Mental illness is prevalent in America, there’s no question about it. According to the National Institute of Mental Health (NAMI) 1 in 5 American adults suffer from a mental disorder of some kind. 10 million American adults have a serious impairment due to a mental illness, and 20% of children between the ages of 13-18 have/had a debilitating mental disorder.  Every day, there’s someone, famous or otherwise, confessing their struggles with mental health and how they’re seeking therapy to combat it. Or, there’s a TV special with professionals discussing mental health and spreading awareness. With all of this openness and sharing, one may think that America has gotten past the mental illness taboo. Unfortunately, that is not the case. The United States has a long way to go before people suffering with mental illness can freely go about in society without someone fearing for their safety. A lot of the blame for the American public’s gross misunderstanding of mental health can be shouldered by Hollywood. Hollywood has a long and rocky relationship with mental illness and how it is portrayed onscreen. Sadistic psychiatrists, murderous psychopaths, a bullied girl who seeks revenge on her classmates via telekinesis, and many more examples contribute to why the general public is afraid of people suffering mental illness. Not only that, but most movies do not seek to delve deeper into the mental illness spectrum, choosing instead the illness that is most “entertaining” or “relatable”. Even off-screen, the public become engrossed in the ongoing saga of the fallen child star. The perfect, immensely talented young celebrity whose meteoric fame is too much to bear, and end up “going crazy” or addicted to drugs and/or alcohol. Or they deal with their pain in ways that most people would deem strange. Regardless, these child stars become the subject of intense scrutiny for years until they “return to normal” or tragically pass away. The reality is that a mental health reform is long overdue. Movies do not correctly portray mental illness, and moviemakers/directors must attempt to realistically portray all aspects of it. 

To understand how deeply ingrained the prospect of the “scary psycho” or “mentally unstable” is, one must first learn where this notion originated. While mental illness has been used as a plot device since Shakespearean times, there is one movie that has truly made the psychotic killer a trademark of horror and thriller movies: Alfred Hitchcock’s Psycho. Norman Bates’ difficult relationship with his mother and his love for taxidermy became the caricature for the modern horror villain- traumatized with a strange interest or obsession, the underlying cause of his derangement. Plus, who could forget that famous shower scene that has been parodied and remade numerous times since the film’s 1960 release? Psycho is a cinematic classic, which is part of the problem. Since Psycho, the horror film genre has capitalized on horrifying mental illness. The measure of which film stands the test of time depends on how intricately insane the killer is, and how much of him is hidden in the viewers. The self-proclaimed “women’s movie channel” Lifetime has also revolutionized how women with mental illness are viewed. Countless movies about the “crazy ex-girlfriend” or “vengeful abused wife” has sculpted the (rare) typical female protagonist of horror/thriller. Much like the male killer, the female killer is also tortured and shunned by the people around them, however, the person is oftentimes a romantic partner, like an abusive boyfriend or husband. The main climatic point of a female protagonist in horror/thriller is when she “snaps”. The quiet, unassuming, perfect girlfriend or daughter turns into a raging, murderous machine, killing anyone who may get in the way of her target. 

Not to be overlooked is the issue of asylums as another major plot point in movies and TV shows. Despite mental illness itself becoming more mainstream to talk about, asylums and psychiatric hospitals will probably remain mainstay as a “hush-hush” topic for a long time. The intrigue surrounding asylums have much to do with their secrecy and what goes on behind those heavy doors. Asylums have particular popularity with the teen horror-drama genre. In the American supernatural horror series Teen Wolf, Eichen House was a fixture in the series, especially in the third and fourth season. Eichen House was the typical portrait of a “horror asylum”: old, mossy, and heavily secure. The patients in Eichen House were either severely mentally impaired or a supernatural creature. The psychiatrists and doctors there were abusive to the patients and subjected them to cruel and unusual punishments, and never allowed them outside Eichen House.  

The demographics of characters struggling with mental illness in cinema has roughly remained the same for the past few decades. If it is a horror/thriller, the person is a white male, usually in his 30s-40s. If it is a drama, the protagonist is a young, usually teenage girl, who is also white. The lack of representation and diversity onscreen directly translates offscreen. People of color are disproportionately less likely to seek out mental health services or talk about their mental illness than white people. In a 2005 study conducted by May Yeh and her colleagues, they found that “…Relational Issues and Prejudice beliefs were also part of the combination of explanatory etiologies that partially mediated the relationship between race/ ethnicity and mental health service use. Notably, the endorsement of Prejudice as an etiology was associated with a 42% lesser likelihood of mental health service use, even when controlling for race/ethnicity…” African-American and Latino-American families are especially less likely to seek out mental health services. In general, families of color are much more tight-lipped and less likely to discuss mental illness than white families. Some factors resulting in this include cultural beliefs and lack of education and resources available for communities of color. Dior Vargas, a mental health advocate who suffers from major depressive disorder stated: “…I always felt like I was the only one, and like I didn’t have anyone to turn to and talk to…I felt like I was alone. When people talk about mental illness, when it’s discussed or shown through the media, they never really show people of color. That’s…why I felt alone.” People of color have always been underrepresented in the media, but they are especially misrepresented in movies and TV shows discussing mental illness. Even with 13 Reasons Why, a 2017 mega-hit that boasted a diverse cast, the main character suffering from depression and eventually committing suicide was a teenage white girl. People of color suffering from mental illness never see themselves as the main character struggling with anorexia, depression, or anxiety. If anything, they are often the calm and level-headed friend, or worse, the ignorant bully. Onscreen representation of minorities in these roles can and will help spark discussion about mental health in not only communities of color, but in all communities. 

The stigma and effects of mental health cannot be overlooked for white people, however. White women are especially victims of stereotypes about mental health; in other words, white women are often labelled “the crazy chick”. In fact, it can be argued that many actresses in Hollywood can thank their “A-List Celebrity” status to playing a “crazy chick” onscreen. “Not only do actresses win Academy Awards by playing insane--just ask Kathy Bates (Misery), Nicole Kidman (The Hours), Angelina Jolie (Girl, Interrupted), or Jessica Lange (Blue Sky)--but movies featuring women beyond the verge play equally well with female and male audiences” (Setoodeh, Ramin). Women feel better about themselves when watching these movies because “the beautiful, perfect character is crazy”, while men may be attracted to the “helplessness” of the character. While women are often portrayed as beautiful and perfect until they snap, or are viewed as helpless because of their mental illness, men are portrayed as violent, terrifying, and calculative. Men with mental illness are portrayed as predators, while women are portrayed as victims. Which helps explain why it is especially difficult for men to openly discuss their mental illnesses. On one hand, they can be perceived as dangerous if they have a more severe mental illness. On the other hand, men are often labelled as weak and less masculine if they suffer from mental illnesses like depression or anxiety. 

Ethnicity and gender are not the only determining factors in “who’s supposed to have a mental illness”, personality also plays a large role. Think of the many times someone might have not-so-politely called attention to the quiet kid in class, claiming that the kid may “shoot up the school or something” someday. People who are quiet and/or shy are more likely to be assumed to have a mental illness, or will “snap” than their smiley, happy-go-lucky classmates. Once again, movies and TV have influenced and created these stereotypes, particularly the horror/thriller genre. Oftentimes, the murderer or “scary figure” in horror/thrillers have tragic and cruel backstories. The character, usually male, is abused at home and ostracized by his classmates at school. They’re lonely and misunderstood without a friend in the world, or if they do have a friend, that friend is taken away from them in some way. This results in the lonely, strange, forgotten child “snapping” or becoming a murderer. Which brings about the next point: In most movies of these genres, the mentally ill is never portrayed as a “regular person”. They are almost always portrayed as a superior or inferior being in some way, shape, or form. For example, in Silence of the Lambs, Hannibal Lecter was a genius, whose extremely high intellect caused him to be such a monster that he had to be completely restrained and monitored every second of every day. However, he still manages escape. Another great example is Carrie (1976). Carrie was shy and severely bullied by her schoolmates, but she was also abused and overly sheltered by her vehemently religious mother. When Carrie was doused in pig’s blood when her classmates voted her prom queen as a cruel prank, Carrie used her telekinetic powers to kill students, faculty/staff, and set her school on fire. Of all the mental illnesses, the more severe and rarer illnesses like schizophrenia and multiple personality disorder (DID), are the most subject to ridicule and fear. The horror/thriller genre monetizes off vilifying these illnesses with movies like Psycho and Split, where the characters suffer from psychosis, schizophrenia, and/or multiple personality disorder. People suffering from mental illness are not superhuman nor murderers. They are just regular people struggling with a real illness, as one suffers from diabetes or a broken foot. 

There are many who agree with mental illness being a topic that should be brought more into the spotlight, but they disagree on movies portraying mental illness inadequately. After all, movies are just movies, right? People watch movies for entertainment, and to take a break from reality. The illness is exaggerated for the plot, people can clearly discern where the exaggerations lay. “Is it fair to criticize an absurdist television drama as riveting as Homeland for its tenuous relationship to reality?” (Markowitz, Miriam).  Others still believe that going too in-depth into the dark side of mental illness can trigger those suffering, and make them feel hopeless, as critics of 13 Reasons Why and To the Bone will argue. The decision to show Hannah Baker’s graphic and tragic suicide, or the all-too-real portrayal of anorexia nervosa can be detrimental to people who are in recovery or are susceptible to seeing these scenes as “guidelines”. These shows “glamorize” suicide and anorexia, and sufferers of these disorders need to see the positivity and resources available to them, instead of the tragic outcomes.

Except, showing a teenage girl full of promise slitting her wrists and bleeding to death in a bathtub, or a girl getting skinnier and skinnier each day because she starves herself and hates her appearance is not “glamorization”. It is painfully real. Movies are a reflection of real life and influence culture. People base their assumptions and generate stereotypes from movies and TV. Therefore, filmmakers and directors are responsible for showing the truth. The success stories and survivors cannot be the only stories shown, that in itself is dangerous. It feeds false hope, and it glosses over the struggles and pain that people suffering from mental illness deal with. People die from mental illness every day, and if their stories are not shown, it will eternalize the false notion that mental illness is a “fake disease”. Society will continue being blissfully ignorant to the realities of mental illness. 

Hollywood has a long way to go in the case of portraying mental illness correctly. Fortunately, the new generation of openness and inclusivity can help that process move along more quickly. Audiences will no longer remain complicit, and sufferers of mental illness will no longer stay silent to inaccurate portrayals. Hollywood must diversify the faces of mental illness, and the mental illnesses people suffer from. The “common” illnesses- anxiety, depression, and others cannot be the only illnesses shown. Movies must be made destigmatizing schizophrenia, psychosis, multiple personality disorder, etc. Mental illness is not “one-size fits all” and it does not discriminate. Anyone can suffer from mental illness regardless of race, ethnicity, sex, gender, age, or personality. Everyone is or will be affected by mental health and mental illness, so Hollywood must reflect reality more realistically. 
