Why Joker’s depiction of mental illness is dangerously misinformed

Annabel Driscoll and Mina Husain

The Guardian Mon 21 Oct 2019 11.04 EDT

With films playing a key role in shaping attitudes to mental health, two doctors say Joaquin Phoenix’s troubled supervillain perpetuates damaging stereotypes

As junior doctors who work on acute inpatient psychiatric wards, serious mental illness is our daily reality. We have, therefore, watched the controversies around Todd Phillips’s Joker – in which Joaquin Phoenix plays a troubled loner who turns to violence – with professional interest.

The film’s dominance in the debate about portrayals of mental illness in the movies comes at a curious time. Recently, we’ve witnessed great leaps of awareness about relatively common mental-health issues such as depression and anxiety, and with that awareness, increasing dismissal of the sort of unhelpful prejudices that used to surround them. These are now readily discussed without shame and often represented in the media with a well-informed grasp of the facts, thanks to effective information campaigns.

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However, severe mental health conditions, such as psychotic illnesses, remain shrouded in stigma and are consistently misrepresented and misunderstood. Portrayals of mental illness in film can perpetuate unfounded stereotypes and spread misinformation. One of the more toxic ideas that Joker subscribes to is the hackneyed association between serious mental illness and extreme violence. The notion that mental deterioration necessarily leads to violence against others – implied by the juxtaposition of Phoenix’s character Arthur stopping his medication with his increasingly frequent acts of violence – is not only misinformed but further amplifies stigma and fear.

Studies show this association is exaggerated and people with severe mental illness are more vulnerable to violence from others than the general population. Interesting, then, that Joker’s earnest attempt to create an empathetic character with mental illness – who writes: “The worst part of having a mental illness is people expect you to behave as if you don’t” – contributes to the very prejudice that Arthur longs to evade.

Arthur’s supposed loss of grip on reality is suggested by a peppering of nods to psychotic symptoms: delusional ideas of a grandiose nature (“I am an undiscovered comedic genius”) and hallucinations of his neighbour – which are confirmed by his eventual admission to a psychiatric institution. This restoration of order via Arkham Asylum affirms the overarching inference of 

the film: Arthur’s descent into violence and destruction is triggered by his mental deterioration. The result of this is to – disappointingly – remove Arthur’s agency and divert attention from a potentially more stimulating conversation about wealth inequality and its responsibility for societal collapse.

We wouldn’t want to get bogged down in labels, but the psychopathology Arthur inhabits is foggy at best: his apparent lack of disordered thinking means the attempt to illustrate psychosis is half formed. He also displays traits of narcissism and depression. This diagnostic vagueness may create a more relatable character that reflects the pain of any psychiatric illness; but it gives the impression that many disorders have been squashed into a plot device. In the end, it undermines Phoenix’s hypnotic performance and Joker’s sincere attempts to explore the interaction between poverty, inequality and social isolation.

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Arthur’s chilling quirk – his bursts of incongruous and uncontrolled laughter – is no laughing matter either. Presumably, he suffers from the neurological condition pseudobulbar affect – also known as “emotional incontinence” – perhaps caused by his childhood head trauma. Joker may make an attempt to unpick the difference between the psychiatric and the neurological – between a mental illness and a medical disorder – but it runs the risk of conflating the two with a haunting, stigmatising and problematic image. Whether intentionally or not, Arthur comes across as a hysterically laughing supervillain, stereotypically “mad” to the untrained eye; a murderous clown laughing alone on a bus.

Cinematic depictions of mental illness – most infamously, One Flew Over the Cuckoo’s Nest – have profound and lasting implications in the real world. It is widely acknowledged within psychiatry that Cuckoo’s Nest led to inappropriate levels of suspicion and misinformation regarding electro-convulsive therapy, and may have meant many people did not receive treatment that is proved and effective. All this due to a single film’s misinformed presentation.

Films have the power to perpetuate stigma and fear, which is why the misrepresentation of severe mental illness in Joker should not be dismissed lightly.


  1. I love that you wrote about this. It’s very disheartening to hear so many stereotypes and judgements of people with mental illnesses. Most have which have likely resulted from poor depictions on tv and movies. Thanks for the post!

    Liked by 1 person

  2. If I may, before being diagnosed with bipolar, all I knew about it was from 2 things. An episode of the hospital TV drama “ER” when a manic patient is wheeled in, strapped to a gurney, thrashing about and screaming jibberish. They basically had him act like a wild animal. The nurses shook their heads as if to say “here comes that crazy bipolar dude. He’s off his meds again!” The other was a news story about Hollywood actress Margot Kidder. As I recall, they found her in the middle of the night, roaming the streets, completely naked. And incoherent. Pretty sure “she was off her meds” was mentioned.
    People, most all bipolar folks are not raving lunatics. Personally, I’ve never even had a full blown manic episode. I’ve never been arrested. Never hospitalized. Never roamed the streets naked. These are stereotypes! I have several friends with bipolar and I’ve never heard anyone say they were just going to stop taking their meds Willy nilly. I’ve been in between doctors when I ran out of meds for like a week and I never morphed into the Tasmanian devil. We’re not all the same. There are different types of bipolar and different levels of severity.

    Liked by 1 person

    1. I’m Bipolar and agree 100%, I’ve been manic and it’s crazy but people only thought I was an asshole or arrogant. I’ve been mostly on the depressed side of bipolar and it sucks just the same. We have to fine tune everyday, it’s a reality we have to deal with to stay as well as possible. Have a great day.

      Liked by 1 person

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