How various groups, from women and racial groups, to LGBT people, nationalities and people of differing political views, are represented in films is a topic of much discussion, including on this blog. But no group has been more consistently maligned in mainstream cinema than the mentally ill.

One in four people will suffer from a mental illness at some point in their lives, yet the perception of mentally ill people as your typical movie psychopath is certainly not helpful to the enormous stigma attached to mental illness. With the furore this week surrounding supermarkets selling “mental patient” Halloween costumes, this is a topic that’s come into the public eye, but how have films contributed?

Here are some of the best and worst representations of the mentally ill in films. (spoilers throughout)

Worst

3. Batman

I’m cheating here a little, and using an entire franchise, but considering it’s a franchise where virtually all the villains are considered insane, and the main prison is an asylum, it’s hard to pick just one example. While this was toned down in the films compared to the comic books, there are still a large number of villains who become evil after a mental breakdown triggered by a traumatic incident.

This includes Batman‘s Joker, Batman Returns‘ Catwoman, and The Dark Knight‘s Two Face. The correlation between committing heinous crimes and being mentally unstable is clear. However, the most high profile is one of the best villains put to screen, Heath Ledger’s Joker, who is completely unhinged, possibly following the trauma of facial scarring. He’s terrifying, ruthless and psychotic, and frequently labelled as insane by various characters in the film.

The franchise’s one saving grace is its heroes also tend to face mental strain or anguish of their own, which redresses the balance ever so slightly.

2. Psycho

It’s hardly surprising that a film called Psycho doesn’t paint a flattering picture of the mentally ill, with Norman Bates, a schizophrenic man who has taken on the life of his mother, committing a string of murders. The film ends with Bates sat in a police station in a straight jacket, with the resident psychiatrist declaring the battle to be over. Norman has taken on completely the character of his mother.

1. The Silence of the Lambs

The Silence of the Lambs is one of my favourite films. It’s one of the few films I’ve seen where I can’t think of anything to be done to improve it. That being said, it’s a shame it has to rely on outdated perceptions of the mentally ill to achieve its brilliance. Hannibal Lecter, possibly the most well known movie psychopath, takes his residence in an ultra secure prison for the criminally insane thanks to a shady past involving mass murder and cannibalism.

Add to this Lecter’s inmates, such as “multiple Miggs”, the schizophrenic man in the next cell who throws his semen on Clarice, and you have a picture which can only contribute to the idea of the mentally ill being a group who should be feared and locked away. The film also upset some transgender groups because the film’s main villain, Jaime Gumb, desires to be a woman, motivating him to capture, imprison and murder women.

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My intention here is not to detract from any of these films. On the contrary, they’re three of my favourites, but that’s kind of the point. Many of the best movie villains are in some way mentally ill, and all of the above show the benefit this can have to a story. It’s scary for us to think of a person whose mind doesn’t work like ours, who may be unpredictable or not have the power to empathise.

But it surely also doesn’t help perceptions of real life mental illness when the only idea of a psychiatric hospital people have is the prison in The Silence of the Lambs. Would we accept a caricature of a race or religion being presented on film for the purpose of creating fear? I suspect not. The importance is in separating fact from fiction, and improving our understanding of real life mental illness, but this is a difficult process. 

So what about films with a more realistic or less damaging idea of mental illness?

Best

3. One Flew Over the Cuckoo’s Nest

This film is fantastic for its portrayal of a whole array characters with psychiatric problems locked in an institution, all of whom are well drawn with varying conditions, most of which are never really made clear. It’s on the side of the poor souls forced to live in the blank surroundings at the mercy of the stern nurse Nurse Ratched, and shows both sensitivity and maturity in dealing with these characters. Jack Nicholson’s McMurphy brings some light and enjoyment into their lives in spite of living under the watchful eye of the medical staff, which makes this one of the best cinematic representations of mental illness.

2. Memento

Memento was highly praised on its release for its presentation of the short term memory loss of its main character, Leonard. Unable to form new memories since an incident in which his wife was murdered, he lives his life by a series of notes and photos.

The film starts out like a standard thriller. There’s a guy whose wife has been murdered and he wants revenge. But as it plays backwards we come to realise that the man who at first seemed in control and able to live normally is actually being manipulated by people who present themselves to him as his friend. He’s a likeable and honest character who also manages to be capable in spite a serious mental handicap, but is also vulnerable to the manipulations of the unscrupulous.

1. Rain Man

Dustin Hoffman’s stellar performance as the severely autistic Raymond is great for many reasons. Not only is it a highly sensitive portrayal of this extremely likeable character, but it also shows his strengths as much as his weaknesses. Yes Raymond struggles to deal with people, is vulnerable to manipulation and highly reliant on routine, but he also has a perfect photographic memory, and is able to count large numbers of items in seconds.

Raymond is completely exceptional, and in the film his brother, played by Tom Cruise, goes on the journey the audience is expected to make in accepting this character for who he is and acknowledging the good aspects of his condition as well as the bad.

It’s true that representations of disability have become more realistic since then, and the film has since been re-evaluated as potentially unhelpful to people suffering from problems which, as in most cases, don’t also grant them apparently superhero abilities. But this was the 90s, and Hoffman’s portrayal was undoubtedly a big step in the right direction.