Critics rarely applaud Hollywood for its realistic portrayal of life and its hardships. So it should surprise no one that the myth-making industry gets mental illness, especially schizophrenia, wrong more often than right.

Hollywood's most common sin is its fuzzy-headed habit of confusing schizophrenia with other psychiatric illnesses. "They all get lumped together," says Stella March of the National Alliance for the Mentally Ill (NAMI), a consumer advocacy group for people with severe mental illnesses and their families.

A recent example is Jim Carrey's character in the 2000 comedy, Me, Myself, and Irene. While his silver screen cohorts repeatedly refer to Carrey's character is as a "schizo," Carrey actually portrays a man with a dissociative identity disorder, or multiple personalities. The condition's rarity has not stopped Hollywood from mining the dramatic potential of the so-called "split personality" in many of its classic mental illness movies, from The Three Faces of Eve (1957) to the many more faces exhibited by Sybil (1976).

One of Carrey's sub-personalities is a violent sociopath, another Hollywood stereotype of the person with schizophrenia. In suspense master Alfred Hitchcock's Psycho (1960), Anthony Perkins plays a man who has two personalities: the mild-mannered Norman Bates and his homicidal deceased mother -- not a visitor you'd want in the house while you're showering. Norman's homicidal tendencies seem almost quaint next to later incarnations such as Freddy in Nightmare on Elm Street (1984), one of many movie psychotics who slash and gash their way through silver screen sororities, summer camps, and Saturday nights.

The National Institute of Mental Health in its statement on schizophrenia notes that "most violent crimes are not committed by persons with schizophrenia, and most persons with schizophrenia do not commit violent crimes." Laurie Flynn, former NAMI executive director, might as well have been speaking about any of these movies when she said of Me, Myself and Irene: "This movie reinforces a total misunderstanding of what schizophrenia really is. This character's violent, unpredictable behavior will be unfairly associated with having schizophrenia. It's terribly stigmatizing." NAMI's March makes the point that these demonizing portrayals "cause people to fear and isolate the mentally ill," and can discourage those suffering from psychosis from pursuing treatment, she says.

If the violent maniac is one portrait of mental illness Hollywood puts forward, quaint character is another. These movies paint mental illness with rosy, romantic colors. In the French classic, King of Hearts (1966), patients in the local mental hospital wander into an abandoned town and show themselves as a happy and fun-loving group. The large, furry hallucination that accompanies Jimmy Stewart in Harvey (1950) makes Stewart seem more charming than ill.

A variation on this theme are movies such as One Flew Over the Cuckoo's Nest (1975), which portrays the institution as far more sickly than those who are kept inside its walls. Another damning portrait of the psychiatric hospital, not altogether inaccurate, is The Snake Pit (1948), which depicts the hellish institution Virginia Cunningham (Olivia de Havilland) must escape before she is cured.

How does Hollywood cure schizophrenia? In The Snake Pit, it's a pipe-tapping psychiatrist who saves the girl. The talking cure, as psychoanalysis is sometimes called, also helps Natalie Wood put her life back together in Elia Kazan's Splendor in the Grass (1961). If talking doesn't help, Hollywood relies on its most favored antidote, true love. In Spellbound (1945), a psychiatrist named Dr. Peterson (Ingrid Bergman) falls in love with an amnesiac patient played by Gregory Peck, a doubly successful antidote that cures Peck's symptoms and solves the murder he is mistakenly accused of.

"Talk therapy is not what people with severe mental illness need," contends March, noting that the conventional wisdom today describes schizophrenia as a genetically-based neurological and biological disease. "Talking does not cure people with serious brain disorders."

Where does A Beautiful Mind (2001) fit in to Hollywood's image of mental illness? Dr. Louis Sass, professor of clinical psychology at Rutgers University and author of Madness and Modernism, likes how the movie portrays John Nash as a little "awkward, weird, cold, and off-putting," not uncommon traits for people who eventually develop schizophrenia. Dr. Sass also says that portraying a person with schizophrenia who wins a Nobel Prize helps make a connection between those inclined toward schizophrenia and a precociousness in fields such as math, physics, and philosophy. "There is often a creative aspect to many people who develop schizophrenia, even though the onset of the disease usually devastates their ability to express this potential," notes Dr. Sass, arguing that the movie helps expand the stereotype of the artistic genius prone to only manic-depression, or a bipolar disorder.

March says that NAMI has been overwhelmed by e-mails from people praising the movie. "A Beautiful Mind was something I was hoping to see for years," she says. "The paranoia, the delusions, the behaviors were all recognizable," she argues. Most of all, she was pleased to see a sympathetic portrayal of someone with the disease that also realistically addresses how it can devastate families.

"People have empathy for people with cancer, or Alzheimer's, or Parkinson's, but they often don't have empathy for people with schizophrenia," she says. "This movie can reach millions of people and begin to change attitudes that are hard to change."

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