Psychiatric patients on screen aren’t always accurately portrayed

The waiting room at a psychiatrist's office.
The waiting room at a psychiatrist’s office.

By Daniel Tristyn Silva

Getting help for a mental health issue can be daunting. Portrayals on screen, through film or television, may warp the accuracy of the perceived enormity of the task at hand.

“They didn’t look like crazy people. It was professionals and regular people, like you and me,” said Sonja, who asked that she be identified using her first name.

Seeking normal outpatient care is depicted through many lenses and aspects in television and film. 

According to a National Institute of Mental Health study, 52.9 million individuals in the United States had mental health issues in the calendar year of 2020. Of those 52.9 million, 24.3 million sought help. Meaning, only 46% in need of treatment sought and received it. 

“I thought there were going to be people scratching at their skin or all looking very tired,” she said.

Sonja, 44, said she decided to go to a therapist who specialized in recovery from drug and alcohol abuse.

“I figured I am the one in a million that isn’t court ordered to be here. Everyone is Annalise Keating. They’re all here to keep their job, or the judge is going to take their license away,” she said. “So, not only am I crazy enough to have to be here doing what she did, I’m literally doing it to myself. So, I guess that makes me even more crazy.”

Annalise Keating is a character from the television show How to Get Away with Murder. She is an alcoholic that is ordered to seek substance abuse treatment in order to retain her license to practice law. 

“I definitely wondered if everyone would think that I had committed some kind of problem and a judge told me to go, but like that was a lot of paranoia at that time anyway. I don’t care about people as much as you’d think though. I’ll put it out there,” Sonja said.

Some shy away from asking their therapists or mental health care providers some questions that have potentially concerning answers. This was not the case for Sonja.

“I just came right out and asked him. Like, so, is everyone basically here because they want to or is someone making them so they can keep their kids or job or something? He basically looked at me and laughed and was like yeah no. Pretty much everyone was there, because their family or themselves,” she said. 

Mark, Sonja’s partner, had been trying to tell her that what she was feeling may be irrational.

“I’d been telling her to stop watching stuff and feeling like these guys are your best friends. If they’re on TV it’s purely there to entertain. That’s not their to inform you. People have to know that,” said Mark.

Sonja had held onto that manner of thinking regarding reasoning for people in her position seeking treatment from a drug and alcohol therapist for a long while. In a few minutes that stereotype, perpetuated by television and film, was dispelled. 

Fears or worries to do with internal struggles are so common and often perceived as massive as it is when it comes to getting help with a mental health issue. You can hear something from your mental health care provider that allows a shift in perception. You may also hear something from someone else in the room with you. Even another patient. 

“I was nervous. You’d be shocked by how much is going through your mind even if you just have five minutes before your appointment. It’s that feeling of biting your fingernails in a movie, where they’re looking at all these psycho people staring at the walls back and forth,” said Marina Saenz.

Saenz said she sought treatment for her mental health and met someone in the waiting room that had a dramatic impact on what she thought about what’s going on in the minds of others while there.

“I felt like God, everyone can see me freaking out, like in a movie where everyone is flipping through the magazines, and you’re just there freaking out while everyone is just chilling and waiting,” she said. “I was doing my deep breathing and I noticed this man quietly taking note of everything in the room.”

Having already filled out all of her paperwork, Saenz sat there for a moment and watched him with a curious eye. 

“I didn’t want to be rude, but we were sitting so close. I started to make eye contact with him a couple of times and I was like oh my God what do I say? I just said hi and he told me he was sorry,” she said. “I asked him what he was sorry for and he kind of just spoke under his breath and pointed at things across the room.”

Saenz had momentarily interrupted a man in his ritualistic practice that helped him cope with his schizophrenia. 

“He was explaining to me that he needs to always make himself feel present wherever he is. This man was so far away from thinking about me and wasn’t calm and cool like I thought. He wasn’t calm and cool like I’d seen. He was straight up trying to make it through those next few minutes to get through the door to his doctor,” she said. 

Seeing depictions of seeking treatment in film and television might make you have a way of thinking of why they are seeking that treatment or what they are going through while they are there in that immediate lead up.  “You may feel like your heart is beating fast, or like your lungs are in your head, or like you’re chewing your nails. But unlike the TV everyone else isn’t sitting there turning the pages in the magazines chilling,” said Saenz.

When you are seeking treatment and you are actually there, you have many different things that you might be curious about. Am I the only one struggling right now? Why is everyone else here? However, what about how long have these people been doing this? How do they pay for this? How long will I have to be here? Is it the same as them?

“I knew my appointment was coming up and damn I was like how do these people pay for this with no insurance? Or where is the money? I see it on movies where the person, even if they’re poor just goes and gets the meds or counseling,” said Nick, who also asked that his last name not be used.

“I walked in, sat down, and I was like okay, so cool, these people are paying 175 a pop for an appointment. I have no idea, but I’m assuming they’ve been coming, because they didn’t have the big ole clip board with five thousand papers. In the movie you pay nothing, and no one cares, then Robin Williams comes in and fixes your whole life,” he said. 

Nick was referring to Robin Williams’ character in Goodwill Hunting. Williams plays a therapist that helps the main character work through childhood trauma. 

“I’m over here wondering if all these people are like the ones from the movies and they just have the mental problems, but no money problems. Like, I mean, no money problems that actually like matter in their lives,” said Nick. “They can be poor, but somehow, they still pay for all their stuff. So, I felt like these people in here are all just cruising with everything just paid for.”

It is easy to wonder all of these things based off the primary insight we get into them. This being through fictional media in the form of film and television. 

“I started asking around and looking on these online forums that my doctor recommended. It turns out that, yeah, pretty much every single person is struggling to pay for their stuff. No one can afford it, but somehow, we are all expected to,” said Nick. “I think they are sometimes doing a good job of showing how tough it can be when you’re like depressed, but a bad job of showing how you pay, or try to pay, to get better.”

If you or someone you know are in need of help for a mental health issue call 1-800-950-6264 to speak to the National Alliance On Mental Illness Helpline.