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Schizophrenia in film and television – what’s the reality?

In modern-day society we are inundated by various forms of media, including film and television. However, if we solely focus on entertainment value, it can be easy to forget that not everything we see on our screens is an accurate reflection of reality.

One example of this are portrayals of serious mental health conditions in the media, such as psychosis and schizophrenia, which often appear fuelled by unhelpful and stigmatising false narratives.

Outlining the truth

Psychosis is when an individual experiences reality differently from those considered ‘typical’ in society, and ischaracterised by delusions, hallucinations, and behaviour considered out of the ordinary.

What are delusions and hallucinations?

Delusions are firm or fixed beliefs in something, in spite of contradictory evidence, and are not shared by others.

Hallucinations are things that can be seen or heard but are not real. Often, hallucinations can involve other senses, but the most common form is auditory (e.g., sounds or voices).

What is schizophrenia?

Schizophrenia is a serious mental health condition, characterised by psychosis and various other negative symptoms. These symptoms include social withdrawal, decreased emotional response, and decreased motivation. Whilst the symptoms of psychosis can come and go throughout a person’s lifetime, it is these negative symptoms that are consistent and often have the most profound impact.

But how exactly are schizophrenia and psychosis portrayed in film and television, and just how accurate is it to the reality of living with this serious mental health condition?

Using a study which looked at 41 films that contained a main character with schizophrenia, we’ll take a look at the most common media portrayals of psychosis, and shine a light on their inaccurate portrayals.

Nearly 33% of the characters were murderous

In reality, only around 30 of the 600 yearly UK homicides were committed by people with schizophrenia. When you consider that there are approximately 685,000 people with schizophrenia in the UK, this amounts to less than 0.005%.

Most characters were portrayed as violent or a danger to themselves or others, and 25% died by suicide.

The proportion of violent crime in society attributable to schizophrenia is less than 10%.

The risk of violence in those with psychosis is similar to those without psychosis, when taking levels of substance use into account. In fact, people with serious mental health conditions, like schizophrenia, are more likely to be the victims of violence.

It is true, however, that there are high rates of self-harm in people with schizophrenia, and the lifetime suicide rate in those with schizophrenia is estimated to be 10%.

Positive symptoms were the most frequently portrayed, with very few negative symptoms being shown

The data showed that only around 19% of films showed a reduced emotional response, and 5% showed a lack of motivation. In reality, negative symptoms are more common than positive, with around 60% of people with schizophrenia displaying these. Additionally, negative symptoms are usually the first sign of schizophrenia, but they also occur across other diagnoses.

Around 25% of films indicated that traumatic experiences were involved in developing schizophrenia

It is theorised that adverse childhood experiences (ACEs) can increase a person’s risk of developing schizophrenia.

However, there is substantial evidence for a biological basis of schizophrenia, and this is what drug treatments aim to target.

Treatments shown were invasive, such as electronic-convulsive therapy, or included being ‘cured’ by empathy

The treatment for schizophrenia as recommended by NICE guidelines is a combination of medication and psychological therapy, and they do not recommend electro-convulsive therapy (ECT) for managing the condition. ECT is only recommended in order to gain fast and short-term improvement, after all other treatment options have failed, or if the situation is life-threatening.

photo of a man and woman sitting on chairs in a bright room opposite each other to indicate that this may be a therapy session

Additionally, whilst empathy and compassion play a key role in developing a therapeutic relationship, this is only one aspect of treatment.

17% were portrayed as gifted, either through creativity or intellectual genius

Whilst examples of schizophrenia and genius do exist in our society (e.g. John Nash Jr. portrayed in A Beautiful Mind, and Nathaniel Anthony Ayers Jr. portrayed in The Soloist), they are rare.

In reality, many people with schizophrenia experience negative symptoms and problems with their memory and attention, which can make it difficult, but not impossible, to excel at this level.

The importance of an honest portrayal

Depictions of real experiences of schizophrenia are valuable tools for boosting public awareness, however recent research has found that many news articles used graphic language when reporting violent crimes committed by those with schizophrenia.

These representations are likely to reinforce fear of this diagnosis in the public and in those with schizophrenia, especially as the general population are mostly likely to obtain knowledge of these diagnoses from the media.

In 2016, NCMH Director Professor Ian Jones worked alongside Clare Dolman, a women’s mental health advocate and researcher with lived experience, and BBC writers to develop an accurate postpartum psychosis plotline for its long running soap, EastEnders.

Over 10 million people watched the episode featuring Lacey Turner’s character Stacey Slater, and as a result, Action on Postpartum Psychosis saw their public contact go up by 400%.

This demonstrates the impact accurate portrayals of serious mental health conditions in entertainment media can have, and the importance of using research to positively support this.

Additionally, we hosted a webinar discussing schizophrenia, psychosis, lived experience, and research to mark Schizophrenia Awareness Day 2023 which is available to watch now.

The NCMH is currently looking into experiences of a wide range of mental health conditions, take part today and help us make a difference today.

Read more

NCMH | Take part in our online study

NCMH | Schizophrenia and Psychosis: how research can make a difference

NCMH Leaflet | Schizophrenia

BBC | Jonny Benjamin: How I went from suicide attempt to MBE

BBC | ‘Psychosis and Me’ a film by David Harewood

TED | Eleanor Longden : The voices in my head

Rachel Staples
Rachel Staples is a 4th year undergraduate Psychology student at Cardiff University and past intern
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