NSG3MHI: Mental Health and Illness Essay on A Beautiful Mind

This essay provides a detailed analysis of mental health and illness, focusing on the film 'A Beautiful Mind' and the character of John Nash, who suffers from schizophrenia. The essay begins with an introduction to mental illness and a brief overview of the film. It then delves into the etiology and pathophysiology of schizophrenia, discussing genetic and environmental factors as well as the neurological basis of the disorder. The essay explores the mental health assessments, treatments, and interventions depicted in the film, including psychological, social, and behavioral assessments, pharmacological interventions, and psychotherapy. The impact of schizophrenia on John Nash, his family, and the community is thoroughly examined, highlighting the challenges faced by individuals with the illness, the burden on families, and the societal stigma associated with mental health conditions. The essay draws on current research and literature to support its arguments, providing a comprehensive understanding of schizophrenia and its multifaceted effects.

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MENTAL HEALTH AND ILLNESS
mental Health and illness

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Introduction
Mental illnesses are among the major causes of ill-health and disability worldwide. Nearly 21
million people across the globe are affected by schizophrenia (WHO, 2018). As per World
Health Organisation (WHO), stigma and discrimination and neglect prevent care and treatment
from reaching people with mental health issues. The aim of the essay is to outline a mental
illness through a feature film. For this purpose, the film titled “A Beautiful Mind” was chosen
which is inspired by the life of the mathematician John Forbes Nash, Jr. Nash, played by Russell
Crowe, was one of three Nobelists in 1994 for their work in game theory. The film portrays the
distressing dispute between Nash’s mathematical genius and schizophrenia. He was diagnosed of
paranoid schizophrenia which nearly ruined his excelling career and his marriage to Alicia Larde
played by Jennifer Connelly. A Beautiful Mind depicts Nash as obsessed and, in schizophrenic
episodes, delusional and even violent. The essay will identify and discuss the etiology and
pathophysiology of Schizophrenia as featured in the film. Next, the essay will outline and
explain the mental health assessments, treatment and or interventions that were featured in the
film that support recovery. Further, the essay will identify and describe the impact of the illness
on the John Nash, his family and the community. Lastly, the essay will determine and mention
the stigma or discrimination shown in the film towards John Nash due to his mental condition.
Etiology and pathophysiology of the mental illness featured in the film
Nash is introduced as a young, introvert and dedicated man to the audience at the beginning of
the movie. In the early scenes of the movie, Nash is shown different from his peers due to the
anti-social element in his nature. The difference is clearly depicted during his conversation with
his imaginary roommate Charles. This is the first sign of mental illness of Nash in the movie.
The film does not essay a clear etiology of Nash’s mental condition but the audience can infer
certain causes while watching the movie. First, it was shown that Nash had an inherent condition
of brain which affected the brain that may have been passed down to the son, whom it is said is
as well having auditory hallucinations. So, as a viewer it can be deduced that since Nash’s son
was also developing similar symptoms, it can be postulated that the mental illness of nash had a
genetic etiology. Secondly, environmental factors can be a source of Nash’s mental illness. Nash
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dealt with immense pressure to have a genius discovery which may have been the cause of his
onset of his condition which manifested as clinical symptoms in his later life. Thirdly, it can be
said that both genetic as well as environmental factors played roles in development of
schizophrenia to Nash. pathophysiology of Nash’s disorder can be seen in several symptoms that
is demonstrated by the actor including delusions, visual and auditory hallucinations, strange
conduct, emotions of paranoia and a distorted perception of reality. These symptoms are very
well shown in his interactions fantasy characters of Charles and Parcher and his imaginary
encounter with Marcee.
Studies have indicated that the etiology of the schizophrenia is not yet clearly understood,
however; it is believed to be multifactorial. As depicted in the film, the genetic linkages combine
with environmental factors to develop schizophrenia in John Nash, which corresponds with
findings of current studies (Häfner, 2014). Specifically, the illness has a prominent genetic
element which has an inherent capacity of around 80%. It suggests that around 80% of the
variation in the trait related to the illness can be because of genetic factors (Haller,
Padmanabhan, Lizano, Torous, & Keshavan, 2014). ZNF804A and NRGN are some of the genes
which are associated with an increased risk of developing schizophrenia (Williams, et al., 2010).
Studies have also suggested that a range of environmental factors can interact with the
susceptible genes to boost the risk of developing the disorder. Interaction between the genetic
and environmental factors lead to modified neuroplasticity which are mediated developmentally.
The modifications set out a flow of circuit and neurotransmitter impairments along with
deteriorated connectivity, which explains why Nash experienced the symptoms. It is found that
the onset of these modifications usually occurs in the early years of youth. It appears that a
reduction in the gray-matter occurs in the early stages of schizophrenia and is associated with
unfavorable health outcomes for the patient (Padmanabhan & Keshavan, 2014).
Mental health assessments, treatment and or interventions featured in the film that
support recovery
The mental health assessments shown in the film that resulted in the diagnosis of schizophrenia
are psychological, social and behavioral assessments. It is shown when Nash’s behavior was
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bizarre at the time of giving speech on his mathematical study. He gets delusional which leads to
his admission in a psychiatric hospital. His wife along with the psychiatrist when visit Nash’s
office find innumerable pieces of paper taken from different sources which are linked in
imaginary patterns via frantic lines. So, the doctor finally diagnoses that Nash has developed
advanced schizophrenia. The psychiatrist prescribes pharmacological intervention for Nash
which included antipsychotic medications and insulin shock therapy for management of his
condition. In the later part of the film, it is shown that Nash manages his symptoms without any
medications through support from his wife and friends who give him house to live and job. The
practical support supported Nash’s recovery.
Literature identifies schizophrenia as a complex disorder with a wide range of symptoms which
are presented in other disorders as well. Studies have proposed a crucial stage at the time of
assessment which is identification of other conditions that may be present prior to making the
accurate diagnosis (Pinna, Fiorillo, Tusconi, Guiso, & Carpiniello, 2015). The assessment must
include several experts including psychiatric nurses, psychoanalysts, social workers and many
more. The assessment characteristically includes neuropsychological testing, psychopathology
which evaluates positive and negative symptoms, blood tests, structural brain investigation; BMI
measurement, monitoring of substance use, cardiovascular investigations and review of family
history. Every patient must undergo these assessments.
Due to a lack of accurate account of etiology of schizophrenia, goal of majority of the
interventions is to assist the patients in management or prevention of their symptoms. People
with schizophrenia largely get person-centered care which is delivered based on patient’s current
requirements, background and preference (Dixon, Holoshitz, & Nossel, 2016). The aim of the
interventions and treatments is to minimize the symptoms, support recovery so that recovery
goals can be reached and improved functioning and enhanced quality of life. One treatment
approach of the illness is the pharmacological intervention which is featured in the movie as
well. In pharmacological intervention, patient gets antipsychotic drugs which are usually
successful in managing positive symptoms of schizophrenia. The antipsychotic drugs act on the
neurotransmitters and as such assist in regulating positive symptoms such as delusions and
thought dysfunction. Another approach is the psychotherapy which is implemented along with
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the pharmacological interventions. Psychotherapy includes cognitive behavioral therapy as well
as cognitive remediation therapy as both are required for symptom control and enhancing the
coping skills. In addition, these also assist in moderating the psychological impacts of the
disorder. Last approach is the psychosocial interventions which include family therapy,
community treatment, organised domain care and assisted employment. The movie highlights the
importance of psychosocial interventions as they immensely supported Nash in his recovery.
Identification and discussion of the impact schizophrenia on John Nash, his family
and the community
A Beautiful Mind brilliantly highlighted the impact of schizophrenia on Nash, his family and the
community (Donaldson, 2015). Individually, the disorder impacted Nash profoundly. Nash was
completely introverted from everything and everyone. Nash fails to foster his relationships after
being diagnosed with schizophrenia, which is evident as his wife divorces him, however, later in
the movie she cares for him. Nash also faces trouble in making and maintaining associations with
people around him. This is shown in the film prior to his diagnosis that he tells that he feels more
satisfied and comfortable when he has to handle numbers instead of people. Impact of the disease
is not only shown on his personal but personal life as well. He loses his job because of the
disorder and he wanders around Europe and America.
Film focused on the struggles of his families also while dealing with Nash’s disorder. Nash’s
wife, Alicia was shown feeling overburdened when she has to take care of both Nash because of
his weakining abilities and their new born son. Alicia felt dejected on realizing that Nash is no
longer the man she married which led to their divorce. Therefore, it can be said that Nash’s
family breaks down because of his mental illness. The marriage also suffered as Nash becomes
unable to satisfy the sexual needs of his wife. One of the peculiar incidents shown in the movie is
when Alicia finds their kid nearly drowning when Nash was bathing the kid, which worsened
their family relationships massively. It occurred as Nash experienced an episode of hallucination
at the time of bathing his son which risked his newborn son’s life.
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The impact of disorder on the community is also shown in the film. The association between
Nash and community around him gets hampered due to his symptoms which were indiscreet. It
happened specifically because the people around him thought of him as a brilliant person, but his
unusual actions seemed dissimilar to his genius personality. So, he could not teach any further to
the community due to his symptoms.
Researches have established that schizophrenia has massive influence on the patients mainly
because of the disability caused by it. Particularly, the disorder impacts the daily life of people in
a negative way by modifying their lives and making it challenging as shown in the movie. The
initial manifestations of the disorder make an individual withdrawn and which is frequently
exemplified by avoiding friends and being interested in activities once enjoyed by them.
Moreover, initial cognitive change can lead to challenges in thinking. Studies have also
suggested that with increasing age of an individual, the indicators of schizophrenia become more
distinct which brings up difficulties in employment, housing, etc. Individuals also find it difficult
to nurture relationships because of associated withdrawal and inappropriate mood behaviors.
Further, individual may experience episodes of remission in which he/she is normal with absence
of any symptoms which makes their lives more bizarre.
Studies have also indicated that families of individuals with schizophrenia experience several
challenges. The family faces an objective burden which includes practical, daily issues and
challenges related to having a family member with mental disorder like disturbed routines and
reduced income (Koujalgi & Patil, 2013). Then the families of people with schizophrenia face
subjective burden which includes the mental and emotional impacts of the illness on family
members such as feelings of sadness. It is found that the pressure of disorder exacerbations
along with insufficient social and coping strategies also encompass the subjective burden
(Flyckt, Fatouros-Bergman, & Koernig, 2015).
People with schizophrenia frequently fail to respond properly in the social situations in the
community. They act indolently as compared to normal people probably because of the cognitive
deficits and decline in social skill functioning. Moreover, people with the disorder frequently
have reduced emotional quotient which renders them indifferent or uncaring towards fellow
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community members and anti-social. Therefore, other people in the community also find it
difficult to relate with them which results in their exclusion from the community. People with the
disorder may have abilities, ideas, insights, skills, or conduct which can make them a
contributing member of the community but their disorder comes in the way. Schizophrenia is,
undoubtedly, a net cost to the community as individuals suffering from the illness may reach as
stage at which they may no longer be able to maintain beneficial employment because of their
symptoms (Chaiyakunapruk, et al., 2016).
Identification and discussion of stigma and/or discrimination in the film
Stigma and discrimination are represented by the long-term negative interactions with the
environments which is experienced regularly by majority of the people with schizophrenia.
Stigma and discrimination are also a significant source of burden of the disorder (Aracena,
2012). Moreover, these are obstacles in recovery of the people. The film also features stigma as a
set of negative attitudes, perceptions and thoughts that people possess of Nash. Various scenes in
the film denote stigmatized behavior of the people through various actions around Nash. The
strange and bizarre behavior exhibited by Nash because of his condition becomes off-putting for
his friends and students. These people did not want to associate with Nash. He was also shown
being ridiculed in school by his friends when he writes down arithmetic formulae on window
panes and always wearing a knitted hat. Movie also has a scene in which Nash’s friends wanted
to take undue advantage of his disorder. In the specific scene, his friends dare him to approach
and speak to an unknown girl. Later that girl slapped him for his action which makes him a
subject of jokes. These scenes portray different types of labeling that is done to people with
mental disorder such as mad, easy, etc.
Studies have shown that people who have schizophrenia experience single or multiple forms of
stigma. Stigma refers to prejudiced negative notions, attitudes, thoughts and inaccurate fears that
the society, the media, health professionals, etc. have about the schizophrenia and which impacts
the lives of people having the disorder. It includes deficits in awareness and attitudinal and
behavioral issues which can be exacerbated by an empirically inaccurate focus that experts put
on the biogenetic models of disorders. It must be understood that different types of stigma, that
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are self-stigma, public stigma, labeling have profoundly adverse impact on patients (Li, et al.,
2017).
Healthcare professionals have also identified stigma as a significant challenge which impacts the
patients of schizophrenia. Experts have also commented that the stigma and discrimination is
more damaging than the symptoms of the disorder itself. It is mainly because the stigma has a
negative effect on patient’s mental health and enhances the emotions of isolation leading to low
self-esteem, diminished self-efficacy and hopelessness. Moreover, the negative effects of stigma
can develop though the intrinsic feelings, insights and beliefs of the individual who is
stigmatized, even beyond the impact occurred by direct stigmatization (Koschorke, et al., 2014).
So, the individual who is stigmatized ends up being angry, apprehended, sad, embarrassed and
remorseful. These emotions may prevent his recovery. Stigma also causes hindrance in recovery
by making the patient avoid seeking services which re required for his well-being. For example,
the patient does not seek health care services in fear of being labelled as a mental patient.
The practical consequences of stigma include social isolation, restricted opportunities for
academics, services and employment, inferior housing as shown in the film. These practical
consequences decline the quality of life of people with schizophrenia and their family as well.
Other consequences related to discrimination include opposition for marital associations and
substandard quality of care. A study has found that stigma is related to more secrecy, withdrawal
as an approach of coping, less mastery, reduced support and declined social functioning, all of
which lead to an dimished quality of life (Grover, Singh, & Mattoo, 2016). Society instead of
practicing discrimination must give guidance and assistance to people with schizophrenia which
is needed by them to overcome the impact linked with the disorder. An improved identification
and understanding of the determinants of stigma can provide an insight in ascertaining suitable
strategies to minimize or prevent stigma and its negative impact on people who have mental
disorders and their families.
Conclusion
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A Beautiful Mind is a film which excellently and practically portrays the experience of people
who have schizophrenia experience, by showing the real life of the John Nash. The movie
suitably depicted the complexities of the condition to the audience and therefore it can be
considered as a source of awareness regarding the disorder. The actors brilliantly performed their
roles which made the understanding of Nash’s life more real. The film subtly illustrates the
etiology, pathophysiology, mental health assessments, interventions and treatment, impact and
the related discrimination against schizophrenia. The film specifically focused on the
schizophrenia experience of the John Nash who was a brilliant mathematician however, the
experience may differ for different people. Nash’s schizophrenia went into remission without
using the medication which is a rare situation among schizophrenia patients. Currently it is
known that cognitive behavioral therapy is used along with the pharmacological and social
interventions in management of schizophrenia. So, further research is required to understand
Nash’s case which may guide about improved future interventions of schizophrenia. The film
included accurate depictions of views and science discovered and prevalent in the 1950-60’s
which provided an authentic view to the audience regarding the mental disorder in that period.
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