Mental Health is an aspect of life that we all deal with on a day-to-day basis, so of course the topic is quite prominent in the world of film and television. Mental Health in moving image has also led to many discussions and debates on the authenticity and representation of certain conditions. What is deemed as a ‘good’ representation of Mental Health within the entertainment world? What can filmmakers and showrunners do to better represent Mental Health? To help answer these questions, I approached Dan Warrender and Scott Macpherson: both Mental Health Nursing lecturers at the Robert Gordon University in Aberdeen who run the Mental Health Movie Monthly initiative there. The initiative invites people to watch a film and discuss the mental health explored through the story and characters.
GS: To start off then do you both consider yourself cinephiles?
DW: Yeah, I mean I’ve been fascinated with film probably since … I mean I always liked films as a kid but got really big into Tarantino and Scorsese in my early teens. I used to buy screenplays and stuff like that and I just really love what you can accomplish presenting stories through film. I always found myself really moved by them. So, absolutely.
SM: Yeah, I think I’m similar. In my teens I was lapping up Kubrick classics: The Shining, A Clockwork Orange, Full Metal Jacket, stuff like. In my mid-teens I was more into Blaxploitation stuff like Shaft and Sweet Sweet Sweetback’s Badasssss Song. That probably then led into my later love of stuff like Boys In The Hood, Menace To Society, and GrindHouse.
GS: So when did you first realize that film and television had the power to explore mental health issues? Were there any films from any of the filmmakers that you both mentioned?
DW: I can remember an experience when I was probably quite young, watching … I don’t remember it being a great film, but it was The Man Without A Face with Mel Gibson, but I just remember it was this guy who had some kind of facial deformity. There was a moment where he’s accused of pedophilia. He’s not done anything, he’s clearly innocent but he’s really stigmatized, and I remember watching that and then running away from the screen and crying. I think probably from that point on I recognized the power of film to really connect people with emotional experiences – help people empathize and take perspectives of other people. That really stuck with me.
SM: Aye, I was just, it made me think of that The Simpsons episode where Principal Skinner and his mum are having an argument and he said they’d split everything in the house, she’d made them split everything, and she’d even split the TV and they watched A Man Without A Face and he didn’t realize he had a problem.
DW: (laughs) I have never seen that one.
SM: I’ll send it on to you.
SM: Aye, I don’t remember a defining moment for me, but I know through my parents that film and TV always had the power to draw me in, like I was always really feeling it with the protagonist. I remember my mum saying that we went to the cinema to see Bambi and she said I was sobbing. We also went to see ET when it was released and she said I was uncontrollably sad and I was wailing in the cinema and she was thinking about taking me out. But my daughter’s the same, she gets really emotionally involved in the main characters. It’s really common that she’ll sit holding on to me, sobbing. She can’t get breath for sobbing because she’s right into what the character is experiencing and really empathizing with what’s going on. I think I’ve used film, little bits of film here and there in teaching before when I started teaching, but then it wasn’t really until me and Dan started working together that (we) kind of really thought about theory and research about the formal use of film for exploring mental health.
One of the things that’s fundamental to what we do is that we work on the premise that any film that depicts a human experience necessarily deals with mental health themes.
GS: Obviously you both lecture on the mental health nursing course up at Aberdeen’s Robert Gordon University: on the curriculum. Are there any particular films that you show on the course?
DW: Yeah, one we’ve used pretty religiously over the last few years has been Lars and The Real Girl with Ryan Gosling: where a man suffers a delusion where he kind of attaches a personification or a life to a sex doll that he orders off the internet, he even brings it to dinner and stuff. We essentially just get a class to watch the film and then try and get them to think about it, think about if this guy Lars was presented to local mental health services how might that look? The interesting thing about what happens in that film is that through being accepted and understood within his own community, he kind of works through his own mental health issues without the need of any coercive practice. Without the need of medication, without the need of going into hospital, being restrained, detained, anything like that. So, we really use that to challenge the medical model of mental health in a lot of ways. And it’s actually a really uplifting, warm film as well. It’s got a lot of heart, but it’s also got a deep message.
SM: It’s quite provocative in terms of discussion. Our experience is if someone is presented to the GP or mental health services with that sort of experience, (it’s) highly unlikely they would get what he gets in the film. It usually provokes quite a good discussion amongst students.
Dan and I have done workshops in Finland at a university about the use of film in exploring mental health. One of the things that’s fundamental to what we do is that we work on the premise that any film that depicts a human experience necessarily deals with mental health themes. You can’t separate a person from their mental health experience. We’re all having mental experiences right now. No matter how mundane, we’re always having a mental health experience, so it stands to reason that any film that depicts a character that’s been humanized shows mental health themes that can be explored.
GS: That’s really interesting. So, you obviously mentioned Lars and Real Girl but are there any particular stand outs for you both that explore mental health in a honest light or in a way that doesn’t stigmatize the topic at all?
SM: Our belief is that everyone has their own unique and individual mental health experiences: if the three of us were diagnosed with depression, all of our experiences of depression would be different because it’s based on so many different things. So, an accurate depiction of our mental health experience of having depression might look very different. If we involve the millions of other people who might be diagnosable with depression across the world and in different cultures and so on, then it brings in a multitude of different possible accuracies.
So then, as a filmmaker, I think (if) you try to make a film in terms of an accurate depiction of depression in this example, you’ll probably press some people’s buttons, but other people will feel that you’ve got it completely wrong and maybe criticize it because what they’ve experienced isn’t like that. So, yeah, I guess for us the idea of something that is an accurate and sensitive portrayal of a mental health condition is somewhat of a fallacy. There isn’t necessarily one accurate and sensitive way of depicting a mental health condition or experience.
There are some tropes that are pretty tired, I guess, particularly in older cinema: the person who’s experiencing a psychotic episode or dissociative identity disorder as the killer, or the figure to be laughed at or something. Those are the most common ones I think, aren’t they? But more recently most film makers have moved away from those sort of tired depictions.
DW: One (sensitive representation) that I really liked was the first film that we actually showed for Movie Monthly – Take Shelter, with Michael Shannon. Just a really moving portrayal of a guy that was going through some kind of psychotic episode, appears to be hallucinating, having delusions, although it’s a kind of ‘is he, isn’t he?’ kind of thing. And I think what was moving about that was just the impact that that has on his relationships with his friends, with the community, with his wife and his daughter. It felt like people had put thought into that.
GS: Would you say that what led you both to starting the monthly movie night was not to just explore and generalize a topic within mental health, but empathize with that particular character’s experience, their own personal experience, within that area.
DW: Yeah. I think we had a variety of different ideas. So, when we started it was 2016 and we were approaching Mental Health Awareness Week. We thought we weren’t really doing much as a university to mark that. Scott and I work closely together and we’d regularly talk about films that we’d watched. We’d be having these conversations where we’re talking about the film but we’re talking about it through a mental health lens as well and we’re talking about stuff that might relate to theory.
And we thought during Mental Health Awareness Week, why don’t we show a film and just discuss it? The film is the least important part of it for us. It’s actually the discussion and it’s what people take from that that is really important. A really important thing is hearing and seeing other people’s perspectives, just hearing other people have different ideas to your own.
SM: I think there was a lot of that frustration that we shared that sometimes people don’t really see mental health as being anything to do with them. When the words mental health are used, what they hear is mental illness or mental disorder and then they say that’s nothing to do with me, that’s for crazy people. What we really wanted to do was use film – this thing that people love and talk about all the time – to create a platform for talking about something that people don’t talk about.
I think maybe where filmmakers sometimes are getting it wrong is they are thinking that people have distinct mental illnesses and disorders that are really neat.
GS: Have you seen any sort of impact or change since the initiative started? Maybe people’s behaviors or perceptions?
DW: Yeah, I guess what we have seen is that some people come back and say, “I can’t watch films in the same way anymore.” They talk about that mental health lens. In that they’re watching the film, but then they’re thinking about the experiences within it. They’re really looking at that, they’re taking everyone’s perspective and thinking about it from that way.
GS: I was going to ask about how you both think film and television industries are currently portraying mental health to audiences, but with your belief that it’s not about having one solid aspect, it’s all about that protagonist’s own personal experience, it kind of makes that question redundant unless there is a general sense of filmmaker’s approach to mental health?
DW: I think maybe where filmmakers sometimes are getting it wrong is they are thinking that people have distinct mental illnesses and disorders that are really neat. You know what I mean? Right, okay, there’s nine diagnostic criteria and you’ve got to have any five of these nine, you got five of these nine and then you’ve got this diagnosis and then you behave exactly in that way. It’s just not true. People don’t just fit neatly in that way, and I do wonder sometimes if maybe filmmakers feel that pressure because of the medical models. It’s been the status quo for so long that people do genuinely think that people have mental disorders and conditions that are really neat and they miss the fact that people just don’t fit neatly into boxes. I don’t know if maybe we’re feeling too much pressure to get it right when there is no possible way of getting it right for every single human.
SM: I think maybe to add to that, I know that in recent years filmmakers and TV soap creators, they’ve started to engage mental health consultants as well, so people from mental health organizations. And I think that’s been a good thing, and as much as we’re saying it’s probably impossible to make an accurate depiction that satisfies everyone’s experience of a condition, there are depictions that would be inaccurate or mostly inaccurate for most people, so balance is important. These mental health consultants can help with that balance. They could say, “Well, actually we’ve seen a lot of characters who are meant to have psychosis, or psychotic experiences in film and TV. And the majority of them have been made into killers by the storyline, so maybe that’s a bit tired to use that storyline again. Maybe actually here’s what the evidence says and here’s what our experience says that most people with psychosis don’t become killers. So, maybe we could steer the story in this way instead.”
GS: Yeah, it’s funny talking about this because I did a film course myself a few years ago, and I was making a film where the protagonist was Autistic and Aspergic just like me, and I based it off my own things I’ve dealt with. We had a critique, and it was a Scottish documentary maker who was helming the industry panel to review our first cuts where he suggested that my character did Sudoku to convey the Autistic traits and Aspergic traits.
DW: (laughs) Is that one of the diagnostic criteria for Autism that you do Sudoku?
GS: Because they’re brilliant at maths.
SM: Yeah, I mean I guess it is quite a human thing, isn’t it? To try and put people or things into neat boxes, to organize content so that it uses up less space in our brains and it’s understandable that people do that, but it’s really important to think about alternative perspectives. That was obviously lacking for that guy in that situation. He just had this one perspective. It would have been really useful for him to have other people who could say, “Well, wait a minute, that’s not how it is for me.” Or, “I know this person.” Or, “I’ve had these experiences and this is different for them.” You know. I think that’s what Mental Health Movie Monthly allows. We’ve got loads of different folk who come. Folk who have their own mental health challenges, people who are staff in mental health practices, people who have a wide variety of jobs.
GS: Seems to me a lot of it is about empathy really from both sides: for filmmakers to be more empathetic and in that way helps the audience become more empathetic.
SM: Yeah, we think that. What we teach is that the fundamentals of working with people with mental health problems, the fundamentals of all good human interaction. Empathy is right at the heart of it. It should be the default fall back position for all interactions.
You can follow the Mental Health Movie Monthly through their Facebook page @RGUMentalhealthmoviemonthly and their Twitter page @Rgumhmm
(Interview sections edited and condensed for clarity.)