All About Mental Health in Writing
Good mental health is key in writing … not just for us as creatives, either! As writers we also need to represent mental health in authentic and meaningful ways in our writing too, as I described in my previous article on How To Challenge Stigma In Your Writing.
So I’m delighted to welcome junior psychiatrist and author Rosie Claverton with some big NO-NOs and pitfalls to avoid in your scripts and novels. Over to you, Rosie …
Mental Health Representations
As we talk more about mental health, depictions of people with mental health problems become increasingly common and more varied, including some great own voices narratives. However, the same tired tropes are also still doing the rounds, so let’s try to knock some on the head. Here’s my top 5 pet peeves:
1) Killers are “psychos” without a motive
The “psycho killer” is the worst mental health stereotype, infesting fiction, media and society with fear and loathing of mentally ill people. Psychopathic and psychotic are used interchangeably and any motivation for action is stripped back to a simple “he’s crazy”. Ugh.
Not only is this harmful to people with mental health problems – a group more likely to be victims of violence than perpetrators – it is also lazy writing. A mental illness doesn’t remove agency or make a person a blank slate.
If you hit out because you think someone is trying to deliver you to the FBI? That’s a motive. The experience might not be shared by anyone else, but it’s real to you. It is your motive, even if it’s not obvious to outsiders.
TOP TIP: If your killer must have a mental illness, they are still human. They are not psycho monsters from the shadows whose only motive is “crazy”. Write smarter. MORE: Crime Writing For Beginners
2) It’s all electric shocks and padded cells
If you ask someone about their impression of treatment for mental illness, the most common response involves One Flew Over the Cuckoo’s Nest. A seminal film of the 1970s, it features a scene where Jack Nicholson’s character receives electroconvulsive therapy without anaesthetic as a punishment for his behaviour.
My first recognisable encounter with mental health on TV was Stargate SG-1, where a main character is drugged and locked up in a padded white room. It stayed with me right until I saw my first mental health unit at medical school – and couldn’t find a padded cell anywhere.
TOP TIP: ECT is a seldom-used treatment for the most severe mental illnesses, particularly life-threatening depression. It is heavily regulated in the UK, requiring an independent second opinion if a person is unable to consent. And we don’t use padded cells to contain people, though we sometimes use squishy furniture for safety.
3) People popping pills are all addicts
If someone takes medication in fiction, it is Chekhov’s Tablet – a secret illness or a devastating addiction must be revealed.
Opening a bottle of pills is a shorthand for “this person is Not Coping”. It associates tablets and weakness in the mind of the viewer. It stigmatises mental health medication and painkillers in particular, though asthma inhalers also get a bad rep.
At some point, a well-meaning hero will take the pills and probably dramatically flush them down a toilet. Or they will be used in a suicide attempt, reinforcing their very-bad-no-good label.
TOP TIP: Taking medication is not a sign of weakness or a crutch for the feeble. It is a strength to recognise when support is necessary, and medication can make parts of life accessible where they otherwise wouldn’t be. As the phrase goes – “if you can’t make your own neurotransmitters, store-bought is fine.” MORE: 3 Stories picked around the theme ‘Mental Health Matters’
4) Psychologists sleep with their clients
You would think that this statement was so blindingly obvious that it wouldn’t need saying. Yet I’ve lost count of the number of cool, attractive female therapists who meet a troubled, emotionally-repressed bad boy and end up taking him to bed.
In some forms of therapy, a client unconsciously projects fantasies on the therapist and these are explored. These are not necessarily sexual – parental or mentor feelings can also be placed on the therapist. (Note: do not adopt clients either.)
TOP TIP: Suffice it to say, therapists sleeping with clients is unprofessional! These people should be reported and struck off, and it’s not okay even when you’re not therapist and client anymore. Ever.
5) Mental illness fits into a one-off episode
Sometimes, a TV show or book series is keen to emphasise exactly how much events have affected a character. They want their season finale or big budget spectacle to have further repercussions.
Enter the ‘Very Special Episode’.
The most common illness featured is post-traumatic stress disorder, but depression and addiction are also popular.
Then, next episode, it’s over! The character is probably told to get some help or led to a therapist (who they hopefully don’t sleep with). Then it’s all done and dusted. If you’re very lucky, it might last two episodes or have a couple of brief call-backs during the season.
While some mental illness is episodic, it rarely appears and disappears so quickly and without other consequences. What about the debts racked up during an episode of mania? Or the hours of therapy for PTSD and the lingering hypervigilance whenever a car backfires? How about the third, fourth, fifth relapse of depression?
TOP TIP: Why not think of a story that actually includes the chronic causes of mental illness, the slow recoveries, the altered patterns of life for once? MORE: 5 Ways To Stop Being A Tortured Artist
It is a writer’s role to entertain, but also to understand the impact of their words. Mental illness is a subject in which the impact can be positive and negative, and where the stories we tell can promote social acceptance or social stigma. Depicting a variety of people with mental health problems, not just insane killers or briefly traumatised heroes, and accurately portraying treatment is socially responsible writing that avoids clichés and promotes better storytelling.
BIO: Rosie Claverton is a novelist, screenwriter, and junior psychiatrist. She advocates for sensitive and accurate mental health portrayals, including blog series Freudian Script. She is co-founder of the Welsh crime writing collective Crime Cymru. Her Cardiff-based crime series The Amy Lane Mysteries debuted in 2014, with the latest novel Terror 404 out now. Rosie lives with her journalist husband and nearly new daughter.