introduction
Since the dawn of the big screen, cinema has been a cornerstone of American culture, as well as that of many other cultures around the world. He brought people together and divided people. Great progress has been made in this way of exchanging information and ideas. Benzine says cinema sits at the intersection of art, industry, technology and politics. “It's a universal language that allows us to tell stories about our collective hopes and fears; understand the world around us and the people around us.” It is no surprise, then, that the film had a tremendous impact on people's knowledge and attitudes; especially on topics with which they have little practical experience. Several studies over the past three decades have found significant support for the concept that what people see on television and in films affects their perception of reality and plays a role in shaping their knowledge of the world, including public opinion and of social perception (Kimmerle and Cress; Smith and others). As film developed, both as a means of exploring puzzling concepts and as entertainment, mental illness became a central theme. Inaccurate portrayals of mental illness on film can lead to harmful stereotypes, the spread of misinformation, negative attitudes towards the mentally ill, and barriers for people to cope with mental illness (Kimmerle and Cress; Smith et al.; Pirkis et al.) .
I have analyzed the scientific literature on the portrayal of mental health in films. I've limited the review to publications from 2000, but some of the articles I looked at relate to earlier research. I have found that there are many depictions of mental illness in children's and adult films, and that such depictions are extremely negative. Many mentally ill characters are portrayed as violent, labeled derogatory, or shown in a comic context that downplays their illness. These negative representations can create or reinforce harmful stereotypes and negative public attitudes, which can further isolate people with mental illness and contribute to a lack of treatment-seeking behavior. Inaccurate descriptions seen by people with psychiatric disorders or their family members can also lead to unrealistic treatment expectations. However, there are some positive narratives that have the potential to educate the public and be incorporated into clinical practice. Overall, filmmakers must work to portray mental illness that is both entertaining and accurate, and mental health professionals must be aware of the potential harm that media portrayals of mental illness can have in order to help patients overcome these illnesses.
Effects of negative portrayals of mental illness
Despite significant changes in the understanding of mental health, “from the dark ages of institutions and torture to the light of human rights and neurobiological interpretations,” much stigma surrounding mental illness remains in society (Das et al.). Decades of research has revealed that many people have inaccurate and negative ideas about psychiatric illness. For example, Jorm (2000) found that community attitudes towards people with mental illness are mostly negative and based heavily on misinformed beliefs (cited in Pirkis et al.). Das et al. suggest that these unfavorable and erroneous attitudes stem in part from the fact that the true struggles of people with mental illness often remain hidden and inaccurate and stereotyped representations dominate in the media. Cinema is an important source of these depictions, as filmmakers use the violence and sensationalism of stereotyped, albeit misguided, portrayals of psychiatric illness as a means of making box office money. "In order to popularize psychiatric issues with viewers, [filmmakers] largely focus on unipolar conflicts rather than taking a general view" (Das et al.).
Cinematic depictions of mental illness are often superficial, stigmatizing, and inaccurate. Many overestimate stereotypical negative attributes such as violence, aggression, and bizarre behavior, and use demeaning slang to refer to people with mental illness (Kimmerle and Cress; Smith et al.). Hyler and others. (1991) (cited in Pirkis et al.) classified stereotyped portrayals of people with mental illness in film. His classifications were the aggressive and dangerous homicidal maniac, the eccentric and rebellious free spirit, the enlightened member of society capable of creating a utopia, the nymphomaniac and intensely seductive woman, the overprivileged narcissist, and the dehumanized madman. Two other commonly portrayed negative stereotypes are the irrational and confused naive character, often used in comical ways, and the failure or victim who is unresponsive to treatment, unqualified, and unable to contribute to society (Pirkis et al. ). One of the most prevalent stereotypes about the mentally ill, which the film reinforces, is that such individuals are violent. Despite weak evidence linking mental illness to violence, research shows that a large percentage of children and adults view people with mental illness as violent, dangerous, and unpredictable (Perciful and Meyer). Misunderstandings about the violent nature of the mentally ill increase the discrimination against these people. This discrimination is evident in the areas of housing, employment, interpersonal relationships and health care. Besides the violent character, another stereotypical representation of a mentally ill person is the mentally weak, developmentally delayed, and needy character. These characters are often imprecisely portrayed to add humor to the film. When insanity is used for humor, it is often hostile, pejorative, and trivial (Smith et al.). Another lie fueled by the film industry is that certain diseases, such as dissociative identity disorder, anterograde amnesia, and schizophrenia, are more common than they really are because they are common diseases used for creative melodramatic plots (Pirkis et al.). Finally, treatment and mental health professionals are often portrayed in an antagonistic or misleading manner. Pirki et al. discuss three common types of doctors featured in mental illness movies - Dr. Dippy, Dr. evil and dr. Wonderful. They say metallurgical health professionals are generally ridiculed, feared, or treated with contempt. The depiction of a supportive psychiatric professional group is rare. Gabbard (2001) analyzed over 400 films and found only 3 with sympathetic psychologists. The researchers say that "only treatments that serve a cinematic purpose are presented" (cited in Pirkis et al.). Psychotherapy is often shown because it lets the audience know what's going on in the patient's mind. However, some of these sessions are unrealistic, showing rapid recovery and a lack of interest in medical ethics. Electroconvulsive therapy is commonly used for melodramatic purposes, and patients often receive this treatment without consent or anesthesia. It often results in a zombie-like patient and very few films show positive results. Hardly any film shows a drug therapy as such, which is not so interesting cinematically (Pirkis et al.).
“The depiction of mental illness as something to be feared, avoided, ridiculed, or vilified sends a dangerous message to audiences about how mental illness and the individuals who experience it are treated both inside and outside the narrative framework should” (Smith et al.). Negative public attitudes toward psychiatric disorders can increase feelings of isolation, shame, and hopelessness in people with these disorders (Perciful and Meyer). Extensive research has also shown that widespread negative beliefs about mental illness, which are significantly influenced by film, create an environment that makes it difficult to seek treatment and hinder recovery (Whal et al., Perciful, and Meyer). Research by the US Department of Health and Human Services has found that negative attitudes towards mental illness increase people's harmful stigma and reluctance to seek help (cited in Pirkis et al.). blacksmith and others. say that such depictions "can short-circuit the empathic response and increase antisocial tendencies [for people with mental illness]".
Wal et al. (2003) and Lawson and Fouts (2004) found that references and depictions of mental illness are common in both children's films and adult films. Both pointed out that negative attitudes and misconceptions about mental illness have their origins in childhood and are significantly influenced by the content of films aimed at young audiences. Depictions in children's films can influence how children think about and deal with people with mental illness. Exposure to harmful stereotypes of mental illness through films can lead children to fear, distance themselves from, and act discriminatory against people with mental illness (Lawson and Fouts). Weiss (1994) found that children showed greater fear and distrust of the mentally ill (cited in Lawson and Fouts). In the research discussion, Whal et al. noted that depictions of mental illness in children's films send out two pernicious messages - "first, that psychiatric terminology is appropriately associated with lewd, silly, derogatory, etc. of conversational discourse". The fact that such depictions of mental illness in films aimed at children , are common is of particular concern because children are very impressionable and have a hard time distinguishing fiction from reality.They are constantly learning how to behave in their environment, and what they learn in childhood lays the foundations basis of their knowledge, attitudes, beliefs, and behavior in adulthood. When harmful stereotypes and mental abuse are reinforced by characters that children admire, children are likely to emulate those characters. Lawson and Fouts say that "this combination of molding and reinforcement one of the most effective tools de r socialization and has the potential to teach biased attitudes and distancing behaviors toward individuals who are perceived as mentally ill ... [and] once these beliefs are formed, children perpetuate them into adulthood.”
Influence of positive depictions of mental illness
Despite the dominance of negative stereotypes in film, there is evidence that depictions improved over time from the 1900s to the early 2000s (Pirkis et al.). In addition, some films, while still containing clichés, can have an overall positive impact on viewers. Movies can help people identify with characters with mental illnesses they admire and be more accepting of their own mental illness. A 17-year-old girl interviewed by Butler and Hyler said Angelina Jolie was with themInterrupted girlit empowered her and helped her to be more comfortable with her own bipolar and antisocial disorders. This idea was also further observed by several students while doing their homeworkIt's a funny story🇧🇷 One student said of the impact of movies on people's attitudes, beliefs and knowledge about mental illness: "I think it changes people's attitudes a lot because they can see an actor they like and admire them . It can help mentally ill patients get through their difficult times.” These films can also provide encouragement to people who are struggling to get help (Pirkis et al.; Perciful and Meyer). I think movies can give people who are struggling a chance to see their illnesses outside of themselves. Especially for people who are in denial about their illness, it can help them to recognize their actions, how they affect themselves and others, possible causes of their illness and to seek help.
Certain films can also be educational and challenge stereotypes. “By authentically portraying the subtle and complex ways that mental illness intersects with people's lives, [the film] can introduce audiences to new ways of thinking, ways to ask for help, and ultimately necessary changes in our lives Beliefs produce health” (Smith et al.). Pirki et al. discussed the possibility of using the film as a teaching tool for mental health professionals. They can help explain the symptoms, treatment, and stigma of various diseases. It is important, however, that this is only an adjunct to real-life clinical experience. Another potential use of the film could be as an adjunct to therapy, as discussed in the next section. I also suggest using films in schools to teach about psychiatric disorders and create a productive environment to challenge stereotypes and misconceptions.
Implications for the treatment of mental illness
treatment obstacles
As previously mentioned, films influence public perception and knowledge, and therefore the way psychiatric disorders are portrayed in film can greatly influence the way people view these diseases and their treatment. Furthermore, since more people are exposed to representations of psychiatry in the media than in real life, most of the public's perceptions of psychiatry come from the media and not from personal experience. When films paint a distorted picture of mental illness, they can pose a “significant barrier to the advancement of knowledge and health behaviors related to mental health” (Smith et al.). Stigma is one of the main reasons people do not seek or seek treatment, and this stigma is reinforced by films targeted at children, adolescents and adults (Perciful and Meyer). In addition, incomplete, dramatic, and unrealistic portrayals of mental health treatment in movies can lead to treatment resistance and/or distorted treatment expectations (Butler and Hyler). Butler, an assistant physiatrist at an inpatient facility for teens, provides a narrative that illustrates this problem. One of his patients, a 15-year-old boy, was afraid the doctors wanted to turn him into a zombie. When asked where he got the idea from, the boy replied: "Nightmare on Elm Street🇧🇷 The patient's mother also had misconceptions about psychiatric treatment and believed that her son should stay in the hospital for at least a year, since she had seen in films that children with mental disorders stay in the hospital for a long time. Butler and Hyler explain that "successful confrontation with this notion—mental patients turned into zombies, psychiatrists under omnipotent control, indefinite hospitalization decided in the blink of an eye—will determine medication adherence, family support for treatment, and the therapeutic alliance would." . They think it's important for doctors to know how mental illness and treatment are portrayed in movies so they can counter any misconceptions patients and families may have.
Butler e Hyler's Myths in Film about Child and AdolescentPhysiatry
Throughout film history, child and adolescent psychiatrists have often been shown to "withhold socially unacceptable behavior" rather than addressing the patient's underlying emotional distress. Mentally ill children and adolescents, who were often portrayed as juvenile delinquents in the early to mid-1990s, real mentally ill child and adolescent characters began to appear in the late 1990s, but sociopathic states and unrealistic delinquents continued to dominate, particularly in horror films. Also, some films have characters who, to any psychiatrist or other healthcare professional, are clearly mentally ill but have never received any explicit diagnosis or treatment. The portrayal of undiagnosed or untreated mental illness can distort public perceptions of what is "normal." This can lead to people not recognizing serious problems or normalizing unhealthy behaviors. A given example is the filmThirteen(2003), which tells the story of a 13-year-old girl involved in substance abuse, eating disorders, sexual promiscuity, and self-harm, all presented as "normal" adolescent behavior, with no mention of a possible mental illness. When asked about the film, a 13-year-old said she has friends who do all of this and worse, giving the impression that such behavior is normalized and even glorified. The authors say the most common distortion in film and television is showing the spectacular and omitting the mundane. For this reason, police officers are not shown at office work, but rather solving dangerous crimes, and surgeons are shown performing impossible operations and without routine care. The same applies to representatives of psychiatry, although only the treatment of severe cases is presented. This can give a distorted idea of how severe a mental illness has to be to get help. In addition, the portrayal of extreme, invasive, and often involuntary treatment that is inconsistent with reality for most people with mental illness can give the impression that the treatment is punitive or that one cannot seek treatment voluntarily.
Butler and Hyler discuss 5 Hollywood myths about how child psychiatry works. The first myth is that "a mentally ill child can be cured with enough love." Sometimes the mentally ill child has neglectful parents and the psychiatrist takes on a parental role healing the child as shown indo not say a word(2001),The sixth Sense(1999),to the cell(2000),stay calm(1994),Dom John de Marcos(1995), zAntwone Fischer(2002). Presenting this idea that love cures mental illness in children can have both positive and negative implications. On the plus side, it shows that stable, supportive relationships can help promote behavior change and mental well-being. On the negative side, it trivializes the importance of diagnosis and treatment. In films featuring mentally ill children, there is often a competitive dynamic between the psychiatrist and the parents. If the physiatrist's love and care "cures" the child, this suggests that the mental illness is caused by a lack of love and support. This overlooks the important biological factors at play and suggests that the parents are to blame. This feeling of guilt can make parents reluctant to seek treatment for their child for fear of conviction or loss of the child. Furthermore, the extent to which the doctor's love and support "cures" the child is unrealistic and exhibits unattainable patterns of self-sacrifice. Physicians must be cautious about the role they assume with young patients and avoid creating feelings of competition or displacement in parents. I think this myth can also make children who have loving parents feel like they have no reason to be mentally ill. Every movie I've seen about mental illness has parents who are neglectful or emotionally abusive to some degree. Craig and Liv's parents push them further in school. Ellen's mother is bipolar, her father has abandoned her, and all the adults in her life see her as a problem and at the root of family conflict. Charlie's father is in prison and his mother is depressed. Susanna's parents don't listen to what she wants out of life and simply label her as a problem. In theSkelettzwillinge, the twins' mother was absent for most of their childhood and only shows up when she wants something. While it is true that neglectful, abusive, or similarly ignorant parents can be a trigger for mental illness, they alone are not the cause and need not be present for a child to have mental illness.
The second myth discussed is: “There is nothing in psychiatry; everything can be considered a treatment and everyone a psychiatrist”. Some films like to show the "rebellious" doctor as the successful one, as instay calmwhere the 'accepted' psychiatrist's drugs make the child worse, but 'rebellious' love makes it better. These stories show that medication and typical psychiatric practices are not guaranteed one-size-fits-all solutions and that other treatments can be helpful. However, they can also encourage skepticism and cynicism about psychiatric treatment, even suggesting that there is no such thing as a "real" illness because there is no "real" treatment.
The third myth is "If you don't do what we want you will be imprisoned forever." Popular films that exemplify this belief areOne flew over the cuckoo's nest(1975),silence of the innocent(1991), zNightmare on Elm Street 3: Traumkrieger(1987) showing prison-like mental hospitals, ECT, over-medication, and brutal treatment of patients. These depictions of psychiatric treatment are most commonly seen in horror films and are radically different from modern mental hospitals. One respondent who had never been to a psychiatric hospital said her impression of them was "rusty beds with striped mattresses and this mysterious room in the basement where you were taken if you were unwell or didn't attend the group session." . The authors express concern over the portrayal of psychiatrists as "jailers of nonconformists," saying it could send the message to teenagers that they can take their entire lives by simply saying the wrong thing. It also paints physiatrists as enemies. Films showing psychiatrists in this unfavorable light create a very different impression on the viewer than films showing psychiatrists assuming the role of parents and lovingly "healing" the child, as discussed in Myth One. I wonder how watching these two types of films would affect viewers' beliefs about the physiatrist and whether one portrayal would seem more compelling.
Myth number four is that “mental illness is actually a gift; Psychiatrists take away that gift.” This myth stems from the belief that mental illness is “just another way of looking at the world.” This is more commonly seen in autism. Other films show children with hallucinations or special gifts. Where this concept is not entirely inaccurate, the films showing these "gifts of insanity" often fail to take seriously the emotional and social impact these disorders have on the child. It can also give the impression that the treatment aims to deprive the person of this gift. On the other hand, such depictions can make mental illness diagnoses easier to accept and inspire a sense of pride. I think it's important to see the positive traits in a person that may be contributing to their mental illness and to understand that they can reshape those traits to achieve better mental health without losing them.
The final myth is "Insanity and evil intersect in their depictions." Movies that depict people with mental illness as dangerous criminals posing with evil spirits or the like convey the message that mental illness is to be feared and people with mental illness are to be locked up. Again, such depictions are more common in horror films. Examples of such films areThe Exorcist(1973),Gothic(2003),Heavenly Creatures(1994),disruptive behavior(1998), zdo not say a word(2001).
Use of Film in Treatment
Films can serve as therapeutic tools to discuss the patient's fears and misunderstandings and work to correct these issues in a supportive environment. Butler and Hyler suggest that clinicians become familiar with common film distortions and address them in patients. Additionally, they may use films or clips to educate patients and families. Movies can be used to familiarize patients and families with specific disorders, form therapeutic alliances, help patients reformulate problems, model patients, offer hope, evoke emotions, help patients prioritize values, and to facilitate communication (Pirkis et al.). Several authors have made lists of films that can help with therapy and how they can be used, such as: B. Hesley and Hesley (1998) and Casamento and Niemiec (2003). However, when therapists use film, they must consider the patient's ability to engage with the content and be able to constructively direct the use of the content (Pirkis et al.).
I think using film in this way can be less intimidating for patients and allows them to see their own mistakes rather than just being told they are wrong. This can make the therapy appear closer and also make a clinician more relatable. Overall, I think films can serve as a springboard for open conversation when used in a therapeutic setting where distorted beliefs can be challenged and emotions can be processed.
future directions
With the high rates of mental illness in America and the stigma surrounding these illnesses, it is important to educate and educate the public about what mental illness is and how it can be treated. Knowing that films can profoundly influence people's understanding and opinions, and that many portrayals of mental illness in film are negative, it is the responsibility of filmmakers, policy makers, mental health professionals, people living with mental illness and the community public to work towards more authentic, informative and hopeful accounts of mental illness. I believe everyone can help make this happen. Filmmakers will not change what generates revenue without pressure from politicians and the public, and they will not know how to portray mental illness truthfully and educationally without the input of professionals and people living with mental illness. Pirki et al. acknowledge that improving the way mental illness is portrayed in film must be a collaborative effort. They also say that individuals and organizations pushing for improvement must realize that film's primary purpose is to entertain and generate profit. Therefore, suggestions for improvement must be reasonable and serve to educate and entertain.
Smith et al. indicate what filmmakers should do to improve the portrayal of mental illness. Give instructions. They say it's important to ask 5 questions when making a film about mental illness. The questions are (1) “Why am I telling this story?”, (2) “Is the topic of mental health used as a storyline?” Is unnecessary stigma portrayed?”, (5) “Is seeking help portrayed?” They also emphasize that it It is important to provide "authentic, subtle, and safe accounts" of suicide to make it clear that most people who struggle with suicidal thoughts and attempts lead healthy lives. This was not accurately shown in the films seen in their study, where most people who attempted suicide died. Another important aspect of mental illness that films lack is effective treatment and support. Filmmakers should consult professionals and people with personal experience when illustrating mental illness (Smith et al.).
In addition to the changes in the film industry, further research is needed on the topic of mental illness in film. blacksmith and others. say research should examine how the portrayal of mental illness affects attitudes, behavior, and suicide risk/prevention. Contextual factors such as humor, stigma and violence should be examined in experimental studies to see how they affect viewers. In addition, it should be examined how authors acquire knowledge about mental illness in order to be able to carry out interventions to improve the accuracy of descriptions of mental illness. Lawson and Fouts advise examining behaviors toward people identified in films as mentally ill, as well as those characters' emotional states. This would give a better idea of how these depictions affect viewer behavior and emotions. I believe more research is needed on the positive effects of portraying mental illness in movies. Research on this can provide clues as to which aspects of the portrayal of mental illness make sense, which can be used to advise filmmakers on what to concretely implement in films about mental illness. It could also open new avenues for the use of film in treatment and education.
Works Cited
Gasoline, C. (n.d.). Movie history preview. [video file]. Retrieved from https://thecrashcourse.com/courses/film?page=2.
Butler, J & Hyler, S (2005). Hollywood depictions of child and adolescent mental health treatment: Implications for clinical practice. Child and Adolescent Psychiatric Hospitals in North America. 14, 509-522.
Das, S & Doval, N & Mohammed, S & Dua, N & Chatterjee, S. (2017). Psychiatry and cinema: what can we learn from the magic screen?. Shanghai Archives of Psychiatry, 29(5), 310-313. DOI: http://dx.doi.org/10.11919/j.issn.1002-0829.217014.
Kimmerle, J. & Cress, U. (2013). The effects of television and film recordings on knowledge and attitudes towards mental disorders. Journal of Community Psychology. 14, 931-943.
Perciful, M & Meyer, C (2016). The influence of films on viewers' attitudes towards people with schizophrenia. CurrPsychol, 36, 483-493. DOI: 10.1007/s12144-016-9436-0.
Pirkis, J & Blut, W & Francis. C & McCallum, K. (2006). Screen displays of mental illness: extent, nature and impact. Journal of Health Communications, 11:5, 523-541. DOI: 10.1080/10810730600755889.
Smith, S. & Choueiti, M. & Choi, A. & Pieper, K. & Moutier, C. (2019). Mental Illness in Film and Television: Depictions that Dehumanize and Trivialize Characters [PDF file]. Retrieved from http://assets.uscannenberg.org/docs/aii-study-mental-health-media_052019.pdf.
Whal, O & Wood, A & Zaveri, P & Drapalski, A & Mann, B. (2003). Portrayal of mental illness in children's films. Journal of Community Psychology, 31, 553-560. DOI: 10.1002/jcop.10072.