The purpose of this essay is to develop an understanding of mental illness. This essay will be based on the media portrayal of a mental illness and will be compared to how this portrayal aligns with Pacific Worldview. A discussion will be included of the concepts of stigma, discrimination and public perceptions of mental illness and the impact that these may have on service users. Lastly a discussion will look at the ways in which stigma and discrimination are being challenged by government policy and campaigns. The Soloist is a movie that is based on the true story of a news reporter named Steve Lopez and a homeless musician named Nathaniel Ayers. One day while Lopez is walking through downtown Los Angeles he hears a violin being played. Upon investigating he meets Ayers who is a homeless man with schizophrenia, playing the violin. Lopez learns that Ayers once attended Juilliard but dropped out after two years. Lopez writes a column about Ayers and bonds with him; and begins to discover how this talented musician, wound up living on the streets (Foster, Krasnoff, Grant, & Wright, 2009). Schizophrenia is the mental illness that is portrayed by Ayers in the movie The Soloist (Foster, Krasnoff, Grant, & Wright, 2009). Laracy and Trimmer (2013) describe schizophrenia as a group of disorders evidenced by impaired thinking, emotions and behaviours that hinder an individual’s capacity to make and build relationships and function in society. The depiction of schizophrenia with its accompanying signs and symptoms were evident throughout the movie. Incoherent speech is one of the characteristics of schizophrenia; throughout the movie Ayers displayed verbal rambling, linking words during conversations and jumping from topic to topic (Procter, Hamer, Mc Garry, Wilson, & Froggatt, 2017). An example of this within the movie is when Lopez stops his car while driving in the underpass to talk to Ayers. Ayers talks to Lopez about different sheet music he wants then almost instantly jumps to pointing out a red and green car then talks about a police car and then explains how God lives on the other side of the wall (Foster, Krasnoff, Grant, & Wright, 2009).Auditory hallucinations are another symptom of schizophrenia in which Ayers experiences throughout the movie (Procter, Hamer, Mc Garry, Wilson, & Froggatt, 2017). While attending Julliard he starts to hear different voices calling his name, these voices begin to distract him while practising with his fellow student musicians. These voices tell him that the other musicians can hear his thoughts and that he needs to run away, he does as the voices instruct and runs out of the rehearsal and hides (Foster, Krasnoff, Grant, & Wright, 2009).Those with schizophrenia may dress differently and sometimes inappropriately (Walker, 2014). On each occasion that Lopez and Ayers meet, Ayers always dressed differently than those around him and sometimes dressed inappropriately. On one occasion he wore a black balaclava during the day and at night he painted his face white (Foster, Krasnoff, Grant, & Wright, 2009). Individuals with schizophrenia may also display resistance to instructions; Ayers displayed this symptom when Lopez found him a place to live within Lamp; which is an organisation that envisions ending homelessness among mentally unwell individuals (Because everyone should be housed, healthy and safe , n.d.). An example of Ayers resistance to this move included saying that people that lived at Lamp smoked and they throw their cigarette butts on the ground to torment him. Ayers further resisted by saying that underpass he was at was the perfect playing environment. Ayers eventually arrived at Lamp, but due to his resistance it took him till the next day to arrive there (Foster, Krasnoff, Grant, & Wright, 2009). The last symptom that will be discussed is withdrawal from society and lack of social interaction (Procter, Hamer, Mc Garry, Wilson, & Froggatt, 2017). Ayers family explained in the movie that Ayers love for playing the cello grew, and before long that was all he did. There was no more football, no more baseball, just music, every day, day in and day out. Ayers began to isolate himself from his family and school friends and eventually ends up homeless due to voices and distrust to those around him (Foster, Krasnoff, Grant, & Wright, 2009). The portrayal of schizophrenia within the movie aligns with some information provided in textbooks and lectures; it also identifies attitudes and behaviours of some individuals towards those with mental illness (Laracy & Trimmer, 2013). Discrimination and stigma have long been behaviours associated with the mental illness. Discrimination is when someone treats you in a negative way because of your mental illness (Procter, Hamer, Mc Garry, Wilson, & Froggatt, 2017). Stigma is when someone sees you in a negative way because of your mental health (Procter, Hamer, Mc Garry, Wilson, & Froggatt, 2017). Statistics reveal that attitudes and perceptions of individuals towards those with mental illness have improved; but despite this improvement service users still face discrimination and stigma (Like Minds Like Mine, 2016). Some examples of stigma, discrimination, and public perception that still exists today include; mental illness is a life sentence (Like Minds Like Mine, 2016). Individuals with mental illness are not smart or able to achieve high standards of education or work (Like Minds Like Mine, 2016). Individuals with mental illness are scary and violent (Like Minds Like Mine, 2016). The impact of these perceptions and many more on service users can have a negative effect with the loss of an individual’s self-image, self-esteem and confidence (Overton & Medina, 2008). The loss of self- image, self-esteem and confidence may lead to social isolation and withdrawal from society. The impact of perceptions continue to be seen within the housing sector; service users find it more harder to find accommodation than those with no mental illness (Overton & Medina, 2008). A survey found that people within New Zealand preferred to live beside someone of a minority nationality than to someone with a mental illness (Statistics New Zealand, 2019). Relationships are affected as relatives, friends and significant others may slowly drift away resulting in social isolation (Overton & Medina, 2008). Despite studies revealing more acceptance of mental illness, people tend to withdrawal from working together with individuals with mental illness (Overton & Medina, 2008). As a result of these attitudes and behaviours, people with mental illness face social isolation, social distance, unemployment, and homelessness. An example of an attitude and behaviour within the movie which portrayed discrimination; is when Lopez wanted to take away Ayer’s freedom to choose and make decisions. This was portrayed when Lopez asked David to force Ayers to see a psychiatrist and get him on medication. It is important to remember that people who are mentally ill continue to have rights. These rights are known as patient rights under The code of Health and Disability Services Consumers Rights (Health and Disablity Comissioner, 2019). These rights help to stop discrimination and stigma towards those that are vulnerable. Homelessness is another stigma that is associated with mental illness, and is portrayed within the soloist. It is important to note that not all homeless people have a mental illness; nor are they music geniuses. As the story unfolds we learn that Ayers begins to hear voices while he is at Julliard; these voices make it impossible for him to focus and in turn he drops out. These voices continue to affect him and he becomes suspicious of his mother and perceives that she wants to poison him, thus leading to a fight and Ayers running away and becoming homeless. Evans, Nizett and O Brien (2017) explain that mental illness and homelessness are connected; due to weakened thinking and perception and the inability to maintain relationships. A study taken by the Auckland Council (n.d.) has shown that individuals with mental health issues are most at risk of becoming homeless. Being homeless with an mental illness may lead to a lack knowledge on support available and may lead the individual to further isolation and support (REF). Understanding that mental illness and homelessness are intertwined; non-government organisations have set up programmes within the country to help solve and reduce this problem. Pathways is an example of an non-government organisation that helps to house homeless individuals that experience mental health illnesses (Whatever it takes, n.d.). Through this organisation they have been able to house all clients who have come through their services, thus reducing homelessness numbers that are mentally ill (Whatever it takes, n.d.). Mistaken belief’s and misconceptions are factors that contribute to discrimination and stigma experienced by individuals with mental health illnesses. Within New Zealand stigma and discrimination are being challenged by various campaigns and policies; campaigns such as Like Minds Like mine (Ministry of Health and Health Promotion Agency, 2014). This programme works closely with the Mental Health Foundation of New Zealand and the Health promotion agency in educating and helping to reduce stigma and discrimination experienced by service users (Like Minds Like Mine, 2016). This programme has been running since 1997 and has seen a decrease in discrimination towards those with mental illnesses (Ministry of Health and Health Promotion Agency, 2014). Individuals accessing mental health services are covered under the Health and Disability Services Consumer’s rights (Health and Disablity Comissioner, 2019). This code ensures that service users are always treated with respect, dignity and honesty (Health and Disablity Comissioner, 2019).The Health Practitioners Competence Assurance Act 2003 is another piece of legislation that protects health care consumers (Health Practitioners Competence Assurance Act 2003[HPCAA], 2003, s. 8). The Act ensures that health professionals are component and fit to practice within New Zealand (HPCAA, 2003). Nursing Council of New Zealand oversees registered nurses’ practice, by setting competencies and rules for nurses to follow to ensure safe practise (HPCAA, 2003). Non maleficence is one of the ethical principles of nursing and is defined by the Code of Ethics as the prevention of harm to a health care consumer in a health care setting (New Zealand Nurses Organisation [NZNO], 2010). This principle encompasses the core values in nursing which is empathy and caring (Crisp, Douglas, Rebeiro, & Waters, 2016). Within nursing practice, it is important to remember these core values and to stand up against behaviours of nurses and others that do not reflect these standards. It is important to not let an individuals mental health define who they are. It is important to focus on their strengths and provide encouragement and ensure that they have access to services available. The Pacific world view of mental illness differs greatly to Westernised views; because of these differences the way that Pacific people approach and treat mental illnesses differ. Traditionally Pacific people saw that mental illnesses were spiritually based; Tongan people believe that mental illnesses derive from three concepts avanga , te’ia, and mala all of which are related to the spirit and cursing’s that may come upon an individual (Finau, Tipene-Leach, & Finau, 2004). This is still relevant today as many Pacific people continue to turn to traditional healers for exorcisms, herbal remedies and guidance to receive forgiveness from spirits of the dead (Bloomfield, 2002). Throughout the movie the Westernised view of mental health was seen through Lopez repeatedly asking the David Carter the head staff at Lamp to medicate Ayers. Carter tells Lopez that being diagnosed with an illness does not make any difference in an individual’s life and that the last thing that Ayers needs is another person telling him he needs medication (Foster, Krasnoff, Grant, & Wright, 2009). The Westernised model of health uses medication to treat individuals with mental health illnesses (Evans, Nizett, & O Brien, 2017). Having an understanding of these different perspectives an important aspect in dealing within mental health nursing. In order for change to occur, change needs to begin with me and each individual. Through this assignment we have come to gain a deeper understanding of the realities in which people with mental illness experience. We have begun to look at the portrayal of mental illness through the medium of a movie. We have been able to identify through the movie characteristics that relate to symptoms of schizophrenia. We have looked at the effects that discrimination, stigma have on individuals with mental illness; and how these form barriers in the life of that individual. These views have been compared with the Pacific Worldview and helped to look at the differences of each view. Through government campaigns and policies these barriers are being challenged to reduce the stigma and discrimination they experience; in order for them to live a normal life as possible.
Table of Contents