Exeter, Devon UK • Dec 4, 2023 • VOL XII

Exeter, Devon UK • [date-today] • VOL XII
Home Screen Portrayals of Mental Health in Film

Portrayals of Mental Health in Film

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The representation of mental health and mental illness in film is an important issue, and it goes without saying that some films do it better than others. If we work from the basis that popular culture and art are hugely influential in how people view mental illness, which seems fairly obvious, then it’s crucial that filmmakers treat the subject with care. All art plays a role, particularly, in the reduction or promotion of stigma around mental health.

It’s true that in recent years the cultural stigma around mental illness in the west has been improving; however, the problem is far from dissipated. Firstly, general public stigma is still apparent – as the Mental Health Foundation points out, “nearly nine in ten people with mental health problems say that stigma and discrimination” negatively affects their lives. They say this is partly because many people believe they are “violent and dangerous”. The MHF cites the media as a main exacerbating factor here (such as with the covered of the Germanwings plane-crash), but film is a culprit as well.

“films need conflict, drama or struggle, and mental illness provides good material.”

The number of huge films that portray mental illness purely as a basis for violence far outnumbers the sensitive treatments. Films like ‘Fight Club’ (1999), ‘Fatal Attraction’ (1987), ‘Shutter Island’ (2010), ‘American Psycho’ (2007), and ‘We Need To Talk About Kevin’ (2011) (I could go on) base their violence in exaggerated depictions of madness. I am not saying that these are bad films for this reason – to have such a monochromatic view would be unhelpful. However, when these portrayals become the dominant norm, it is problematic. The reason for this tendency is fairly clear, and extends past violent depictions into ones that are exaggerated or misrepresented – films need conflict, drama or struggle, and mental illness provides good material.

The problem arises when filmmakers misrepresent mental illness in an attempt to make a film more exciting. Often this is a gimmick. For example, the widespread use of visual hallucination as a plot device in Hollywood is at odds with the reality of psychotic disorders such as Schizophrenia. Powerful visual hallucinations like in ‘Pi’ (1998), ‘A Beautiful Mind’ (2001), and ‘Black Swan’ (2010) are very uncommon, and far less likely than auditory hallucinations. ‘A Beautiful Mind’ is a perfect example of this problem, because John Nash, upon whom the film is based, never suffered visual hallucinations – only auditory. This shows an implicit belief that Nash’s real struggle simply wasn’t entertaining enough, and a willingness to eschew all the complicated and varied symptoms of such disorders in favour of more potentially titillating ones.

“Depression and anxiety, in particular, have been dealt with far more effectively on the screen than other lesser understood disorders.”

Beyond general stigma, though, is a deeper problem. Matt Haig, author of ‘Reasons to Stay Alive’, talked on Twitter about how people are far more accepting now of mentally unwell people in the abstract – they won’t immediately ridicule them or discriminate against them based on a label. However, the actual symptoms of the illness are still heavily stigmatised – a person is fine with anxiety in theory, but is dismissive or disbelieving when they see a panic attack over something ostensibly trivial. Film’s role here is clear: to familiarize the general public with neurodiverse behaviours, and to vanquish the plethora of myths and misconceptions about various disorders. This includes viewers who are mentally ill themselves, as often stigma and misinformation is internalised, exacerbating conditions.

Depression and anxiety, in particular, have been dealt with far more effectively on the screen than other lesser understood disorders. This is likely for two reasons. Firstly, they are by far the most common, and so it is easier to depict respectfully – and there is more likely to be outcry if it is not. Secondly, the symptoms (in the majority) are less externally extreme than other disorders, and the temptation to stereotype or exaggerate is curtailed.

PTSD and alzheimers are some other disorders which have been treated impressively, with films like ‘Room’ (2015) and ‘Still Alice’ (2014) which distinguish between a character who has a disorder and a character who is a disorder. A sea of brilliant films portraying substance abuse disorders exist too. Despite this, there is still a lot of work to do to promote greater neurodiversity in film without relying on stereotypes, tropes or clichés. People with Autistic Spectrum disorders are not all a variation of Rainman or Sherlock Holmes, and women with ASDs are severely underrepresented. Personality disorders need to be rescued from lazy stereotyping as in ‘Fatal Attraction’, ‘Mr Nobody’ (2009) and, arguably, ‘Vicky Cristina Barcelona’ (2008).

All of this is not to say that some directors and films don’t do a beautiful job of properly presenting mental illness. Sofia Coppola’s ‘Lost in Translation’ (2003) depicts depression subtly and elegantly through Scarlett Johansson’s convincing acting, and the metaphorization of her isolation in Tokyo. Her ‘Virgin Suicides’ (1999) portrays depression similarly well, as do the David Foster Wallace biopic ‘End of the Tour’ (2015), and films like Jonze’s ‘Her’ (2013), Kaufman’s ‘Synecdoche, New York’ (2009), and Sam Mendes’ ‘Revolutionary Road’ (2008).

Some of these films succeed in different ways – both Lars Von Trier’s ‘Melancholia’ (2011) and Kaufman’s ‘Synecdoche’ externalise the disorder, and impose it on the real world in a postmodern sense, without resorting to delusion. ‘Take Shelter’ similarly captures the menace of anxiety.

“Mental Illness should just be there, as it is in real life.”

But the best films are those that make an overt effort to humanise, and to create true empathy – not exploitative pity – for mentally ill characters. ‘Short Term 12’ (2013) does this fantastically, exploring multi-faceted characters with a variety of problems without being intrusive or over-indulgent. This lack of intrusion, of spotlighting, is likely why it’s often auxiliary characters that perform best, like Carey Mulligan’s in ‘Shame’ (2011), or Robert De Niro’s in (the otherwise simplistic) ‘Silver Lining’s Playbook’ (2012). An honorary mention here should go to so many of PT Anderson’s characters, as well as Kate Winslet’s in ‘Eternal Sunshine of the Spotless Mind’ (2004).

The point is not that filmmakers should avoid attempting to portray mental illness, or that they should explicitly go out of their way to do so. Nor should they seek only to depict the mentally ill in a positive light. Mental Illness should just be there, as it is in real life: an aspect of so many people’s lives – but not their whole existence.

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