There’s a lot of pressure to present people with mental illness accurately and respectfully in film, literature and journalism, and few role models about how to do that. It’s easy to fall into stereotypes because they’re available and recognisable, but that just makes it easier to spread false information and create stigma, even with the best intentions. I’ve done some work in sensitivity editing for portrayals of mental illness in film and literature, and here are a few hints about how to be accurate and respectful.
First of all, double-check your information about symptoms and treatments. The DSM-5 and the ICD-10 are the go-to sources for checking the accuracy of symptoms. The latest editions of Lipincott’s Pocket Drug Guide or the Merck Manuals are good guides to medication.
Another tip on accuracy: present people with mental illness as full people, not just the mental illness. They should have strengths, weaknesses, make mistakes, experience triumphs, and have careers, hobbies, and complex relationships. They’ll have experiences that have nothing to do with their mental illness. Give them any kind of job, wardrobe, or political opinion that makes sense to the story, without necessarily tying everything to their mental illness. Let them go out for breakfast and eat pancakes – without making pancakes a symptom of a manic episode. Instead of writing about a mental illness and creating a character for it, try creating a full character and figuring out how their mental illness would play out in their life.
There are some tropes to avoid. Two of the most important are the violent criminal and the angelic everyday hero. People with anxiety, depression, bipolar disorder, and many other problems exist at every socioeconomic level and in every type of job and relationship. If you find yourself presenting a character that dresses in unwashed clothes, lives in a low-income neighbourhood or a spooky 19th-century mansion, or has violent outbursts, ask yourself if you’re playing into stereotypes unnecessarily.
For many people with a mental illness, stigma is a significant part of their lives. In my role as a psychologist, I’ve helped clients figure out how to address losing a job, being denied housing that they want, and losing important relationships due to false beliefs about a diagnosis. Stigma also takes the form of ‘compassionately’ treating people like poor little victims or everyday heroes rather than complete people. And, of course, there is fear of people with mental illness. I’ve been on public transportation when people shout at or threaten to attack someone who is acting in a way that’s unusual but harmless. So if you’re going to write about people with mental illness, you probably have to deal with stigma. To present stigma without stigmatising someone, you have to present it as something harmful. If a character is being stereotyped, show how it hurts them.
Even positive stereotypes, like showing people with disabilities as angelic heroes, can be harmful because it denies their actual talents and personality while putting them under pressure to look perfect. If a character is threatening or insulting someone with mental illness, show the abuser being rejected or punished, or clearly portrayed as a negative or abusive person. Be careful not to present stigmatising language or actions without also showing that it’s harmful. By showing both realistic discrimination and the consequences of it, you can get very real about mental illness in a more respectful way.
Finally, if you want to write about someone with a mental illness, make sure you take a deep dive into the real lives of people with mental illness. You can look for people to interview, you can read their blogs, memoirs or social media feeds, or look at their vlogs and listen to podcasts to understand the true variety of their lives and experiences. You can also hire someone to go over your book, script, or portrayal with you to help you with all of this. Try googling ‘sensitivity reader’ or ‘diversity editor’ to find one who specialises in mental illness.
Aimee Daramus, PsyD is a psychologist based in Chicago, Illinois.