On World Mental Health Day, local film takes on global stigma

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“Hidden Pictures” follows people diagnosed with mental illnesses on four continents to reveal how a shift in attitudes might improve care.

When Delaney Ruston began exploring mental health from behind the lens of her camera, it was as much a personal journey as it was a narrative to be shared with audiences. The Seattle-based physician and filmmaker had for many years run from her own family history of mental illness.

Soon after filming wrapped on “Unlisted,” Ruston’s first documentary about her father’s diagnosis with paranoid schizophrenia, Ruston got a call that on a morning walk, her dad had handed his wallet to a young couple and jumped from the Santa Monica Pier.

“Unlisted” would go on to air as a PBS special. But the film and her father’s suicide left Ruston wondering how a U.S. healthcare system that had failed her family, compared to others worldwide.

“Data now shows the burden that these illnesses have on the human condition…So many people are affected, whether it be childhood disabilities, dementia or depression,” says Ruston. “To completely ignore it is no longer an option.”

“Hidden Pictures” premiered earlier this year and features five vignettes of individuals diagnosed with depression, bipolar disorder and schizophrenia in India, China, South Africa, and France, as well as our own backyard. What emerged was a story of a disturbing lack of resources, but also of compassion.

Filmmaker Delaney Ruston with her father, who was later diagnosed with paranoid schizophrenia. (Photo courtesy Hidden Pictures)

Filmmaker Delaney Ruston with her father, who was later diagnosed with paranoid schizophrenia. (Photo courtesy Hidden Pictures)

“I wanted to find stories that would resonate with people,” says Ruston. “To me, this documentary isn’t the answer. It’s just a starting point. My goal is to start that discussion.”

Ruston found stories of public health clinics so poorly equipped they didn’t have a single antidepressant, only valium.

In India, she met a young woman whose diagnosis of schizophrenia was kept a family secret. The burden of caring for a grown daughter took a visible toll on her parents. In China, Ruston met Jeff, also diagnosed — she suspects incorrectly — with schizophrenia after graduating from one of Beijing’s top universities. When his father admits him to a mental health institution, he finds himself effectively imprisoned, without even the basic right to appeal his family’s decision.

And closer to home, in Bellevue, Ruston met Patricia, who first saw a man named Jeffrey on the streets of downtown, where he had been living homeless and undiagnosed with severe mental illness for nearly ten years. When Patricia tries and fails to find him housing, she invites him into her own home.

“I had decided that I wouldn’t be able to live with myself if I didn’t make the best effort I could to help him. We live in the wealthiest city in Washington state, if that had been a dog out there for ten years, [we] wouldn’t have left a homeless stray dog. [We] would have taken care of it” recalls Patricia for the camera. “And yet, there’s Jeff, outside.”

Mental illness touches just about everyone’s life in some form — whether it be ADHD, dementia, depression or schizophrenia. The World Health Organization’s official estimate is 450 million people around the world experience it, or one in four American adults. And yet we usually associate it with violence, laziness or mass shootings.

Sonya, an Indian woman diagnosed with schizophrenia, whose condition was kept a family secret, in a still from the film.

Sonya, an Indian woman diagnosed with schizophrenia, whose condition was kept a family secret, in a still from the film.

When news broke last month of the Navy Yard tragedy, most media zeroed in on police reports of the gunman’s unstable mental state: “Navy yard shooter treated for ‘serious mental illness’” as if the label was explanation enough.

But while the headlines provoke important dialogue, they also risk disguising the nuances of an illness believed to have both genetic and experiential influences.

“Media so often links mental illness with violence, yet the vast majority of people with mental illness are never violent,” says Ruston. “The reality is a person dealing with mental illness is much more likely to take their own life than someone else’s. I know this all too well.”

But in her filming of “Hidden Pictures,” Ruston also finds success stories. She derives hope from the strong family ties of most global cultures. That support network, she says, is one of the most critical aspects of recovery and management.

Vikram Patel, for instance, a leading researcher of mental health programs in the developing world, has encouraged training community members to deliver basic psychiatric care, much like ordinary people can be trained to deliver a baby.

Early results are promising. In rural Pakistan, female health visitors delivering cognitive therapy to depressed new mothers were found to have recovery rates of as high as 75 percent compared to those of 45 percent in neighboring villages. In India, workers similarly trained in psycho-social interventions for depression and anxiety, were shown to have success rates of as high as 70 percent.

Delaney Ruston, in the field. (Photo courtesy Hidden Pictures)

Delaney Ruston, in the field. (Photo courtesy Hidden Pictures)

Ruston hopes that dialogue spurred by campaigns like her’s will make this a historical moment for mental health advocacy.

The WHO recently selected Ruston’s film as the cornerstone of its global mental health action plan, with goals to measure the global burden of mental illness and to reduce the suffering, marginalization and denial of basic rights. Ruston is beginning with her own children, now 11 and 14 whose questions about their grandfather first started her down her current path.

“Stigma is a funny and cold word that really doesn’t convey the pain. Stigma can be broken into two things — it’s shame and it’s fear,” says Ruston. “I think we’re getting there…The only way to make progress is to talk about it.”

Oct. 10 is World Mental Health Day. In hopes of shattering stigma and furthering dialogue Ruston has organized private screenings of “Hidden Pictures.” To learn more about the film and local events visit hiddenpicturesfilm.com.

Celina Kareiva is a journalist in the Seattle area, with a particular interest in diversity and health reporting. She's contributed work to The Seattle Times, The Dallas Morning News and KING 5. She is currently helping filmmaker Delaney Ruston launch a mental health advocacy campaign around her film, "Hidden Pictures." Next fall, she'll be working toward her MPH at NYU's Global Institute of Public Health.

1 COMMENT

  1. Thank you for this film and your committment to helping the mentally-ill. I am trying to get help for my son that is so ill and delusional that he doesn’t know he needs help. Alas, our current laws and lack of resources prevent me from succeeding. My fear is that I will lose him completely before I can get him into treatment. Meanwhile, I grieve for the child I lost and continue to support the stranger that is bankrupting me.

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