Avoiding Stereotypes in Fiction: Characters with Mental Health Issues

Readers have spoken: they want more diversity in fiction. And writers are stepping up, but it can be hard to write about someone who’s different than you. Careful research is the key to avoiding misrepresentation, which causes harm to the very identities being portrayed and creates fallout for well-meaning writers when they’re called out by readers.

For this reason, we’re running a series of posts on avoiding stereotypes in fiction. Written by a diverse cast of talented authors, each post highlights a different people group—the common stereotypes to avoid and how to write those characters realistically. We hope this series arms you with the knowledge and tools to write characters you may have been reluctant to write before—ones that will take your story to the next level.

By: Cheryl Rainfield

Books, movies, and TV shows can shape how we think about folks living with mental health issues. Yet popular media often stereotypes or sensationalizes mental health, which can harm people living with those issues while deepening the stereotypes, stigmatization, and misinformation. It helps to be aware of those stereotypes so you can avoid them in your work and make your characters more complex and realistic.

Here are some common stereotypes to avoid when writing about mental health.

Your Character Lives in a Mental Health Issue Vacuum

Your character likely knows many people living with mental health issues, even if they don’t know it. One in five US adults deal with mental health issues, one in 6 youth have experienced major depression, and one in twenty adults live with severe mental health issues. Because of harmful stereotypes, a lack of understanding, and societal shaming, many folks with mental health issues choose not to talk about them. But mental health issues are common.

Fix: Show your character knowing at least one person they care about with a mental health issue—a friend, parent, co-worker, lover—besides just themselves. If your character starts off with a void in this area, create opportunities for others to open up to them about what they’re dealing with.

Your Character is Violent Because of Mental Health Issues

The media tends to pin violence, murder, even evil on folks living with mental health issues—especially schizophrenia, Borderline Personality Disorder (BPD), Dissociative Identity Disorder (DID), and psychosis. But the majority of people with mental health issues are not violent. Only 3%–5% of violent acts are made by people with a serious mental illness, and people with mental health issues are over 10 times more likely to be victims of violent crime than the general population. A study in Sweden found that 19 out of every 20 violent crime convictions in Sweden were committed by someone who did not have a mental illness.

Movies that depict this stereotype: Moon Knight, Split, Identity (DID), Fatal Attraction (BPD), Psycho, Spider (schizophrenia), Psycho, American Psycho, Joker (psychosis).

Violent acts are more likely to be caused by other or combined factors such as alcohol and drug abuse, being male, living in a low socio-economic household, experiencing or witnessing abuse and not working on healing, and social isolation. Major life stressors (such as losing one’s job, going through a divorce, the death of a loved one, etc.) and a lack of support during these events can also play a part.

Fix: Instead of blaming a character’s violence on a mental health issue, dig deeper into their background and current situation. Make sure they have the right combination of factors that could result in them using violence.

Love Cures Mental Health Issues

Romantic love, good parenting, support, and compassion can make dealing with a mental health issue easier, but they can’t cure these issues. The idea that love can fix these issues is dangerous because it may result in a loved one getting angry at or blaming the person living with depression, anxiety, or schizophrenia. They may even blame themselves for not being the cure.

Movies that depict this stereotype: Silver Linings Playbook, Don’t Say A Word. etc.

Fix: A character dealing with a mental health issue who is loved and supported will likely be able to cope better, but they still will live with their symptoms. Pair the love of others with additional proven strategies, such as the character improving their viewpoint about their mental health, incorporating helpful coping strategies, and/or getting support from a therapist.

A Character Being Defined by Their Mental Health Issue

A character whose life revolves around their mental health issue and doesn’t include much else is very one-dimensional. Folks can be incredibly impacted by their symptoms, but they are more than their mental health issue.

Fix: Work to make your character a full character. Consider all the past events that make them who they are and have shaped how they see their world. Show their interests, people and animals they love, viewpoints, work and/or hobbies, and other things that help them get through each day. Figure out what motivates them, what their desires and needs are, and the obstacles that cause them trouble aside from their mental health issues.

Characters with Mental Health Issues Being Crazy or Insane

Referring to or depicting a character with mental health issues as crazy or insane is not only offensive, it also spreads the misinformation that aggression, violence, and/or criminal behavior are linked to mental health issues. The character may have challenging symptoms that affect their mood, thoughts, and behavior, but that doesn’t make them crazy. And someone with mental health issues can still function well and have good mental health.

Fix: Be specific in the words you use to describe your character and their symptoms. Research their mental health issue, giving extra attention to sources who live with it. Show your character living a full life, dealing with their issues but in touch with reality and the world around them.

Characters with Mental Health Issues Are Visually Different

Anyone can be affected by mental health issues and most function well in society. They dress well in public, work at a job or as a parent, have good or good-enough hygiene, and you wouldn’t know by looking at them what issues they’re facing. While some folks with severe depression, PTSD, anxiety, etc. may struggle with hygiene, others can be on the opposite end of the spectrum.

Fix: You shouldn’t be able to tell that most folks have mental health issues just by looking at them. Talk to some people who deal with the mental health issue you’re writing about. Try to show the whole character and a spectrum of behavior and symptoms. If your character does struggle with hygiene, show them using hacks to keep clean.

The best way to avoid stereotypes is to research the mental health issue you’re writing about. Talk to therapists and consult folks who live with those issues. Read first-person accounts, credible articles, the DSM-5, etc. And remember that characters aren’t defined by their mental health, though it can affect their life and viewpoint.

More Resources:

How to Treat Mentally Ill Characters When Writing a Novel by Sonja Yoerg, Writer’s Digest

10 Best Tips For Writing Mental Illness In Fiction, YouTube video by Jenna Moreci and Iona Wayland

Writing About Mental Health In Fiction by Mary Fletcher

Myths and stereotypes about people with mental health issues

Ways Mental Illness Is Commonly Misrepresented in the Media

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Other posts in this series:

Avoiding Female Character Stereotypes
Avoiding LGBTQ+ Character Stereotypes
Avoiding Religious Character Stereotypes
Avoiding People of Color Stereotypes

Discussion is encouraged, but please keep it courteous. Let’s not call out authors for past mistakes, and let’s do keep an open mind. By listening to and respecting each person’s experiences and perspectives, we can better write the stories and characters readers want to see.

Award-winning author Cheryl Rainfield (they/she pronouns) writes gripping YA fiction with heart and realism, writing books they wished they had when they were a teen. Hundreds of readers have messaged her about how her novels about queer and abused teens helped them feel less alone. Cheryl draws on their own trauma and healing experience to write; Cheryl’s scarred arm is on the cover of SCARS. They are the author of six books including SCARS, STAINED, and HUNTED. Cheryl Rainfield is an incest and torture survivor, nonbinary lesbian, and an avid reader and writer. Find them on: CherylRainfield.com; TikTok; Twitter; FaceBook fan page and author page; Instagram; YouTube; plus BookBub for book recommendations.

Cheryl Rainfield has been said to write with “great empathy and compassion” (VOYA) and to write stories that “can, perhaps, save a life.” (CM Magazine)  SLJ said of her work: “[readers] will be on the edge of their seats.”