It’s not difficult for films portraying a tricky topic like mental health to become a hot topic of conversation, garnering a wide variety of responses and often creating an uproar. Several have come under serious scrutiny – those that romanticise mental illnesses, those that create a comedy out of it, and those that twist mental illnesses into dangerous, spooky, and haunted afflictions. The depiction of mental health in movies and TV shows can have grave negative impacts, both on the viewer’s own mental health, and the shaping of their perceptions of mental illness. While, in the past century, people’s awareness on mental health has increased, the vast majority remain ill-informed on the matter (Beachum, 2010).
While many of these representations are terribly inaccurate and harmful to the audience’s attitude, it is occasionally true that their roots lie in the historical treatment of mentally ill patients. Ideas of the afflicted being possessed by the devil and practitioners of witchcraft led to treatments like exorcisms, and later the infamous lobotomy and other inhumane treatments like electroconvulsive therapy (ECT). Institutionalised mental asylums have gained a bad reputation for the way their patients were controlled, treated as less than human, and even tortured, with the way they are shown in horror films playing an undeniable role.
One Flew Over the Cuckoo’s Nest (1975) is one such film that gained immense popularity. Its name is casually thrown around in discussions on mental illness, and it is widely regarded as exceptional film. The film’s impact was tremendous – its representation of mental health in many ways is said to have revolutionised the movement towards humanitarian treatment of patients through its humanisation of those suffering. The institutionalised hospital with its rigid routine and villainous nurse allows the audience to be on the “side” of the patients, rather than fearful of them. Treatment with medication, ECT, and even lobotomies are a reflection of mental health practices of the time. The public response to the movie is said to have played a role in mental health policy change, betterment of facilities, and a movement towards more humanitarian treatment. The book and the movie have even been “credited with irreparably tarnishing the image of […] ECT, and quickening its departure from mainstream mental health care” (The Telegraph, 2011).
But such films also have another side to them. The scenes depicting these treatments, in particular the graphic portrayal of ECT and the loss of agency that the protagonist suffers after a forced lobotomy, are what stick. A study showed the negative impact the movie had on the viewers' attitudes to mental health. The study involved administering an attitude questionnaire to 146 college students in 3 rounds – before the release of the film, after the release when a portion had viewed the film, and after playing a documentary that juxtaposed scenes from the film with more realistic scenes of how the same hospital actually functions. The results showed a clear negative decline in the attitudes of those who had seen the movie, and the documentary intended to balance its effects made almost no difference to the already damaged attitudes (Domino, 1983).
The public’s attitude to mental illness and those suffering from mental disorders already hangs delicately in the balance. For the sake of entertainment, filmmakers over-dramatise features of mental illness that in reality are quite different. Care must be taken to remember that real individuals are facing these problems, and the impact on them might be quite different from what is intended. While, as seen in the response to One Flew Over the Cuckoo’s Nest, movies can have a huge positive influence, to ensure minimal negative effects all the relevant people should first be consulted – including mental health professionals and those struggling with an illness themselves. Even efforts to reduce negative effects show no significant change, as observed in the study by Domino (1983). The starker and more graphic images are what remain imprinted in the audience’s mind, resistant to corrective information. It becomes difficult to separate one’s attitudes to the fiction of television and the facts of reality. With increasing impact of the media, it is more necessary than ever to strike the balance between showing how mental illnesses truly manifest, while being careful not to negatively influence the audience.
References
Beachum, L. (2010). The psychopathology of cinema: How mental illness and psychotherapy are portrayed in film. Undergraduate Research, Grand Valley State University.
Domino, G. (1983). Impact of the film, "One Flew Over the Cuckoo's Nest," on attitudes towards mental illness. Psychological Reports, 53, 179-182.
Swaine, J. (2011). How 'One Flew Over the Cuckoo's Nest' changed psychiatry. Telegraph.co.uk.
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