Spreading Mental Health Awareness: These Films and TV Shows Depict Mental Illness (Mostly) Well
Every May, we acknowledge Mental Health Awareness Month, but this year, as we collectively navigate the COVID-19 pandemic, it feels particularly important to discuss and prioritize mental health. While social distancing and sheltering in place can mitigate the spread of the novel coronavirus, these measures to protect our physical well-being have unfortunate consequences for our mental health — often, we feel isolated and uncertain, and the new routines (or lack thereof) in our new day-to-day existence can have lasting effects.
So, how does popular entertainment figure into this discussion? It's no secret that representation matters. Seeing accurate, nuanced depictions of mental health conditions and mental illness can not only help someone living with a mental health condition or mental illness feel seen, but such portrayals of real-life experiences can be a way to educate, to build support and make folks feel less ostracized. However, according to a study conducted by the USC Annenberg Inclusion Initiative (USC AII) and published in May 2019, "Out of 4,598 speaking characters across the 100 top films of 2016, only 76 [or 1.7%] were depicted with a significant or persistent mental health condition." This is a stark contrast with real life insofar as roughly 20% of adults in the U.S. live with a mental health condition. In short, art has the propensity to dismantle stigma and mental health stereotypes — and it’s about time film and television harness that potential.
Why Is It Important to Depict Characters With Mental Illness?
In both mediums, mental health is stigmatized, trivialized (made into a character "quirk" instead of being taken seriously) or used as a plot device. The aforementioned study found that, of 87 film characters who have mental health conditions or mental illness, 47% of characters were disparaged, 22% of characters’ mental health conditions or mental illness were met with humor and 15% of characters felt the need to conceal their mental health condition or mental illness. When characters with mental illness are portrayed on screen, 46% of them were found to be perpetrators of violence. Regardless of intention, most films and shows unfortunately normalize name-calling, with characters slinging words like "psycho," "crazy," "freak," "silly," "nuts," "weird" and "monster" at other characters who outwardly express a mental health condition or illness.
The study also shows that when there is representation, it’s not reflective of most audience members’ identities or experiences. For example, while 20% of teenagers in the U.S. experience a mental health condition, only 7% of film characters (of that 87) were teens. Mental Health America found that 6.8 million Black Americans report having a diagnosable mental illness, but, despite this fact, only 11 of the characters with mental health conditions surveyed by USC AII were Black. This trend of underrepresentation continues for all people of color: Only four of the characters in the survey were Asian; only one character was multiracial; and none of the characters identified as Hispanic, Latinx, Middle Eastern, Native Hawaiian or Pacific Islander, or as Indigenous or First Nations peoples.
Additionally, the National Alliance on Mental Illness (NAMI) has found that LGB adults are more than twice as likely as heterosexual adults to experience a mental health condition, and LGBTQ people are at a higher risk than cis and/or heterosexual folks for suicidal thoughts and suicide attempts. But portrayals of mental illness often leave out the LGBTQ community as well. Out of 50 TV shows surveyed by USC AII, just eight LGB characters experienced mental health conditions, while the transgender community wasn’t represented at all. Out of 100 films, none of the characters with mental health conditions identified as being part of the LGBTQ community.
All of this is to say that, in addition to stigmatizing mental illness, depictions of mental health on screen often don’t account for the multifaceted experiences of most folks, nor do these depictions account for diversity in race, gender or sexual orientation and how those intersections of identity may interact with mental health conditions or illness. So, how can content creators work toward more authentic, nuanced and safe portrayals of mental health?
Common Onscreen Faux Pas When It Comes to Depicting Mental Illness
In order to shift how stories portray characters with mental health conditions and mental illness, USC AII suggests that writers ask themselves a very fundamental question: Why am I telling this story? This can help creators avoid common pitfalls, like depicting unnecessary stigma, using a mental health condition as a plot device and making mental illness into the punchline. To be frank, the lived experiences of folks who have mental health conditions are missing from popular culture.
When these experiences are depicted, they’re often displayed irresponsibly: Netflix’s 13 Reasons Why was heavily criticized for its depiction of suicide, an act that’s often romanticized or shown as "the only choice" a character who is struggling can make. As in life, medication is stigmatized, with characters eschewing treatment because it inhibits them in some way — such as the old trope of an artist who can’t create because they feel blocked by their medication. Moreover, because mental health conditions are stigmatized and often associated with shame — a dark secret a character must hide or can’t talk about — they often aren’t surrounded by any sort of support system.
And then there’s the association between mental illness and violence that’s particularly prevalent in the horror genre, which derives scares from our very human fear of the "unknown" or the "unfamiliar." For example, in Alfred Hitchcock’s classic Psycho, a movie that spawned countless slasher films, the main character, serial killer Norman Bates, is given a "diagnosis" by a psychiatrist, who cites a "split personality" as the source of Bates’ violent tendencies. "When the mind houses two personalities, there is always a battle," he says. "In Norman’s case, the battle is over and the dominant personality has won."
Even critically acclaimed films, which have, in some cases, been praised for their depiction of mental illness, aren’t without their faults. A writer for Resources to Recover states that although the Academy Award-winning A Beautiful Mind "may have done more than any other popular movie to combat stigma and draw attention to the positive contributions of people with serious mental health disorders," it still misses the mark. "The only problem is that [the intriguing Soviet espionage plot line] all takes place in [John] Nash’s head, as the audience discovers late in the story," states Resources to Recover writer Jay Boll. "Hollywood loves twists, and mental illness is one of its favorite plot devices for spinning a story in a new direction. But people with schizophrenia don’t normally have visual hallucinations where they see the human players in their delusions represented before them."
Meanwhile, Silver Linings Playbook, a feel-good rom-com dramedy that centers on two characters with bipolar disorder, may depict the toll mental illness takes on individuals and families in a more realistic, nuanced way, but it misses the mark when it comes to treatment and managing mental illness. For those living with mental health conditions or mental illness, the day-to-day is about managing, not "curing" said condition, illness or disorder. "Silver Linings Playbook is my favorite movie of all time and it’s very relatable," says The Mighty user Maddie B. "[But] it falls short in the ending where it gave an impression they were ‘cured’ by love. I don’t think that was the intention, but it looked that way." That is, the characters getting together feels inextricably linked to their mental well-being. Perhaps this speaks more to the limitations of film and television shows, which (feel the need to) resolve characters’ "struggles" in two hours or less. But, limitations or not, this sort of resolution perpetuates the idea that something is "wrong" with the characters and that they can heal one another if they just try hard enough.
Movies and Shows That Get It (Mostly) Right
When it comes to mental health representation, it’s not all bad news. In fact, in the last decade a few standout shows and movies have made great strides by centering lived experiences, eschewing stigma (or at least having the main character navigate it authentically) and depicting characters who seek treatment and support. Most of all, a common thread here is that the characters depicted in these pieces all learn there’s no Hollywood-esque cure-all for their mental health conditions and mental illness and, instead, learn to manage and live with them.
Lady Dynamite: Loosely based on comedian (and creator/star) Maria Bamford’s experience being hospitalized for bipolar disorder, Lady Dynamite doesn’t treat the main character’s mental illness as an obstacle or as an excuse for surreal or comic moments. Writing for Slate, Evelyn Anne Clauson argues that the show builds Bamford’s bipolar disorder "into the very fabric of its world… It’s the rare comedy that shows us that the reality of mental illness is that darkness can coexist with creativity and fun and hope."
Inside Out: In this landmark film from animation giant Pixar, a young girl named Riley (Kaitlyn Dias) deals with depression when her family moves from Minnesota to San Francisco. For those who haven’t seen Inside Out, the film personifies the emotions that exist inside Riley and influence how she presents herself to the outside world. Two of those emotions, Sadness (Phyllis Smith) and Joy (Amy Poehler), drive the plot. By her nature, Joy just wants to find a way for Riley to be happy again before she completely shuts down. On the outside, Riley represses her emotions and, while experiencing depression, lashes out at her parents and tries to run away. In the end, Sadness convinces Joy that it’s more than okay to be sad sometimes — in fact, it’s better to feel sad, to talk about those feelings, than to mask them with faux-happiness.
The Perks of Being a Wallflower: Writer Stephen Chbosky decided to adapt his seminal young adult novel into a film because he feels it’s "harder to feel alone if you see dozens of people around you laughing and crying or nodding their heads at the same issues." It also helps that the film depicts the main character Charlie’s (Logan Lerman) depression in a nuanced, genuine way: Charlie makes new best friends and shares real happiness and laughter with them. What he doesn’t share? Everything that’s bottled up inside of him. The film has also received praise for how it portrays post-traumatic stress insofar as Charlie is navigating his memories of childhood sexual abuse in addition to a depression that those around him link to other events in his life. Moreover, Charlie's romantic relationship with Sam (Emma Watson) doesn't magically fix or save him; instead, she's just one part of his support system and helps him, boundaries in tact, to navigate his mental illness.
Crazy Ex-Girlfriend: Although at first this show seems like it will be all over-the-top musical numbers and a lot of the main character Rebecca (creator Rachel Bloom) harping on her ex, Crazy Ex-Girlfriend actually depicts a woman who is triggered by intimacy and relationships and who must navigate depression, anxiety, OCD, fixation and borderline personality disorder. Throughout the show, Rebecca is unwilling to really open up to her therapist — a source of frustration for the viewer, which, in a way, helps underscore how important seeking treatment really is for folks with mental illness. Writing for Self, Claire Gillespie notes that "At the crux of Crazy Ex-Girlfriend’s success is its understanding that mental illness doesn’t end with a diagnosis."
You’re the Worst: In the second season of FXX’s edgy dramedy You’re the Worst, one of the show’s main characters, Gretchen (Aya Cash), spends a day drinking and essentially running away from a depressive episode. Of course, she can’t outrun it. Moreover, she realizes she can’t hide her diagnosed clinical depression from her partner. Fearing she’ll alienate him, Gretchen downplays her clinical depression, but, as Vulture points out, "what’s especially striking about this scene is that it takes place in an episode that is, by and large, overly comic." That is, the surrounding circumstances are funny, but the character’s mental health is never the punchline.
Black Swan: Although Darren Aronofsky’s film about a ballerina striving for near-unattainable perfection leans into psychological horror, it does a surprisingly good job of eschewing the common pitfalls of the genre. As Nina Sayers (Natalie Portman) tries to put on a perfect performance as the lead in Swan Lake, she descends into what many viewers have assumed is a kind of psychosis. "The movie perhaps unfairly draws the conclusion that mental illness is an unavoidable conclusion to this type of pressure," The Mighty states. "[But] it does do a good job of showing a reality many with mental illness face — needing to appear ‘OK.’"
Frozen: This one may come as a surprise to some readers. Sure, Frozen has an anthropomorphic snowman and a wildly catchy song that our brains just can’t let go of, but Elsa (Idina Menzel) and her ice powers are also the perfect metaphor for dealing with anxiety and depression, which director Jennifer Lee says is no coincidence. After hurting her sister with her ice powers as a child, Elsa, at the behest of her parents, locks herself away in her room and lives by the mantra "conceal, don’t feel." For Elsa, her past mistake means she "deserves" isolation — she feels she’s a "bad person." In the end, Elsa learns that she can't hide parts of herself; instead, she must manage her emotion-fueled powers.