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Innovation

Using film screenings to raise public awareness of mental health

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Monthly screenings at Robert Gordon University use film as a medium to increase awareness of, and promote discussion around, mental health issues

Abstract

Mental Health Movie Monthly was launched in 2016 at Robert Gordon University by two lecturers with the aim of improving understanding around mental health and increasing empathy with people who experience mental health issues. Films chosen for their potential for fruitful debate are shown, followed by an open discussion in which all members of the audience are welcome to participate. The screenings attract a wide-ranging audience not limited to the field of mental health. This article describes the initiative and the rationale behind it.

Citation: Macpherson S, Warrender D (2018) Using film screenings to raise public awareness of mental health. Nursing Times [online]; 114: 7, 29-31.

Authors: Scott Macpherson and Dan Warrender are lecturers in mental health, both at Robert Gordon University, Aberdeen.

Introduction

Mental Health Movie Monthly (MHMM) uses film as a medium to increase awareness of, and promote discussion around, mental health. This free event, which takes place every month at Robert Gordon University in Aberdeen, is an opportunity for people to watch and discuss a film with themes that are pertinent to mental health.

How MHMM was born

We created MHMM in 2016 with the aim of improving understanding of mental health and increasing empathy with people who have mental health problems. The idea was born from both an enthusiasm for film and a passion for raising discussion about mental health. Conversations around film often lead to discussing the human experience; we thought discussing films would help raise awareness and improve understanding of a subject that is still often taboo.

Film has become a mainstay of our culture and conversations about films are commonplace, but the same cannot be said about mental health. We believe there are benefits to be gained from widening the discourse on mental health – using film as a platform for discussion offers a chance to bring mental health into the spotlight.

MHMM was launched in May 2016 with a showing of Take Shelter to celebrate Mental Health Awareness Week. The screening was well attended by university staff, students, mental health professionals and the general public, and was followed by honest, open and interesting conversations. This gave us the confidence to run a monthly event.

Mental health stigma

Corrigan and Kleinlein (2005) described stigma as comprising three elements:

  • Stereotype;
  • Prejudice;
  • Discrimination (Box 1).

Stigma and misunderstanding still exist around mental health and mental ill health, not only among the general public but also among health professionals (Riebschleger et al, 2008). This can lead to negative experiences for those living with mental health problems – as well as for their families and carers, who can feel ignored, isolated, criticised or blamed (Riebschleger et al, 2008, Schulze, 2007; Mirabi et al, 1985). Stigma is reduced when members of the general public experience positive contact with people who have mental health problems (Holmes et al 1999; Link and Cullen, 1986).

Box 1. Stereotype, prejudice and discrimination

  • Stereotype – a simplified or sweeping belief about a group of people based on a certain characteristic, for example, gender, religion or diagnosis
  • Prejudice – occurs when someone validates a stereotype, particularly when this involves negative attitudes towards people because they belong to a particular group
  • Discrimination – manifests when prejudice leads to the unjust treatment of people, for example, a person being rejected for a job based on the belief that their mental illness will result in them being unable to fulfil the role as well as someone who does not have a mental illness

Source: Corrigan and Kleinlein (2005)

The power of film

Film is a hugely influential medium (Goodwin, 2014). Portrayals of mental ill health in film can have a significant impact on the public’s views on mental illness, and consequently on how people with mental health problems are considered and treated (Darbyshire and Baker, 2012; Chouinard, 2009).

Historically, depictions of mental illness in popular cinema have tended towards the negative, and film has been described as “a reservoir of prejudice, ignorance and fear that feeds and perpetuates damaging stereotypes of people with mental health problems” (Byrne, 2009). However, film has also been shown to be a useful tool in learning about mental health and mental illness (Wedding and Niemiec, 2003). Furthermore, there is evidence that it can stimulate discussion on topics that people with mental health problems would otherwise find difficult to broach. Using film allows engagement in a “once-removed” way (Raingruber, 2003).

A number of studies have explored the use of film for teaching medical students about mental health disorders as part of the undergraduate curriculum (Friedman and Hall, 2015a, 2015b; Hall and Friedman, 2015; Akram et al, 2009; Hyler and Schanzer, 1997), while Webster et al (2015) have explored the use of film to the same end through an extracurricular film club. Film has also been explored for its use with patients as an aid to therapy (Lampropoulos et al, 2004; Schulenberg, 2003; Sharp et al, 2002; Hesley and Hesley, 2001). The way film is used at MHMM – that is, as a platform for fostering discussion, creating empathy and reducing stigma – however, seems to be an original concept.

Equal platform

Our MHMM screenings aim to engage people from all walks of life, not just those who study or work in the field of mental health. It provides an opportunity to share the experience of watching a film, along with the chance to discuss thoughts, feelings and opinions openly and equally, without judgement or criticism. There is no ‘expert panel’, as one of the aims is to promote equality and collaboration. Instead, everyone who attends is considered an expert on their own experience and, as such, is given an equal platform. Post-screening discussions are facilitated by us; we are both mental health nurses and lecturers with experience in clinical and educational settings.

Izod and Dovalis (2015) argued that it is difficult to engage deeply with the emotional experience of film in any setting other than a cinema, as a cinema offers a sanctuary that allows audience members to immerse themselves into the complexities of the film. We create a cinema-like experience for MHMM by screening the films in a darkened lecture theatre with tiered seating while offering free popcorn and snacks.

Film selection

It can be argued that any film depicting human beings addresses the human condition and therefore deals with mental health. We choose the films based on their potential for fruitful discussion, rather than on their subjective quality.

All films are considered, from major Oscar winners to bargain-bucket flops. Participants are encouraged to suggest films – as well as to present their chosen film and their reasons for selecting it if they so wish – and we have screened films from a variety of styles and genres. Examples include the tragicomedy Adam and Paul, which follows two heroin-addicted companions through a series of encounters in Dublin, and the Australian horror film The Babadook, which tackles grief and loss. Pixar’s Inside Out, a computer-animated film that illustrates psychological concepts such as mentalisation, has also been shown, with children attending the screening and participating in the discussion.

Film-makers’ responsibilities

At the risk of sparking controversy, we screened The Voices, a dark comedy featuring a central character who experiences auditory and visual hallucinations, and ultimately commits a series of murders. The character, Jerry, is happier when he is not taking his antipsychotic medication. Then he is faced with the grisly reality of his deeds, which become apparent to him when he is medicated.

The screening was followed by an animated discussion around the nature of the issues Jerry is experiencing, the role of the physician, the pros and cons of medication use for mental health problems, and whether or not film-makers have an ethical responsibility to depict mental health conditions accurately and sensitively. Some argue that film is art and should, therefore, be free from rules and boundaries, but others argue that stereotypes and stigma can be reinforced by inaccurate or insensitive portrayals of mental health issues in films – there was some debate among the audience, particularly around the responsibilities of film-makers.

The facilitators used their skills as mental health nurses and therapists to validate and explore each perspective. Through an initiative like MHMM, any film, regardless of its subjective quality, can lead to fruitful discussion and raise awareness, and this has the potential to improve outcomes and experiences for people with mental health problems.

Everybody’s business

Mental health is everybody’s business and everyone has a personal experience of their own mental health, which – just like physical health – can fluctuate from fragile to robust. To reduce, and ultimately eliminate, negative experiences caused by stigma, it is crucial that people without lived experience of mental ill health see mental health as something that concerns us all.

The sharing of experiences and understandings that happen at MHMM has the potential to reduce stigma in local communities and, therefore, improve the experience of people with mental health problems. It also has the potential to improve nursing practice. Both students and registered nurses usually attend our screenings; they can take the experiences and understandings into their practice, thereby improving the lives of people experiencing mental health difficulties at times of great vulnerability.

Wide-ranging audience

Screenings are advertised through a mailing list, social media, university newsletters, the local press and word of mouth. We run MHMM in our free time and ensure it is completely free to attend, with pizza, sandwiches, popcorn, tea and coffee available to all. Pizza and sandwiches are provided free of charge, while Robert Gordon University takes care of the screening license, purchase of films and money for tea and coffee.

The initiative has attracted academics and students across disciplines, service users, people working in mental health and members of the general public. Feedback has been overwhelmingly positive; some of the comments we have received feature in Box 2. People with lived experience of mental ill health regularly attend screenings and some have been encouraged to attend by the carers and professionals who support them – this shows that MHMM is perceived as being of therapeutic value over and above its value in raising awareness and breaking down stigma.

Involvement in community projects – such as the NHS Youth Forum, the local Health and Social Care Partnership and the Look Again Festival, which focuses on contemporary visual art and design – has allowed MHMM to reach a wider audience. Since 2017 the Scottish Mental Health Arts Festival has included MHMM showings in its programme to mark Mental Health Awareness Week and these programmes have been supported by a variety of partner organisations across Aberdeen. The MHMM message has also been developed into a week-long workshop delivered in both 2017 and 2018 at Häme University of Applied Sciences in Finland during its International Wellbeing Week.

Box 2. Attendees’ feedback

  • “A good way to promote discussion/awareness of mental health issues”
  • “Love the concept – using something familiar (movies) to make difficult topics more accessible”
  • “I enjoyed the extra depth of understanding [gained] by listening to others”
  • “It’s perhaps the development of a community of understanding”

Conclusion

MHMM creates opportunities for exchanging experiences, sharing opinions and discussing issues around mental health that may otherwise remain hidden. Using film as a platform for broaching the subject of mental health makes it accessible, attractive and engaging for a wide range of people, which may be more difficult to achieve through formal discussion groups or expert panels.

Since its inception, attendance has grown to an average of 30 people, which provides an array of experiences and ideas to fuel discussion. There is, however, capacity for increasing numbers, and the aim over time is to spread the word to a wider audience, particularly members of the general public who may not necessarily consider themselves affected by mental health issues. 

Key points

  • To reduce stigma, mental health needs to be seen as something that concerns us all
  • Using film as a platform offers a chance to bring mental health into the spotlight
  • Films have been used as a tool to teach medical students and as an aid to therapy
  • Discussing a film can help people with mental health problems to broach difficult subjects
  • At Robert Gordon University, screenings of films with mental health themes are used to foster discussion, create empathy and reduce stigma
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