Mental Health at the Movies: 2023 Academy Awards

Madness at the Movies book cover
Cover image of Madness at the Movies

The study of classic and contemporary films can provide a powerful avenue to understand the experience of mental illness. In Madness at the Movies, James Charney, MD, a practicing psychiatrist and long-time cinephile, examines films that delve deeply into characters' inner worlds and analyzes moments that help define their particular mental illness.

Based on the highly popular course that Dr. Charney taught at Yale University and the American University of Rome, Madness at the Movies introduces readers to films that may be new to them and encourages them to view these films in an entirely new way. Through films such as Psycho, Taxi Driver, Through a Glass Darkly, Night of the Hunter, A Woman Under the Influence, Ordinary People, and As Good As It Gets, Dr. Charney covers an array of disorders, including psychosis, paranoia, psychopathy, depression, bipolar disorder, obsessive-compulsive disorder, and anxiety. He examines how these films work to convey the essence of each illness and how each film reflects the understanding of mental illness at the time it was released as well as the culture that shaped that understanding. By viewing these films through the lens of mental health, readers can hone their observational skills and learn to assess the accuracy of depictions of mental illness in popular media.

Dr. Charney shares his thoughts below on how two of the movies nominated for Oscars this year handle the topic of mental health.

Image still from the movie Aftersun showing Calum and Sophie lying side by side next to a pool
Frankie Corio and Paul Mescal in the film AFTERSUN. Courtesy of A24 Films. © 2022 All Rights Reserved.


Paul Mescal, the lead actor in Aftersun (which won the BAFTA for Best Debut), is nominated for an Oscar for Best Actor. The film is a work of fiction that seems very personal for its writer-director Charlotte Wells—an exploration of memory and an attempt to understand one’s parents.  

Calum, the father played by Mescal, seems distant, preoccupied, and melancholy. He calms himself with meditation and tai chi techniques. He is on vacation with his 11-year -old daughter Sophie, whom he sees infrequently, and whose company he cherishes. He does his best to give her his full attention, to be caring, and to treat her as the grown-up that she is becoming as she enters her adolescent years. 

The story is told with interruptions of images of the adult Sophie in a rave party with intense, strobe lighting. This makes it hard for us to see what is happening, but conveys the force of the memories that she is trying to recapture, and the force of the understanding that she is trying to have of her father, who is clearly no longer in her life as she is approaching her 31st birthday. 

The main event in the movie is the vacation that Calum and Sophie share at a hotel in Turkey. In this part of the movie, Calum is approaching his 31st birthday. 11-year-old Sophie uses her father’s home movie video camera to interview him, to take pictures of herself, to talk about her experiences, and to also show glances of the other people at the hotel. When she asks Calum in one of her interview videos what he imagines he will be doing when he’s 40 years old, he seems flummoxed and says that he had not expected to live to age 30.

We sense the profound sadness that this man feels, which he is able to mask during special moments with his daughter, but also how the joy that his daughter gives him in these moments seems to do very little to alleviate his pain. 

The film is elusive in that there is so much we don’t know about Calum’s past. We understand that he is very young to be the father of an 11 year old. A guest at the hotel asks if she is his sister. Calum shyly but proudly tells him that he is her father. We learn that he had a difficult childhood where he was ignored and disparaged. We don’t know if there was any formal abuse but it may be part of his story. We do see that he is untethered in life, that he has not found work that is gratifying or that brings in enough money. Sophie astutely notices that he very often will make a promise that he does not have the money to keep. She chastises him for that, one of their few moments of friction. You see how caring she is of him when she hears his story of having a birthday that was forgotten by his parents, and then brushed off with a quick trip to a toy store. She rounds up strangers at the hotel to surprise him and sing happy birthday. Calum shows no pleasure at this gesture; instead, he seems stunned. Even a touching moment like this cannot bring him out of his misery.  

There is a moment when we see him—alone, drinking too much and walking, purposefully onto the beach, and then directly into the ocean. The camera lingers in the dark, the waves crashing on the shore. The implication is that he is committing suicide, and from everything we have seen this is very possible, and something that we dread because he would be abruptly leaving his beloved daughter. Sophie has demonstrated her resourcefulness when, locked out of her room with her dad missing, she gets Reception to open the room for her. Calum is discovered there, lying on the bed, passed out drunk and naked after his time in the ocean.  She gently covers him as he sleeps. 

The end of the film suggests that when he says goodbye to her at the airport as she flies to return to her mother in Scotland, that she will not see him again. This is a tender and beautiful film filled with melancholy. It shows a relationship that is loving and caring, with real moments of joy. The film powerfully conveys not only how little we can know about our parents, and how little we could ever find out about their lives before we were born, but also how terrible it can feel to be unable to engage our parents as adults if they are not with us, and especially if they left us when we were small. It shows the depths of the sadness of depression, how even moments of joy and connection cannot always overcome that pervasive sadness. It is the portrait of a young man at sea in the world who, nevertheless, does everything he possibly can to prepare his daughter for a better life.

—James Charney, MD

Image of Micheal Ward and Olivia Colman in the film EMPIRE OF LIGHT sitting side-by-side on a bus. Courtesy of Searchlight Pictures. © 2022 20th Century Studios All Rights Reserved.
Micheal Ward and Olivia Colman in the film EMPIRE OF LIGHT. Courtesy of Searchlight Pictures. © 2022 20th Century Studios All Rights Reserved.

Empire of Light

I very much enjoyed watching this film, but, afterwards, found many things to criticize. The film is discussed as a love letter to the magic of movies, but really it is nostalgic for the wonder of the movie palaces of old, which are beautifully filmed, with cinematography by Roger Deakins, who is nominated for an Oscar for the movie.

The story offers a portrait of how caring the workers are at the Empire Cinema movie palace—how supportive they try to be for each other and how dedicated they are to the small professional details of their work, especially the projectionist played by the wonderful actor Toby Jones. Olivia Colman plays Hilary, the manager of the movie palace, who does her job very efficiently but without any pleasure, and seems very lonely. She is taken advantage of sexually by her boss, and we learn that she has been previously hospitalized for some kind of mental breakdown.  

The lithium medicine bottle in her bathroom cabinet suggests she has been diagnosed as manic-depressive. She is portrayed as a depressed, lonely woman, who takes some pleasure in the company of her colleagues but without realizing how much they truly care for her. And we also learn that though she works at a movie house, she never watches the movies. This is a rather ironic stance in a movie that is supposed to be glorifying the power of movies to heal. When she finally does watch a movieBeing There starring Peter Sellersshe finds the experience engrossing, uplifting, and exciting in a way that makes her feel as though a new world is open to her. The film takes a very long time to get to that point, however, and it frankly seems a rather cliched realization. 

Meanwhile, Hilary develops a friendship with Stephen, a new young Black worker, who becomes her lover. There is a too on-the-nose metaphor of them finding a bird with a broken wing, which Stephen gently cares for, binding the wing so that it can heal. Too obviously, Hilary is meant to be that wounded bird. 

With this new hopeful connection with Stephen, Hilary stops her medication and then becomes profoundly depressed and hostile when Stephen tells her that he is leaving to go to college, something that she had encouraged him to pursue when they first met. Her depression is portrayed effectively: she stops going to work, closes all the blinds in her apartment, does not get dressed or groom herself, and tries to keep at bay anyone who tries to help.  

Encouraged by Stephen to return to work, she appears formally dressed at the Grand Premiere of a major film, an event that matters greatly to her exploitative boss, played by Colin Firth. Uninvited, she marches up on stage in front of an audience of dignitaries, and reads a poem, disrupting the normal course of the festivities, and then has a powerfully angry outburst, confronting her boss and revealing to his wife that her boss had been having an exploitative affair with her. This outburst could be read as a manic episode, but it looks more like a final release of an anger she has carried for too longan anger at being taken for granted, for being sexually exploited, and for not being “seen.” When she later asks Stephen if she had humiliated herself, he tells her she seemed like a hero. In fact, however, she appears untethered and winds up being hospitalized again.

We next see her months later sitting quietly on a bench, and we discover that she is back at work at the movie palace. She is now enthralled with the wonder of the movies that she had been near, but never paid attention to before. 

The problem with this film in terms of mental illness is that we see very little to explain or show the course of her illness. A passing mention that her father and other family members exploited her suggests a more complicated history than we ever get to know. Her boss, in reaction to her tirade at the premiere, erroneously calls her schizophrenic. I see nothing about her behavior or her moods that suggests schizophrenia. It is a misuse of the term that is quite common and unfortunate. There is one previous meltdown when she is on the beach with Stephen when he tells her he is leaving. The suddenness of the outburst is startling to Stephen and to us in the audience, making it clear there is much we don’t know about her inner world.

However, one can make the case that the doctors got it right with the lithium in her cabinet, and that she has been depressed. If she had in the past episodes of mania, we don’t convincingly see that now. Her stopping her medication may have made her uninhibited, extravagant taking over of the stage at the film premiere and the outburst directed at her boss more likely to happen, making it easier for her to express the anger she has been sitting on for so long. But I don’t think it qualifies as a manic episode, though it certainly shows a volatility of mood. It definitely is not schizophrenia.

The film tries to take on too much without exploring anything with enough depth. It brings up issues of racism. It brings up issues of a relationship between an older woman and a younger man, as well as issues of sexual harassment at work. The central conceit about the beauty of the movie palace as a church for sanctifying movies, and movies as a celebratory communal experience, gets lost in the grab bag of these other issues. But, the movie is well worth the watch for the wonderful performances of Olivia Colman, Toby Jones, and Colin Firth, and for the glimpses of a past age, when movies offered an occasion that one could look forward to, and even dress up for.

—James Charney, MD

Written by: Kristina Lykke
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