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‘Suicide Squad’ Would Have Been Much Better With a More Accurate Depiction of Mental Illness

Two forensic psychiatrists review DC Comics’ latest blockbuster—and offer advice on writing multidimensional characters.
Suicide Squad rides a fine line between perpetuating mental health’s stigma and complicating it with likable, if unpredictable, antiheroes.

Suicide Squad rides a fine line between perpetuating mental health’s stigma and complicating it with likable, if unpredictable, antiheroes.

Judging by the film’s 26 percent score on Rotten Tomatoes, Suicide Squad is no Last of the Mohicans. Nevertheless, before they arrived at work on DC Comics’ latest, several of the film’s actors did something like Method-work: They pursued ambitious, Daniel Day Lewis-esque acting methods to mine their characters’ psyches, with a particular focus on the mental illnesses with which they diagnosed their characters. Jared Leto has said he spent time with psychopaths and psychiatrists to get into character as the Joker; actress Margot Robbie, who plays supervillain Harley Quinn, researched co-dependent relationships.

Robbie’s and Leto’s are laudable efforts, as mental illness is not something that mainstream superhero comics—especially those published under the DC Comics label—tend to portray with accuracy, sympathy, or depth. Batman’s Arkham Asylum, for instance, conflates a psychiatric hospital with a prison, decking what the former considers “patients” out in orange jumpsuits and shackles; the Joker is not “psychotic” but psychopathic—an important clinical distinction that is often glossed over by comic-book writers.

With comics now selling as well as they did in the mid-1990s and reaping billions at the box office, this distorted message is getting broadcast to a broad swathe of the American public. For this reason, such films’ outlandish personae have energized the psychiatrists of Broadcast Thought, a group that consults with media and entertainment industries on their depictions of mental illness, to devote a prominent portion of their public work to comics. In their consultations with several television series, talks at pop-culture-centric venues like San Diego and New York Comic-Cons, and semi-regular pieces for The Walking Dead official magazine, the group is trying “to reduce the stigma associated with mental illnesses and their treatment,” says Dr. Vasilis Pozios, a forensic psychiatrist based in Ann Arbor, Michigan, and a co-founder of Broadcast Thought.

With at least three characters labeled “crazy” over the course of the film and one harrowing depiction of psychiatric treatment gone wrong, Suicide Squad rides a fine line between perpetuating mental health’s stigma and complicating it with likable, if eccentric, antiheroes. But the film’s take on the subject is complicated: And so, to review the nuances, we checked in with Pozios and his Broadcast Thought colleague Dr. Praveen Kambam, a forensic psychiatrist based in Los Angeles. The two experts offered their reviews of Suicide Squad, along with some smart suggestions for how to improve it.

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As you’ve written before, DC Comics has a pretty spotty history representing mental illness. Does Suicide Squad represent a step forward or a step back in the label’s representation of mental illness?

Vasilis Pozios: It’s mixed at best. But if you look hard enough, there are some positive things that you can dig out of Suicide Squad. Quinn, a really complex and somewhat controversial main character in the film, is portrayed as having a mental illness. Though it’s not particularly clear what mental disorder she might be displaying symptoms of, it’s positive that we have somebody who is regarded as having a mental illness and not completely playing the villain part. She has heroic qualities about her, and she makes some heroic choices, especially in the third act.

That said, one of the things that fans really like about Quinn from her portrayal in the comics is that she sticks it to the Joker: She rebukes his abuse, stamps out on her own, becomes her own person. I was a little disappointed that that wasn’t portrayed in the film. And, of course, some of the stigmatizing language that’s used to describe Quinn and some of the other characters—“crazy,” “psychotic antisocial freaks”—is problematic.

Praveen Kambam: Another issue is Quinn’s backstory. She’s a psychiatrist who’s working at Arkham Asylum and is essentially tortured to became a criminal character later on. If you take that [story arc] literally, it describes criminal behavior that is coming from some sort of stress and trauma: While certainly those things can contribute and do contribute in real life, it does a disservice to the innate biological components of an illness.

The movie also depicted things like treatment [inaccurately]. For example, the Joker tortures Quinn with what appears to be the ECT, or electro-convulsive therapy, paddle. That’s a scary scene, [which feeds] a lot of public misconceptions about ECT in general; people are afraid of it despite it actually being a very effective and safe treatment.

VP: One of the most concerning things is the movie’s linkage between mental illness and violence. Everything that has to do with mental illness in this film has to do with violence. Take Quinn’s origin story: Even though she [initially] gives the Joker a machine gun to break out of Arkham Asylum, she’s not depicted as committing acts of violence until she takes a dive into a vat of chemicals [at his request]. All of a sudden she’s, one, perceived as being mentally ill, and, two, dangerously violent. Scientifically, we know that that’s just not true. Only 4 percent of violent crime can be attributed to people with severe mental illnesses.

You’ve spoken previously about how the trope of villains being “crazy” reinforces society’s negative stereotypes of mental illness. Is there a way in which the Suicide Squad antiheroes are bringing some sort of nuance to the base-level “psychotic-villain” archetype?

PK: Well, we have to be careful about language. In mental health, language matters immensely. So your question, does it bring change to that kind of “psychotic villain”—that itself, when people say that word, they’re talking about psychopathic villains. When you use the word “psychotic,” it’s like hearing voices.

To answer your question, it’s tough, because it’s a mixed issue. We’re not clear what diagnosis or diagnoses Quinn would be displaying, but there are a couple of things she says, like “Voices in my head are telling me to kill you all” and later, “Are you guys seeing these supernatural things because I’m off my meds?”—implying that people who are having hallucinations are the ones that are going to become violent and criminal. Yes, you can have mental illnesses and be an antihero, but the film goes beyond that in some ways, and depicts them as sort of unstable and unpredictable because of the mental illness.

VP: There is an overarching theme in Suicide Squad about mental illness, whether it be clinically accurate or a lay perception of mental illness. But what you’re really talking about with the majority of these characters is criminal behavior and antisocial behavior. Why, as a society, do we conflate criminality with mental illness? I think there’s a perception that people with mental illnesses are irrational, but it really is an erroneous conclusion to make [to connect the two].

Before the film’s release, actors like Leto and Robbie gave multiple interviews underscoring their research into mental illness. Is there a point at which marketing this kind of method acting makes light of mental illness?

PK: It’s a good question. On the one hand, Hollywood uses consultations, technical advisors, and subject-matter experts to improve accuracy for things like the accuracy of a police scene or physics, so I don’t think that it’s incorrect to do the same with mental health—in fact, we would encourage that at Broadcast Thought. But if somebody flippantly says they were able to understand a mental illness, or in a flippant way used it to drum up excitement about their film, then, yeah, I would have a problem with that.

VP: What I would be interested in is knowing, were any people who have experienced mental-health challenges involved in the [creative] process? With regard to psychotic symptoms, Quinn is perceived to be experiencing auditory and possibly visual hallucinations—was somebody experiencing schizophrenia included in that process? And, if that consultation is done in the spirit of trying to portray things in a more accurate way so that they are less stigmatizing, then I’m all for it. If the accuracy when it comes to mental-health issues is just included for voyeuristic purposes, then I’m a little bit cautious about that.

If director David Ayer had given you a script of Suicide Squad to consult on, what would you have changed or edited?

VP: The biggest single piece of advice that I would give to Ayer is treat people with mental illnesses as people. We all deal with our personal challenges, and, for people with mental illnesses, a mental-health diagnosis is one of those challenges. Their diagnosis is not who they are in their entirety; it’s just one thing they deal with. Having a character like Quinn break out from her abusive relationship with the Joker, come into her own, move toward self-actualization, and not be constantly chained to her perceived mental illness is one thing that I would recommend.

The second biggest thing is remembering that the vast majority of people with mental illnesses are not violent. Of course, this is an action film and a quasi-comedy, it’s not a documentary. But it is important to be mindful not to reinforce negative stereotypes because negative stereotypes have very real consequences. It’s the same logic that you would apply to representations of racial minorities, ethnic minorities, and religious groups.

PK: Here’s what I would have told Ayer: If you’re going to use mental illness here, what’s it going to add that you couldn’t add from somebody’s human experiences? So, these folks are going to be violent because it’s an action movie, and they’re criminals, but using the language of mental illness, or portraying them as having a mental illness, does that actually add to the story for you? If it doesn’t, then I would say you really want to think through using [the trope], because there’s going to be a lot of negative consequences potentially in the real world with respect to stigma and misinformation.

In fact, I think that might actually help the three-dimensionality of the characters. So, for example, with the character [Captain] Boomerang [played by Jai Courtney], he is called a “deranged lunatic,” but there was no real three-dimensionality beyond that. He acted unstable in lots of ways as a criminal, so he could just be a criminal.

VP: He was just uncouth. So does being both uncouth and violent equate to being a “deranged lunatic”?

You guys could have improved the movie. It did seem like it was a narrative shortcut.

VP: It should be said that the narrative shortcut that you’re referencing is not something that pertains solely to Suicide Squad or to DC Films or DC comic books; you see this everywhere, and it’s been going on for a long time. In order to change media representations of people with mental illnesses, we need to educate folks about why these depictions might be potentially problematic and encourage positive representations of people with mental illnesses in media. Hopefully, we’ll see a slow but positive change toward a more accurate and less stigmatizing representation that may one day have a positive effect on making it OK for people to say they have a mental illness and to seek treatment—that could save lives.

If readers want to check out a comic book with a really positive approach to mental illness, where would you suggest they look?

VP: While we’re talking about DC, a positive example of a DC comic that features a depiction of someone with a mental illness who is a hero is Starman in Geoff Johns’ run on Justice Society of America. Starman is from the 31st century, and he has schizophrenia. In the 31st century, there is a treatment for schizophrenia that leads to complete remission as long as you take a certain medication. Of course, Starman gets sent back in time to the 21st century, so he doesn’t have access to his medication and becomes symptomatic. And yet, even though he’s symptomatic and has some disorganized thinking and other psychotic symptoms, he’s a really integral member of the superhero team, and he’s really well-regarded and well-liked. He’s a great example of a comic-book character who can be a hero but also have a mental illness—and that mental illness is not the defining characteristic of his character.