It is not possible to diagnose a character in a film with a mental health problem, partly because we don’t have all the information of what is going on but also the actions they take will be made for purposes of storytelling, not accurate descriptions of health conditions. So when the 1960 classic horror movie Psycho used that word to describe the film and its villain, what were they trying to say? Most of the conversation of Norman Bates’ diagnosis seems to suggest Dissociative Identity Disorder, DID, previously known as Multiple Personality Disorder. The term “psycho”, or even psychopath, is not present in either of those conditions. “Psycho” was simply a word used to denote a dangerous and “crazy” person. The audience does not need any understanding of mental health to know what the title is suggesting. An academic article in The European Journal of Trauma & Dissociation argued that portrayals in media of people with DID were prone to over-the-top displays of switching of personalities and they were violent, dangerous and engaged in criminal behaviour, despite “that the vast majority of individuals with DDs (dissociative disorders) do not perpetrate violent crime; instead, they are more likely to be victims of it”.

The word “psycho” is a shortened form of the clinical term psychopath, this is someone felt to have a severe form of Antisocial Personality Disorder. There is also the term “psychosis” which is when someone suffers from a break from reality. Many, many horror villains would probably fall under the umbrella term of suffering a psychosis, but again those suffering from psychosis are more likely to be a danger to themselves than others. It is safe to say that the portrayal of DID, psychopaths, and those suffering with psychosis in the film Psycho is an inaccurate and negative one.

Halloween

Another horror movie considered a classic which leans heavily on mental health tropes is Halloween. The killer Michael Myers murdered his family as a six-year-old and has been held in a secure hospital ever since. There is a very vague explanation of any mental health problems Michael Myers has and more relies on the fact that he is a dangerous violent person who escaped from “lunatic asylum”. There are assertions about Myers being pure evil and even in the first film suggestions of superhuman or supernatural abilities. The clinical psychologist in charge of Myer’s care refers to him as “it”. Halloween is not trying to make a nuanced film about mental health, and neither would most of the audience accept this as a realistic portrayal but it further feeds into extremely negative views on mental health.

Split is a relatively recent addition to the horror genre and again focuses on Dissociative Identity Disorder. James McAvoy plays the villain, a serial killer with 23 distinct identities, some of whom are violent and dangerous and often seem to have abilities beyond normal humans. There was a negative response to the film from those working in mental health, stating that it sensationalised aspects of the disorder and showed that someone suffering from DID as inherently dangerous. In the movie the villain’s psychiatrist is pushing the medical community to move from a model of incarceration to treatment for people suffering from DID, many of her former patients have been incarcerated rather than treated. Now given that the villain is her patient, and is in fact a very dangerous individual who is actively harming people is Dr. Fletcher simply a naïve patsy? A message that for all doctors talking of treatment, understanding, and compassion are misguided, even though the actual real-world reality shows the view of people with DID as violent is incorrect.

The Babadook

Not all films handle mental health in such a negative way. Horror masterpiece The Babadook has a lot to say about depression, grief and the genuinely soul-destroying exhaustion a parent can go through, dealing with incredibly dark thoughts and feelings of negative thoughts a parent could have of their own child. Hereditary, widely considered a modern horror classic, is largely about grief and family trauma. This is not new – Don’t Look Now released in 1973 while dealing with typical horror ideas of the occult and murder is about parents grieving the loss of their child. What is notable about these films and their relationship to mental health is that the horror is a metaphor for the problems they are going through, it is not that a person who is suffering from depression and grief is murdering people but rather the supernatural danger they are dealing with represents that.

The criticism of how these films handle mental health is not to say they’re bad movies but that they could have made other choices, and portrayed things differently. Almost inevitably if the villain of a horror movie is identified as having a mental illness…then that will be the driver behind their actions and routinely misrepresented and sensationalized.

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