The portrayal of ECT in American movies

On-screen portrayals of mental illness: extent, nature, and impacts

This article reviews the published literature on the extent, nature, and impacts of portrayal of mental illness in fictional films and television programs. The literature suggests that on-screen portrayals are frequent and generally negative, and have a cumulative effect on the public's perception of people with mental illness and on the likelihood of people with mental illness seeking appropriate help. The article concludes that there is a need for the mental health sector and the film and television industries to collaborate to counter negative portrayals of mental illness, and to explore the potential for positive portrayals to educate and inform, as well as to entertain.

Electroconvulsive therapy: attitudes and misconceptions

This article deals with the current literature regarding general attitudes toward electroconvulsive therapy (ECT), and why there are so many misconceptions regarding this form of treatment. MEDLINE, PsychLIT and internet searches were carried out to gather the information discussed. Considerable stigma still surrounds ECT, and this probably remains the greatest barrier to public acceptance of this treatment.

Can a seizure help? The public's attitude toward electroconvulsive therapy

Despite controversial discussions in the general population, little is known about the public's attitude toward electroconvulsive therapy (ECT). We examined in a representative opinion survey (N=1737) (1) whether the lay public views ECT as an appropriate treatment for schizophrenia and depression, and (2) how demographic, psychological, sociological, and cultural variables influence attitudes. Most respondents (57%) considered ECT as a harmful treatment, and only a small number (1.2%) were in favor of ECT. A large number of respondents did not consider ECT as a treatment. We identified three predictors of negative attitude toward ECT (younger age, cultural area, greater degree of contact with the mentally ill; R2=0.042). The finding was not affected by the type of illness. Thus, having a prejudice toward ECT is a 'uniform attitude' that does not significantly vary between individual, demographic, or cultural contexts.

The psychiatrist's image in commercially available American movies

OBJECTIVE

To explore quantitatively how American movies portray psychiatrists/therapist.

METHOD

A total of 106 movies were reviewed regarding how psychiatrists/therapists were portrayed. The psychiatrist's or therapist's sex, age, clinical competence and knowledge, boundary violations, attitude toward the patient, influence in the movie's events, treatment modality or modalities used, intervention's outcome, and therapeutic setting.

RESULTS

The psychiatrists/therapists tended to be males (71.2%), and (regardless of sex) middle-aged (50.8%). Despite the general view of the psychiatrists/therapists as friendly (63.6%), there was an over-representation of boundary violations. The percentage of total boundary violations was 44.9% of the cases portrayed and sexual violations accounted for 23.7%, while non-sexual violations accounted for 30.5% (with 9.3% overlap). The appearance of clinical incompetence was 47.5%.

CONCLUSION

The image of psychiatrists/therapists in commercially available movies is not flattering: close to one out of two violated boundaries, close to one out of four committed a sexual boundary violation, and the psychiatrist/therapist was as likely to be incompetent as competent. The bright point is that psychiatrists/therapists were depicted as more likely to be friendly.

Patients' and their relatives' knowledge of, experience with, attitude toward, and satisfaction with electroconvulsive therapy in Hong Kong, China

Although electroconvulsive therapy (ECT) is a safe and efficacious treatment, there is a widespread negative view of ECT in public and professional circles. There are no data on Chinese patients' knowledge of, experience with, attitude toward, and level of satisfaction with ECT in Hong Kong. The aims of this study were to examine patients' experience of ECT, and patients' and their relatives' knowledge of, attitude toward, and level of satisfaction with ECT. To this effect, a prospective cross-sectional survey was conducted, involving 96 patients and their 87 relatives. The study showed that the majority of patients believed they had not received adequate information about ECT. The most commonly reported side effect was memory impairment. Patients and relatives had only limited knowledge of ECT, yet the majority of them were satisfied with the treatment and, having found it beneficial, maintained a positive attitude toward its use. The researchers concluded that Hong Kong Chinese patients and their relatives accepted ECT as a treatment. The way information is provided to patients and relatives when obtaining consent for ECT needs improvement.

Medical student knowledge and attitudes regarding ECT prior to and after viewing ECT scenes from movies

We surveyed samples of medical students in the United Kingdom (U.K.) and Australia, prior to their psychiatry placement, to ascertain views about electroconvulsive therapy (ECT) and the effect on those views of watching ECT scenes in movies. A 26-item questionnaire was constructed by the authors and administered to the students. At set times during the questionnaire, students were asked to view five movie clips showing, or making reference to, ECT. The clips were from Return to Oz, The Hudsucker Proxy, Ordinary People, One Flew Over the Cuckoo's Nest, and Beverly Hillbillies. Ninety-four students participated in the study. Levels of knowledge about the indications, side effects, and mode of administration were poor, and attitudes were generally negative. Viewing the ECT scenes influenced attitudes toward the treatment; after viewing, one-third of the students decreased their support for ECT, and the proportion of students who would dissuade a family member or friend from having ECT rose from less than 10% to almost 25%.

ECT in poetry

We sought to identify poems about Electroconvulsive therapy (ECT) and describe their major themes, with a view to using some of those poems in clinical situations-for persons receiving ECT and their families-as well as for teaching purposes. Several poems were identified, eight almost exclusively about ECT and a number of other works containing references to the treatment. The poets, some of whom have won distinguished prizes, came from the United States, U.K., Australia, and Estonia. The poems included very positive accounts of ECT and more denigrating pieces. Some of the themes covered by the poems were the desperate plight of persons prior to ECT, the potentially striking beneficial effects of the treatment, fears about the use of electricity, ECT procedure, and memory impairment, and the stigma associated with the treatment.