Mental Health in Horror

Horror is my greatest love in terms of movies. Gore, body, supernatural, monster, slasher. I love great horror and I love terrible horror. Historically, the genre has been the most self-aware, self-referential and self-deprecating. It’s spawned some of the most iconic filmmakers of all time- Hitchcock, Cronenberg, Craven, Carpenter, Romero, del Toro. Each delivering something so exquisitely their own, each influencing one another, creating a blood splattered collaborative tapestry that continues to be woven today in new ways by fascinating new filmmakers. Horror has given us innovative uses of practical and visual effects. Modern responses to horror have also been a reflection of our social circumstances- the ‘video nasties’, censorship, moral panics, social outcries. Horror changes as we do- our fears and understandings of ourselves change according to what is going on around us and the genre changes with it.

I think we’re entering a new phase of horror in which critics and audiences alike are being forced to take it more seriously as a genre- this is in no small part because of modern horror titans like Jordan Peele and Ari Aster, who have shown that horror can be a great vehicle for progressive, interesting and current narrative themes and disturbing, beautiful and lasting imagery. As representation of race, gender, sexuality and ability are becoming more and more important in wider popular culture (although there is much more work left to be done) it seems as though horror is a leading player in the depiction and inclusion of some marginalised groups. Why, then, is it so difficult for horror writers to leave the mental illness trope in the past where it so clearly belongs?

The history of mental illness in horror is not a proud one. Psycho (1960), Halloween (1978), The Shining (1980), Misery (1990), Orphan (2009), Split (2016)- one film from each decade of the last 60 years and by no means an exhaustive list of the lax and careless representations of mental illness horror has offered in that time. The crux of the issue is this: horror all too often paints those with mental health conditions as the perpetrators of violence when they are far more likely to be the victims, and characters with mental health conditions are almost always one dimensional villains.

There is a wealth of horror villains whose only characteristic is their mental illness, although this is sometimes retrospectively added and built on into the film’s or franchise’s lore. I can’t think of a better example of this that Michael Myers. Michael’s cinematic career began in 1978’s Halloween, in which he murders his sister on Halloween night and is committed to a mental institution. He escapes the hospital to find and kill Laurie Strode (played by ultimate woman Jamie Lee Curtis). Of the 11 Halloween movies, it was Rob Zombie's that serialised Michael’s descent into murderous insanity by Zombie (I would imagine) having a Reasons a Young White Boy Might Go Mad checklist beside him during the writing process and ticking off every single point when penning for us a Michael Myers backstory absolutely no one asked for. Socioeconomic deprivation? Check. Abusive father? Check. Sex worker mother? Check. Bullied at school? Check.

Probably the worst film I have seen in recent months is 2018’s Bird Box, which despite its mediocrity was actually really popular. The film takes place in the aftermath of an invasion by a breed of monster that shows people such disturbing imagery that it makes them kill themselves. And who are the people that get to survive this invasion? The people who are “already crazy.” Great. Sandra Bullock, John Malkovic and Lil Rel apparently had nothing better to do with their time and they join a rag tag bunch of survivors holed up in Malkovic’s house, where they board up the windows and have almost as bad a time as I did watching this shit film. A new survivor enters their midst after arriving at the door begging to be let in. He turns out to be an escaped patient from a mental institution and violently tries to force all the residents of the house to look at the monsters so they can see what he sees. Cool. Fuck off, Bird Box.

Mental health institutions in horror films are almost always filled with patients who are drooling and dissociative (American Horror Story: Asylum [2013]; Halloween [2018]; Gothika [2003]), violent and threatening (Shutter Island [2010]; Unsane [2018]; The Visit [2015]) or calculating and manipulative (The Silence of the Lambs [1991]; The Uninvited [2009]; The Ward [2010]). These caricatures may not be quite as perplexing were it not for the fact that they are often players in really impressively written narratives, supporting more rounded and balanced characters. The Silence of the Lambs was the first Academy Award winning horror film- yet one of its villains, Buffalo Bill, a schizophrenic transgender woman, murders and skins women to make herself a ‘woman suit.’ Are you fucking kidding me? 2018’s Halloween was released in the post-MeToo Hollywood era and certified Best Woman Ever Jamie Lee Curtis helms an empowering female-led film that manages to overturn expectations of women in horror without being tokenistic or pandering. And yet, the opening sequence in the mental institution contains some of the worst caricatures of mental illness I have ever seen. The point is that it’s not as though these writers are incapable. Incompetence is not the problem here- rather it is that people with mental health conditions do not fall under the banner of those who deserve fair media representation in this new and very welcome wave of socially aware popular culture.

I get it- mental illness is an interesting theme. The human brain and its capacity for neurodiversity is without a doubt interesting, but surely there is a way of giving us two dimensional, likeable, non-murderous characters in horror? I’m as guilty as anyone else for enjoying these films, but I can see them for what they are and I so appreciate when a writer frames a character with a mental health condition differently because we’ve seen time and again that representation matters.

So why is it so important that marginalised groups are represented fairly in media? It has real world consequences. There are obvious examples of the impact of media, like propaganda and sensationalist news reporting. We can see it in our current political and social landscape. It’s the coded language and means of dissemination that really bury their hooks into us, and this doesn’t just work in the case of non-fictional media. Media is one of the ways in which we understand ourselves and one another, and film is a way for us to look at the world through a different lens. Whether it’s in popular culture or news media, representation of marginalised groups has always had an impact on how wider society has viewed that group. I think we have to look at both fictional and non-fictional representation of mental health in this case to get a clear picture of exactly why we need more nuanced and careful representation.

Horror sometimes exists in a Venn diagram of news media and film- movies “based on a true story” tend to compound the view that those with mental health conditions are dangerous and to be feared. When stories of violent crimes like those of Ed Gein, the Manson family and Jeffrey Dahmer are dredged up, reanimated and re-served to us wearing a different hat every couple of years, it’s no surprise that stigma still exists. It’s no surprise that over a third of people think those with a mental health condition are likely to be violent. It’s no surprise that people with a mental health condition are significantly more likely to be the victims of violence than the perpetrators. If we tell these same stories over and over it’s always going to go one of two ways- a Rob Zombie-esque apologist narrative of why a social reject became a killer, or a sensationalist and almost entirely fabricated one dimensional story. There’s very little room in the middle ground.

Aside from “based on a true story” films about the violent crimes of mentally ill people, I think it’s fair to say that the horror genre is part of a wider universe of fictional media that has real world implications for marginalised groups. Fictional film and TV as a wider entity has historically informed the way we have viewed difference and diversity, for better or worse. 1965’s Till Death Do Us Part fell on its sword when main character Alf Garnett (who was intended to be a figure of satire) became a champion and justification for outward racism, sexism and homophobia. Still to this day, Alf Garnett is appropriated for all the wrong and unintended reasons. Adversely, the representation of women in engineering in 2018’s Black Panther seems to have had a measurable impact on the engagement of women in science- a positive step for a group woefully underrepresented in the sciences.

If we take it as fact that fictional narratives can have a (positive or negative) impact on societal views of marginalised groups, we must be prepared to accept that a constant stream of negative stories about characters with mental health conditions are having serious consequences in terms of continued stigma. In a social climate in which news outlets are ready to blame mental illness for mass shootings, it is the responsibility of storytellers to humanise mental illness rather than demonise it.

Despite an overall gloomy picture, some recent films and TV series have got it absolutely right. 2014’s The Babadook builds a terrifying eponymous villain representative of grief and its subsequent depression and perhaps psychosis. This villain is then exquisitely taken down and tamed- kept in the basement and rendered manageable by the family it had attempted to destroy. Both of Ari Aster’s feature length offerings- Hereditary (2018) and Midsommar (2019)- deliver nuanced views of mental health. Both these examples are perhaps arguable as both central characters end their narratives with ritualised murder, but I don’t think either character is ever dehumanised, and the rituals exist as part of wider plot devices. Compelling arguments could be made against the idea that either Midsommar’s Danni or Hereditary’s Annie could be held accountable for their actions at all. Neither kill as a result of mental ill health. Well, maybe Danni.

By far the best representation of mental health conditions in the horror genre that I have so far seen came in 2018’s The Haunting of Hill House, which proved that it is entirely possible to write a genuinely terrifying story with several characters who happen to have mental health problems and whose illnesses are never once presented as a fundamental flaw in them. They are so much more than their conditions. From Luke’s addiction to Olivia and Nell’s depression and possible psychosis, mental illness is always presented as a part of these characters- not their defining characteristic. Luke is kind and likeable, and we see his heroin addiction as a circumstantial tragedy. Luke breaks traditions set by many other fictional renderings of addiction in that we so desperately want him to recover. Nell’s depression is induced by grief for her mother and husband. Her family begin to lose patience with her and they see her in the same way they see Luke- as a burden. We never see Nell or Luke that way, and I think anyone who has experienced depression knows what it’s like for someone to get fed up that they’re not recovering quickly enough, they’re not trying hard enough. Olivia is consistently presented as a dedicated mother and wife, and even when she makes an attempt on the lives of three children we never see her as malicious, evil or one dimensional. The Haunting of Hill House is a masterclass in writing characters with mental health conditions.

I’m not convinced that people see mental health as something that needs decent representation- let’s make no bones about it though: people with mental illnesses are part of a marginalised group. It wasn’t so long ago that people suffering from mental health conditions were involuntarily sterilised, given electroconvulsive therapy or lobotomised. Stigma around violence, unpredictability and danger are prevalent; workplace and education based discrimination still thrives; and we are the scapegoat of the day for gun violence despite this having absolutely no basis in reality. In half the states in the US, having a mental health condition can mean losing your driving license, refusal to be able to serve on a jury and it can even lead to losing custody of a child. If popular culture can strive to encompass fair representation for different races, sexualities, genders and abilities I believe they can afford the same treatment to mental health. I know horror to be a vehicle for self-reflection and progression, so I know it can spearhead a new kind of character with a mental health condition. I know new iterations of horror to be fresh, socially conscious and headed up by smart, reflective and innovative creators. As a genre, it is constantly redefining itself while remaining self-referential, giving audiences a wink as it titters at itself. I have every faith that, once more recognition is given to the fact that people with mental health conditions deserve the same fair representation as other marginalised groups, horror can retain the good and discard the bad.