The Importance of Accuracy in Media Representations of Mental Illness

I’ve recently seen a lot of buzz on social media around Leonardo DiCaprio‘s decision to play Billy Milligan in the upcoming film “The Crowded Room”.

For those who aren’t familiar with the name, Billy Milligan was the first person to successfully use Multiple Personality Disorder (now referred to as Dissociative Identity Disorder) as a part of an insanity defense in court. Milligan was diagnosed with MPD and found to have 24 different personality states. This diagnosis came after an evaluation by a team of psychologists in preparation for his defense against several violent crimes, including armed robbery and rape. Milligan’s attorney claimed that his female lesbian alter, Adalana, was responsible for the three rapes he was charged with and a Yugoslavian communist alter named Ragen committed the robberies.

Here’s the thing, I understand that this is a true story. Milligan was said to have suffered early childhood abuse consistent with the development of dissociative disorders. And he was legitimately diagnosed with MPD/DID. So in that respect, this is admittedly a refreshing departure from the use of DID as the “plot twist” wherein someone pretends to have DID for the sake of getting away with a crime (I’m thinking specifically of Edward Norton’s character in “Primal Fear“).


Which, by the way, the idea that DID patients are all fakers is a tremendous stereotype surrounding DID. I remember when I first started searching for information on the disorder. I was immediately inundated with research papers and websites about how to tell whether someone is “really” dissociative or just pretending to be. Seriously. Here is one little gem for you:

“While most psychologists demonstrated belief that DID is a valid diagnosis, 38% believed that DID either likely or definitely could be created through the therapist’s influence, and 15% indicated that DID could likely or definitely develop as a result of exposure to various forms of media (Cormier & Thelen, 1998).”

However, the overwhelming majority of films depicting DID portray the diagnosed character not as a malingerer, but as a violent criminal. If these characters are not explicitly violent, they (or a specific alter) are most certainly cast as the “villain”. Also, this particular trope is exclusively played by men. In case you can’t think of any films that apply, here is a list of the first 10 movies that come to mind:

  1. Dr. Jekyll and Mr. Hyde
  2. Psycho
  3. Raising Cain
  4. Fight Club
  5. Me, Myself, and Irene
  6. Identity
  7. Secret Window
  8. The Lord of the Rings
  9. Mr. Brooks
  10. Shutter Island

So here we have at least 10 films showing Dissociative Identity Disorder through violent, criminal, or dangerous male characters. There are surely men (and women) with DID that have committed violent crimes, such as Milligan himself, but that is hardly the standard manifestation of DID. Research from the American Psychiatric Association shows that there is not a link between mental health and violent behavior (except in the case of substance use). Here is a great quote from Psych Central:

“Violence is most oftend6ed0ae2edb4172b1230f1477035c0f7 a criminal activity which has little correlation with a person’s mental health. Most people who suffer from a mental disorder are not violent — there is no need to fear them. Embrace them for who they are — normal human beings experiencing a difficult time, who need your open mind, caring attitude, and helpful support.”

If we were to link mental health and violence, it would actually go in the OTHER direction. Statistics show that people suffering from mental illness are far more likely to be the victim of a crime or to be violent towards only themselves (both of which are true for me).

Another important point is that this movie does absolutely nothing to de-mystify or clarify what Dissociative Identity Disorder actually is. Many people confuse DID with things like schizophrenia, psychosis, psychopathy, and sociopathy. In fact, there is already confusion about what, exactly, Milligan was diagnosed with. This UK article announcing the casting of DiCaprio says,

“It was revealed last week that the 40-year-old actor is planning to co-produce and star in ‘The Crowded Room’ as schizophrenic criminal Billy Milligan.” (Emphasis mine).

Some may argue that there is no reason to be upset because it’s “just a movie”. However, it’s important to remember that nothing happens in a vacuum. Media portrayals of mental illness are one of the primary determinants of how the general public understands and reacts to the mentally ill. Negative and/or inaccurate representation only adds to the already existing stigma. The President’s New Freedom Commission on Mental Health has this to say about the impact of stigma:

“Stigma leads others to avoid living, socializing, or working with, renting to, or employing people with mental disorders – especially severe disorders, such as schizophrenia. It leads to low self-esteem, isolation, and hopelessness. It deters the public from seeking and wanting to pay for care. Responding to stigma, people with mental health problems internalize public attitudes and become so embarrassed or ashamed that they often conceal symptoms and fail to seek treatment (2003).”

If society is only shown images of individuals with DID that are either violent or faking, how will they ever know any different? These stereotypes are not just offensive, they are also dangerous because they perpetuate the misconceptions and stigma around persons suffering from mental illness. This stigma only exacerbates their suffering, isolating, and pathology.

It  is so important to have representation in this world. My post reflecting on the impact of meeting other individuals with similar experiences with and symptoms of DID shows how crucial it is to see ourselves reflected in other people.

But it is not enough to just make a movie about DID (or any other mental illness). It is also imperative, for the sake of all members of our society, that we make films that are accurate and a true representation of the people who live with the illnesses being portrayed.

10 thoughts on “The Importance of Accuracy in Media Representations of Mental Illness

  1. jenasauruswake says:

    Fab blog post 😊 I won’t be watching the film, it was bad enough to have DID come up on Criminal Minds in Season 1 in the context of using it as a defence (the guy wasn’t a multiple). I, and my parts, are lots of things. Criminal isn’t one of them

    Liked by 1 person

  2. Cat says:

    If you came to the UK, you would find it a lot more difficult to find health professionals who recognise DID, let alone be willing to work with it. I don’t know anything about this character and I don’t usually watch movies like this, or the “live studies” on telly. Another great post!

    Liked by 1 person

  3. Zoe says:

    Why, Leo, why? We were all rooting for you /Tyra Banks voice. I’m very disappointed. I have no doubt he will deliver a hell of a performance; I’m just horribly disappointed people keep beating a very dead horse. Can we have movies with OUR stories be made? Why must our conditions only be shown in such negative ways?

    My friend is currently watching two shows from Korea (she’s Korean and that friend I told you about) whose main characters are diagnosed with DID. In these, she says, the DID is used as comedic relief (so far.) She is trying to give it a chance, but she is having issues getting through it all.

    Absolutely fantastic post. Bless the whole thing.

    Liked by 1 person

    • Andi says:

      Omg, I LOVE Tyra! Yeah, I’m sure the movie will be amazing and if not, Leo will because: Leo. I’ve never seen him be BAD in a film, ever. But WHY?!!?! This is such classic Oscar bait bullshit.

      So interesting that Korean Television has two shows about DID. I’d love to see them, but I imagine I would also have difficulty getting through it.

      I’d like to think these are all first steps on a necessarily frustrating road to better and more accurate representation. Katy Perry’s “I Kissed a Girl” is a disastrous stereotype of queer woman, but it paved the road for other songs like Gaga’s “Born this Way” and Macklemore/Mary Lambert’s “One Love”, which DO have accurate and inclusive representations.

      That might be stupid wishful thinking, but I try to lead my life with a healthy dose of cautious optimism 🙂


      • Zoe says:

        Let me take you back to when I was 11 years old, sitting in the movie theater, watching Titanic. I fell in love with this man the moment I saw his eyes when he looked up from behind the cards. I had posters, books, magazines… all the things and I swore: “I will watch you until I die” that day. I grew out of that idol thing, of course, and I learned to admire him for more than his blue eyes; he is a great actor.

        Classic Oscar bait is right.

        I did watch one show about mental illness from Korea one time and was pleased with how they handled it for the most part. Follows the life of a very successful fiction author and a traumatized psychiatrist. In which they do not evolve from patient-doctor to lovers since she never treats him (they become housemates.)

        If she gives me the green light on these ones about DID, I’ll probably watch. It’s always interesting to see how stigma is or isn’t in other cultures. We’ll see.

        I want to hope that, if anything, this film will prompt people to look up what DID means instead of assuming everyone with that diagnosis will be like that. Certainly, in me, when I see a film with a topic like that, I like to look up the “illness” to see just how much bullshit I was fed. If it can inspire the same neutral curiosity in others and begin a movement of awareness: YES!

        You’re totally right though, about the Katy Perry song. It did open up an avenue of acceptance toward queer women (in my experience my queer lady friends have had a harder time being accepted in society than my queer male friends… possibly due to the whole patriarchy thing where we’re just baby-making-machines — heaven forbid we don’t do our biological job of populating the world!) A lot of times good things come out of crappy stuff; so hopefully this film will make people research a bit and find some good, informative articles.

        Otherwise, I’ll want a planet just for all of us who are currently shunned by our society.

        Liked by 1 person

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