Cinemeducation: you don’t just
learn from reading
Hélène Gorring, Birmingham & Solihull Mental Health
NHS Trust &
John Loy, Avon & Wiltshire Mental Health Partnership
NHS Trust
Background - NHS Libraries
• Core business - involvement in teaching mainly centres around
training in database searching
• Film Clubs - 2 case studies from Birmingham and Bristol which
won an NHS innovation award*
*Sally Hernando LQAF Innovation
In the beginning
• Cinema and psychiatry born and grew up together
• Dr Dippy’s Sanitarium (1906) – first mental health professional
on screen
• Fred Astaire (Care Free 1938) the dancing psychiatrist
1940s first “mental health” feature films
• Hitchcock’s Spellbound (1945)
• First appearance of stereotype - female psychiatrists just
can’t help falling in love with the patients
• Nearly twice the number of films portray females falling for
their patients, compared to males
• Snake Pit – (1948)
• First sympathetic portrayal of mental illness
• ECT – dramatic portrayal, but an effective treatment
Why the fascination with mental
health on screen?
“You play a mental
you win an Oscar”
Kate Winslet
(playing herself)
in Extras
Oscars – for playing a mental
Oscars
Only one performer won an Oscar twice for “playing
a mental”
• A – Jack Nicholson
• B – Vivien Leigh
• C – Tom Hanks
• D – Meryl Streep
–
C
yl
St
re
ep
0%
–M
er
D
To
m
en
ivi
–V
B
0%
Ha
nk
s
Le
ig
ol
so
n
ich
kN
Ja
c
–
A
0%
h
0%
10
Oscars – for playing a Dr or Nurse
• Louise Fletcher – Cuckoo’s Nest
• Robin Williams – Good Will Hunting
• Anthony Hopkins – Silence of the Lambs
AFI - Top 5 screen villains of all time
•
•
•
•
•
1. Hannibal Lecter
2. Norman Bates
3. Darth Vader
4. Wicked Witch of the West
5. Nurse Ratched - Cuckoo's Nest
One Flew Over the Cuckoo’s Nest
•
•
•
•
•
•
First film in forty years to win all of the “big five” Oscars
Film
Director
Actor
Actress
Screenplay
Silver Linings Playbook
•
•
•
•
•
•
This year nominated for the “big five” Oscars
Film
Director
Actor
Actress – the only winner
Screenplay
Oscars - Only one film since Cuckoo’s Nest has
won the “big five” Oscars
ty
au
er
ic a
n
lam
bs
th
e
of
le
nc
e
Si
Ri
ng
s–
th
e
re
...
ta
n
Ti
0%
Lo
rd
of
th
e
0%
Be
0%
ic
0%
Am
A. Titanic
B. Lord of the Rings –
the return of the
king
C. Silence of the lambs
D. American Beauty
10
One Flew Over the Cuckoo’s Nest
• Film clip
Cuckoo’s Nest
• “…didn’t win…because of the breadth of ethical issues it
covered – it was successful because it is both thought
provoking and entertaining”
• Jim Pink, Cardiff University,
BMJ March 2007
Cuckoo’s Nest
• “…showcases both the general population’s fear of mental
patients as aliens and the need to control or overpower them,
sometimes disguised, whether knowingly or unknowingly, as
caregiving”
• Jacqueline Zimmerman, People Like Ourselves: portrayals of
mental illness in the movies Scarecrow Press 2003
ECT – on film
• Having commenced its movie career as a severe but helpful
remedy for personal distress, ECT on film has become a
progressively more negative and cruel treatment, leaving the
impression of a brutal, harmful, and abusive manoeuvre with
no therapeutic benefit.
• The Portrayal of ECT in American Movies
• McDonald, Journal of ECT - Dec 2001 Volume 17(4)
Case Study 1 – Birmingham
• Inspired by undergraduate medical education curriculum
• Medical Humanities – the arts can provide an insight into human
condition which can help doctors in training develop some key skills
such as reflection and empathy.
Format
• Library organises a film club
programme, identifying a film with a
mental health theme and a clinician
with (where possible) a specialty in the
condition portrayed to help chair
• Film is screened in lecture theatre
• Short discussion – key themes include:
•
How is mental health portrayed in films?
•
How do the ‘bad’ depictions of mental
illness in films influence public opinion?
•
How is mental illness used in film for plot
development, narrative and dramatic
conflict?
MBChB Year 4
Case example – Shock Corridor
Key learning outcomes
• Being able to observe uncommon textbook symptoms: ‘waxy’
rigidity, a characteristic of catatonic schizophrenia.
• Appreciation of the impact that environmental factors can have as a
catalyst to mental ill health
• Understanding the impact of the media on the public’s stigma of
mental health and empathy of fear that patients may feel in being
admitted.
• Reflection on the environment of the psychiatric hospital – to learn
of the ‘asylum’ history and impact the therapeutic environment, or
lack of may have.
• Observation of the decline – watching a ‘sane’ man deteriorate
Feedback from attendees
I particularly found the discussion of portrayal of psychiatric conditions
insightful. The films often highlighted areas relevant to work in the clinical
environment such as prejudice and stigmatisation, and difficulties relating to
diagnostic practices. Interesting points about portrayal of psychiatric issues in
the media were also raised.
It is a useful way to develop thought about important issues relevant to our
work in a relaxed social environment.
Senior Research Fellow, University of Birmingham
Benefits
Widening the learning experience
“…it helps you realise that learning can come from all sorts of
sources, not just the overtly academic”
Education Development Specialist, College of Medical and Dental Sciences
University of Birmingham
Benefits
Facilitating a link between professionals and students
“… the library is playing its part in exposing the students to good
role modelling and also the roles of various professionals in the
care of patients. (Probably more important than stocking texts
on inter-professional education and teamwork.)”
Education Development Specialist, College of Medical and Dental Sciences
University of Birmingham
Benefits
Raised the Profile of the Library
“I think organising this sort of thing, especially when librarians
are present at the showings and participate in discussions is
great for demonstrating to students the vital link between
clinical academics and the library and the respect academics
have for librarians.”
Education Development Specialist, College of Medical and Dental Sciences
University of Birmingham
Case Study 2 - AWP
• 1st Sally Hernando Library Innovation Awards
• Very much using Birmingham as a model
• Two years to date
• Attendance just into double figures
• Actively sought to attract multi-professional
audience
• As a result, now need to attract more doctors
Observations
• Very much seen as a “great idea”
• Not reflected in attendance figures
• Need to strengthen links with undergraduate
medical curriculum
• Raised library profile
Wider engagement
• Within the Trust
• Outside the Trust
• Contributing to Trust’s
strategic objectives
Feedback
• A remarkable little film which may well challenge
preconceptions about mental health
• Consultant Nurse – “Lars and the Real Girl”
• Honest and accurate portrayal of the impact of
Alzheimers on the individual and their family
• Consultant Psychiatrist – “Iris”
Educational engagement
• Undergraduate curriculum
• Prescribe a film
• 4-6 weeks to borrow and watch
• Group discussion and feedback session
Supporting Organisational
objectives
• Educational curriculum
• Expanding the remit of the library in supporting
leisure time
• Improving Working Lives (NHS)
• The Student Experience (HE)
Legalities - NHS
NHS
Public Viewing Screening License from Film Bank
PRS for Music License (for soundtrack)
Legalities – HE
• If the clips that are shown are excerpts from an original source tape
or DVD then they can be shown at an educational establishment for
the purpose of instruction, even though the DVD might contain a
warning that they are for home use only (s.34 of the Copyright,
Designs and Patents Act 1988)
• Box of Broadcasts (BOB
Practical Issues
• Refreshments?
• Check length of films on
programme!
• Day of the week – other
key events going on
• Numbers will increase
over time!
Your questions or comments…
Further Reading - Books
• Wedding, Danny; Boyd, Mary Ann; Niemiec, Ryan M. (2010) Movies
and mental illness : using films to understand psychopathology (3rd
ed) Cambridge, Mass : Hogrefe and Huber
• Zimmerman, Jacqueline Noll, Lanham, Md : Scarecrow, (2003)
People like ourselves : portrayals of mental illness in the movies
• Gabbard, Glen O.; Gabbard, Krin Psychiatry and the cinema (1999)
(2nd ed) Washington, DC : American Psychiatric Press
Further Reading - Articles
• Pink, J. Jacobson, L Medical classics: One Flew Over the Cuckoo's
Nest BMJ 22 March 2007;334:641.2
• McDonald, WG The Portrayal of ECT in American Movies Journal of
ECT - Dec 2001 Volume 17(4)
• Hyler, SE DSM-III at the Cinema: Madness in the movies
Comprehensive Psychiatry Vol. 29 (2) p.195-206
• Byrne, P. Why Psychiatrists should watch films (or what has cinema
ever done for psychiatry?) Advances in Psychiatric Treatment Vol. 15
p.286-296.