In “Hidden Pictures,” a Mental Health Doc Confronts Global Stigma

by on May 10, 2013

Sonal is in a private garden, tugging at her necklace; a weariness in her eyes, she tells us, “I sometimes think, Is there a monster in me?” She’s a young woman with thick black hair and a kind face softened by big brown eyes. She lives in New Delhi with her mom, who worries that her daughter won’t find a husband. Sonal leaves home only when her mom takes her — over two hours each way — to see her psychiatrist: Sonal has schizophrenia.

In Hidden Pictures, physician and Seattle filmmaker Delaney Ruston takes us around the world and introduces us to individuals like Sonal who live with mental illness. The film screened at STIFF in early May, and was voted “most moving documentary” by the festival’s judges. Ruston says it will air on PBS stations soon. (Her documentary, Unlisted: A Story of Schizophrenia, which recounted her experience of her father and his schizophrenia, also aired on PBS.)

Delaney Ruston

Delaney Ruston

Through her lens we travel to five countries: India, South Africa, China, France, and the United States. We see glimpses of what life is like with a mental disorder, and how mental illness is viewed and treated in different parts of the world. The film is a patchwork of people with varying illnesses in assorted cultures, and as the personal stories unfold, we see that stigma permeates all borders. In this pioneering documentary, Hidden Pictures exposes us to an intimate view of mental illness on a global level.

In South Africa we meet Buyisva who has been diagnosed with depression and bipolar disorder. Like Sonal, she isolates herself from her community. “Maybe they will laugh,” she says. On the other hand, in Beijing, Tang Lei (“Jeff”) has been institutionalized for eight years with a diagnosis of schizophrenia, though he doesn’t appear to have a mental disorder.

Comparatively, France has one of the best health care systems in the world. All mental health care costs are covered, including therapy sessions for family members, but despite tremendous federal support, societal stigma remains. To treat his depression and anxiety, Steve spends six months at an inpatient hospital on the government’s dime, but after his recovery, he feels he has to hide his mental illness to find work. Steve’s mom doesn’t know what to tell people about her son so she avoids social events. The barnacle of shame that clings to mental illness affects more than the afflicted.

Anecdotally at least, it’s apparent that stigma against mental illness runs rampant. Regardless of culture, the shame associated with mental disorders exists in all demographics. Ruston “found it nearly impossible to find someone affected by mental illness — even leaders in mental health activist groups” she told Global Pulse, who was “willing to appear on-camera.” Stigma, Ruston concludes in her film, is found in “poor countries, rich countries, and countries known for strong family ties.”

Over 450 million people across the globe have a mental illness, but this number only represents incidences that have been reported, notes the World Health Organization. Almost half of those reported to have a mental disorder live in a country where there is one psychiatrist or less to serve 200,000 people. That’s like eight psychiatrists serving the 1.6 million people living in Manhattan, explains Global Pulse’s Emily Judem: “Worldwide spending on mental health is less than US$2 per person, per year. In low-income countries, that number drops to less than 25 cents per person, per year.”

In fact, claims mental health advocate Vikram Patel, “the treatment gap between developing and developed countries is 90%, and 50% of people in Europe don’t get care.”

If you see Hidden Pictures, it will be hard to ignore the role that stigma plays in the dire state of global mental health care. The degree of support that can be provided hinges on how high the stigma barrier climbs. Ruston aims to arm viewers with the knowledge and awareness needed to continue to break down the stigma barrier. The shame and misunderstanding surrounding mental illness must be dispelled, she argues, for effective progress to be made worldwide.

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