artificial intelligence (AI) has been used to generate images related to mental health. However, first reports suggest that AI-generated images do not depict mental health conditions accurately. In-depth studies on the topic of mental health representations in AI-generated images are still missing. Objective: The main objective of this study is to analyze and compare the visual representation of depression in mass media and in AI-generated images. Methods: The methodologies used were discussion groups (15 participants) and a quasi-experimental online survey (792 interviewees), aimed at people with depression and young people. Results: The results showed that both the images used in the media and those generated by AI reproduced stereotypes and stigmas about depression. However, participants considered AI-generated pictures to be more stereotypical, stigmatizing, and more likely to have a negative impact on people with depression. In contrast, media images were considered more appropriate, realistic, inclusive, and that better reflected the relationship between gender and depression. Statistically significant differences were observed between the control and test groups in both people with depression and young people (P<.001), indicating that when people were aware of what images were AI-generated, they tended to reject them to a greater extent. Conclusions: Considering the current trend toward the widespread use of AI in mental health communication, it is crucial to promote closer collaborations between science journalists, AI developers, and mental health experts, including patients' associations, as well as a shift toward user-participatory AI design.