Thankfully, understanding of mental illness and support for those affected is getting better all the time even if some misconceptions still persist in public consciousness. The portrayal of mental illness on screen and the representation of treatment has one enormous problem, for years and years cinema has used them both as powerful tropes for various purposes and the way in which they are used varies very little. With the release of ‘A Cure for Wellness’ the latest film to be set in an institution, I’m revealing seven ways cinema sends viewers to the asylum.
1. The fear of the mad. The majority of films that feature psychiatric institutions are horror films, quite often slashers and violent thrillers. If you need an easy backstory for a dangerous villain, have them escape from the local looney bin. Obviously, in real life not all mentally ill people are dangerous and there is a scale of mental health issues, but films for the most part make baddies out of the mentally unbalanced, and dangerous criminals that you can really fear out of the clinically insane.
Our instincts are to fear people who behave oddly and cinema doesn’t help attitudes to the mentally unwell. It exploits those fears and all the associations. The hospital setting is unsettling because it reminds us of being ill, the graveyard because it speaks of mortality and the afterlife. The asylum is a powerful horror setting because it reflects insanity and the strange unknown. Shutter Island (2010) is most unnerving when the clues are only starting to emerge and the strange mysteries of Ashecliffe Hospital are confusing and alienating the film audience. When details are slowly revealed the film switches from psychological horror to detective story and loses some impact.
2. The fear of being mad. Whether it’s a psychiatric hospital or a sanitarium, characters that go in always face the risk that they may never come out again. It’s enough to put someone off visiting a care home for the elderly. I mean sure you’re young and you’ve got all your marbles but you get one grey hair and lose your name badge and before you know it you’re an inmate. Films like One flew over the cuckoo’s nest (1975) describe how instead of treating illness, these institutions can drive a person to madness. Whether they contribute to a negative view of mental health treatment is an issue but they hit a mark with audiences as they speak to our fear of only being one step away from our own insanity.
3. The comeuppance. Sometimes when you can’t kill your villain it’s more appropriate or ‘funnier’ to make them lose their minds. When capital punishment is too serious and final why not resort to a debilitating illness to finish your nasty character off. Even if we don’t see them carted off to the funny farm, we get to view the total mental breakdown of many unscrupulous characters, from Jerry Lundegaard in Fargo screaming uncontrollably as the police arrest him, to Cruella De Vil driven (more) insane by the puppies that outsmart her. It’s hard to feel any pity for characters that get what’s coming to them. Of course some characters like Mr Glass in Unbreakable (2000) are revealed to be insane from the beginning in which case their incarceration in a psychiatric institute as opposed to a regular prison is testament to how ‘evil’ they were. Still, locking them up for life is more satisfying than letting them escape via some quick death.
4. The unbelievable story. If you ever see an alien or a monster or if you ever find out the world is going to end, do yourself a favour and keep quiet about it. You can’t do anything about it from inside a psychiatric facility as many film heroes discover to their cost. You’d think they would realise how mad they sound and quickly get cured. At least when the ghostbusters get themselves committed in Ghostbusters II (1989) Peter (Bill Murray) realises the correct thing to say; “I think these people are completely nuts”.
In real life it would be surprisingly difficult to get yourself committed to a hospital for witnessing a bizarre event. There are people walking around freely claiming to have been abducted by aliens. If you are sane enough to act normal you’re probably free. How then Sarah Connor begins Terminator 2 locked up isn’t clear. I know that she tried to blow up a factory but if she was able to get an insanity plea why doesn’t she realise she can fake her sanity unless of course the events of the first film have really pushed her over the edge.
5. The Victorian madhouse. Without giving a history lesson on the brutality once faced by the mentally ill, (I’m too lazy to do the research) we are all aware thanks to film and television that for a long time science didn’t get it right when it came to the diagnosis of mental health conditions. Arguably the more scientific and enlightened we became, the more horrific it got for sufferers, with Georgian and Victorian Britain providing the classic Hollywood asylum horror story.
But given that we have come a long way with understanding mental illness in the last 100 years, is there any reason to keep on showing the same asylums of the past without exploring anything new. Stonehearst asylum (2014) at first seemed to be just another criticism of Victorian attitudes, taking the source material from Poe and expanding it to cover the misunderstanding of female hysteria and shell shock. The twist right at the end, which follows the vein of Shutter Island, also featuring Ben Kingsley, is completely ridiculous, but it serves to blur the boundaries of the sane and insane and demonstrate the difficulty in distinguishing the mentally ill. In my opinion however, being ‘madly in love’ and an unhappy childhood in an orphanage should have been enough to justify the protagonists behaviour.
6. The home of evil. Any prison is full of particularly nasty people but evil is typically reserved for the asylum. Or it is according to DC comics and the films inspired by them. Arkham asylum (for the criminally insane), where all Batman’s villains are incarcerated at the end of each film, really needs to sort out its security issue, as it constantly provides evil nemeses for Batman films.
You could be forgiven for thinking that cold calculated murder is worse when its sane but even beyond superhero films, the insane criminals represent true evil far more than your average serial killer. Hannibal Lecter has been voted the greatest villain of all time mostly due to Anthony Hopkins’ eerily terrifying portrayal but partly because he radiates terror in spite of and some might say because of his incarceration; the prison bars, the straight-jacket and the mask.
7. The character study. A character with no demons is pretty boring stuff. A character with multiple personalities is gold dust to an actor. Whether your Natalie Portman or James McAvoy, nothing is more challenging and ‘ahem’ awarding than playing multiple parts within one role. Mental illness produces complex characters so it’s a shame that most representation of the mentally ill is simplified and extreme.
There are few roles which normalise mental illness or where actors can play an understated version of a psychiatric patient. In Silver lining playbook (2012), Bradley Cooper does an excellent job of portraying a man recently released from hospital but as with most Oscar nominated films, the plot often feels contrived; a fictionalised romantic view of mental illness instead of normalising and humanising its characters. In my view one of the best portrayals of the modern mental institution is Girl, Interrupted (1999) featuring probably the best performance of Angelina Jolie’s career, although it too suffers from Hollywood trying to sensationalise true events.
These are the seven uses of what I loosely refer to as the asylum in cinema, although of course films can fit into more than one category. By asylum I mean any one of many institutions on the scale between hospital and prison but the associations with madness and mental health are pretty consistent whatever the name of the mental prison.