We’ve all seen the terrifying images of dark, dirty psych wards where patients are screaming in the halls or climbing the walls to get out. Or films where the murderer is a cross-dressing serial killer who wears the skin of his victims as clothing.
In nearly every horror movie, the killer is portrayed as “crazy”. An archetype that not only instills a sense of fear in the viewer but paints a dangerous and disturbing picture of what someone with mental health issues looks like.
“In the movies, people with mental illness are literally seen as monsters and dehumanized,” says Barry Katz, PhD, a forensic and clinical psychologist at the West Essex Psychology Center in Livingston, New Jersey. “This takes fears and lack of understanding people already have and exploits them by presenting a narrative in which the individual is threatening or scary,” he says.
How Mental Health Stereotypes Are Sensationalized in Film
While horror movies are meant to entertain, the problem is that these negative stereotypes surrounding mental health disorders can have real-world consequences, ultimately impacting peoples’ perception of those with mental health disorders, Katz says. “These stereotypes increase fear and dangerousness associated with people who have a mental illness; it gives the public a reason to be scared of these individuals.”
And the consequences can be detrimental. “Recently, a law was passed in New Jersey stating that if someone is showing suicidal ideation, a mental health professional would have to call the police,” Katz says. The problem is, there is no good basis for doing that, especially if the person is willing to get help. “Legislation like this is, in part, a result of negative stereotypes perpetuated in films—that people who have a mental illness are at risk to others,” Katz explains, “The reality is, mental illness does not predict dangerousness, nor is it inherently correlated with dangerousness.”
Representation in film and media matters, says Michael Damioli, LCSW, CSAT, clinical director, Colorado Medication Assisted Recovery. “It helps define our view of the world. And for a lot of people, their only experience with mental illness is through these movies,” he says. “People are more scared of things they can't control. Because they don't understand mental illness, it can be scary—that's why it's easy to make movies about it,” Damioli says.
Over and over, certain mental health disorders—and even psychiatric hospitals—themselves, are unfairly misrepresented and stigmatized on the big screen.
Here are some examples of how the media contributes to the mainstream notion of what terror looks like.
Multiple Personality Disorder: The Face of Evil in Many Movies
In the 2016 psychological horror film Split, for example, the main character has 24 distinct personalities, including “the beast,” a literal monstrous version of himself with superhuman strength and animalistic tendencies—he feeds on his victims before killing them.
“What this portrayal shows is someone with multiple personality disorder who is evil, dangerous, and violent,” Katz explains. “This ends up validating unreasonable fears that people have about those with this condition and gives them a reason to be scared.”
The reality is most people with multiple personality disorder aren't inherently violent people, adds Damioli. “They have jobs, and they go about their lives, and no one else would know what they are dealing with. And on the flip side, we put a label on violent people as mentally ill, and that's also not accurate or fair,” he says.
The Truth about Psychiatric Hospitals
Most of the time, in horror films, the slasher originates from a mental hospital, Katz says. Take Halloween for example. The killer, Michael Meyers, escapes from a sanitorium only to murder his victims. Then there are the countless films set in places straight from your worst nightmares—otherwise known as insane asylums.
“The 2018 film Unsane is the story of someone who wasn't mentally ill and gets trapped in a psych hospital, and the horrors of that,” Damioli says. Seeing these images of a fictionalized and terrifying psychiatric hospital ends up instilling fear in people who really need help.
“I’ve seen it in my practice many times: If someone needs inpatient psychiatric treatment, they're terrified to get it,” Damioli says. “These hospitals are often wonderful, caring places. They're clean and safe and people’s lives are saved and changed there every day,” he says. “Most people in psych hospitals aren't chronically ill. They're having really bad days. They just got divorced. They just got bad news and they're unable to cope.”
Antisocial Personality Disorder And Serial Killers
This is the clinical term for a sociopath, Damioli says. If you look at a film like American Psycho (2000), the main character presents the classic signs: “He's narcissistic. He's neurotic. He's very manipulative, and he lacks empathy towards other people,” he says.
And he’s also a serial killer who violently murders multiple victims—and one of them with a chainsaw. “Most people who live with antisocial behavior never have violent thoughts,” Damioli says. “In fact, many people in society are likely to be anti-social, from actors to CEOs of Fortune 500 companies—high-achieving people who may tend to be on the more manipulative side of things but never end up being violent or hurtful towards other people.
