Unless you majored in psychology or attended medical school, chances are the bulk of your knowledge about mental illness comes from the newspapers you read, the television shows you watch and the movies you see. Studies indicate that mass media is one of the public's primary sources of information about disorders such as bipolar, schizophrenia and depression.
The catch? Research also suggests most media portrayals of mental illness are stereotypical, negative or flat-out wrong -- meaning many people gain an unfavorable or inaccurate view of those with psychological disorders simply by skimming a few sentences or picking up a remote control.
"The worst stereotypes come out in such depictions: mentally ill individuals as incompetent, dangerous, slovenly, undeserving," says Stephen Hinshaw, a professor of psychology at the University of California--Berkeley. "The portrayals serve to distance 'them' from the rest of 'us.'"
Over time, the media has slowly become conscious of these harmful portrayals, experts say. In 2013, the Associated Press added an entry on mental illness to its Style Book to help journalists write about mental illness fairly and accurately. And in recent years, Hinshaw notes, screenwriters have made an effort to portray more humanized characterizations of individuals with mental illness -- for example, Carrie Mathison on Showtime's "Homeland," who has bipolar disorder; Bradley Cooper's character in "Silver Linings Playbook;" and John Nash, the Nobel Prize-winning economist with schizophrenia in "A Beautiful Mind."
Still needed, Hinshaw says, are more realistic portrayals of the everyday struggles associated with mental illness. And despite new scientific advances in the understanding and treatment of mental illness, recent studies indicate that media depictions of mental illness are as outdated and harmful as ever, says Dr. Otto Wahl, director of the graduate institute of professional psychology at Connecticut's University of Hartford and author of "Media Madness: Public Images of Mental Illness."
If media representations of mental illness aren't improving, individuals can at least become aware of the insidious portrayals that shape their perceptions of real-life people with psychological disorders. That way, they can distinguish between fact and fiction, stereotype and reality and the characters onscreen vs. their real life peers.
Here are a few common, inaccurate and misleading media stereotypes of people with mental illness:
People with mental illnesses are criminal or violent. Studies show that not only are individuals with mental illness less likely to commit violent crimes, they're actually more likely to be victimized. Still, Wahl points out, many news outlets conflate mental illness with violence. A common news account of mental illness, for instance, involves a sensationalized and violent crime in which an innocent person is killed by a mental health patient. The article is laced with graphic descriptions, emotional diction and a glaring headline. It also depicts the mentally ill person as devoid of social identity and dangerous, capricious, aggressive and irrational.
This goes for fictional media, too. For instance, TV characters who've been identified as having a mental illness are typically shown as violent, says Don Diefenbach, professor and chair of mass communications at University of North Carolina--Asheville, who researches media portrayals of mental health issues.
Diefenbach analyzed the portrayals of psychological disorders on prime time television. He found that characters who were identified through behavior or label as having a mental illness were 10 times more likely than other TV characters to commit a violent crime -- and between 10 to 20 times more likely to commit a violent crime than someone with a mental illness would be in real life.
People with mental illness look different than others. Maybe it's the disheveled hair. Maybe it's the rumpled clothes. Maybe it's the wild eyes. Whatever it is, Wahl notes, there's usually something "different" about the appearances of people with mental illnesses -- be it on TV shows or in video games, movies or comics. These traits serve as visual signifiers to cast these characters -- who are often threatening or evil -- as the "other."
Many homeless people -- who often lack the resources or wherewithal to take care of their appearances -- are mentally ill. "But there are also a huge number of people with mental illnesses who are getting up -- showering every day, going to work, etc.," Wahl says.
In short? People with mental illness look like, well, everyone else -- not like their media stereotypes.
People with mental illnesses are childish and silly. Many movies and TV shows -- for example, "Me, Myself and Irene," starring Jim Carrey as a patient with dissociative identity disorder, or "Monk," the show about a detective with obsessive-compulsive disorder -- make light of mental illnesses. They portray otherwise serious psychological conditions as mere quirks, or those who have them as silly, funny and childlike.
These portrayals don't "convey the way most people with serious mental illnesses are in pain," Wahl says. In reality, he says, "they hurt. They're struggling."
Mental illnesses are all severe -- or all alike. According to Diefenbach's research, depression only accounted for 7 percent of the psychiatric disorders shown on TV. However, 12 percent of the characters suffered from some form of psychosis -- experiencing delusions or voices, or losing touch with reality.
In reality, depression is much more common than mental disorders such as schizophrenia and bipolar disorder. "The real-world relationship is going to be that depression outnumbers the family of psychotic disorders by about 6 or 7 percent to one," Diefenbach says. Yet on TV, the most extreme cases -- and the most rare disorders -- tend to be disproportionately represented.
Individuals with mental illness also note that various conditions tend to get lumped together. "Mental illness" is used as a catch-all phrase to describe someone's condition, as opposed to specific medical terminologies such as "schizophrenia" or "anxiety disorder." And even then, little variation is shown from patient to patient; one movie portrayal of bipolar disorder tends to resemble another.
"There's no discussion that each disease is different in each person, because each person is unique," notes Nikki Marks, 46, who has bipolar disorder. "In real life, mental illness shows up differently in everybody. The media does not represent the complexity of mental illness in general. There's this sense that it's just a one-name-fits-everybody, or one-title-fits-everybody."
Psychiatric hospitals cause more harm than good. Hospitals for the mentally ill have come a long way since 17th century Europe, when cold, dark facilities housed hoards of physically and mentally disabled patients, along with prostitutes, alcoholics and other social outcasts. Those mental institutions resembled a prison more than a place of healing -- an image that's still perpetuated by cinema, according to a recent study conducted by researchers at the University of Salamanca in Spain.
Despite sweeping reforms that occurred over the past half-century, many films and television shows continue to portray psychiatric hospitals as bereft of comfort or care -- empty corridors, bare walls and intimidating wings filled with manipulative doctors whose treatments cause more harm than good. And patients are often shown as committed against their will, or psychotic and out-of-control.
While all medical facilities differ in quality and care, today's psychiatric wards and treatments are different -- even if the public's perception of them isn't, experts say. And despite the common television or movie theme of a patient being sent to a psychiatric hospital against his or her will, that's often not the case.
"In reality, a great number of people elect to go to [psychiatric wards]," says Wahl, dispelling the notion that most patients are involuntarily committed. Laws differ from state to state, but on average it's very difficult to send patients to a psychiatric ward against their will.
People with mental illnesses can't recover. "Recovery is seldom shown" in the media, Wahl notes. "When people [are shown seeking] therapy, when they go to psychiatric hospitals -- rarely do they get better." And if they do get better, he adds, "it's enough that they're stabilized, but not enough so that ... they're integrated with the world, and have friends and jobs." The resulting message, he says, is that individuals with mental illnesses have no hope for a "normal" life.
The reality is that this isn't true: Experts say not only do patients often recover from psychiatric illnesses, but they can live health lives with the help of medications, therapy and support networks.
Pamela, a 57-year-old who lives in the District of Columbia who did not wish to use her last name, cites her story as proof. Pamela has bipolar disorder, and spent years dropping in and out of college and shuffling between doctors. But 10 years ago, she finally found a medication that stabilized her moods. She moved out of a group home, purchased a condo, held down a job and recently retired from her job as an office assistant.
"My recovery," Pamela says, "was like a phoenix rising out of an abyss."