Mental Illness and Indian Cinema

Cinema is one of the key structures in understanding of any culture, and the portrayal of mental illness within such a context should be of major interest to clinicians in understanding its influences on society. The way mental illness is used in the narrative of the film is determined by the state of the society and the reflection of political and economic factors which are prevalent at a specific time in the history of the culture and society. Cinema in general and Indian cinema in particular has a fantastic disconnectedness from reality. In a country like India, where people idolise film stars and are markedly influenced by cinema, it is very important that issues like human emotions and mental illnesses are portrayed accurately and responsibly. For long, the Mumbai-based Hindi film industry (Bollywood) represented the mentally challenged as comic supporting characters that add an amusing sideshow to the central story. While Hindi cinema has evolved on various aspects in recent years, for some strange reason, it continues to be irresponsible in its projection of mental illness. A filmmaker spends crores of money on exotic locations and costumes but somehow does not feel the need to research the cause of disability suffered by his/her protagonist. Despite innumerable social and moral debates raised by experts on this subject there seems very little attempt on part of our filmmakers to empathise with the victim. The Bollywood movies, churned out in dozens each month, have been portraying the therapist as romancing, dancing and at times sleeping with their patients. Most characters including the storyline are often straight lift from the Hollywood with dance and melodrama sprinkled liberally. Deewangi is the Hindi adaptation of the western thriller The Primal Fear, while Amitabh played the role of a psychiatrist in the desi version of Analyze this. Its not just the formula filmmakers but even sensitive directors like Satish Kaushik in Tere Naam(2003) or Priyadarshan in Kyon Ki did not project the illness in the right perspective. Salman Khan playing a schizophrenic in Tere Naam is tied up in chains (reminiscent of Erwadi) and ill treated in a mental asylum which we would agree is not an accurate depiction of reality. In Kyon Kihe is subjected to Direct ECT (without anesthesia,) a practice banned by the Supreme Court though still followed in remote regions of the country. However, Aparna Sen is one film director to have given visibility to the disabled in her Bengali and Hindi films (which appears closer to the reality). While Poromitar Ek Din delved on schizophrenia, Sati told story about a deaf and mute girls exploitation within her family. 36 Chowringhee Lane had Geoffrey Kendall portrayed as a dementia patient and Mr. & Mrs. Iyer portrayed a young mother accompanying her paraplegic child in the bus. Even her most recent endeavour 15 Park Avenue focuses on the trauma of a schizophrenic, which appeared to have been well researched. The Indian filmmakers seem to remember the physically or the mentally challenged only when the film portrays them as protagonists. Whether it was Rajshri Productions Dosti about the bonding between a lame and a blind friend or Gulzars Koshish about a deaf and mute couple living with a blind companion. Sai Paranjpyes Sparsh and Sanjay Leela Bhansalis Black, about life without light or Nagesh Kukoonoors physically challenged character in Iqbal. Actor Ajay Devgan had chosen Alzheimer's disease, which leads to gradual memory loss, as the subject for his directorial debut U, Me Aur Hum, while Rakesh

Roshan had depicted the world from the eyes of four mentally unstable men in the much hyped Krazzy 4. Aamir Khan's directorial debut Taare Zameen Par, which was based on SLD/dyslexia, took a sensitive view of the differently-abled and promoted inclusiveness. For a long time filmmakers didnt feel the need to elaborate on the ailment. All characters portrayed were cases of general mental illness and strangely, the audience didnt miss an adequate diagnosis of the ailment. Over the years, however, filmmakers began to make special efforts to research the illness. It has been a long battle by our mental health workers to break the negative stereotypes associated with disability in our mainstream movies. Many years ago, legendary filmmakers Bimal Roy and V.Shantaram inspired a movement with films like Sujata, a crusade against untouchability and Do Aankhen Barah Haath, about rehabilitation of prisoners. The Rajesh Khanna and Wahida Rehman starrer Khamoshi was also one of the memorable films based on mental illness. It had, from psychoanalytical viewpoint, dealt with transference issues and depicted the attending nurse, Wahida Rehman herself becoming a mental patient, in the process of helping in the recovery of the patient Rajesh Khanna. This film also highlighted the problems of the mental hospitals staff.

Today, most of the film makers have commercial interest and do not worry about clinical accuracy and contemporary treatment principles. Movies these days have the aim to drown the (gullible) audience in fantasy while being entertained. Unfortunately, such crass fare is served to pass for wholesome entertainment for the masses. Many, who understand the irrationalities of a scene, are willing to suspend logical judgment and even accept it as artistic license. Are we asking for too much from film makers expecting them that they portray only the true picture of psychiatry in the films? The filmmakers are not in this business to make mere documentaries. The million dollar entertainment industry drives the media, not accuracy or fairness. The passive acceptance of irrational ideas does not necessarily affect society at large in any big way. However, the same stance cannot be taken with regard to sensitive issues, such as mental illness. Owing to their mystic element, the psychological issues, mental illness and the mentally ill occupy an important place in the minds of film makers. Its true that Films on issues related to mental illness have been box office hits! This repeated portrayal of the mentally ill and mental illness with the usual distortions has contributed a lot to the stigma and burden which the mentally ill and their caretakers have to unfortunately bear.

Depictions of ECT in Hindi movies have been by and large inaccurate, distorted, and dramatized. Electroconvulsive therapy was administered to punish, to obliterate identity, to induce insanity, and for other rarely clinically valid ind ications. Electroconvulsive therapy was almost always administered by force. Premedication was rare. Genuine ECT devices were uncommonly used. Multiple shocks were frequently delivered in the same session. The convulsions were usually bizarre. The treatment caused mental disturbance, amnesia, weakness, and even a zombie like state, thought not mortality; clinical improvement was rare. There was no pattern of increasing accuracy of depiction of ECT even in the recent movie releases (barring an odd exception in the form of 15 Park Avenue)

Andrade et al examined the extent to which the identified inaccuracies are practically important and offer reasons for the inaccuracies. Considering the potential for harm in the dissemination of misinformation, filmmakers should exhibit a greater sense of ethics when creating impressions that might adversely influence health. There have been some eye-opening works on films and psychiatry. Most recently, Prof. Dinesh Bhugra's Mad Tales of Bollywood has exhaustively studied mental disorder in Hindi cinema. As per Bhugra, compared with Hollywood's portrayal of psychological ailments, Indian cinema is perhaps less enlightened. Among other seminal works are the scholarly Psychoanalysis and Film and Psychiatry and the Cinema by Prof. Glen Gabbard.

The power of the mass media can never be overestimated. Film as a medium should be used to advantage to dispel the stigma associated with psychiatric disorders. Care should be taken to ensure that only scientifically sound messages are conveyed to the audience and for this, it is essential to have a censor board that is sensitive and well informed. The dissemination of erroneous messages relating to mental disorders through cinema only aggravates the longstanding problem of stigma associated with such disorders. Its high time that it got changed, for good. Some of our senior colleagues like Prof Mohan Agashe can play a key role by acting as a link between our community (of mental health professionals) and the film industry. Suggested Reading: 1. Andrade C, Shah N, Venkatesh BK. The depiction of ECT in Hindi cinema. J ECT 2010 March 2010 - Vol26 - pp 16-22. 2. Bhugra D. Mad tales from Bollywood: Portrayal of mental Illness in conventional Hindi cinema (Maudsley Monographs) Psychology Press; 2006. 3. Gabbard GO. Psychoanalysis and film. London: Karnac; 2001. 4. G. Swaminath and Ajit Bhide. Cinemadness: In search of sanity in films. Indian J Psychiatry. 2009 OctDec; 51(4): 244246. 5. Gabbard GO, Gabbard K. Psychiatry and the Cinema. Washington, DC: APA Press, 1999.

(Contributed by Dr DEEPAK KUMAR, Email: srivastav.deep@gmail.com)