USC Annenberg Inclusion Initiative Releases Part Three of Their Mental Health Study in a Film Titled Misrepresentations: Popular Movies Misrepresent the Reality of Mental Health Conditions

EXCLUSIVE: Mental health is on the minds of medical professionals, policy makers, parents and advocates these days. Yet a new study reveals that one area where little has changed for mental health is popular movies.

The new report, by Dr. Stacy L. Smith and the USC Annenberg Inclusion Initiative, is the third in a series examining the portrayal of mental health in popular movies. The study, Mental Health Conditions Across 300 Popular Films, was also supported by Dr. Christine Yu Moutier and the American Foundation for Suicide Prevention. The new research examines the prevalence and representations of mental health conditions in the 100 highest-grossing films of 2022, comparing the new findings to previous Initiative studies covering 2016 and 2019.

You can read the full report here

Only 2.1% of 3,815 speaking characters surveyed in 2022 had a mental health condition. This is consistent with the results from 2016 (1.7%) and 2019 (1.5%) and reveals that there has been no change over time. The percentage also falls below the 21% of US adults who reported having suffered from a mental illness in the US National Comorbidity Survey.

Our work has shown that change has occurred in entertainment across a variety of indicators, said Dr. Smith, the founder of Initiatives. However, when it comes to mental health conditions reported by a significant portion of the population, there has been no improvement over time. Entertainment may play a role in shaping perceptions of mental health conditions, but the absence of these representations communicates that mental health conditions are invisible as are those who live with them. This has to change.

Nearly half of the films reviewed (48%) did not even feature a character with a mental health condition. Another 34% of the films in the sample featured only a single character with a mental health condition. That means more than three-quarters of the best films of 2022 contained little or no representation of mental health.

The most commonly represented mental health conditions were addiction, mood disorders, and anxiety/PTSD. There was some year-to-year variability in the types of conditions shown in the films, but the top-grossing films consistently portrayed few.

There was little difference in the percentage of men (50.6%) and women (49.4%) represented with mental health conditions. However, the majority of characters with a mental health condition were white (76.3%) and a few characters were from underrepresented racial/ethnic groups (23.8%). Only 7 LGBT-identified characters were shown to have a mental health condition. Finally, 15 characters with mental health issues were also depicted with disabilities.

The studio also looked into how characters with mental health issues were portrayed in the ongoing storyline. Nearly 80% of characters with mental health issues have experienced some form of on-screen contempt. While this could include general taunts that were unrelated to a character’s mental health condition, nearly half of the characters (47%) were taunted specifically regarding their mental health.

In addition to experiencing storyline derision, nearly 20 percent of the characters were also the subject of humor or jokes about their mental health condition, which is similar to the findings of the 2016 and 2019 film reports. The negative context surrounding the representations of mental health paints a problematic picture for the public.

Often when characters with mental health issues are shown, we see how badly they are treated, says study co-author, Al-Baab Khan. It’s clear from the results that little has changed in how storytellers portray characters suffering from mental illness. There is a huge opportunity, especially given our current climate, to be better and to be recognizable.

The report also revealed that characters with mental health issues were linked to violence. Since 2016 (46%), the percentage of characters shown as perpetrators has increased significantly, reaching 63.4% in 2019 and 72.3% in 2022. A similar result was observed for characters with conditions of mental health sufferers who have been subjected to violence, this percentage has increased from 60.9% in 2016 to 77.1% in 2022. Films continue to perpetuate and convey to viewers a portrayal of mental health infused with violence.

Violence was also a hallmark of how characters with mental health issues died in popular movies. Nearly 40% of the characters are dead by the end of the film, including those who took their own lives and those who were killed by another. Of those characters who died, 54.5% died by violent means. On screen, suicide was the cause of death for 21.2% of characters with mental health issues.

The film appears to have little value for the lives of characters with mental health issues, Dr. Smith said. From violence to death, popular movies tap into outdated stereotypes in ways that can negatively impact audience members’ attitudes, perceptions, and beliefs when it comes to mental health.

Additionally, the study explored the frequency with which help-seeking behaviors occurred in relation to representations of mental health. Approximately one-quarter (25.3%) of the characters with mental health conditions were shown in therapy, including individualized support, group therapy, and substance abuse treatment. There has been no significant improvement in portrayal of therapy since 2016. In 2022 films, only 15.7 percent of characters have used medication or other forms of treatment for their condition. While low, this figure hasn’t changed since 2019.

One solution to increase representation of mental health is for creatives to use the Mental Health Media Guide. The Guide is a comprehensive blueprint for content creators outlining best practices at each stage of the production process. Developed by the Annenberg Inclusion Initiative in conjunction with MTV Entertainment Group and expert professionals, the Guide offers insights for increasing the number and authenticity of mental health representations through scripted and unscripted entertainment. The Guide is also one of the signature efforts of the Mental Health Storytelling Initiative, which also includes the Mental Health Storytelling Coalition, a collection of leading mental health industry groups and nonprofits. Through the Mental Health Media Guide and the Mental Health Storytelling Coalition, storytellers can learn and be connected to experts who can help shape safe, authentic and nuanced portrayals of mental health.