Portrayal of violent male psychiatric patients by entertainment media and the stigma of psychiatric illness

To the Editor

Male psychiatric patients are frequently portrayed as violent or even homicidal in movies and contemporary media. For example, a recent study (Owen, 2012) has shown that a majority of movie characters with schizophrenia displayed violent behavior toward themselves or others, and nearly one-third of these violent characters engaged in homicidal behavior. A majority of these patients (73%) were males.

Male psychiatric patients are indeed sometimes violent. However, most male psychiatric patients, including psychotic and dual diagnosis patients, are not violent (Fazel et al., 2009). Regrettably, the portrayals of these movies encourage and promote a stigmatization of psychiatric illness which is harmful for psychiatric patients, their families, their friends and society in general.

However, the association of violence with mental illness in media serves a reinforcing function for the viewer. The violence and homicidal acts depicted in these films satisfy in fantasy wishes and urges which many people experience, to some degree and at some point in their lives, of violent rage at the all-too-real individuals and scenarios in their personal lives. By characterizing these violent wishes as alien products of a distant other in the form of the schizophrenic or psychotic individual, stigmatizing films permit a safe distance between the viewer and the violent act on the screen. The producers of these films, consciously aware of this function or not, capitalize on this function. Unfortunately, the consequence of stigmatization to individuals with mental illness, and in particular to males, is the untoward byproduct.

Mental health professionals need to address the consequences of stigma toward individuals, and especially men, with mental illness. Dimensional approaches to psychopathology, including the recent Research Domain Criteria Project (RDoC; Insel, 2014), promote a perspective that emphasizes a spectrum from normality to pathology. Psychiatrists should emphasize in their work that the transition to materialist brain-based dimensional models may help to reunite the suffering male’s experience with the human purview and thus reduce stigma. A greater recognition of violent films’ function to contemporary culture may assist suffering men bear their burden by helping to normalize and provide an empathic validation of all the ranges of human emotional experience. Mental health professionals should also move beyond psychoeducation provision in isolation at the clinic to full participation in programs of public education for the betterment of health and welfare to both those stigmatized and the public at large.