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Joker: Stigma, Inaccuracy, and Implications for Mental Health Policy

Updated: Apr 11, 2021

A tale of violence, societal neglect, and a lonely man experiencing symptoms of serious mental illness, 2019’s Joker has stirred controversy and opinion among the public. An undertone of dark humor infiltrates the film, at times, seemingly inappropriately, as the violent murders depicted on film, matched with real-life tangible themes in present society produced unsettling feelings. As moviegoers in the audience laugh, I sit in discomfort and confusion: is this something to really laugh about? Am I being too sensitive? Perhaps this is too close to home.


As a professional and advocate within the mental health sphere, I’ve worked with client’s who have serious mental illness comparable to that of Joker, such as chronic hallucinations, delusions, and difficulty managing very distressing thoughts and emotions. Feelings of being let down, abandoned, misunderstood and neglected by society, in addition to their own family and friends, aren’t uncommon. Not being able to make medical appointments, afford treatment, and take medications every day are real barriers and concerns that prevent persons from accessing and maintaining treatment regimens for their needs. Poverty, homelessness, addiction, chronic disease, traumatic brain injury, and limited social support only exacerbate these issues, complicating the backdrop to what Gotham City really would reflect in today’s society. Arthur Fleck was let down, abused and neglected, there is no mistake. But is Joker even accurate?


Here lies the problem: Joker spins mental illness in an inaccurate light, and is portraying those with serious mental illness, like schizophrenia, as unstable and committers of violent crimes, when in reality, most person’s experiencing comparable symptoms of serious mental illness, such as that of Arthur Fleck, do not commit violent crimes any more so than the rest of the population. Joker’s seeming attempts to bring awareness to a political issue in fact, get the issue wrong, mislead the viewer, and further perpetuate stigmatization of a vulnerable population.

For a viewer outside of the scope of mental health practice, serious mental illness, abuse from others, severe societal neglect can be directly linked to violence. In reality, serious mental illness is much more complex than this. Viewing it in this light discredit’s the lived experience of many person’s with serious mental illness that don’t experience behaviors similar to Joker. In fact, many, if not most live isolated, secluded lives, wishing to avoid confrontation with others and maintain peace. This perception can also perpetuate myths of violence within the mental health community, creating political and policy barriers that don’t address the true needs of this group.

Person’s with serious mental illness are very rarely depicted as leading character’s in the movie spotlight, and ironically, despite reaction’s that Joker has brought awareness to this issue, it may also have defeated it’s own purpose by misconstruing reality. This can have effects and implications for the general public’s perception of serious mental illness, public awareness, and political and economic policy. Film’s like Joker can have a huge impact on broad perceptions of vulnerable and marginalized populations and subsequent decisions about how we behave towards this group.

Regardless of Joker’s brashness and potential negative effects, there is something to say about what the movie did do well, which are important to note. It provided viewer’s with an inside look into Arthur Fleck’s life, perhaps allowing one to build empathy for the villain as we learn his story of abuse, neglect, and mental illness. This invokes a sense of understanding of how he became a villain in the first place, allowing the viewer to step inside of his life, riddled with abuse and feelings of being disconnected and stuck. Despite stigmatizing elements of the storyline and it’s real-life implications for people today, Joker also provokes the audience to consider society’s role in his unfolding character development, and has opened an important dialogue, one that we need to keep talking about in regards to mental health in the United States.

In the end, however, there is ultimately a sense of personal and social responsibility that Joker hones and yet also inherently rejects through it’s careless depictions of violence and mental illness. If filmmakers are to create Gotham City and Arthur Fleck’s rise to supervillain-dom through such a realistic and emotionally provoking way in the first place, there’s something to be said about also giving weight and acknowledgement to the real-life implications it may have on society.


Dr. Alexandra Zuck, OTD, OTR/L is an occupational therapist based in Los Angeles. She’s a clinician and advocate with a passion for healthcare and policy. #mentalhealth


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