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Crime is usually connected to mental health in fiction. What that really means and what that looks like in fiction may vary a bit, with some stories showing empathy for the person and others favoring lock them up and throw away the key scenarios. Often the interactions are cheap and over simplified and cater to the lowest common denominator. A perfect example of this is Primal Fear.

Primal Fear is the 1996 movie that launched Edward Norton’s career. The story focuses on Richard Gere’s portrayal of Martin Vail, a hotshot lawyer in love with publicity. When the Archbishop of Boston is brutally murdered, he agrees to pro bono defend Aaron Stampler, the young, stammering suspect. Aaron is at first confused by how he wound up covered in blood and fleeing the scene, but after questioning, a violent split personality named Roy appears and confesses to the murder. Martin, knowing he can’t introduce an insanity defense midway through the trial, he uses his previous relationship with the Prosecutor to get what he needs into evidence.  He then gets Roy to manifest during the trial. The Judge dismisses the jury and finds Aaron guilty by reason of insanity. There is a twist ending, though.  When Martin goes to his cell to tell Aaron, Roy tells him that Aaron never existed.

This is the big fear people have, isn’t it? That someone who “gets off by reason of insanity” is just playing a game. That they’ll pretend to be sick, and get away with it, and then spend two years in a mental hospital and be free to kill again. This feeling is why people say “get off by reason of insanity.” It allows people with mental health conditions to be the boogeyman who comes back to hurt other people. It also reinforces the idea that psychiatrists have no idea what they’re doing, just pointing at people and labeling them as sick. The idea that someone can have no control over what they’re doing, or doing something honestly with the completely wrong concept of what’s going on is so foreign to a person who’s never experienced it before that they can’t understand it. So much stigma exists because people ignore what they can’t understand, and this is the perfect example of it.  The insanity defense is so misunderstood that movies like this can help solidify its image in people’s minds.   

The problem with this understanding of the insanity defense, and of mental health and the criminal justice system in general, is that it’s completely wrong. In the United States, less than 1% of defendants used the insanity defense, and of them, only 1 in 4 was successful (statistic from Bulletin of the American Academy of Psychiatry, Vol. 19, No. 4, 1991). Of people sent to mental hospitals instead of prisons, they are likely to spend much more time there than they would in jail; in fact, some spend double the time. They are also likely to be under long-term court review, unlike people released from prison (from The Jurisprudence of the Insanity Defense, citing Rodriguez, LeWinn, and Perlin, The Insanity Defense Under Siege: Legislative Assaults and Legal Rejoinders, 14 Rutgers Law Journal 397, 402 (1983)). In addition, the Department of Justice’s Bureau of Justice Statistics reported in 2006 that approximately half of inmates in prisons had mental health conditions (according to NAMI), an estimated, and troubling, 1.25 million people. Often people with mental health conditions are imprisoned for minor infractions, and have severe trouble adjusting to prison life, leading to longer incarcerations (from

This crisscross of people with mental health conditions and the justice system is complicated, rooted in history and not easy to solve. The average person, however, doesn’t see that unless they go looking for it. So stories like Primal Fear, which is a good movie, perpetrate the idea that people with mental health conditions are faking it (or that they can be easily cured by love, respect or material goods) because the actual answer is too complicated.

By saying that someone is “crazy,” the creator can sidestep the harder questions of whether anyone can be violent, and mental illness becomes a shortcut. Answering why anyone would kill innocent children can be answered easily with “they’re crazy,” as if no other answer was necessary. Everyone involved can shrug and move on with life, safe in the knowledge that they would never do anything like that. It’s a simplified answer to a complicated question.

Primal Fear is a good movie, in so far as I enjoyed watching it again. The acting is top-notch, the story is tight, and the mystery is exciting. It’s one of the better cheap thrillers of the 1990s. Like a lot of the movies I’ve watched for this blog, the problems appear when you start to compare them to the real world, and look at how they are commenting on life. It’s not one instance of mental health on film; it’s the accumulation of all of the views and they portray. It gets overwhelming.

Next week, the mother of all crazy movies, Psycho. Have you seen Primal Fear? What do you think?