Movies and Mental Illness: What Do We Do About Stigma? (Updated 12.11.13)

iStock_000009307982LargeI’m a great fan of films and really grateful to the film industry for the entertainment they’ve produced. I’m grateful for free speech, letting everyone have their say even if we don’t like what it is they’re saying. But there come’s a point when we have to just take a step back and see the bigger picture.

Mental illness is extremely common. Most people will experience mental illness during their lives. Sometimes this might be very brief and might not impact too greatly on their lives. A person might have a mild acute adjustment reaction which resolves and allows them to move on with their life

Other people might have more severe adjustment reactions. They might have a Bipolar illness with recurrent Depression, chronic Schizophrenia which may be treatment resistant or be developing Dementia with a severe course. Even for these illnesses the course varies considerably between people. Some people with mental illness aren’t able to speak up for themselves. They might have difficulties with cognition including language and just won’t be able to understand what is happening or to hold and communicate views about these issues.

Movie stars are iconic figures. Watching movies has a universal appeal. They make us laugh and cry, make our hearts race and can make us feel good when we come out. With all of this that the movie industry has given us, there are times when it isn’t so good. There are (thankfully rare) times when the films can be harmful for people with mental illness. There are times when the films are so influential that other organisations base entire events on a single film. These events in turn can be harmful.

Here are some films that in my opinion are stigmatising for people with a mental illness.

1. One Flew Over the Cuckoo’s Nest (1975). In this film one of the main characters played by Jack Nicholson goes into an inpatient unit. He gets into conflict with Nurse Ratched and after a course of Electroconvulsive Therapy used as a ‘punishment’ he undergoes a lobotomy to control his behaviour. One of the other characters in the film kills him to stop his suffering. To add to this the film won numerous oscars, BAFTA’s and Golden Globe Awards. Despite the passage of nearly 37 years the film has had a profound cultural influence. I wonder how many people have refused ECT or coming into an inpatient unit because of seeing this film.

2. Halloween (1978). A boy is institutionalised and emerges after many years to go on a killing spree. The film spawns a number of sequels and is classically associated with the use of a chainsaw mask. There is a description here of how the film was made. The premise of the film is that the main character is the most evil boy in the world. From this IMDB review, ‘After being institutionalised for 15 years, Myers breaks out on the night before Halloween…..no one knows, nor wants to find out, what will happen on October 31st 1978 besides Myers’ psychiatrist Dr Loomis‘.

3. Psycho (1960). Norman Bates, dead mother kept in the house, shower, knife and a psychiatrist that talks about a split personality. Psycho can be short for psychopathy and psychotic leading in my opinion to one of the most unfortunate associations in film history for people with mental illness.

4. The Crazies (1973) and the remake. Crazy is a pejorative label for mental illness and the premise of these films is that a toxin makes people mentally ill and dangerous. Unaffected people must defend themselves.

5. The Demented (2013). In this film the afflicated afflicted become zombies and are the focus of the title. Those unaffected must defend themselves. There is a lot of stigma about Dementia with a number of excellent campaigns to raise awareness. The last thing that’s needed is a film with a title like this.

6. American Psycho (2000). The title suffers the same problem as Psycho and makes an unfortunate links with axes. A title change would be sufficient to avoid this association.

If you can think of other titles to add, just include them in the comments section (there might be a delay of a few days before they are added).

Why tackle stigma in the movies – isn’t this taking it too far. Student nurse Katie Sutton has written this article about typical responses to an anti-stigma campaign. I’ve included some of the themes below.

Free speech – there is a right to express views or establish events even if these are not popular

Speech involves a balance between the right to express views and to consider the effects this has on others.

This is not meant to be realistic

Regardless of whether is realistic, for those with little knowledge of mental illness and its treatment this may inadvertently form a part of their education (about mental illness and its treatment).

How are people being made aware that this is unrealistic?

The financial support for mental health awareness campaigns is counterbalanced by the revenues generated and by and financial support for potentially stigmatising film portrayals of mental illness which may be unrealistic.

Its Just a Bit of Fun

There are lots of creative ways to do similar things without targetting people with mental illness

Having fun is incredibly important and can be done with planning. Why plan something that can perpetuate stigma which can cause suffering for others. It is an equation – not just looking at people having fun on one side but also people with something to lose on the other side.

Mental illness is very common. Most people are likely to develop mental illness at one point in their life. If films such as these perpetuate stigma then people having short term gains (i.e. fun) would find that stigma contributes to their experience if they later develop a mental illness.

Index: There are indices for the TAWOP site here and here Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link. Podcast: You can listen to this post on Odiogo by clicking on this link (there may be a small delay between publishing of the blog article and the availability of the podcast). It is available for a limited period. TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link. Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk. Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog. Conflicts of Interest: For potential conflicts of interest please see the About section.

3 thoughts on “Movies and Mental Illness: What Do We Do About Stigma? (Updated 12.11.13)

  1. Simon Braybrook MRCGP

    Id like to recommend the series of books Movies and Mental Illness (Danny Wedding, Mary Ann Boyd, Ryan M. Niemiec) which is now in its third edition. It is a great reference to films that accurately portray psychopathology and those who don’t.

    Cinema can be a great way of portraying the human experience and when I am trying to illustrate psychopathology to my students, I often use film clips. For example, Geoffry Rush gives an excellent portrayal of bipolar disorder both in terms of mania and depression in his movie “Shine”. It is therefore such a shame when movies are so lazy to stick to the tired stereotype of the violent psychopath.

  2. George Dawson, MD, DFAPA

    I think that there is a real danger that more recent portrayals of mental illness are clearly moving away from sterotypical portrayals to include some features or mental illness that are reported in the media. To me this is more than a theatrical portrayal at that level. That also seems like a rationalization when media bias against psychiatry and mental health issues has been well documented in the UK. There are many social issues that are not handled as crudely.

  3. moviedoc

    Lots of works of art probably promote stigma, but just as many, if not more, may discourage it. The best we can do is expose the errors, and for that purpose movies may help tremendously. In my opinion Cuckoo’s Nest’s portrayal of the misuse of ECT and psychiatry in general does much more good than harm. Why do you pick on the movie and not the book? Did you know Dr. Spivey was played by a real psychiatrist at the hospital where it was filmed. I met him years ago. He just died this past year.

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