A man who suffers from schizophrenia goes on a shooting spree in Times Square and later stabs a pregnant physician in the stomach. These are the opening scenes from Wonderland, a drama set in the psychiatric and emergency room units of a New York City hospital. Premiering in 2000, Wonderland was promptly canceled because of dwindling ratings and heavy criticism from mental health groups (though it was brought back in January 2009).
The series portrayed a bleak life for people with mental illness and groups like the National Alliance on Mental Illness (NAMI) criticized its theme of hopelessness.
But images of individuals with mental illness aren’t always so in your face. Subtle stereotypes pervade the news regularly. Just the other day, a local news program in Central Florida reported on a woman setting her son’s dog on fire. The reporter ended the segment by stating that the woman had been depressed recently. Whether it’s a graphic depiction or an insinuating remark, the media often paint a grim and inaccurate picture.
And these pictures can have a big influence on the public. Research has shown that many people get their information about mental illness from the mass media (Wahl, 2004). What they do see can color their perspective, leading them to fear, avoid and discriminate against individuals with mental illness.
These myths don’t just damage public perceptions; they also affect people with mental illness. In fact, the fear of stigma can prevent individuals from seeking treatment. One study even found that workers would rather say they committed a petty crime and spent time in jail than disclose that they stayed at a psychiatric hospital.
Whether it’s a film, news program, newspaper or TV show, the media perpetuates many myths about mental illness. Below is just a sampling of common misconceptions:
People with mental illness are violent. “Studies have found that dangerousness/crime is the most common theme of stories on mental illness,” said Cheryl K. Olson, Sc.D., co-director of the Center for Mental Health and Media at Massachusetts General Hospital Department of Psychiatry. But “research suggests that mentally ill people are more likely to be victims than perpetrators of violence.” Also, recent research found that mental illness alone doesn’t predict violent behavior (Elbogen & Johnson, 2009). Other variables—including substance abuse, history of violence, demographic variables (e.g., sex, age) and the presence of stressors (e.g., unemployment)—also play a role.
They’re unpredictable. A focus group composed of individuals who affect the lives of people with mental illness, such as insurance executives, was asked what they thought about people with mental illness. Nearly half cited unpredictability as a big concern. They feared that individuals might “go berserk” and attack someone.
Contrary to these beliefs, the vast majority of people with mental illness are ordinary individuals who go to work and try to enjoy their lives, said Otto Wahl, Ph.D, professor of psychology at University of Hartford and author of Media Madness: Public Images of Mental Illness.
They don’t get better. Even when portrayals are primarily positive, we rarely see progress. For instance, the lead character in Monk, who has obsessive compulsive disorder (OCD), regularly attends therapy, but has yet to improve, Wahl said. He believes this perpetuates the myth that treatment is ineffective. Still, if you’re seeing a therapist and haven’t experienced much improvement, you might feel the same way. However, this may mean that it’s time to switch therapists. When searching for a therapist, remember it’s best to shop around. Here’s a good guide that can help with the process. You also may want to research the most effective treatments for your condition and check if your prospective therapist uses them.
Even people with more severe disorders, such as schizophrenia, “can be treated effectively and lead integrated lives in the community if we allow them to,” Wahl said.
If the media rarely show people getting better today, you can only imagine the portrayals a decade ago. When he was diagnosed with bipolar disorder, Bill Lichtenstein, founder and director of Lichtenstein Creative Media, spent almost four years before meeting another person with the illness, because “no one talked about it.” In the 1990s, when he got better, Lichtenstein produced Voices of an Illness, the first show to feature everyday people, including a Yale graduate and a Fortune 500 executive, discussing their illness and recovery. And clearly the need was there: After providing NAMI’s number on the show, the organization received 10,000 calls a day.
Depression is caused by a “chemical imbalance.” Thanks to direct-to-consumer drug ads, many think mental illness treatment is simple and requires only a wonder drug to correct a chemical imbalance, Olson said.
Though there’s a plus side — it squashes the idea that mental illness is a “moral failing,” Olson said — this hypothesis hasn’t been substantiated with research (see here and here) and oversimplifies depression’s causes and treatment.
It isn’t that neurotransmitters are insignificant in contributing to depression; it’s that they’re part of an intricate interplay of causes that includes biology, genetics and the environment. “The more we study the causes of mental illness, the more complex they can seem,” Olson said. Also, “many people with depression are not helped by the first drug they try, and some never find a drug that helps.”
Teens with mental illness are just going through a phase. Movies like the “Heathers” and the “American Pie” series depict alcohol and substance abuse, depression and impulsivity as normal teen behavior, according to Butler and Hyler (2005). The authors also point out that the movie “Thirteen” features substance abuse, sexual promiscuity, an eating disorder and self-injury, but the main character never seeks treatment. Ultimately, these behaviors may be viewed as “a glamorous benchmark to beat.”
All mental health professionals are the same. Movies rarely make distinctions among psychologists, psychiatrists and therapists, further confusing the public about how each practitioner can help. Here’s a detailed look at the distinctions between these professionals.
And they’re evil, foolish or wonderful. Since the 1900s, the movie industry has been crafting its own field of psychiatry, giving the public an inaccurate — and often terrifying — view of mental health professionals. Schneider (1987) categorized this portrayal into three types: Dr. Evil, Dr. Dippy and Dr. Wonderful.
Schneider describes Dr. Evil as “the Dr. Frankenstein of the mind.” He’s vastly disturbed and uses dangerous forms of treatment (e.g., lobotomy, ECT) to manipulate or abuse his patients. Dr. Evil is often seen in horror movies, Olson said. “A surprising number of people, especially teens, get misinformation about psychiatry and hospitals from those films — they’ll lock you up and throw away the key!” Olson described a recent episode of Law and Order: Special Victims Unit where the “greedy and arrogant” psychiatrist who “exploited his patients” turned out to be — gasp! — the killer.
Though he rarely harms anyone, Dr. Dippy “is crazier than his patients,” Olson said, and his treatments range from the impractical to the wacky. Dr. Wonderful — think Robin Williams’ character in Good Will Hunting — is always available, has endless time to talk and is supernaturally skilled. This portrayal, too, has a downside. For one, clinicians can’t live up to this kind of accessibility, Olson said, or to the idea that they’re “supernaturally skilled, almost able to read minds and immediately give accurate profiles of people they haven’t seen,” Wahl said. In fact, to properly diagnose a patient, practitioners conduct a comprehensive evaluation, which often includes using standardized scales, obtaining a mental health history, administering medical tests, where appropriate, and talking with family members (all of which can take several sessions).
Dr. Wonderful also can breach ethical boundaries, making it difficult for people to know what’s ethical and unethical behavior, Wahl said. Williams’ character violates confidentiality by speaking with his buddies about his patient. Plus, “many of these fictional docs lack boundaries between the personal and professional,” Olson said. Films frequently feature psychiatrists sleeping with patients, an egregious violation. Here’s a closer look at the American Psychological Association’s Ethics Code.