Tropes vs. people with mental health difficulties

A recent victory by people with mental health difficulty shows that it is possible to challenge stories that use the history of mental illness as a prop and why it’s vital

Mark Brown
16 min readJun 20, 2017

Over the last decade the UK has made progress in challenging some of the ways in which people with mental health difficulties are discriminated against, with a shift in attitudes that is noticeable. Increasingly, people are aware that overt statements of prejudice are unacceptable and cause real harm. However, prejudice runs much deeper than words. Negative cultural attitudes toward mental distress and mental illness are a thread woven deeply into our collective psyche. They are the underpinnings to stories and ideas that, on the surface, to a less sensitive eye or ear, appear to have nothing to do with the real life political, economic and social position of people with mental health difficulties. Prejudice and denigration hide in the bones of culture.

‘It’s just a story, it doesn’t harm anyone’ is a refrain used by people to whom the result of a story or the history that gives it power does not matter. In popular culture, cultural production is a kind of power. Historically, the interaction between money and culture has meant that the most dominant tropes have been the ones that sit best with the current status quo of social organisation. Tropes have power, that’s why they’re the building blocks of stories. Unexamined tropes act upon marginalised people by confirming and reaffirming the negative ideas and notions others hold about them, making fictional worlds that either wittingly or unwittingly confirm biases and prejudices. People with mental health health difficulties are one such group who are actively harmed by the kinds of stories people tell.

A Leeds based company offering teams of people immersive experience-based games based on escaping from a room by solving puzzles found themselves receiving heavy criticism from some in the mental health world for the subject of their latest game ‘Asylum’. The premise of the game, according to company The Great Escape Leed’s website was that the players had strayed into the abandoned ‘Leeds Asylum’ where you have fallen victim to the sadistic games of ‘A Doctor’.

After meeting with local mental health representatives the company issued a statement on June 19th: “We have changed the name of our newest escape game to ‘Abducted’. We are also in the process of developing the game to ensure that it has no connection to mental health. This will take some time, therefore, please continue to be patient with us.” This came after weeks of campaigning from people with mental health difficulties on social media and media coverage covering critical points of view. Throughout this, the company maintained that their game had nothing to do with mental health yet resisted calls to change elements of the game.

The company running ‘Asylum’ persistently claimed that ‘Asylum’ had nothing to do with mental illness. This claim was disingenuous, but wasn’t necessarily untrue from the perspective of the organisers. It did however come from a position of privilege. Why, if the game was so unrelated to mental health as the company saw it, was it so difficult for them to alter elements? The answer is that the very things the game relied upon to generate its atmosphere were tropes impossible to detach from their history of real world oppression, fear and prejudice. To get to the bottom of this we’re going to have to go on a little dangerous escape game ourselves. To win we’re going to have to work out why the asylum as place of danger retains such cultural power and to set out, without magic words like ‘stigma’, why it damages the lives of people who experience mental distress and then we’re going to have to say a final incantation of banishment to open the door to the future.

The Escape Game Leeds: No asylum

The teaser trailer for the ‘Asylum’ game on the The Great Escape Game Leeds website featured a distraught woman in a straitjacket forced to record a message to camera by a silent blank-masked, white coated figure. The text introducing the experience set the scene:

“Stumbling upon a collection of worn photographs, you find images of other captured souls, tortured and tormented. People bound to a chair, locked in straight jackets, fitted with mouth traps. Unadulterated sickness. Strange devices, which could not have possibly had any medicinal value. Yet still, your curiosity urges you to continue, thumbing through old boxes, each photo more sick and twisted than it’s predecessor.

“One particular photo catches your eye. A person starved. Excruciatingly thin. Mouth sewn together and eyes bleeding crimson tears. You struggle to breathe. As you look closer, you realise the date printed on the photograph reads the very day you entered the asylum.

The name printed is yours, you could not contain your curiosity… and finally, you are mine.”

So far, so Saw. On this evidence, ‘Asylum’ attracted a campaign of criticism from people with mental health difficulties, local and national mental health charities and NHS mental health staff. BBC local news covered the story:

Leeds itself does have a decommissioned ‘asylum’, the stereotypical self-contained community at the edge of town, making this a sensitive issue for some. High Royds Hospital, which began life as the The West Riding Lunatic Asylum in 1888, closed its doors in 2003. It was the subject of an exhibition where people who had spent time there shared their experiences and memories.

On the 16th of June The Great Escape Game Leeds issued a statement after meeting with representatives from the local council, Leeds Mind and local NHS. The company claimed: “Over the coming weeks, we will be looking at elements of the game to ensure it remains popular without any further distress;” stating they were looking to review game’s name, storyline, the straightjackets used in the game and their marketing strategy. They also, in response to criticism they had been received via social media, stated “While some parties have been willing to enter a rational and mature conversation, there’s also a fraction of people who want to do nothing but abuse and are not willing to engage. We feel that they have nothing to add to this situation, so therefore we have no option but to block them from our social media accounts.”

In response to complaints for Claire Woodham and Nuwan Dissanayaka the company stated: “I can assure you that the game has absolutely nothing to do with people who suffer from mental illnesses, far from it. The game is merely set in an abandoned asylum where the story’s antagonist performs experiments on his victims (a very common horror trope in movies).”

The Escape Game Leeds are not the only UK company running games based on a similar premise. Atherton Escape Rooms also have an experience called ‘The Asylum’, where players have sixty minutes to avoid being admitted to an asylum which asks in its promotional material “Are you an escapee or a crazee?” Project Breakout announce as forthcoming an escape room where you are “trapped in the old Asylum at the edge of town,” where you have one hour before a doctor returns to administer “The Medication” that will “render you in a zombie like state, leaving you to wander through life as a mere shell of your former self.” Tick Tock Unlock offer a game which involves exploring a secret room in an Asylum gutted by fire in the 1940s where you can “devote time to discovering the true cause of the fire, the story of the unregistered patient betrayed, and the secret which has haunted the asylum ever since.”

All trade on common tropes from horror films: scary asylums; horrible doctors; forced incarcerations; secret and malign treatments. These tropes come from somewhere beyond fiction, from a real history and real group of people. The argument made by The Escape Game Leeds was that the elements they were using in their story were common tropes in horror, and as such were merely storytelling conventions which function only as elements within horror stories. This is where the elements of privilege come into play.

Popular culture is dominated by the same cultural biases that dominate a culture as a whole. Written into our popular culture are the same expectations and prejudices about how the world can and should work as those in action in everyday life. Genre fiction has for decades been in a process of examining its tropes and trying to create work that reflects more the reality of a range of people’s lives and also tries to remove the elements of stories and genres that reinforce real world injustices. The last three to four years has seen a backlash against this progression. A group of right wing writers and bloggers tried to hijack the voting of international science fiction awards The Hugos in protest that too much of the work celebrated was about social justice, feminism and progressive view about sexuality, gender, race and politics. The gamergate phenomena was about a mass mobilisation of right wing voices to fight the danger that ‘social justice warriors’ — people who weren’t white men — would take away everything that was fun about computer gaming. The online explosion of hostility toward the all-female central cast of the remake of Ghostbusters which culminated in the banning from twitter of arch troll Milo Yiannopoulos for leading racial abuse of leading actor Leslie Jones is another example of this trend. Anita Sarkeesian, famous for a series of youtube videos ‘Tropes Against Women’, became a symbolic hate figure for these genre fans. The argument goes that ‘social justice warriors’ — people wishing to explore and challenge tropes in fiction- are ‘taking away the fun’ from genre fans by criticising the real world implications of their fictional pleasures. This is where privilege is a factor: these fans and creators are unhappy that they are unable to continue to feel comfortable using and enjoying ideas and conventions without the people who suffer at the understanding of the world these ideas and conventions promote saying ‘hang on, could you just not?’

Tropes work in fiction because they speak to our already existing sense of what makes a story make sense. They work because we are familiar with them. This familiarity is drawn from their repeated usage across different media across time and also within our cultural expectations and preoccupations. It is the interaction between this cultural reproduction and cultural resonance that gives tropes their potential to enact prejudicial or oppressive ideas even when the creators deploying them are not aware of the implication of their artistic decisions. This is why the response from creators when called out for their use of damaging tropes is often ‘we are sorry you are offended’ rather than actions to atone for the offense or damage caused. Creators are often trapped by the tropes they use, being unable to change those tropes without significantly altering the story they are trying to create. This is a best a failure of imagination, at worst an arrogance; an ignorance or sense of privilege that says ‘that wasn’t what I meant, how dare you suggest I don’t understand the meaning of my own work?’ Fans of the media that are being challenged will often fall back on the idea that individuals and organisations are ‘looking for something to be offended by’ and ‘seeing offence where there is just good fun’. Responses to those questioning The Great Escape Leeds exhibited both of these tendencies. People were told they didn’t understand horror; didn’t understand that the game content was not harmful and were a rent-a-mob looking for things to be offended by.

Our mission, then, is to explore where these mental health tropes come from and why they are not just scary stories for adults in search of a thrill and why it was so hard for The Escape Room Leeds to let go of them. If the battle is to be a battle about the status of tropes, then let tropes be our battle ground.

Knowing the tropes: tropes vs. people with mental health difficulties

Escape games draw strength from emotional reaction. In part this is based on atmosphere and in part upon the ability of the people running the game to create an immersive atmosphere where the individuals taking part are seduced into believing that there is a kind of jeopardy whilst also knowing that they are actually safe. It’s a kind of play acting, encouraging players to submerge themselves in the story in the way that children submerge themselves in stories. The player must trust that they are safe, that all will be returned to normal upon completion of the experience, while also believing in the ‘reality’ of the situation while they are taking part in the events that unfold. They’re basically live action roleplaying for people who don’t like live action role playing.

In the building of atmosphere, the creators are drawing upon a number of elements that they know will add to the verisimilitude of the experience. They are choosing elements that feel right and correct in the context of the story being set out. And that’s where our problem begins. Deserted asylums, spooky doctors, straightjackets: all are based in real historic social events. These are all tropes that actively harm people with mental health difficulties.

In something like ‘Asylum there are a number of fears at work, all of which centre upon historic cultural beliefs around asylums and the people you might find there. Experiences such as ‘Asylum’ work only because they play upon the residual cultural beliefs that there is something of which to be afraid.

Negative tropes around mental health and the use of genre staples such as decaying asylums or ‘mad doctors’ come from a fear that mental ill health is contagious, that anything to do with mental health treatment is sinister and should be feared and that mental health is terrifyingly beyond comprehension and that madness is almost supernatural in the threat it presents to good, moral, ‘normal’ people

One of the most common horror tropes that surround asylums and people with mental health difficulties is that no one in their right mind would ever choose to go anywhere near them. This trope functions on the basis that there is somehow an inherent risk for those who consider themselves normal even to visit such a place. In horror, the trope of the haunted, decaying asylum is a kind of gothic whether the decaying ancestral pile is replaced with the decaying, wayward institution and the hidden passages, intrigues and family curses replaced with more modern fears of loss of autonomy, loss of identity, medical experimentation and wayward authority figures. People without mental health difficulties want to both feel scared of people with mental health difficulties and also to pity them while never seeing them as people in the same way that they are people. This is a common experience with other people who are marginalised, people who are painted as a problem and a danger to the smooth running of the lives of others.

The idea at work in the original conception of ‘Asylum’ is that the asylum is a world of its own, ungoverned by the rules of normal conduct and society. Similarly, by association ‘mental patient’ is fiction short hand for unpredictable, disruptive or disturbing individuals. This too is based on the person with mental health difficulties as a kind of other; a person that is not quite a person in the way other people are people. One of the fears this operates is the fear that any mental ill health or distress within yourself will lead you to be exiled to spend your time with the ‘real’ crazy people; that you’ll be the only sane person in a horrific world of people who are unwell and threatening.

A common trope is the asylum as a place of cruel and unusual experimentation, where the unfortunate people detained there are at the mercy of the whims and perversions of the staff. Stories situate the asylum as a community where people who have forfeited their right to demand and receive the rights and benefits of normal society are sent making the asylum a place for fantasies about what happens when societies rules do not apply. People break the rules of normal conduct and are sequestered away, and are interned in a place where the rules of conduct are suspended. The asylum is a place where people are sent when they cannot observe the rules of proper society, and as such could only attract professionals themselves who have some kind of malign interest in having power over others. This is the conflation of the idea of incarceration for transgressing norms and the fear of having our own autonomy removed. It is just this idea that keeps people who are having difficult experiences from seeking help or support.

Asylums work in fiction as places of mystery, where outside scrutiny is limited. Anything could be happening in there, the trope will have it. The asylum is a space where any form of depravity or abuse of power might happen, because no one cares about you once you go there. Indeed, you might disappear forever. The story of an innocent sent to investigate an asylum stretches back at least as far as Edgar Allan Poe’s ‘The System of Doctor Tarr and Professor Fether’, itself written at a time of debate about the treatment of those mentally unwell in the US. Another common trope is that once entering the asylum the individual will be subject to a loss of self, that somehow just be being in proximity they themselves will become mad. This works because we assume that in treatment facilities are terrible places and contributes to the tendency wider society has to want to turn a blind eye to the complaints and needs of those experiencing mental distress.

To become unwell, in these tropes, is to lose all agency. The individual is first at mercy of their own mind; second at mercy of institutions and third at the mercy of the other people in those institutions. The tropes work because they let people imagine that they will never be unwell and so can play out the thrill of what might happen if they were through a series of distorted tropes that do not reflect the actual reality of such an experience. Such tropes are another way in which people are interested in everything about mental health apart from the actual experiences of those that experience mental ill health.

In this cultural imagination the asylum must be an institution where different rules of conduct and morality have arisen because it is a institution beyond the scrutiny of good, normal, moral society. In real history the asylums were placed toward the edges of towns, and did historically function as their own closed environments. It is also true that these institutions did enact harmful practices sometimes by commission but also by omission by failing to care for and enable the people who found themselves living there.

Overall, the tropes at play position mental ill health as a challenge to normal life, with asylums just being a concentration and magnification of that threat. We have an ambivalence toward the idea of asylums. They function both as places of incarceration and of care. We cannot decide culturally whether such places provided protection and care in the face of a hostile community or whether they protected communities from dangerous, strange or disturbed individuals. This has seeped into the notion that asylums were places of inevitable decay, haunted by the suffering of those who made them their homes. Even outside of fiction ‘good’ liberals find themselves confused around the idea of what might represent liberation for people with mental health difficulties. If, society thinks, we save people from the total institution of the asylum then we’ll just have to deal with the mad people in our everyday lives. Socially and culturally we still have both a fear of mental ill health and a fear of its treatment.

Your trope: my life

It is easy for someone who has not been touched by mental ill health or who has not had to deal in the practical realities of hospital stays for mental health difficulty to declare all of the negative tropes around these issues all part of the spooky fun. At a political level, such tropes are as damaging as the trope that every young black man is a threat or that every women needs a man to save them. They are pleasurable deployments of outdated ideas.

For The Escape Game Leeds, the decision to cease the deployment of such tropes came from outside pressure from people with direct experience of mental health health difficulties people who know how far close to home these tropes are. Their problem was that they had not interrogated the tropes they were deploying to tell as story and build an atmosphere. They had fallen into one of the biggest traps presented by uninterrogated tropes: the use of tropes as if they exist only within a genre and have no effect on the world beyond the fiction. The escape Game Leeds gummed together a lot of tropes that they knew their intended audience would recognise without any consideration of what the totality of those tropes might create. Without considering the reality of the history of asylums and only focusing on the history of stories about asylums they managed to create a story which could be boiled down to ‘don’t go to even a deserted asylum because madness will get you and you’ll be trapped forever.’

In a world where people with mental health difficulties experience marginalisation; are repeatedly told to lower their expectations of treatment and care; are shunned by friends and neighbours and excluded from communities; and where real abuses of power do happen The Escape Game Leeds unwittingly defended their right to endorse this status quo because it did not have a direct effect upon them. Having gummed together tropes without a strong sense of what sort of story they were telling The Escape Game Leeds initially fought to hang onto those tropes, as if they could not imagine how to tell the story they wished to tell without them. This is what happens with unexamined tropes used without interrogation: they become short cuts where the creator cannot think of another route to the same effect. Tropes are used precisely because they are deeply embedded in social prejudices and thus easily recognisable.

This is not a battle between people with mental health difficulties and creators and fans of horror. Many people with mental health difficulties are both creators and fans. It is a battle between people need justice and change and their allies and those who either do not want social change or would prefer to look at the things that the consume for pleasure. As the Feminist Frequency slogan goes ‘Be Critical of the Media You Love’.

Stories are the way that we make sense of the world. We consume stories to comfort us, and to stretch our imagined knowledge of the world and how it works. The stories we make end up making us. While story of The Escape Game Leeds is one where, it seems for the moment, that the forces of progress won, this is only a tiny skirmish in the overall battle to redefine the stories we tell about mental health difficulty.

In the game of ‘Tropes vs. people with mental health difficulties’ we haven’t reached the end of level one.

Thanks to @sectioned_ for their help in preparing this article.

@markoneinfour

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Mark Brown

Mark Brown edited One in Four, mental health mag 2007–14. Does mental health/tech stuff for cash (or not). Writes for money. Loves speaking. Get in touch