As Mental Health Awareness Month kicks off, news and stories about mental health may seem to saturate media outlets. Yet a new report reveals that in top movies, mental health is rarely in the spotlight.
The study, entitled “Mental Health Conditions Across 200 Popular Films” is the second report on mental health in popular media from Professor Stacy L. Smith and the USC Annenberg Inclusion Initiative. The report is supported by the American Foundation for Suicide Prevention and NYT best-selling author, purpose coach, host of the top health and wellness podcast “On Purpose,” and former monk, Jay Shetty. The study provides an update on the prevalence and portrayal of mental health conditions in popular films by examining the 100 top-grossing films of 2019 and comparing the findings to those from the initiative’s report on popular movies from 2016.
Of the 4,502 speaking or named characters across the top films of 2019, 1.5% were depicted with a mental health condition. There has been little change over time, as 1.7% of characters in the most popular films of 2016 had a mental health condition. As a point of contrast, 21% of U.S. adults experience mental illness, according to national population research studies, such as the U.S. National Comorbidity Survey.
“Stories can provide a window into different worlds and experiences, but the results of this study demonstrate that mental health is rarely a focal point in popular film,” said Smith. “With the growing need for mental health care in the U.S., and the ongoing concern about well-being, storytellers and creatives are missing critical opportunities to educate audiences.”
More than half of the films included in the study from 2019 didn’t feature even one character with a mental health condition, and thirty percent had only one character with a mental health condition. A total of seven different mental health conditions appeared across the sample. Those included: addiction, anxiety/PTSD, depression/mood disorders, suicide, significant disturbances in thinking, cognitive impairment, and obsessive-compulsive disorder. There were more depictions of anxiety/PTSD in 2019 than in 2016, while portrayals of cognitive impairment and spectrum disorders declined. The remaining mental health conditions remained consistent with 2016.
More than half (59.2%) of characters with a mental health condition in the most popular films of 2019 were male while 40.8% were female. Three-quarters of the characters with a mental health condition across the films of 2019 were White, while only 16 characters were from underrepresented racial/ethnic groups. Only two characters with a mental health condition were LGBTQ, and 42.3% had a disability. The picture of mental health conditions in popular film remains one of predominantly white, male, straight, and able-bodied characters.
“The portrayal of mental health in film has a powerful role to play especially during this period of global mental health crisis,” said Christine Yu Moutier, chief medical officer at the American Foundation for Suicide Prevention. “Entertainment educates the public, whether it’s with intention or not. And because humans are deeply wired for social connection and imitation, contagion can occur with detrimental effects or with positive impact. Portrayals can not only destigmatize and stop perpetuating dangerous tropes about people who live with mental health conditions, but they can also have the potential to deepen mental health literacy and inspire hope. All people have mental health, and now more than ever, Americans are hungry for information and resources to allow us to not only cope, but to flourish, and to support others’ mental health.”
The study also explored the portrayal and context in which mental health conditions are depicted. Nearly three-quarters of characters with mental health conditions experienced some form of disparagement in the film — either verbally or nonverbally expressed by the character themselves or another character. While disparagement could be general and not connected to a diagnosis, 45.1% of characters with mental health conditions faced derisions specifically about their mental health. More than 40% of characters with a mental health condition were the object of jokes or humor related to their mental health, an increase from 2016 (22%).
“The confluence of these contextual factors means that when mental health is presented in film, it is often stigmatized or demeaned,” said Smith. “For audiences, the nature of mental health portrayals may heighten the possibility of negative effects when it comes to real-world outcomes.”
Characters with mental health conditions were also linked with violence in several ways. More than half of characters with a mental health condition were perpetrators of violence (63.4%), a significant increase from 2016 (46%). Additionally, nearly two-thirds (66.2%) of characters with mental health conditions were victims of violence. Finally, more than one-third (38%) of the characters with mental health conditions died at some point in the film, including by homicide or suicide. Over half (59.3%) of the characters with a mental health condition who perished did so by violent means. Nearly one-quarter (22.2%) of the characters with mental health conditions who died did so by suicide.
Less than one-third (29.6%) of characters with a mental health condition were shown in therapy, including individual appointments, group therapy, addiction, support, and inpatient care. Only 12.7% of characters with mental health conditions utilized medication or other treatments. Films in 2019 showed more characters receiving both therapy and medication or other treatment compared to 2016.
With solution in mind, the initiative brought Purpose Coach, NYT best-selling author, and “On Purpose” podcast host Jay Shetty into the fold as Chief Well-Being Advisor. In this role, he will serve as a resource to the program and entertainment industry at large on issues of mental health and wellbeing, strategizing new ways to approach the subject matter on-screen and on sets, to work towards positive change.
“I am thrilled to be joining Dr. Smith and the USC Annenberg Inclusion Initiative as the Chief Well-Being Advisor,” said Jay Shetty. “It has always been my passion to bridge the gap between mental health and entertainment. The access that the initiative has to further explore these important matters on-screen and on sets and make real systemic change within the industry is what excites me the most.”
The study also provides a core solution for depicting mental health in popular entertainment. Building on the Mental Health Media Guide, the study offers a blueprint for a mental health policy that can be adopted by production companies, studios, and other groups. This policy outlines ways that creative talent, executives, and those overseeing production can tell authentic stories, provide opportunities to nurture mental health for those working in production, and provide audiences with more information on mental health.
The report is the latest from the Annenberg Inclusion Initiative and can be found online here.