Movies and Mental Health

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					Cinemeducation: you don’t just
learn from reading
   Hélène Gorring, Birmingham & Solihull Mental
   Health NHS Trust &
   John Loy, Avon & Wiltshire Mental Health
   Partnership NHS Trust
In the next twenty minutes…

    Mental health on the silver screen

    Case studies from Birmingham and

    Case studies from non-mental health
In the beginning

  Cinema and psychiatry born and grew up
  Dr Dippy’s Sanitarium (1906) – first
   mental health professional on screen
  Fred Astaire (Care Free 1938) the
   dancing psychiatrist
  1940s first “mental health” feature films
Why the fascination with mental
health on screen?
 “You play a mental
 you win an Oscar”
 Kate Winslet
 (playing herself)
 in Extras
Oscars – for playing a mental
Oscars – over to you

 Only one performer won an
 Oscar twice for “playing a
    A – Jack Nicholson
    B – Vivien Leigh
    C – Tom Hanks
    C – Meryl Streep
Oscars – for playing a Dr or Nurse

     Louise Fletcher – Cuckoo’s Nest
     Robin Williams – Good Will Hunting
     Anthony Hopkins – Silence of the Lambs
AFI - Top 5 screen villains of all time

   1. Hannibal Lecter
   2. Norman Bates
   3. Darth Vader
   4. Wicked Witch of the West
   5. Nurse Ratched - Cuckoo's Nest
One Flew Over the Cuckoo’s Nest

  First film in forty years to win all of the
   “big five” Oscars
  Film
  Director
  Actor
  Actress
  Screenplay
Oscars – over to you

 Only one film since Cuckoo’s
  Nest has won the “big five”
    A – Titanic
    B – Lord of the Rings: the Return of the King
    C – Silence of the Lambs
    C – American Beauty
One Flew Over the Cuckoo’s Nest

    Film clip
Cuckoo’s Nest

  “…didn’t win…because of the breadth of
   ethical issues it covered – it was
   successful because it is both thought
   provoking and entertaining”
  Jim Pink, Cardiff University,
   BMJ March 2007
Cuckoo’s Nest

    “…showcases both the general
     population’s fear of mental patients as
     aliens and the need to control or
     overpower them, sometimes disguised,
     whether knowingly or unknowingly, as
    Jacqueline Zimmerman, People Like Ourselves:
     portrayals of mental illness in the movies
     Scarecrow Press 2003
ECT – on film

    Having commenced its movie career as
     a severe but helpful remedy for personal
     distress, ECT on film has become a
     progressively more negative and cruel
     treatment, leaving the impression of a
     brutal, harmful, and abusive manoeuvre
     with no therapeutic benefit.
    The Portrayal of ECT in American Movies
    McDonald, Journal of ECT - Dec 2001 Volume 17(4)
Case Study 1 – Birmingham
   Inspired by undergraduate medical
    education curriculum

   Medical Humanities – the arts can provide
    an insight into human condition which can
    help doctors in training develop some key
    skills such as reflection and empathy.

 •   Film with a mental health theme
     screened in lecture theatre (6:30

 •   Short discussion chaired by a
     clinician – key themes include
         How is mental health portrayed in

         How do the ‘bad’ depictions of
          mental illness in films influence
          public opinion?

         How is mental illness used in film
          for plot development, narrative and
          dramatic conflict?

 •   Raised profile of library service &
     engaged new users

 •   Has made us an integral part of
     Undergraduate Medical Education
     teaching programme

I particularly found the discussion of portrayal of psychiatric conditions
insightful. The films often highlighted areas relevant to work in the
clinical environment such as prejudice and stigmatisation, and
difficulties relating to diagnostic practices. Interesting points about
portrayal of psychiatric issues in the media were also raised.
 It is a useful way to develop thought about important issues relevant to
our work in a relaxed social environment.

Senior Research Fellow, University of Birmingham
MBChB Year 4
Case example – Shock Corridor
Key learning outcomes
    Being able to observe uncommon textbook symptoms: ‘waxy’
     rigidity, a characteristic of catatonic schizophrenia.

    Appreciation of the impact that environmental factors can have as
     a catalyst to mental ill health

    Understanding the impact of the media on the public’s stigma of
     mental health and empathy of fear that patients may feel in being

    Reflection on the environment of the psychiatric hospital – to
     learn of the ‘asylum’ history and impact the therapeutic
     environment, or lack of may have.

    Observation of the decline – watching a ‘sane’ man deteriorate

•   Medical bias

•   Group dynamics

•   Including service users
Case Study 2 - AWP

  1st Sally Hernando Library Innovation Awards
  Very much using Birmingham as a model

  8 films to date
  Attendance just into double figures

  Actively sought to attract multi-professional
  As a result, now need to attract more doctors

  Very much seen as a “great idea”
  Not reflected in attendance figures

    Need to strengthen links with undergraduate
     medical curriculum

    Raised library profile

  A remarkable little film which may well
   challenge preconceptions about mental health
  Consultant Nurse – “Lars and the Real Girl”

  Honest and accurate portrayal of the impact of
   Alzheimers on the individual and their family
  Consultant Psychiatrist – “Iris”
Future development, Autumn 2012

  Undergraduate curriculum
  Prescribe a film
  4-6 weeks to borrow and watch
  Group discussion and feedback sessions
Beyond Mental Health
                            Arose out of Deanery
                             Quality Assurance
                             review; David is now
 David Copsey                Trust lead for medical       humanities

                            The Winslow Boy
                             (establishing Trust
                             between professionals &
                             families) The Third Man
                             (changing drug dosage
                             due to shortages)
Beyond Mental Health

 Susan Smith

   •   Public Viewing Screening License from Film

        PRS for Music License (for soundtrack)
Practical Issues

 •   Refreshments?

 •   Check length of films
     on programme!

 •   Day of the week –
     other key events going

 •   Numbers will increase
     over time!
Your questions or comments…
Further Reading - Books
    Wedding, Danny; Boyd, Mary Ann; Niemiec, Ryan M. (2010)
     Movies and mental illness : using films to understand
     psychopathology (3rd ed) Cambridge, Mass : Hogrefe and Huber

    Zimmerman, Jacqueline Noll, Lanham, Md : Scarecrow, (2003)
     People like ourselves : portrayals of mental illness in the movies

    Gabbard, Glen O.; Gabbard, Krin Psychiatry and the cinema
     (1999) (2nd ed) Washington, DC : American Psychiatric Press
Further Reading - Articles
    Pink, J. Jacobson, L Medical classics: One Flew Over the
     Cuckoo's Nest BMJ 22 March 2007;334:641.2

    McDonald, WG The Portrayal of ECT in American Movies Journal
     of ECT - Dec 2001 Volume 17(4)

    Hyler, SE DSM-III at the Cinema: Madness in the movies
     Comprehensive Psychiatry Vol. 29 (2) p.195-206

    Byrne, P. Why Psychiatrists should watch films (or what has
     cinema ever done for psychiatry?) Advances in Psychiatric
     Treatment Vol. 15 p.286-296.

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