How The Depiction Of Mental Illness In Bird Box & Bandersnatch Fails Horror Fans Like Me

Stuart Hendry/Netflix
By James Factora

Over the past few years, we’ve seen the horror and thriller genres become more progressive in terms of representation both in front of and behind the camera, with movies such as Get Out and The Babadook receiving widespread critical and commercial success. While it’s wonderful to see these leaps and bounds being made in a genre that has historically been marred by racist and sexist tropes mentally ill people are not just being left behind, but actively villainized, as evidenced by both Black Mirror: Bandersnatch and Bird Box, two recent — and massively popular — Netflix releases. Spoilers ahead.

Not even five minutes into Bird Box, a horror movie starring Sandra Bullock, a news broadcast reports that masses of people in Europe and Siberia are exhibiting “psychotic behavior," which entails committing suicide upon viewing unexplained entities. As the pandemic spreads to the U.S. it’s revealed that mentally ill people, referred to by some in the band of survivors as “the psychos,” are not only immune to the entities, but have made it their mission to expose as many (sane) people to the entities as possible, causing them to kill themselves. One of the major turning points comes when Gary (Tom Hollander), a seemingly normal man, finds his way to the safe house, allegedly on the run from the “psychos from Northwood,” which is explained to be “a mental institution for the criminally insane.” Naturally, he ends up being one of those patients and gleefully exposes most of the survivors to the entities, turning their relatively safe haven into a bloodbath.

Statistically, it’s very possible that you know at least one person who has experienced psychosis in their life, and you might not have ever known.

Meanwhile, Bandersnatch is Netflix’s first foray into adult-oriented interactive content, meaning it’s a branching narrative in which you can choose your own path, of which there are several. Stefan (Fionn Whitehead) is a computer programmer in the ‘80s who has gotten the green light on creating a video game adaptation of one of his favorite choose-your-own-adventure novels. There are many endings, but they basically fall into two categories: the “boring” routes (i.e. working with adequate support from a team, taking his meds), which end hastily with a middling to terrible rating on the game from an expert, and prompt the viewer to go back and try again; and the more eventful routes, where you can watch him devolve into madness, coding away in isolation, experiencing what seem to be classic delusions of control, killing his father and chopping him up into bits, and landing a 5-star rating for his game only after he stops taking his prescribed medication.


The reality of psychotic behavior and/or “madness” is vastly different from both of these portrayals, though. According to the National Alliance on Mental Illness, psychosis generally consists of “disruptions to a person’s thoughts and perceptions that make it difficult for them to recognize what is real and what isn’t.” The most well-known symptoms are hallucinations and delusions, but other symptoms can include disorganized thinking, social isolation, incoherence of speech, irritability, loneliness and more.

Psychosis is most often associated with schizophrenia, but it can present in a number of other disorders, including both unipolar and bipolar depression, according to WebMD and Healthline, respectively. Some new parents can even experience postpartum psychosis, per Postpartum Support International. Web MD reports that it can also be caused by certain prescription medications, alcohol, drugs and even sleep deprivation.

It’s also far more common than you might think. Three percent of the U.S. population will experience psychosis at some time in their lives, and about 100,000 adolescents and young adults in the U.S. experience first episode psychosis each year, according to the National Institute of Mental Health. Statistically, it’s very possible that you know at least one person who has experienced psychosis in their life, and you might not have ever known — no matter how many mainstream movies would have you expect symptoms to manifest.

Most importantly, an overview of several studies published in World Psychiatry concluded that the link between mental illness and violence is unclear. Some studies discussed in the overview report that mentally ill people are actually as likely as non-mentally ill people — or even less likely — to commit acts of violence. Ironically enough, one study found that schizophrenic people were actually the least violent compared to those with mood disorders, and delusions were not associated with violence at all.

The fact that these stereotypes are still perpetuated in the horror and thriller genres (see also: Split, Hereditary, Halloween) make them not just inaccurate and disappointing, but actively dangerous. According to JAMA Psychiatry, severely mentally ill people are up to 23 times more likely than the general population to be a victim of a violent crime, with the authors of this study declaring violence against mentally ill people to be a public health crisis. The findings also only include reported crime, without even addressing domestic violence, which mentally ill people also experience at higher rates than the general population, according to the scientific journal PLOS One.

With so many stigmas attached to mental illness, many people who deal with these disorders are discouraged from seeking treatment. Another equally harmful subset of these stereotypes is the notion that psychiatric medication hinders true creativity. In Bandersnatch, the exact words from the reviewer who gives Stefan’s game 2.5 stars when you choose to have him take his meds are, “It's as if the creator simply gave up halfway through and went on autopilot.”

The idea that medication makes you essentially a brainless zombie is simply untrue. I’m not currently taking medication, but I can say that being on antidepressants for the first time was a revelatory experience. I actually felt like I was operating on autopilot before I was adequately treated — monotonously going through the motions of everyday life, doing the absolute bare minimum that I had to survive, let alone create. Taking medication in combination with weekly therapy (much like Stefan does, in certain storylines) enabled me to actually get stuff done and feel like I was living up to my potential for the first time in years.

The science backs this up too. According to Psychology Today and the American Psychiatric Association, a combination of medication and psychotherapy is recommended for the treatment of moderate to severe depression.


As for the nightmarish references to Northwood in Bird Box, the trope of scary, haunted insane asylums has been around forever. The reality of psychiatric institutionalization is indeed scary — for patients. While inpatient care has certainly improved over time, allegations of abuse and mistreatment at the hands of caregivers and other medical professionals are unfortunately still very prevalent. It’s a complex issue, but ultimately there is absolutely nothing wrong with needing to go to the hospital for mental health issues either, especially when you consider their prevalence; according to the Agency for Healthcare Research and Quality, 8.6 million inpatient stays in the U.S. in 2012 involved at least one mental disorder or substance-use disorder diagnosis, accounting for nearly a third of all inpatient stays.

I’ve had a lot of experience with mental illness since adolescence, both on a personal level and because many of my loved ones are mentally ill as well. I'm also an avid lover of horror movies. And every time yet another horror movie falls into these tired tropes about mentally ill people, I can’t help but cringe.

I want to see mentally ill people championed as the heroes of the stories that we love.

It’s not a coincidence that some of the most representative horror movies of the past few years have also been the most well-received. But this diversity should also include neurodiversity, not just because tropes like the "psycho killer" are offensive, but because they’re lazy, boring storytelling. And because mentally ill people deserve better.

I want to criticize the genre and push the boundaries of it, so it can be better. I want us all to examine our unchecked ideas about mentally ill and disabled people and how the media perpetuates them, and leave them fully in the past.

And beyond just destigmatizing, I want to see mentally ill people championed as the heroes of the stories that we love. How cool would it be to flip the script and see something like hearing voices, for example, treated as an asset in a horror movie rather than a cheap source of scares? I want to see more mainstream narratives of mentally ill people, including psychotic and schizophrenic and traumatized people, living full, happy, accomplished lives, because it is possible. I'm the proof.

If you or someone you know is considering self-harm or experiencing suicidal thoughts, call the National Suicide Prevention Hotline at 1-800-273-8255 or text HOME to the Crisis Text Line at 741741.