The 2019 film The Joker was a chilling narrative about mental illness, and depicted how devastating it can be. The public was frightened of how realistic it was. Critics and fans alike were stunned with the sobering depiction of how detrimental living with mental health conditions can be. There is a scene near the beginning of the film where Arthur Fleck (played by Joaquin Phoenix) is talking to his court appointed therapist. The scenes explore him describing how much agony he’s in, and how indifferent his aid is to it. The film held up a mirror to society, and perhaps that is what scared it, or perhaps it was an experience that showed the terrors and difficulties of living with mental health issues.
Mass media plays an alarmingly large role in the public’s perception of any given issue. Over the course of many decades — television, film, news reporting, and other channels of media have painted those impacted with mental health under a negative light. This stigma has impacted those affected by mental health by making them feel unwelcome, and unnatural.
“I remember looking at people and thinking it was weird they had legs.”
Suraya DAWN
Suraya Dawn was diagnosed with obsessive-compulsive disorder (OCD), Complex Post-Traumatic Stress Disorder (PTSD), generalized anxiety and general personality disorder. Dawn lives in Prince Edward Island with her mother, and teaches dance and arts. “When I was first diagnosed, I talked to someone a lot about it. And I did have someone be very hesitant being friends with me because of that,” says Dawn.
Her first diagnosis was in 2015, where she was told she has OCD. Dawn says that she believes that she’s had OCD since she was 11 or 12, but was too afraid to visit a doctor at the time. Dawn feels as though she has been struggling with her mental health her entire life. Talking to friends and family was difficult for her, because she was worried how people would take it. “I assumed it was a safe space, but you will get judged and not everyone’s gonna have the capacity or the will to be friends with someone like that.”
Dawn says that even from a young age, she was worried what people would think of her when she told them about her mental health issues. Specifically, Dawn was worried that the prejudice produced by television shows and movies would label her as a freak, or some sort of social outcast by her peers.
Conversations surrounding mental health are slowly being accepted, however the media continues to paint a negative picture undermining the public perception on mental health.
Every year, one in five Canadians experience a mental health problem or illness. That’s about seven million Canadians per year. Despite how common it is, and the continuing dialogue surrounding it – mental illness continues to be massively misunderstood by the public.
Mental illness is a complex issue, involving a variety of doctors, diagnoses, treatments, medication, and services.
“My mom didn’t see it as a disorder at the time, we have very similar brains so I thought feeling this way was normal,” says Dawn. “I remember looking at people and thinking it was weird they had legs.”
Dawn explains that she always feels reluctant to tell new people about her conditions, because she’s worried that people will judge her. This stigma is everywhere, in our hospitals, our workplaces, our schools, and even in our homes.
A nurse, who asked to remain anonymous for this story, says that she sees these stigma everywhere in her workplace. She works in the neurology unit, and has grown up with a mother that has struggled with depression.
“At work sometimes we deal with people who suffer from mental illness, and sometimes my colleagues aren’t the kindest and patient with those individuals, unfortunately,” she says. “The way that people judge and laugh at people with mental health is really sad.” This isn’t her first time experiencing mental illness, she has grown up seeing it her entire life.
“My mom has severe depression, so I grew up seeing what that looks like, and how hard that is to live with,” she says. “It’s a never-ending battle, and I feel for her and her struggle.”
She says as a child, she’d always overhear people making jokes about suicide, or calling people with mental illnesses “retarded” or “mentally ill”. All words that made her never want to reach out for help.
“I never wanted to talk to my friends about it, how my mom was unwell, because I was worried they’d think she was a freak, or that I was one just based on association,” she says.
THE PROBLEM
The Carter Center of Mental Health, based out of Atlanta, has explained that reducing stigma and discrimination is the key to improving the lives of those impacted by mental health, and the systems at work to help those in need.
“The mass media’s power to impact public perception and the degree to which people are exposed to the media representations make the mass media one of the most significant influences in developed societies,” wrote Kismet Baun in her article Stigma Matters: The Media’s Impact on Public Perceptions of Mental Illness (2009). Kismet Baun is a senior Communications Advisor at the Canadian Mental Health Association in Ontario.
For better or worse, the media helps inform and shape the general public’s understanding of mental health. For those suffering from mental illnesses, the implications of the often negative and incredibly inaccurate portrayals of mental health issues are significant. Misrepresentation in the media about mental illness, even if the portrayal is a positive one, can result in misunderstandings that can have considerable consequences.
In the film, A Beautiful Mind (2002), the movie shows John Nash (played by Russell Crowe) wrapped up in a conspiracy to crack codes against the Russian government. Later on in the film, it turns out to be a fabrication in Nash’s head due to his battle with schizophrenia. This is a gross misunderstanding and misrepresentation of schizophrenia, because that’s quite simply not how it works.
Schizophrenia is defined as a mental disorder characterized by disruptions in thought processes, perceptions, emotional responsiveness and social interactions. To formulate an entire fiction is simply not how this mental illness works.
“For example, inaccurate depictions of schizophrenia (which is often confused in the media with multiple personality disorder) can lead to false beliefs, confusion, conflict, and a delay in receiving treatment,” Baun writes.
Many mental illnesses are associated with stigma. Whether it is self-directed or originates from society, dealing with this shame can be debilitating and can have severe impacts on daily life.
Those suffering from mental illnesses continue to receive negative attention, largely due to fear and prejudice. People who suffer from mental illness are often pushed to the fringes of, or are directly excluded from, society.
In the 1999 Surgeon General’s Report on Mental Health in the United States, they identified stigma as one of today’s biggest obstacles to improving mental health care, “stigma tragically deprives people of their dignity and interferes with their full participation in society.”
23 years later, these words still ring true. Stigma, in relation to people impacted and affected by mental illness is often a concoction of lack of knowledge, attitude, and behavior. Basically, the stigma in question is a public attitude towards mental illness, and that discrimination is a result of that attitude.
“Words have power. They have the power to hurt or soothe, to honor or insult, to inform or misinform.”
Kismet Baun
Television, and other media forms are the most powerful way to frame public consciousness. Over the course of a three-week sample, mental illness was mentioned on television over 100 times.
In news reporting, as well as television and in film, there is a way of excluding those with mental illness, or they are separated from the other cast of characters.
“Words have power. They have the power to hurt or soothe, to honor or insult, to inform or misinform,” writes Baun.
Often, the media uses language that perpetuates myths and stereotypes in regards to mental illness, which in turn promotes fear in the public communities. These have direct impacts on negative assumptions surrounding mental illness, and are exactly what needs to change in order to better represent mental health in the media.
Misrepresentation is everywhere, for every Bojack Horseman(2014) there is a 13 Reasons Why (2017). A key reason why Bojack Horseman has resonated with so many viewers is because it does not offer any concrete solutions to the mental health issues presented. It simply explores the root causes of these afflictions, and shows the main character on a path of rehabilitation. Bojack Horseman understands that mental health conditions can be a lifelong struggle and does not bother to provide fixes. Contrarily, shows like Netflix’s 13 Reasons Why glamorize depression and suicide, which can be very harmful for the viewership. To write a plot about surrounding the suicide of a character can seriously harm, and impact impressionable people in the public who can be risks to themselves and to others.
Silver Linings Playbook (2012) is an excellent portrayal of mental health. The film is about how Patrick Solatano (played by Bradley Cooper) moves into his parents home after spending some time in a mental institution. The film explores his path of rehabilitation, as well as how he has to overcome the trauma of his past and move on. The Harvard Medical School psychiatrist Steven Schlozman, MD, said, “they did a very nice job of depicting manic depressive illness or bipolar disorder in somebody who’s quite bright, and who has limited but present insight on it.”
Perhaps one of the most stigmatized mental health symptoms is psychosis. As it stands, “psychotic” remains to be an extremely common on-screen insult, used to depict someone as unhinged, crazy, and dangerous. In the comic book film adaptation, The Dark Knight (2008), where Gotham’s District Attorney Harvey Dent asks if his girlfriend has “any psychotic ex-boyfriends” that he should know about.
More times that “psychotic” has been used in recent media as a casual insult. In the The Suicide Squad (2021), where a crew of criminals are consistently referred to as “psychotic, anti-social freaks.”
Other unfortunate myths surrounding mental health portrayed in the media include: violence, refusal to seek help, dramatic personalities, and so on. While these sorts of plots can make for engaging television, it proves to be harmful and produce dangerous solutions for those who engage and watch these forms of media.
Andre Picard, a health reporter and columnist for The Globe and Mail has written and shared a pseudo guide to mental health reporting in Canada – titled Mindset: Reporting on Mental health. Picard suggests that journalists should be as willing to write about depression as breast cancer, stating there is no difference.
“In all their work, reporters and editors should be aware of the damage that can be done by reinforcement of stereotypes and strive to minimize it,” he writes.
Treating mental illness/health as a single category is a big part of the problem.
“With physical health, we routinely differentiate, for example, between infections, heart problems and cancer,” Picard writes. “When it comes to mental health, however, much tends to become conflated.”
Picard suggests that a fear is produced by hearing and reading about extreme psychosis of a much larger range of people with anxiety disorders.
“With the exception of a tiny minority, most people diagnosed with a mental illness are significantly more likely to be the victims rather than the perpetrators of violence,” he writes. “But this is seldom recognized by the public at large.”
Vagueness only makes it worse. When dealing with stories involving mental illness and violence, it’s important to be specific, Picard cautions. Reporters should seek authoritative confirmation on a specific diagnosis. A police officer’s word or a neighbor’s vague assertion that someone in the news had “mental problems” can be wildly offbase and contribute to stigma.
Every province in Canada has its own Mental Health Act. Generally, they all lay down the conditions in which a doctor can prescribe treatment against a patient’s will. For some patients with mental health concerns, their symptoms can include a lack of insight into the fact they are unwell.
MOVING FORWARD
Intentional or not, naïve assumptions and stereotyping can and has had damaging impacts on an individual’s course of recovery from mental illness. Reducing stigma requires a change in behavior on a massive scale. Attitudes need to shift towards acceptance, respect and understanding as opposed to fear, judgment and ridicule.
The media may also be an important ally in challenging public prejudices, initiating public debate and finally, projecting positive, human-interest stories about people who live with mental illness.
“For me, my struggles with mental health started when I was around 10 or 11 and at that time I was so young and nobody had ever talked to me about depression or anxiety,” says Cas Latta. “There is a wild assumption that kids that young just don’t experience it.”
A decade later, Latta feels as though she’s learned to live with and overcome her trials and tribulations with her mental health.
“When you’re in the muck and want to give up – don’t. Because you never know when things will start to change for you,” she says. “I think the media portrays mental illness as this life long struggle but it isn’t always. I never imagined being where I am today, I’m happier than ever, successful, have a great relationship with the people in my life, and I’m now the person that people come to when they’re down in a rut.”
Latta says that she felt as though there was no end in sight, until there was. Suddenly, things got better for her. These are the sorts of stories the media needs to be pushing, not how “crazy” someone is, or how “dangerous” they can be. But, stories about resilience, and overcoming mountains.
“It’s the most rewarding feeling to know I stuck it out and worked through everything to be able to now help others along on their journey.”
