Mentally ill characters are few and far between in fiction. Fortunately, they’re very common in horror, one of my favorite genres. Unfortunately, they’re almost always the villain. The “psycho” serial killer. The axe murderer with “multiple personalities”. Etc etc.

But I don’t think that mentally ill characters should never exist in horror at all. As a mentally ill person who loves horror, I would never say that absolutely nobody is ever allowed to represent me in one of my favorite genres. I just, y’know, wish that people would work with us instead of against us and portray their mentally ill characters kindly. If you’re interested in doing that, here are some tips on how to do it well.

Don’t…

… make your villain mentally ill.

I’m sorry, I’m just gonna put a big ol’ stop sign here. There’s a history here that cannot be ignored: mentally ill people—particularly those with “scary” disorders like schizophrenia and dissociative identity disorder (commonly known as multiple personality disorder)—have long been stereotyped as evil and violent, and this stereotype has formed the basis of a huge swath of popular horror. But this is an incredibly harmful stereotype that contributes to mentally ill people being discriminated against by a society that views them as inherently dangerous. (Editor’s note: Mentally ill people are 16 times more likely to be the target of police violence, which is additionally compounded by factors like race, gender expression, class, etc.)

In addition to being harmful, it’s also just plain inaccurate. Being mentally ill is far more likely to make you a victim of abuse than a perpetrator of it, as abuse against mentally ill people—in forms like institutionalization, forced sterilization, and parents/spouses being given the legal right to control our lives—is socially acceptable because it’s considered a way to keep those Scary Evil Crazies from hurting Good Normal People. 

(“But this mass shooter was mentally ill—” no, he was racist/homophobic/sexist, thanks for your time.)

A caveat: if you yourself are mentally ill, I’m not going to tell you what you can and can’t do. But I am going to tell you that if you don’t have the specific mental illness that you want to give your villain (or something very similar), that’s probably not your story to tell. Dealing with anxiety doesn’t mean that it’s okay for you to give your serial killer dissociative identity disorder. 

… bait and switch “mentally ill” characters who are actually neurotypical. 

Alright, work through a thought experiment with me.

You’re queer. You hear about a movie released by a major studio that has a lesbian character in it. You think, “Oh boy! A queer character in a big movie? That never happens. I should go watch it.” So you go watch it, and you’re all excited at the start of the movie because hey, lesbian character! But then the twist comes: the character isn’t actually a lesbian, she was just being haunted by ghosts who made her think she was a lesbian, and she’s actually straight and ends the movie in a relationship with a man.

… Yeah, okay, it’s not a perfect metaphor. But you get what I’m going for, right? The bottom line is this: when you’re part of any marginalized group, it really sucks to see a character who you think is going to be like you until the big twist reveals that they were never like you at all.

… make your mentally ill characters helpless victims.

Okay, so, you have a character who’s actually mentally ill and who isn’t a villain. Great first steps! The next one: do they have agency? Do they get to do cool, interesting things—or, if that’s not really the kind of story you’re telling, do they have some say in the actions they take? Or do they just exist to be helplessly brutalized without ever getting a chance to fight back? If it’s the latter, please reconsider that. 

A writing tip I see frequently is that your character’s actions should have actual effects on the plot—both good and bad. A character who just deals with things happening to them is nowhere near as interesting as a character who’s given the room to make actual choices, take actions, and then deal with both the positive and negative repercussions of them. I think that’s good writing advice in general, but I think it particularly applies to mentally ill characters.

I would love to see a mentally ill horror protagonist who actually gets to do cool things. A character with dissociative identity disorder who saves the day. A schizophrenic Final Girl. Mentally ill characters who get to actually do things instead of just having things done to them. 

Maybe…

… refrain from using psychiatric hospitals as a setting.

I am ducking tomatoes right now from other mentally ill people who think that this should be under the “don’t” list because they don’t think that horror should ever, under any circumstances, be set in a psych hospital. But I disagree! 

There’s an episode of The Magnus Archives, “MAG 177: Wonderland”, that takes place in a mental hospital. I actually loved that episode, because it’s very clear in the way it’s portrayed that the horrifying thing is not the patients. Rather, the horror comes from the doctors who abuse the mentally ill patients under their care. I, personally, am fine with horror like that.

Read more: How The Magnus Archives Helped Me Love Horror Again

Because the truth is that there’s a lot of abuse that goes on in psych hospitals, both historically and presently. And it is genuinely horrifying. To me, the issue with how psych hospitals are portrayed in most horror isn’t that they’re portrayed at all. Rather, it’s that the horror usually comes from the “crazy”, violent, evil patients who were locked up for good reason, because if they weren’t locked up, they would hurt people. 

In the smaller number of portrayals where the doctors are portrayed as abusive, the main character of the story is usually a neurotypical person who is mistakenly locked in the hospital despite not being mentally ill at all. The implication is that the abuse happening to them is only bad because they’re not really mentally ill, which itself carries the inherent implication that if they were mentally ill, they’d deserve it.

But in real life, there is a lot of abuse that happens in psych hospitals to patients who are genuinely mentally ill and absolutely do not deserve abuse. It happens, it’s scary, and it’s worth talking about. Dare I say, it’s even worth making horror about. So, yeah, I am actually okay with psych settings where the horror comes from the abuse that the mentally ill patients face.

… avoid giving your villain trauma.

Yes, yes, we all love a good tragic backstory for a villain. Done right, it can serve to humanize them a little, to show that they’re hurting the world because the world hurt them first. Done wrong, it can come across like the creator is trying to justify the villain’s unjustifiable actions. Done really wrong, it can imply that the very act of experiencing trauma turns you evil.

I’m not saying that you can never give your villain a tragic backstory. But if your villain has undergone some form of trauma (whether that’s sexual assault, abuse, the death of a loved one, or anything else traumatic) and your heroes have not, that carries some bad implications. When your villain is the only primary character who’s undergone trauma—especially when that trauma is a key part in what turned them villainous—the implication is that the very act of experiencing a traumatic event makes you evil. 

But in real life, trauma does not make you harm people. On the contrary, it can actually make you more likely to experience further harm: if you’ve been abused before, that can affect your baseline standards for how other people should treat you, which can make you more likely to stay in future abusive situations because you think you don’t deserve better. 

This is in the “maybe” section because, like above, I don’t want to say that you can never have a villain who underwent something traumatic. But I am saying that if you give your villain trauma, you should give at least one of your heroes trauma, too. And really, doesn’t giving both your hero and villain trauma and showing their different reactions to it just make them better foils?

Do…

… write mentally ill protagonists, not just side characters.

I can think of a very small number of protagonists in any genre who are canonically mentally ill, and an even smaller number who have “scary” mental illnesses like personality disorders, schizophrenia, and DID. Let us be the heroes instead of just the side kick or the one-off character intended to teach a Very Special Lesson.

… show how it affects their life.

I’m not saying that you have to write your character experiencing ableism—you don’t—but mental illnesses do, by definition, affect some part of your life. How does your character’s mental illness affect their hygiene, their eating habits, their sleep schedule? Are there certain things they avoid because they trigger depression/psychosis/anxiety/etc? How does this affect them? How does it affect the story? If a character avoids being in total darkness because it’s a psychosis trigger, that’s going to become an issue real quick if they’re facing a demon who thrives in light and can only be avoided by being in the dark.

… research.

Any time you write a character in a marginalized group that you’re not in, it’s imperative that you do a lot of research to make sure you’re writing them correctly. Research the specific mental illness you’re writing, focusing primarily on resources written by people who have that mental illness themselves—not medical professionals who have worked with people who have it, not neurotypical people whose family members/friends have it, but actual mentally ill people who really have that illness. 

Research the symptoms, but don’t just read dry bullet point lists on medical websites—read personal accounts of what it’s actually like to experience them. Read nonfiction by us, but read fiction, too. Read the stories that we write about ourselves. Research stereotypes, things to do avoid. Ideally, you’ll also hire a sensitivity consultant—someone who has the mental illness you’re writing who can look over your work and verify that it’s accurate and not harmful.

Yep, that’s a lot of work. You know what else is a lot of work? Writing. You didn’t burst from your father’s head like Athena, fully-formed and with a perfect knowledge of everything you’ll ever want to write about. You practiced writing. You got feedback on your work. You researched how to write well. When you started writing fiction about things you weren’t familiar with, you did more research—whether that was looking into how long it takes someone to bleed out from a bullet wound, what people wore in medieval Europe, or how long it takes to drive across a country. You researched what it’s like to be a doctor, a firefighter, a lawyer. 

You’ve done research for your writing before. Do it again. And if you really, truly have some reason why you cannot do extensive research on this topic, don’t write mentally ill characters. I’m serious. Just don’t do it. No representation is better than harmful representation.

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