Lasse Gammelgaard • Mental Illness Costumes: Divisive Discourse and Untold Stories of Stigma

About the blog: The Instrumental Narratives blog aims to popularize the insights and methods of narrative scholarship and features analyses of instrumental storytelling by high-profile narrative scholars. The analyzed cases deal with uses or abuses of the narrative form, storytelling practices or narrative sense-making in many areas of life: politics, journalism, business, identity work, artistic or literary sphere, activism, and forms of social participation. The blog texts evaluate possible societal risks or benefits of contemporary storytelling, for example through cases from the author’s own national, linguistic, or cultural sphere.



This blog post is about damaging, stigmatizing and stereotypical notions of mental illness in contemporary cultural discourse, but it is also a personal reflection on the risks and rewards of immersing oneself into these public debates as an academic. I have made ad-hoc translations of all text originally in Danish.


Opinion Piece

When I wrote the Danish high school textbook Madness in Literature with Thomas Søgaard Boström (a Danish artist, author and teacher of writing classes at The Outsider, a mental health organization based in Copenhagen), we wanted to include an image from Amazon of a costume called “Adult Skizo Costume” for a section of the book on stigma and taboo. However, we were told that the business had withdrawn the costume.

I was subsequently very surprised to learn that these costumes were sold on basically every online costume shop in Denmark. The signature reference to mental illness is the straitjacket. We tried to get permission to use an image from one of the Danish web shops, but none of them replied. I thought these costumes were highly problematic, so I wrote an opinion piece for Weekendavisen (a weekly newspaper in Denmark) right before Halloween in 2019, where one would imagine that they would sell the most.

The costumes would have names like “Loco Straitjacket,” “Mr. Crazy,” and “Bloody Straitjacket Costume,” but some of the prose descriptions of the products would be far more severe. The “Crazy Babe Costume,” stated: “Dress up as an insane person in a straitjacket with this sexy costume.” “Female Mental Patient Costume,” had: “This is the costume, if you want to trick your friends into believing that a mental patient has escaped the asylum! The straitjacket, which can be zipped on the back, is a costume with a realistic expression, but you can also use it if you just need to rest your hands.”

It goes without saying that the costumes had very little to do with realistic representation. In fact, they resemble characters in horror movies more accurately than people with mental illness diagnoses (who do not look a particular way). Madness is a well-established topos in fiction, in which mad characters function well with other resources to create suspense and thrill. Even though such works unavoidably and misleadingly imbue in the viewers notions of psychiatric patients as dangerous and violent, I was not, of course, out to criticize movies like Alfred Hitchcock’s “Psycho” or John Carpenter’s “Halloween.” I did, however, want to criticize the drift from dressing up as fictional characters in horror movies to purportedly depicting people suffering from mental illness. There is a world of difference between dressing up as, say, Hannibal Lecter from “The Silence of the Lambs,” on the one hand, and as a person with a schizophrenia or bipolar disorder diagnosis on the other hand. Dressing up as Hannibal Lecter is, in my opinion, comparable to dressing up as the monster in “Frankenstein” or “Dracula.” But in that case, the reference to a fictive character should be made as explicit as possible, and the web shops should refrain from inviting people to dress up as psychiatric patients in general. In the opinion piece, I addressed all of this and highlighted the discrepancy between the actual costumes and the branding with names, product descriptions etc.


Media Reaction

I do not normally engage in public debates in this way, and no journalist ever called or e-mailed me to get a follow-up interview on my research on poets’ use of aposiopesis in nature poetry about experiences of the sublime – or any other research topic for that matter. One reason why I was hesitant to write the opinion piece is that the debates that follow typically are exaggerated and undiscriminating. The media need people to fit into clear-cut roles: the injured party, the villains, etc. Therefore, a main goal of mine was to avoid writing an angry piece to avoid a divisive discussion.

The week after the piece was published, I was contacted by numerous media outlets, which resulted in a follow-up interview in a newspaper (Berlingske), two radio interviews (a local division, P4, and a national division P1 of DR, Danish Radio, which is the Danish equivalent of BBC), and an interview in a feature on the topic in the evening news at TV2.

The media work in such a way that they need to discuss a clear problem, and the positions in a debate are often presented in a crude way. They look for tensions, contradistinctions, inconsistencies etc. Interviewees, including scientists, are cast in accordance with that logic. Hence, you could almost plot the participants in the ensuing debate into Greimas’s actantial model (Greimas 1983). The Subject would be: anyone living with a mental illness who feel the stigmatization of society. The Object they desire: recognition and destigmatization. The Helper: scholar writing an opinion piece. The Opponent: Costume web shops and people buying the costumes. The Sender: the aforementioned scholar. The Receiver: people living with a mental illness.

After the actants have tacitly and seamlessly been assigned their structural roles, they are then challenged from that position. For instance, I was repeatedly asked, if I had a psychiatric diagnosis – the subtext being: who are you to speak about this on behalf of others? Did anyone ask for your help? Can they not speak up for themselves? Et cetera.

Part of this divisive rhetoric was prepared by the editor at Weekendavisen, who changed the title of my piece from something less colorful to “Offensive Costumes” without checking in with me first (so much for my attempt to avoid an aggressive tone). If I learned anything from the subsequent debate it is this: live interviews are by far preferable to formats that are edited. Journalists I spoke to seemed surprised, when I tried to explain that I was not trying to lecture or blame anyone, I had nothing against costume shops, nor did I think people who might wear the costumes were bad people.

It was important for me to break the actantial script, because issues of identity are always much more complicated. The past few years, there have been numerous debates in Denmark about “offensiveness.” Who has the right to decide, when something is offensive? What is new is that the voice of those “taking offense” is getting more airtime and is taken more seriously. Experiences that perhaps were not told previously are now being heard. This often clashes with people who have no ill intentions and who refuse to be thought of as “the offender” (nor do I necessarily think that they should). The latter group who view themselves as broad-minded complain about “the readiness to take offense” (krænkelsesparathed). Costumes, in particular, have been a hot potato, so I was not surprised at all that I was asked to comment on and compare dressing up as a psychiatric patient to other possible costumes.

The types of questions I was asked are telling of the divisive media rhetoric: What are we even allowed to do? Is there not always a minority group that might be offended by any given costume? Is wearing a sombrero or dressing up as a samurai not an atrocious appropriation of the cultural heritage of Mexicans or Japanese people? Where do you draw the line? It is strange that I was asked to be the judge of such borderline cases. Although I have not walked a mile in their shoes, I feel fairly confident in saying that I do not think that the werewolves or the zombies would be offended by our way of depicting them when dressing up in costumes. But other than that, all I could say was that my opinion piece was about mental illness costumes, and that I thought there was a categorical difference between dressing up as a person suffering from an illness and potentially problematic instances of cultural appropriation – no one would dress up as, say, a cancer patient.

TV2 contacted many costume shops to get a reaction. Only a shop called Faraos Cigarer (Pharaoh’s Cigars), located in Odense, agreed to an interview. The sales clerk’s reply was that we should not be too rigid, and that we should be able to have fun. We should avoid “Swedish conditions.” This is a knee-jerk reaction in Denmark: When something is thought of as moralizing, preachy or excessively politically correct, it is seen as a stance that would be more at home on the turf of our Scandinavian neighbors. We Danes, on the other hand, take pride in our liberal-mindedness. We do not easily take offense. There are many cases from the past few years where the alleged “readiness to take offense” clashes with actions of people who had no intentions of offending anyone.

TV2 wrote a news story on their website that summarized the feature in the evening news, in which they had interviewed the sales clerk, me, and the president of “Sind” (a mental health organization in Denmark). They included a pop-up survey in the news article that laid bare the divide in the population’s opinion regarding the tenability of mental illness costumes. The question asked was: “Would you dress up as ‘a mentally ill patient’?” The 1,489 users who engaged with the survey, answered as follows:

“Yes, I don’t see a problem with that” – 46 %

“Maybe, but it could be problematic” – 8 %

“No, I wouldn’t dream of it” – 39 %

“Don’t know” – 7 %

The 46 % who clicked “Yes, I don’t see a problem with that” probably believe that people get outraged too easily, and they most likely do not harbor any bad intentions or ill will towards people with a mental illness. They just do not see the problem. And that leads me to the most interesting questions posed to me in media: How big is the problem? Has it caused problems for any actual individuals out there? What do you fear will happen if people wear the costumes? Like me, the president of Sind had not known the costumes even existed. All I could say was that I did not know the extent of the problem, but that I thought it was problematic in principle regardless of whether it actually harmed anyone in a direct way. I am sure there will be people who live with diagnoses, and their next of kin, who do not mind the costumes. I am also sure that they could be worn at specific parties without offending or harming anyone. It might also be the case, though, that if someone is hurt by the costumes, they would not speak up. This is how stigmatization works. The stigmatized will feel ashamed, and those stories might not be told.


The Aftermath

In the wake of the media reaction, I was contacted by several people. One person, let’s call her “Ann,” shared exactly such a story, and she has given me permission to recount it anonymously:

The incident took place 15 years ago. “Ann’s” husband who was 51 years old at the time had just been admitted to Riiskov Psychiatric Hospital in Aarhus. He was diagnosed with frontotemporal dementia, an illness that can change one’s entire personality (you can become impulsive, inappropriate, emotionally indifferent, just like it affects one’s language). The diagnosis also meant that he would not be able to live in their shared home anymore. One of her sons who was 13 years old at that time was, of course, greatly affected by this. Right after the time of the diagnosis, he was supposed to go to a weekend camp with his table tennis club. He hesitated to go, but ended up going. He could always call, if he wanted to go home. When his mother came to pick him up at the end of the camp, he fell apart crying. During the night, the adults had arranged a “night run activity.” It was a kind of role-playing game, where the teenagers were told that a dangerous criminal had escaped from the nearby psychiatric hospital (the same one where his father was presently admitted). He said he did not want to participate, but was pressurized to be a part of it. He told his mother that they had even arranged for a police officer in a police car to be involved (“Ann” did not know if it was a camouflaged car or if someone had known an officer who had agreed to play the role). In the end, they had to deliver the dangerous man to the police officer.

Given the circumstances, the boy could not bring himself to tell them that his father was hospitalized, and if anything, he learned that having a father with a mental illness was a bad thing that you should try to hide. This example is clearly more elaborate than simply wearing a costume to a party, but both actions contribute to perpetuating the same prejudice: That being dangerous, rambunctious, and violent are core features in people struggling with mental health issues. Whether intended so or not, it contributes to what the medical historian, Roy Porter, has termed cognitive apartheid, where you think in them-us binaries (Porter 2002, 63). We, the sane (the majority), and them, the insane (whom we should be afraid of). It would be better to think of mental health in terms of a continuum with lots of grey areas on it. Perhaps Sind had not heard complaints about the costumes because most people are not offended by them, but it might also be because speaking comes with a risk of stigmatization.

What to make of the 46 % who do not see a problem with dressing up as a psychiatric patient? Sure, it might not feel like there is a problem, because it is not a problem for me. My guess is, though, that few of them would maintain that position, if they had had an experience remotely akin to “Ann” and her son’s.



Greimas, Algirdas Julien. 1983 [French original 1966]. Structural Semantics: An Attempt at a Method. Transl. Daniele McDowell, Ronald Schleifer, and Alan Velie. Lincoln: University of Nebraska Press.

Porter, Roy. 2002. Madness: A Brief History. New York: Oxford University Press.


Lasse Gammelgaard 10x15.jpg

Lasse R. Gammelgaard (1983), PhD, Associate Professor at Aarhus University. Presently working on a project on “Forms of Mental Illness Representation,” funded by the Independent Research Fund Denmark. Co-director of “Health, Media and Narrative” and member of “Narrative Research Lab” and “Center for Fictionality Studies” at Aarhus University, Denmark. Co-author of Galskab i litteraturen (Madness and Literature) and editor of Madness and Literature: What Fiction Can Do for the Understanding of Mental Illness (forthcoming in the University of Exeter Press’s book series “Language, Discourse and Mental Health”).







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