The evolution of mental illness on screen

True, those depictions have sometimes been crass (making the mentally ill figures of fun? Poor show, Hollywood). But there are movies that take the issues more seriously, and it's those we're looking at today, films that try—however imperfectly—to understand the maladies of the mind...

We must begin with The Cabinet of Dr. Caligari, if only because so much does. Made in 1919, in a country that had just lost a cataclysmic war, it was a film about madness inside and out, playing out amongst famously distorted—"expressionist"—sets. Every filmmaker that has tried to map interior states, from Bunuel to Cronenberg and beyond, owes it a debt.

The Germans and their Austrian chums revolutionised treatment of mental illness, none more so than Sigmund Freud. So celebrated was Freud that producer Samuel Goldwyn invited him to pitch a movie, reasoning he could write “a really great love story”.

Freud declined but one of his colleagues did work on a film: Karl Abraham collaborated with director G W Pabst on the German film, Secrets of a Soul, about a scientist who develops a morbid terror of knives. It's most notable for its dream sequence, a future feature of many Freudian films.

Mention should also be made of Dr. Mabuse, by day a respectable German psychiatrist, by night a devilish criminal mastermind. He lost his mind at the end of his first appearance (in Dr. Mabuse The Gambler) and still hadn't found it when director Fritz Lang brought him back for a sequel, The Testament of Dr. Mabuse.

Dr. Mabuse The Gambler (1922) 

Like Caligari before it, this is a study of collective insanity but Lang was addressing other topics besides mental health: consider that it was released (and promptly banned) a month or so after the election of new chancellor Adolf Hitler and you might see what he was getting at.

We're (a bit) more savvy about mental health these days, and it's interesting to apply that knowledge to films that were grasping to understand problems that are now more better understood.

Most especially, to look at films made just after The Second World War that showed issues we know much more about now. Take The Best Years of Our Lives, a movie that shows the difficulty three troops have in re-integrating into civilian life.

If the term "Post Traumatic Stress Disorder" was used in 1946, it would have been in Psychiatric circles exclusively; that, though, is what the film diagnoses, even if it doesn't have the terminology.

The cases of PTSD in The Best Years of Our Lives are mild; William Bendix has things far worse—like, homicidally worse—in The Blue Dahlia. This was shocking stuff for the time (returning soldiers were heroes, goddamit) but reflected an under-acknowledged truth many had to live with.

The Blue Dahlia (1946) 

There's one last film to mention. It's a documentary, called Let There Be Light, directed by John Huston and shows psychiatrists trying to heal those most profoundly traumatised by battle.

The government banned it for many years (for fear it might deter future recruits) but it's a deeply compassionate film; Paul Thomas Anderson drew on it for his own film, The Master (about a damaged vet) but it deserves recognition on its own terms.

Hollywood producers were early, and enthusiastic, adopters of Freudian analysis—as if there weren't enough people to tell them they were raving egomaniacs.

None was more devoted than David O Selznick, and he decided to make a film about it. Unfortunately, his chosen director—one Alfred Hitchcock—was more sceptical and the film they made (Spellbound) is a travesty. An entertaining travesty for sure, but no less a travesty for that.

Around the same time, Otto Preminger made Whirlpool. Superficially, it's as daft as Spellbound (its villain is an evil hypnotist, whose powers become ever more ludicrous as the film progresses) but it's also a sensitive study of a neglected wife (Gene Tierney) and her burgeoning neuroses; few directors could marry silliness and seriousness so well as Preminger.

A more sober—if less entertaining—film of the same vintage is The Snake Pit, set in a psychiatric hospital where Olivia De Havilland is receiving treatment. It's well-intentioned but suffers from a need to have its heroine walk out of the gates at the end right as rain, as though schizophrenia was no worse than a bad case of the flu.

Shock Corridor (1963)

We don't call them "asylums" anymore. More properly, they are psychiatric wards or hospitals. Then again, the films that depict such places—and there are many—aren't usually much bothered with accuracy.

Sometimes, the asylum is a stand-in for something else. Sam Fuller, for instance, borrowed a trick from Fritz Lang for his film Shock Corridor; the mental hospital here is a stand-in for 1960s America, with racism, nuclear terror and more—a place to drive even sane people round the bend.

Something similar happens in One Flew Over The Cuckoo's Nest, where the authorities in the asylum represent the wider forces of repression in society, attempting to stifle creativity and freedom. (Yes, it IS based on a novel written in the 1960s. How ever did you guess?)

Not every film gets so sociological. The French film La Tête Contre les Murs looks at an asylum through the eyes of a young man incarcerated by his bullying father. It was directed by George Franju; something of a surrealist, he well captured the fragility of the patients.

Mention should be made too of Titicut Follies. As with Let There Be Light, it's a documentary. And as with Let There Be Light, it was banned for ages. And no wonder, because it's unsparing, juxtaposing the patients preparing for their annual concert with their brutal daily routine, which includes force-feeding and casual violence. We must hope that it isn't just the terminology that changed when "asylums" became "hospitals".

Society has got a lot better at talking about mental health issues in recent years, and more understanding too. This can certainly be seen in the movies.

Most obviously, there's the work of the Danish director Lars Von Trier, who has been open about his own depression and made two films informed by it. Antichrist is a report from the frontline, an attempt to describe the destructive despair that he felt when he was ill; more considered is Melancholia, a semi-sci-fi story about a depressive (Kirsten Dunst) at the end of the world.

Antichrist (2009)

Beyond those, there is at least one outstanding film about schizophrenia. No, not A Beautiful Mind; it might have won the Best Picture Oscar but, let's be honest, this biopic of mathematician John Nash never really comprehends the illness that so devastated him.

Rather, it is Spider, a remarkable work starring Ralph Fiennes and directed by David Cronenberg. This is one of the great films of the 21^st century, a first-person evocation of a damaged mind struggling to understand the world.

Of course, it's likely future generations will find much to criticise about the films of our era—look at how much our understanding of mental health has changed in the near-century since Dr. Caligari.

But whatever the other failings of the films included here, the best invite us to treat sufferers with decency and care: that's a message that should be forever timely.

Like us on Facebook and follow us on Twitter

Enjoyed this list? Share it!