Psychology in Action

Addressing the Portrayal of Mental Illness in Film and Television

This article was authored by Jenna Signorelli and Emily Neer as part of the 2020 pre-graduate spotlight series.

 

[Trigger Warning: Mental illness, Sexual assault: This blog post references scenes from various television shows and films that depict mental illness, suicidal thoughts, and a case of sexual assault.] 

 

With accessibility to film and television at an all-time high, this form of media is able to reach a very large audience. It is easy for one to get caught up in the plot of their favorite movie or emotionally attached to their favorite character, without realizing the lasting effects that these films and shows have on the way we think and perceive those around us. 

 

When we consider sensitive topics like mental illness, media portrayals often do more harm than good. Mental illness portrayed in film and television has been found to contribute significantly to the stigma surrounding a broad range of illnesses such as bipolar disorder, obsessive compulsive disorder, anxiety, and schizophrenia. Stigma surrounding mental illness starts with the belief in a certain stereotype about mental illness (Corrigan & Kleinlein, 2005). Stigma can also manifest in the internalization of this stereotype by both the person with the mental illness and the general public. This internalization often leads to discrimination against the person with the mental illness by both institutions and individuals. In the United States, research found that one-fifth of prime-time television programs depict some aspect of mental illness and 2–3% of the adult characters in these shows are portrayed as having mental health problems (Diefenbach, 1997).

 

While there are many films and shows that incorporate mental illness into minor plotlines, other films and shows use mental illness to guide their main storyline. One example of this is FX Network’s American Horror Story: Asylum (Murphy, 2012). The show focuses on a fictional institution for a variety of mentally ill characters, many of whom are being held against their will because of accusations of criminal behavior. Though the season itself was set in the 1960s, American Horror Story: Asylum was written and broadcasted for the modern audience. Consequently, the show’s dramatization of mental illness still has the potential to subconsciously impact present day viewers’ perceptions of mental illness. According to the Television Academy, American Horror Story: Asylum garnered seventeen Emmy nominations for its single season alone, which emphasizes how prevalent mental illness representation is in entertainment media today. 

 

It is crucial that mental illness is depicted accurately, without any of the added dramatizations often found in film and television. Inaccurate and unrealistic storylines have the ability to fuel the stigma surrounding mental illness. Research has consistently shown that entertainment media provides “overwhelmingly dramatic and distorted images of mental illness that emphasize dangerousness, criminality and unpredictability” (Stuart, 2006, para. 1). In addition, it has been found that media representation of mental health professionals as “unethical, exploitative or mentally deranged,” promotes extreme distrust of mental health providers and avoidance of psychiatric care (Stuart, 2006). For example, a scene in Showtime’s Shameless (Abbott & Dahl, 2011) depicts a questionable in-home therapy session for a character with agoraphobia. Agoraphobia is the fear of being in unfamiliar or open spaces that results in the avoidance of these situations (APA Dictionary of Psychology, n.d.). In the scene, the character, Sheila, is receiving an in-home virtual reality therapy session. Though her exact title was never defined, it is implied that the woman who arrives at Sheila’s house in a scrub top specifically for the session is a professional that Sheila trusts to help her through her agoraphobia. During the scene, the professional provides Sheila with weak encouragement throughout the virtual reality process while at the same time making and consuming an alcoholic beverage. This unethical and inappropriate behavior from the woman that Sheila trusts to help her with her mental illness is consistent with Stuart’s (2006) description of poor representations of mental health professionals in media, which is shown to discourage viewers from seeking out mental health treatment. 

 

Another example in which entertainment media has contributed to poor mental health portrayals is the inclusion of negative reactions to the characters with mental illness. These negative reactions include emotional displays of fear, rejection, or ridicule directed towards the character with mental illness (Stuart, 2006). In the popular television show Thirteen Reasons Why (Yorkey & Alvarez, 2017), the main character, Hannah, meets with her school guidance counselor to discuss her worsening depression following her sexual assault. The guidance counselor implies that Hannah made a decision that put her in the position to be assaulted. He even suggests that Hannah’s experience did not involve a lack of consent, and rather that Hannah was simply experiencing an instance of regret. The guidance counselor’s dismissal of Hannah’s problems and his claim that Hannah could be at fault could lead people in a similar situation as Hannah to not seek help from others out of fear of rejection and ridicule.

 

However, mental illness in entertainment media can also be depicted in a more positive manner by accounting for sensitivities and excluding exaggerations of mental illness. There is empirical evidence that the majority of those with a mental illness never commit a violent act, rather they are actually more likely to be a victim of violence than a perpetrator (Stuart, 2003). Bearing this in mind, entertainment media portraying mental illness should not associate it with violence. According to Ruggiero and Harrison (2019), good representations of mental illness in media display help-seeking behavior such as reaching out to a trusted adult or mental health professional. In the film The Perks of Being a Wallflower (Chbosky, 2012), the main character, Charlie, is hospitalized for depression and suicidal thoughts. In an impactful scene, Charlie allows himself to be vulnerable and open up to his psychiatrist about the way he feels and the thoughts he had leading up to his hospitalization. 

 

Additionally, having other characters support this help-seeking behavior and inserting messages of treatment, hope, and recovery into the script are good ways to approach writing mental illness into a storyline (Ruggiero & Harrison, 2019). In the movie, Good Will Hunting (Van Sant, 1997), Will’s therapist (played by Robin Williams) establishes a connection with Will during a therapy session. His therapist incorporates previous conversation topics into his advice, brings up personal experiences that Will can relate to, and points out all that Will has left to see and achieve. By tailoring his language to Will during the session, the conversation ends on a note of optimism and encouragement. Good Will Hunting provides a great example of a positive and professional therapist-client relationship. 

 

The cinematic and television communities have made strides towards eliminating characters and storylines that contribute to the mental illness stigma. The annual Sentinel Awards Show honors television shows that “inform, educate and motivate viewers to make choices for healthier and safer lives” (Hollywood, Health and Society, 2020, para. 1). Programs such as Hollywood, Health and Society connect writers and producers with script consultations for a variety of different topics including the mental health stigma. Hollywood, Health and Society has a network of experts readily available to assist in developing characters and storylines that are representative of true cases of mental illness. In addition to these resources, writers and producers have made their own progress towards ending the stigma surrounding mental illness. More and more films and shows are coming out each year that feature strong characters with mental illness who go on to live normal and successful lives- some even using their mental illness to their advantage. For example, Monk, an early 2000s television series arguably ahead of its time in regard to its positive depiction of a mental illness, is about an accomplished detective with obsessive-compulsive disorder (Breckman & Hoberman, 2002).

 

There are still significant gaps in the research assessing the relationship between entertainment media and mental illness interpretation. In addition, much of this research is very dated. More research is needed to determine the best way to depict mental illness on the screen. Especially research studies that examine the long-term effects that film and television have on our understanding and opinions of mental illness (Wahl, 1992). Film and television are popular forms of media that should be used to evoke positive change in the perspectives that people hold of mental illness. There are many ways to entertain and one must be wary of boundaries that are easily pushed. It only takes one poorly designed movie or show to inflict prejudice and harm on the reputation of those who struggle with mental illness.

  

If you are a UCLA student or affiliate experiencing a mental health crisis, call the CAPS 24-hour line (310) 825-0768 to speak to a counselor. 

 Here is a list of nationally available (24/7) resources: 

 Thoughts of suicide: 

 Sexual Assault: 

 

References

Abbott, P. (Writer), & Dahl, J. (Director). (2011, February 13). Killer Carl. (Season 1, Episode 6) [Tv series episode]. In J. Wells, P. Abbott & A. Stearn (Executive Producers), Shameless. Bonanza Productions; John Wells Productions; Warner Bros. Television; Showtime Network; Sterling Films. 

APA Dictionary of Psychology. (n.d.). Agoraphobia. In APA Dictionary of Psychology. Retrieved March 23, 2020 from https://dictionary.apa.org /agoraphobia

Breckman, A., & Hoberman, D. (Executive Producers). (2002-2009). Monk [TV series]. Mandeville Films, Touchstone Television, USA Network.

Chbosky, S. (Director). (2012). The perks of being a wallflower [Film]. Mr. Mudd Productions.

Corrigan, P., & Bink, A. B. (2005). On the stigma of mental illness. American Psychological Association.

Diefenbach, D.L. (1997). The portrayal of mental illness on prime-time television. Journal of Community Psychology, 25(3), 289–302. https://doi.org/10.1002/(SICI)1520-6629(199705)25:3<289::AID-JCOP5>3.0.CO;2-R

Hollywood, Health & Society. (2020). Sentinel awards: Hollywood, Health & Society. https://hollywoodhealthandsociety.org/sentinel-awards

Murphy, R. (Executive Producer). (2011-present). American horror story [TV series]. 20th Century Fox Television; Ryan Murphy Productions; Brad Falchuk Teley-Vision.

Ruggiero, A., & Harrison, V. (2019, May 6). Avoiding mental health stigmatizations & encouraging help seeking through entertainment media. Center for Scholars and Storytellers. https://www.scholarsandstorytellers.com/representation-blogs/2019/5/6/avoiding-mental-health-stigmatizations-amp-encouraging-help-seeking-through-entertainment-media

Stuart H. (2003). Violence and mental illness: An overview. World Psychiatry, 2(2), 121–124.

Stuart, H. (2006). Media portrayal of mental illness and its treatments: What effect does it have on people with mental illness? CNS Drugs, 20(2), 99–106. https://doi.org/10.2165/00023210-200620020-00002

Television Academy. (n.d.). American Horror Story: Asylum. https://www.emmys.com/shows/ american-horror-story-asylum

Van Sant, G. (Director). (1997). Good Will Hunting [Film]. Lionsgate.

Wahl, O. F. (1992). Mass media images of mental illness: A review of the literature. Journal of Community Psychology, 20, 343–352. https://doi.org/10.1002/1520-6629(199210)20:4<343::AIDJCOP2290200408>3.0.CO;2-2

Yorkey, B. (Writer), & Alvarez, K. P. (Director). (2017, March 31). Tape 7, Side A. (Season 1, Episode 13) [Tv series episode]. In B. Yorkey, et al. (Executive Producers), Thirteen reasons why. Anonymous Content; Paramount Television.