What’s the Harm in Poking a Little Fun? Plenty, Actually

“Me, Myself & Irene,” the movie that is grossing big bucks for Fox, the Farrelly brothers and comedian Jim Carrey, is just one more light entertainment piece designed to get audiences through a hot summer by offending just about everyone. The film’s portrayal of a Rhode Island state trooper with some kind of “schizophrenic” disorder that gives him two personalities--an obnoxious bad guy and an angelic doormat--is so contrived, so “over the top,” that no one could possibly take it seriously. So what is the harm?

The harm is that film comedy that reinforces myths and further stigmatizes a group of people who can’t always advocate for themselves can hurt.

The truth is, people with schizophrenia--part of the “diagnosis” assigned to Carrey’s Charlie Baileygates--have a terrible brain disease. Often beginning in young adulthood, schizophrenia can distort one’s sense of reality. Victims may see things and hear voices that aren’t there. They may hold false beliefs--the FBI is following them; radio receivers have been planted in their teeth. It is like slipping into a nightmare in the middle of the day.

Today, with new and more effective medications and supportive, community-based treatment, there is hope. But people with schizophrenia must struggle each day to control their illness, to complete school, to hold a job, to enjoy friends and relationships. Most succeed to varying degrees; others do not. Despite the effectiveness of the newer treatments, 10% to 15% choose suicide as the only way out of their nightmare.

I doubt that the millions of people who suffer from this, or some other form of severe mental illness, or their parents and friends, will find the outrageous behaviors of Carrey’s character(s) very funny.

We also should be concerned about the film’s impact on the public’s understanding of mental illness. To those who may be tempted to accept Carrey’s stigmatizing portrayal as accurate, please note that the film is misleading on at least three counts:

First, schizophrenia has nothing at all to do with “split personality.” That is pure myth. “Split personality,” or dissociative disorder, is extremely rare and difficult to treat, and people with dissociative disorder don’t shift into good guy-bad guy personalities simply because they have not taken their medication.

Second, the film trivializes the treatment of mental illness. Charlie is “cured” when he learns to overcome his anger and tries to “behave” normally. The underlying message is that all that people with mental illness have to do is to try harder. Grab those bootstraps and pull!

Would we suggest this to someone with multiple sclerosis--also a brain disease?

Appropriate, timely treatment relieves suffering and saves lives. Most forms of mental illness, including schizophrenia, are as treatable as other medical illnesses, and the vast majority of patients live productive lives in the community, indistinguishable from everyone else.

Third, the film links mental illnesses with violent behavior. Wrong again. There is a very small subset of individuals with severe mental illness who are at risk of being violent when they are untreated and, or when, they abuse alcohol or other drugs. The vast majority of people with schizophrenia, or other forms of mental illness, are not violent. If anything, they are more likely to be the victims of violence.

Yet Hollywood continues to exploit fears in this regard by using mental illness as a plot device to justify violent or bizarre behavior and generate audience fear or laughter. Thus, it is not surprising that the NIMBY (Not In My Backyard) phenomenon remains an issue for many communities when it comes to offering neighborhood housing for people with mental illness.

So, again, what’s the harm? Carrey’s film is just one more Hollywood product that perpetuates centuries-old myth, stigma and persecution. Throughout history, people with mental illness have been treated as if they were creations of the devil--burned at the stake, chained to the walls of an asylum or, in modern times, left to fend for themselves on a subway grate. Surely in the most technologically advanced and richest country on the planet, we can do better.

The film industry has demonstrated that it can create, with intelligence and sensitivity, financially successful movies that both enlighten and entertain. Mental illness is a major public health problem. Why exploit those who suffer from these misunderstood and often devastating illnesses?

Dr. Steven M. Mirin is medical director of the American Psychiatric Assn. He resides in Potomac, Md.

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