Last week, The Washington Post published an article about the Halloween industry's depiction of mental illness in haunted attractions and advocates' efforts to put the negative stigma to an end. As I read the article, I breathed many sighs of relief as I agreed with every word. As Halloween is my favorite holiday, our yearly haunted house excursion is a highlight of the season. For years, I have seen scenes depicting asylums filled to the rim with dangerous people in straight jackets. They have always bothered me but this year, that bother came to a boil as just last month I spent time in a mental hospital myself. These scenes moved from a place of mild discomfort to deep pain and offense.
As I sat and pondered the implications of this issue, I let my mind wander past just haunted houses. I don't know how many movies I have seen that are set in a mental hospital, making a mockery of disorders that plague people in very real ways. When I google searched "movies set in psychiatric hospital", Wikipedia provided me with a comprehensive list of over 100 titles.The horror industry capitalizes on the scares that come from mental illness, casting every patient as a psychopathic murderer. Comedies depict disorders like schizophrenia and dissociative identity disorder as flippant, like hallucinations are entertaining and deserving of laughter.
These patterns are dangerous. Not only are they misinforming the general public about the truths of mental illness and the legitimacy of their treatment practices, they are perpetuating the negative stigma that surrounds mental health around the world. This crippling stigma makes people far less likely to seek help, leading to more and more cases of untreated mental illness. If the world believes that mental hospitals are full of psychopaths that are being tortured by crazy doctors, why would I want to go to one in order to get better?
Due to the fact that I don’t see inaccurate mental illness being removed from mainstream media any time soon, let's clear a few things up. Here are some myths about mental hospitals reinforced by the entertainment industry:
1. Straightjackets
Almost every movie that I have ever seen about a mental hospital has a straightjacket but in reality straightjackets are often the last possible option in mental health care. The Mental Health Bill of Rights requires that the least restrictive restraints be used at all times. Now, that usually means chemical restraints in the form of sedative drugs. If those don't work or safety is especially worrysome, physical restraints are an option. Physical restraints are classified into hard and soft--soft being solely arms and hard being for both arms and legs. Most mental hospitals use leather cuffs for safety reasons. A straightjacket, if available, is the last stitch effort for retaining a patient. A lot of hospitals do not even have these types of restraints available in house due to the efforts to get away from them. Unlike movies that put any hostile patient into a straightjacket and in solitude, mental health professionals recognize that this isn't the most humane or effective way of treatment.
2. Escape
Sorry to fans of many mental hospital movies but escape is next to impossible. I have never seen so many locked doors in my life. You are locked into your bedroom at night. Your bathroom locked at all times. The Ward only has one door and is locked at all times with a security guard on duty 24/7. The hospital itself had a maximum security system, including an airport style metal detector. On top of the physical security features of the facility, every 15 minutes a nurse has to account for every single patient. Even if someone were attempting to escape, a staff member would notice very quickly and the hospital would go on lockdown until they were found (something that happened twice while I was there). You can breathe a little easier knowing that all of the crazed murderers locked inside the asylum will not be breaking out to haunt your families any time soon, I promise.
3. Prison for the Insane
Yes, there were bars on the windows and required escorts anytime you went anywhere outside the designated ward. There was a giant list of things that were banned from the premises and I was searched very thoroughly when I was admitted to ensure that I wasn't bringing in any weapons. But all of these things were not for punishment but for the safety of myself, the other patients and the staff. For the most part, patients are not treated like criminals. Mental health professionals recognize that mental illness is not a choice and patients are treated with that in mind. The hospital allows for you to bring your own clothes--with certain restrictions. I was allowed to use the phone and the washing machine freely. We had free rein over the TV. We could even choose what food we wanted and have it delivered to our bedsides. And because most of the patients checked themselves into the hospital, they have the ability to check themselves out if they wanted (at the risk of not getting doctor approval and leaving without a treatment plan or prescription). Although I've never been to prison, I would imagine the biggest difference is the sense of compassion. Looking past the restrictions, the intentions behind the rules and the care behind the staff really make the difference. They want the patients to get better and are willing to serve in ways to make that happen.
4. Entertainment Value
Movies and TV shows about insane asylums are often exciting and eventful. In actuality, most of the time is spent sleeping or in therapy sessions. Those few days that I was admitted, I was so bored I could hardly stand it. In my short time admitted into the hospital, I slept, read two books, went to group therapy sessions, and met with various doctors and social workers. The most exciting thing we did was watch Edward Scissorhands on a broken TV. No one was killed, there were no fights, nothing was set on fire and no one escaped. Even the music we were allowed to listen to was uneventful, mimicking that of elevator tunes. Establishing a sense of routine and not exposing patients to too much stimulation are definitely treatment techniques that mental health professionals utilize in institutional care.
5. "Crazy" People
Contrary to popular belief, most people with mental illnesses aren't crazy, in the popular sense of the word. I met some very interesting people during my time in Ward 1 but all of them were just normal people struggling with some really hard stuff. In movies, patients are often seen throwing things and yelling at the voices in their heads, attacking doctors and doing explicit things with other patients. The only throwing that occurred was with a wad of hospital socks that two men turned into a ball to play catch. Only one patient that I encountered yelled, and not to the voices in his head, but to his "baby momma" over the phone. I had very normal conversations with everyone I met about what I was studying in college, what sports teams I supported and who I was going to vote for in the upcoming election. We had a lot of things in common, most of which I could easily have in common with anyone I met outside of the hospital. The only things that bonded us more was our location and need for care. If needing medical help is crazy, than call me insane.
6. Forced Treatment
In a lot of movies, people are sent to the hospital against their will but a majority of the people that I met during my stay actually admitted themselves into the hospital, myself included. Although sometimes the case, most people aren't being forced but are instead willingly seeking treatment. Three of the women I met were mothers, all trying to beat their addictions to provide better lives for their kids. My roommate in the ward checked herself in after a suicide attempt prompted by her son being murdered. A man that had been there for two weeks cried as he told everyone how desperately he never wanted to come back there. And a majority of patients were seeking admittance in to longer term facilities to assure their health. We all wanted to get better. Doctors didn't force anyone to take drugs that they didn’t want to take because they knew that they drugs would be the next step to getting better. They didn't force anyone to go to therapy sessions, people wanted to go. Most patients are hospitalized not because people need them out of the world but because they have reached rock bottom and desperately want to get help, making the overall hospital experience extremely different from the movies.
I am not condemning you for enjoying entertainment from films (wrongly) depicting mental health. My favorite movie of all time is Silence of the Lambs which features a straightjacketed Hannibal Lector of a solid 30 minutes. I will probably continue to watch movies of this type and will not cease to visit a haunted house every October. But the next time you watch Shutter Island or American Horror Story: Asylum, keep these things in mind. Remember the entertainment industry is just that, a form of entertainment. Everything you see in movies or on TV is not truthful. Challenge yourself to learn more about the truth of mental illness and encourage others to see past what the media is wanting you to believe.
(Disclaimer: These are observations from my unique experience at the specific mental institution that I was admitted in to. Generalizations are being made. Treatment and hospital conditions vary).