Could We Use Films to Teach the Ignorant About Mental Health?

The film industry is often accused of exaggerating, downplaying or perpetuating stereotypes about mental illness. But this is far from the whole story; there have been many great, delicately nuanced portrayals of mental illness in cinema and, as a result, a vast panoply of films – with budgets big and small – have been used by academics looking to educate people about issues of the mind.

For example, a psychiatrist might use Silver Linings Playbook, to illustrate what bipolar disorder looks like; Virginia Woolf drama The Hours for a compelling presentation of depression; Woody Allen's Blue Jasmine to poignantly display the effects of histrionic personality disorder, a condition that is difficult to convey to students using words and a computer screen alone. He Loves Me… He Loves Me Not, meanwhile, offers a pretty authentic depiction of a delusional disorder courtesy of Audrey Tautou, while Russell Crowe in A Beautiful Mind shines a light on the severe schizophrenia of late mathematician John Nash.

Dr Danny Wedding, Director of Behavioural Sciences at the American University of Antigua, is the author of Movies & Mental Illness, an immense tome that catalogues what happens when cinema gets mental health right. In his appendix are almost a thousand examples of films that can be used as teaching tools, primarily by psychiatrists, psychologists and social workers.

"Films are entertaining, that's why we go," he tells me. "I've spent most of my life teaching medical students and psychiatry residents, and they remember film clips because they're much more vivid than, say, a PowerPoint lecture. I could make points about bipolar disorder or bring in a clip from a film like Michael Clayton showing somebody in manic excitement, and they would remember the vignette. It's very gripping. It's dramatic."

The point is echoed by Dr Susan Hatters Friedman, Associate Professor at the University of Auckland, who teaches using films and has coauthored papers on the "Crazy Lady" trope in contemporary television and the psychopathology of Star Wars. She agrees with Wedding, and adds that the technique "makes things appear more real". She continues: "It's been a long time since I watched that Russell Crowe movie, A Beautiful Mind, but he had those hallucinations and you can actually see him having them, as opposed to, you know, when you see a patient in your office and it's maybe not as real because you can't see everything that they're seeing."

Through film, rather than receiving mere hints or descriptions of symptoms, as you would in a consultation, you can actually observe and experience the traits of the illness through the gaze of the actor (who may effectively be examined and diagnosed like a patient). Friedman refers me to the following quote from the cinematically-inclined psychiatrist, Irving Schneider: "If psychiatry had not existed, the movies would have had to invent it."

It's now becoming increasingly common for big budget Hollywood films to hire psychiatrists to advise on the depiction of individuals with mental health conditions (Alfred Hitchcock was one of the first to consult real psychiatrists in the making of Marnie), and what comes out at the production end are some brilliant and fairly accurate portrayals of mental health. So beyond the education of medical students and trainee psychiatrists, why shouldn't we use these movies to teach us, the general public, about mental illness?

Clara, a humanities student, has learned a great deal about her own mental health by watching the David O Russell-directed Silver Linings Playbook, which centres around the bipolar disorder of protagonist Pat. She saw the film last year, having dropped out of university for medical reasons. "I thought the opening scene was very touching because it seemed to mirror what'd happened to me," she tells me.

"None of the doctors were sure what was going on. At first I was told it was depression, but then I suffered paranoia and incredible aggressive mood swings and kept repeating the same things and concentrating on little details. When I saw the film, it gave me reassurance that I hadn't been making it up or had been a really manipulative person. But that I had an actual mental disease."

This poignant opening sequence essentially allowed Clara to better flesh out her own experiences, showing a character who was paranoid and destructive, constantly consumed by insignificant minutiae. In the film Pat craves his wedding video; in real life, Clara lay awake at night, disturbed by not being in possession of her passport. But does she think such scenes could be valuable tools for initiating discussion about mental health in the classroom?

"I think so, especially because teenagers often use 'bipolar' to mean someone who alternates between moods," she explains. "While that may happen, that is not what bipolar is; it's the alternation of a prolonged depressive episode and two weeks of an extremely elated period. I'm sure you've seen the Facebook statuses of 'I hate being bipolar, it's freaking awesome'. So it's an easy way to show that bipolar is not just 'having strong emotions'."

An article published in the BMJ back in 2004 also found that films may educate the public through "…challenging and changing beliefs, clarifying values, and debunking commonly held stereotypes". So even if some films (say, One Flew Over the Cuckoo's Nest) have played a part in perpetuating certain myths about mental health, frequently in the guise of stock characters, it may be possible that, by analysing and challenging those cinematic myths, and by looking at how we respond to those with mental illnesses, we can help demolish the stigma, debunk stereotypes and encourage change.

Wedding used to organise a monthly film night as director of the Missouri Institute of Mental Health, when he would open the institute up to 100 or so of the general public. After the movie, a subject-matter expert would give a talk. As he explains, "If it was a film about schizophrenia, I'd have a psychologist who had expertise in schizophrenia come in. If it was a film about tardive dyskinesia and the side-effects of medication, I'd have a psychiatrist there to talk. If it was a film about family therapy, I might have a social worker there to answer questions. That mechanism proved very useful and there was a lot of enthusiasm."

This is actually something I could see taking off at independent cinemas and schools; a touring film club that stops off across the UK. "My guess is it wouldn't have to be obligatory," Wedding chips in. "You might be able to do it just because films are intrinsically interesting… A free movie is a big draw." Such events would push a similar approach to the nascent [Hip-Hop Psych]( Hip Hop Psych) initiative, which uses hip-hop culture and lyrics to teach about mental health – I learned a whole load about Tupac's psychosis and Kendrick's addiction when I went to one of their talks late last year. There seems no reason why popular cinema – if the films were carefully selected and given context with the right information – couldn't do the same.

@HuwOliver

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