Photo: A billboard for Joker displayed in West Hollywood in 2019. Credit: Mario Tama/Getty Images
Much of the discourse surrounding mental health over the last few years has focused on stigma: breaking down those unhelpful myths around mental illness that both prevent people seeking help and, sometimes, lead to outright discrimination.
What part culture has to play in this mission is an interesting question. Both the “madman” and the asylum have been a ubiquitous presence in cinema, literature and television, often to the chagrin of those who have had such stereotypes directly affect their lives. A new study, published in JAMA Network Open, has looked at the impact one recent film, Joker, might have had on prejudice.
The film is a gritty retelling of the origin story of Batman’s nemesis, the Joker, inspired by classic 1970s cinema. Arthur Fleck, played by Joaquin Phoenix, is depicted as having unspecified mental health problems: after his medication supply is cut off, he goes on a violent rampage and becomes the antihero we know from the comics.
Whether or not the film was stigmatising was subject to great debate at time of release: in The Guardian a pair of doctors argued that the film perpetuated damaging stereotypes, for instance, whilst another piece in the same paper described it as an authentic depiction of someone misunderstood by an uncaring society.
To investigate whether watching the film influenced people’s attitudes towards those with mental illness, Damian Scarf from the University of Otago and colleagues held screenings of Joker for 84 participants and of Terminator: Dark Fate, a film with no depiction of mental illness, for 80 participants. Demographic data was taken for all participants, including whether or not they had personal experience of mental health problems.
Before and after both screenings, participants completed the Prejudice Toward People With Mental Illness (PPMI) scale, which gauges how much the respondent fears or avoids people with mental health problems, and how much they view them as unpredictable or malevolent .
Results suggested that watching the film did increase negative perceptions of mental illness. Participants watching Joker had a mean score of 2.99 before watching: this increased to 3.20 after having seen it. Those watching Terminator: Dark Fate, on the other hand, had a mean score of 2.91 before and 2.88 after watching the film. Unsurprisingly, those with a history of mental illness had lower PPMI scores across the board.
There were a few limitations to the research. Sample size was extremely small, to start: future research could look at a larger sample, and at a wider range of media. The study was also unable to probe how often prejudicial attitudes lead to tangibly discriminatory behaviour towards people with mental health problems: though discriminatory behaviours are included in the PPMI scale, self-reporting such behaviours may not be a fully accurate way of linking perceptions and related actions.
No matter what you think of Joker itself, it’s hard to deny that cinema hasn’t always been kind to mentally ill people, whether that’s in schlocky asylum-based horror films or in less antagonistic but intensely pitying alternatives. As society tries to leave stigma behind, however, it may be time for the stereotypes to be retired completely in favour of the richly drawn and complex narratives that are truly deserved.