How cinema stigmatises mental illness

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You don’t have to be ‘mad’ to be in the movies – but the film industry has generally shown a shaky vision of mental health. It’s not that cinema evades ‘taboo’ themes here; it’s more that it tends to swing wildly from sentimentality to sensationalism. Which means that the perspective of Mad to Be Normal, a 1960s-set biopic of Scottish psychiatrist RD Laing, just out on video on demand (VoD), feels intriguingly new. David Tennant stars as Laing: a complex and charismatic figure, who earned fame for his radical, empathetic treatment of mental illness.

The real-life Laing was sharply quotable (he described insanity as “a perfectly rational adjustment to an insane world”) and counter-cultural (he argued that traditional society was “driving our children mad”; he recommended LSD for his adult patients). He also fought personal demons including alcoholism and depression. Tennant’s onscreen Laing is impressively joined by Elisabeth Moss, Gabriel Byrne and Michael Gambon. Still, mainstream cinema struggles with a mental health ‘hero; Mad to Be Normal’s trailer booms: “To some he’s certifiable… To others he’s a saint”.

Meanwhile on the small screen, there’s a feverish buzz around the imminent Netflix series Maniac (based on the Norwegian psych ward-set drama of the same name). In the glossy and trippy US show, Emma Stone and Jonah Hill star as strangers undergoing a mysterious drug trial that claims to resolve mental health issues; “It’s not therapy – it’s science,” Maniac’s eerie Dr Mantleray (Justin Theroux) tells his patients. Stone explained to Elle magazine:

“The thing I liked about Maniac was that it’s about people who have their own internal struggles and are trying to fix them with a pill. But you see over the course of the show that human connection and love is really the only thing that gets us through life.”

So creative drama is drawn to the complexity and fragility of the mind – but mainstream entertainment still demands a snappy fix. And the definition of ‘insanity’ is inherently problematic; it’s regarded as an outmoded medical term. Dr Ryan Howes writes in Psychology Today that “it’s informed by medical health professionals, but the term today is primarily legal, not psychological” and cites the Law.com definition: “mental illness of such a severe nature that a person cannot distinguish fantasy from reality, cannot conduct her/his affairs due to psychosis, or is subject to uncontrollable impulsive behaviour.”

Yet our mainstream perceptions of ‘madness’ are still fixated with movie scenes – much more emphatically, in fact, than the novels or memoirs on which they might be based. A classic film like One Flew Over the Cuckoo’s Nest (1975) seals the impression of a soul-destroying psychiatric asylum, where livewire convict RP McMurphy (Jack Nicholson) feigns insanity to escape prison labour – yet is ultimately crushed by the system. The dramatic depiction of patient treatment, particularly its brutal electroconvulsive therapy sequences, had far-reaching impact. In 2011, The Telegraph went so far as to say that the film was responsible for “irreparably tarnishing the image of ECT… It also catalysed the development of more effective anti-psychotic drugs that allowed patients to… live more normal lives.”

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