The Psych Unit: What Movies Get Wrong and Why It Matters

The television screen goes dark with flashes of red. A scream. Broken glass. Laughter. The nurse prepares a syringe. There’s a squeaking metal hospital bed. There’s a man in a straitjacket talking to himself, to the voices in his head. The background music is getting faster and louder and faster and louder and faster and louder. The man is talking faster.  He is twitching. The nurse is walking faster. Her white heel clicks on the shining floor. Click. Click. Click. The horror movie is moving adrenaline through the viewers veins:  rapid pulse, dilated eyes, clenched teeth. Fear has been achieved! It has been achieved through the antiquated trope of the “scary” hospital mental ward.

With so many movies to choose from, psychiatric hospital horror is its own genre of film: Shutter Island, Asylum, Clockwork Orange, Insanitarium, The Ward, Halloween, Hellraiser, Netflix’s Nurse Ratched, etc. Something else that these movies have in common besides horror is that they perpetuate a fear and stereotype of psychiatric hospital units. Because most people don’t have the opportunity to see a real psychiatric unit, the television screen may be the only representation that they  experience. Fear and confusion thus pervades at the thought of a psychiatric unit. Nobody wants to go. Nobody wants to visit. Nobody wants to know someone or admit that they know someone that spent time there. It’s taboo. It’s a dirty secret.

Psychiatric units actually look a lot like other units in a hospital. Patients have their own rooms. The lights are on (not flickering). Equipment is well maintained by an entire team of operational engineers and things are kept clean by hard working house keepers. The differences between a medical patient room and a psychiatric patient room are for safety measures. A psychiatric patient room often has plastic furniture, no strings on window blinds, and cabinets are locked along with entry to the unit. These are not punitive measures; they are protective to prevent patient harm as the patient gets through the current psychiatric crisis they are in.

Psychiatric units also are not areas of murder mystery or ghost inhabitation. Patients aren’t “crazy” because they see or hear ghosts. Patients sometimes have a mental illness that causes auditory or visual hallucinations; this doesn’t mean that they are possessed. Nurses aren’t plotting against the patients and psychiatrists aren’t doing bizarre experiments. These units of the hospital are monitored by health care organizations, such as the Joint Commission on Accreditation of Healthcare Organizations, just like the rest of the hospital is. Medications and therapy are provided per rigorously researched guidelines under strict monitoring with the intent to improve the quality of life for the patient.

The patients on these units are also treated like other patients. Staff are trained to keep the patients safe from harming themselves and others. Staff are also held to a standard that strongly disallows any purposeful harm done to the patients by staff members. There are firm laws about restraining patients against their will. Certainly, you won’t find anyone in chains or being tortured in anyway. Patients get clean clothes, hygiene products, laundered sheets, and three meals a day plus snacks. There is usually an activity room within the psychiatric unit that provides coloring books, colors, novels, puzzles, movies to watch, and board games. They are treated as humans and individuals as they should be, not monsters.

But so, what? Those are entertaining movies for the purpose of entertainment, just a reality escape that people enjoy. Everyone knows that Micheal Myers is a made-up character in a make-believe world. And those movies label psychiatric units as asylums; everyone knows we don’t have asylums anymore. Yes, and people that go to the “looney bin” are still called crazy, psycho, nuts, lunatic, insane, or even possessed. No-one wants to be called these names or have this judgment cast upon them.

So, they avoid it. They don’t go. They don’t get the help they need, and they get worse. Finally, some of these patients are forced to go or they force themselves. They won’t tell anyone unless they must. It’s a secret illness, a secret occurrence, a skeleton in the closet. A support system is vital to any type of healing. To have a support system, you have to say you need support. Many patients close off further; they shrink their support systems rather than growing and strengthening them…. all because of public perception, a perception propagated by the antiquated trope of the “scary” mental health ward.

That’s why it matters. Public perception matters. Public perception influences people’s opinions of who they are, what they do, and where they go. If there were better reflections of psychiatric units in movies and television, it could be a positive influence for people to get the help they need and deserve.

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