Noah Packard

Film & Culture

12/8/2017

Portrayals of Mental Illness in American Film and Their

Effect on Society's Perceptions of Mental Illness

From depression and posttraumatic stress disorder to schizophrenia and autism, mental illness is

a fairly common theme in American Cinema. Even in films that don't feature it as a primary theme or

element of the story, mentally ill characters are not uncommon in all genres of American film. Despite

how frequently these themes come up, however, American filmmakers' depictions of these characters

typically leave a lot to be desired in the way of showing these characters and conditions in sensitive and

nuanced ways. This element of filmmaking can frequently show mentally ill characters in an inaccurate

and potentially damaging light. This paper will examine the portrayal of mental illness in American

film, and the ways that these images can create harmful stereotypes and stigma against the mentally ill

in real life.

American's perceptions of mental illness have improved dramatically over the past century. In

the 1950's, People's perceptions of mental illness included almost exclusively psychotic symptoms,

excluding a huge range on non-psychotic symptoms. Since then, the public's definitions have expanded

to include things like depression, phobias and anxiety disorders (Beachum 4). Despite this encouraging

trend, Americans still very commonly have strongly negative perceptions of mental illness. As Lauren

Beachum writes in an essay about stigma toward mental illness and its portrayal in film, People may

have an enhanced awareness or broader conceptualization of mental health care and mental illness, but

they are not necessarily more informed about these topics (Beachum 4). While Americans have a

deeper understanding of mental illness and its treatment as concepts, but their perceptions of people

with these conditions are still ignorant and potentially very harmful. These stigmas are particularly

harmful toward the mentally ill, since it makes them much more hesitant to seek out much-needed help
for their conditions.

Beachum goes on to say, ...Although the public acknowledges that mental illness includes

more than just psychosis, the stigma still makes people reluctant to seek help. There is a discrepancy

between attitudes towards abstract mental illness, and how people perceive and react to mental illness

when it becomes more salient. People with mental illnesses are alienated and discriminated against in

society, despite the fact that Americans' general attitude toward mental illness appears to have

improved.

These negative associations and attitudes toward mental illness are largely rooted in the media,

including film and television. In these mediums, the mentally ill are extremely portrayed as

incompetent, violent and murderous. Beachum writes: The prevalence and significance of the

overwhelmingly pejorative representations of mental illness in the media are not lost on people

suffering from mental disorders, or on their families. Many find the media images profoundly

damaging, and family members report the effects of these images as saddening, discouraging, enraging,

and hurtful. Primarily what is the most problematic are their inaccuracies, the language used to refer to

mental illness, and the disrespectful treatment of mentally-ill characters. These depictions have both

immediate and far-reaching consequences for those with mental conditions. They must both cope with

the media's negative portrayal of them as incompetent and violent, and must deal with prejudices

inspired in other members of society by these depictions.

Despite the fact that there is virtually no real-life link between mental illness and violence,

American film tends to promote an image of the two being extremely closely linked. According to a

2006 study on the subject, half of all mentally ill characters in film and television inflict harm on

another person, and one in four kill someone (Beachum 3). This statistic is in sharp contrast to a 2004

study that found that only about three to five percent of violent acts in society involve mental illness

(Holmes). The same study, however, found that over a third of all news stories about mental illness also

involved violence towards others (Holmes). Additionally, while mentally ill characters are typically
given background roles and roles as side-characters, in cases where they do have speaking parts, they

are ten times more likely to act violent than characters without mental illnesses (Beachum 5). Statistics

like these show a clear and dramatic disconnect between the way the American Media show mental

illness and reality.

While filmmakers' portrayal of mentally ill people is frequently inaccurate and harmful, their

depictions of mental health professionals are just as skewed. Classic films like One Flew Over the

Cuckoo's Nest feature doctors and staff who are sinister and manipulative, which is a broad and widely

accepted stereotype in society. These stereotypes about mental health professionals are not only unfair

to the real life counterparts to the fictional characters, but can also be damaging to real people

experiencing mental illnesses, as these preconceived notions can make it more difficult for therapists to

properly treat their patients, as it fosters inherent distrust between them. Patients begin to perceive their

doctors and therapists as exploitative and unethical, and feel that their treatment is oppressive and

overly controlling, due solely to the imagery of fictionalized versions of these people. The people who

actually need treatment are manipulated by this imagery into resisting and rejecting the much-needed

help of professionals (Beachum 6).

The reason for these inaccurate depictions of mentally ill people and mental health professionals

is simple: they make for good stories. Mental illnesses can, at times, be causes for volatile and

unpredictable behavior, sources or personal struggles for characters, or even a dramatic twist for a film.

One of the more prominent examples of an illness used in this context is Dissociative Identity Disorder,

or DID. Formerly called as multiple personality disorder and still frequently mislabeled as

schizophrenia, DID is defined by the American Psychiatric Association as a severe condition in which

two or more distinct identities, or personality states, are present inand alternately take control ofan

individual. This has been a favorite topic of filmmakers for almost as long as the medium has existed.

From Psycho to the much more recent Split, films use DID as a motivation for violence and murder,

which can make for a good story, but simultaneously is a huge misrepresentation of the condition in
real life. Films like these imply a link between DID and violence, when, in reality, none exists. These

depictions. Psycho is one of the most obvious offenders; Just the title alone is enough to give

audiences the wrong understanding of the disorder writes Madison Verhulst, in an essay about

Dissociative Identity Disorder in film. Despite the fact that there is virtual no link between DID and

violent tendencies in reality, people almost universally believe that there is one, since their only

exposure to the disorder is through film and television, and these mediums almost exclusively portray

DID in relation to violence and murder.

This imagery of mental illness and it's treatment can have an extremely profound impact on

society's perception of these things, much more than most people assume. Nowhere is this more

apparent than in the public's perceptions of electroconvulsive therapy. ECT is commonly defined as a

medical procedure in which a brief electrical stimulus is used to induce a cerebral seizure under

controlled conditions (Enns) and is only ever administered after receiving informed consent from a

patient. It is well established as a safe and effective method of treatment for multiple major mental

disorders (Beachum 10). Despite these facts, the public's general perception of ECT is that of a

torturous and painful procedure with no medical value whatsoever. Americans, when surveyed about

their knowledge of the procedure, very frequently used terms such as torture and cruel, and

associated the procedure with punishment and manipulation rather than actual psychological treatment

(Beachum 10-11). This perception is based almost solely in American filmmakers' depictions of the

procedure in movies, which is almost totally unrelated to the actual procedure. By far, the most famous

of these depictions is seen in One Flew Over the Cuckoo's Nest, where Jack Nicholson's character

McMurphy is subjected to what is ostensibly ECT as a punishment for rebelling. A 1983 study found

that after watching this film, stundents had a dramatically more negative perception of ECT than those

who had not. Eight months later, half of this group was assigned to view a documentary that showed

clips from One Flew Over the Cuckoos Nest alongside more realistic reenactments of institution life

filmed at the same hospital where the movie took place. The other half, the control group, was shown
an unrelated film. Interestingly, the first group continued to show the same biases as before, despite the

fact that they had been introduced to real-life depictions of the procedure that contradicted the images

seen in the film (Beachum). These statistics show that, while people understand the depictions of these

people and procedures they see in films can often be exaggerated and inaccurate, they still retain

influence and biases based on the fictional imagery. This also demonstrates that beliefs like these can

be extremely resistant to contradictory and corrective information. Even more amazingly, these

fictional portrayals have been shown to affect people who have been formally educated in psychiatry.

Research shows that medical students who have been trained about the application of ECT and fully

understand the procedure and its effects still frequently cite movies as their primary source of

knowledge about the procedure (Walter).

The depiction of mental illness in film is not universally bad. Many film, both fictional and non-

fictional, such as A Beautiful Mind and I'm Still Here endeavor to accurately depict mental illness and

its place in society, as well as its treatment in a way that is both accurate and healthy. By creating more

films like these, much of society's stigma toward mental illness can be overcome, and those with

mental conditions can be encouraged to seek the help that they need, without fear of discrimination or

prejudice. If appropriately enlisted, the media may challenge stigma and promulgate mental health

messages. However, integrating mass media outreach and public education into clinical psychiatric

practice remains largely unexploited (Stuart 104). While depictions of conditions such as Dissociative

Identity Disorder can make for interesting stories, filmmakers are frequently unaware of the effects that

their art can have on the real-life counterparts to the characters in their films.
 Works Cited

American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders: DSM-5,

American Psychiatric Association, 2013

Beachum, Lauren. The Psychopathology of Cinema: How Mental Illness and Psychotherapy Are

Portrayed in Film Grand Valley State University Psychology Common, GVSU, 2016,

scholarworks.gvsu.edu/cgi/viewcontent.cgi?

referer=https://www.google.com/&httpsredir=1&article=1036&context=honorsprojects.

Enns, M.W., Reiss, J.P., Chan, P. . Electroconvulsive therapy, Canadian Journal of Psychiatry, 2010

Holmes, Lindsay. The Media Is Perpetuating A Dangerous Myth About Mental Illness. National

Alliance on Mental Illness, National Alliance on Mental Illness, 6 June 2016,

namimc.org/media-perpetuating-dangerous-myth-mental-illness/

Stuart, Heather. Media Portrayal of Mental Illness and Its Treatments. CNS Drugs, vol. 20, no. 2,

2006, pp. 99106., doi:10.2165/00023210-200620020-00002.

Walter, G., McDonald, A., Rey, J.M., & Rosen, A, Medical student knowledge and attitudes regarding

ECT prior to and after viewing ECT scenes from movies, Journal of ECT, 2002

Verhulst, Madison. Psycho, Fight Club and Split: Dissociative Identity Disorder in Film. University

of Wyoming Honors Theses, 12 May 2017, repository.uwyo.edu/cgi/viewcontent.cgi?

article=1050&context=honors_theses_16-17.