SPOILERS: Joker – A Mental Health Review


If you have not seen the 2019 film “Joker” and wish to remain spoiler free, stop reading now. To discuss the way I wish to discuss, all plot points must be on the table.


Because of the film content, a trigger warning may also be in effect on this one.

The Musical Score


Love the film, hate the film, refuse to see the film – I don’t even have a real analysis for this part except to say that you owe it to yourself to check out Hildur Guðnadóttir’s musical score. It’s hauntingly beautiful and she completed it before they made the movie. According to Phillips and Phoenix, they played the score live while filming associated scenes and one feels it.

Mental Health

“Good for you, Bats! Eddie doesn’t need psychiatric help. No, no, no. Beat ’em up. Lock ’em up. That’s the best medicine.”

Joker to Batman after arresting Riddler in Arkham Knight

Arthur Fleck’s transformation into Joker and proclivity for violence is a social ailment, not a mental one.

“Joker” opens with the sequence of Arthur preparing for work, having his sign stolen, and getting jumped in the alley. The sequence provides a great deal of characterisation for both Arthur and the city without much dialogue. Only in the subsequent scene where Arthur meets with his social worker do we finally get to hear his thoughts.

Arthur is meeting with a social worker to counsel his mental health issues and monitor his medication, with allusions made during his sessions to time he spent committed to a mental health facility. The film ultimately closes with Arthur meeting another worker in Arkham State Hospital and then running through the halls*.

Mental health was not something unspoken in the background of “Joker” – the film put it upfront.

It’s here that I feel compelled to share a general disclaimer: I despise when films employ mental health as a sort of deus ex machina to explain the motivations of a nefarious character. Usually the introduction of mental illness into the equation is not only harmful to those who struggle with mental health conditions by adding unnecessary stigma, it also belies the profound ignorance of the writer.

“He was the killer all along. It was the undiagnosed multiple personality disorder that prevented him from knowing that one of his alter-egos did the killing!”

The writer had everything they needed about the plot except a valid motivation for why the villain did what they did, so they write in some incorrect version of a mental illness.

Joker has long impressed audiences because, well, he might not be “crazy”. When mobsters accuse him of being crazy in “The Dark Knight”, he specifically replies that he’s not. Poor writing might suggest, “He’s too crazy to realise he’s crazy,” but most people with mental health issues are quite aware of a problem. They might not possess a specific diagnosis, but at least in more lucid moments they are aware of a general issue.

For example, I struggle with multiple anxiety issues. During an episode, I feel overcome with anxiety that is either completely baseless or disproportionate to the situation. That is the illness lying to me. In the moment I feel genuine anxiety even though a part of my mind knows there is no reason for it – it’s part of the reason why “Just relax” is part unhelpful and part annoying to hear from a bystander.

In most iterations, Joker is lucid the entire time. I have seen other writings on the character that suggest in place of mental illness a sort of hyper-sanity where Joker, faced with the absurdity and irrationality of the world, functions on a level that makes objective sense (even though it’s anti-social and therefore disagreeable behaviour). This is where outlier groups, like incels, sometimes adopt Joker as a mascot of sorts. To their flawed ideology, his hyper-sanity represents a justification of their socially reprehensible behaviours and beliefs.

Still, it leaves us with the question of Joker’s mental health.

One of the things that I truly enjoyed about “Joker” is that for much of the film we see an Arthur Fleck with off-the-charts empathy. He mentions that he’s never happy, but we also see a man with a clear sense of right-and-wrong who goes out of his way to be nice. He does want to make other people smile and laugh. This is often a hallmark of people with mental illness and something I observe frequently in comedy – people who know the deeper depressions of life and wish to spare others that feeling.

The Arthur Fleck we see at the beginning of the film is, like most people struggling with mental health issues, far more likely to become a victim of abuse or violence than to perpetrate it. In fact, we learn from the Arkham records that Arthur was subject to abuse at least once in his life.

I don’t know about other viewers, but in the scene where Arthur meets Bruce I did not feel tension. Granted, we know that nothing severe would happen to Bruce because, you know, Batman, but nothing felt insidious about the meeting. Arthur did look like a man at the manor to see Thomas who simply saw Bruce and decided to share a laugh with the boy. Even when Alfred appears, Arthur is contrite and conciliatory. Only when Alfred makes comments about Penny does Arthur snap, and then it’s Arthur who realises what has happened and he flees the scene.

This is where the film draws a critical line between mental illness and radicalisation.

It would be easy to conclude, “Joker is crazy and that’s why he does the things he does.” Society makes that conclusion all the time. It’s simple and palatable (to anyone who doesn’t have a mental health issue anyway). We have a right, or normal, way to do things, and then we have the abnormal ways.

Arthur Fleck likely has a mental health issue. Depression, possibly bi-polar disorder – none of the cinematic hallmarks like schizophrenia, which, as stated earlier, does not make a person violent. Most people with schizophrenia are averse to violence and far more likely to fall victim to it than commit it. I am not a mental health professional, so I will refrain from offering a diagnosis of Fleck.

What I do feel is important is that mental illness is not what transforms Fleck into Joker. Whatever mental illness Arthur possessed was present in the opening scene of the movie and in the final scene. He developed nothing in the interim except a sense of radicalisation.

Now, one could make the argument that Fleck, turned Joker, does not become violent until he goes off his medication and he does make a comment to the clerk at Arkham that he did not feel bad after committing the initial murders like he thought he would. At least, if I were forced to make an argument against my position, that is where I would focus.

He does go off his medication, by force (they discontinue the service that provides it for him – he actually begins the film by inquiring about additional medication) and he does make that comment to the Arkham clerk. However, the comment to the Arkham clerk also demonstrates a clear sense of right and wrong.

The current assessment of the mental health community, at least in the United States, is that sociopathy and psychopathy are not diseases in their own right, but are part of the diagnosis for antisocial personality disorder (APD). Determination of a sociopath or psychopath starts there, and with that one might regard the diagnostic criteria for APD:

  • Being very charming or witty in order to manipulate someone or get what they want. (Arthur might aspire to this, even become this, but we see the precise opposite in the film)
  • Exudes a sense of superiority or arrogance. (If anything, Arthur rebels against this)
  • Impulsive and prone to taking risks or engaging in dangerous behavior with little regard to how it may affect others. (Again, knowing what we know about Joker in general, he might become this but we do not see this in the film)
  • Lack of empathy or feelings towards others or a situation. (The first example we see of Arthur lacking empathy is the murder of the Wall Street guys on the subway, and his Murray appearance indicates his frustration with their lack of empathy triggered that – mental illness or radicalised behaviour?)
  • May display hostile, aggressive behavior, or become violent. (He comes this – was it always present and restrained by medication, or is his violence the result of his radicalisation?)
  • Being dishonest or lying to people. (Not by Arthur)
  • No regard or care for what is right or wrong. (Conversation with the clerk and even his appearance on Murray suggest he cares deeply about right and wrong – it’s the excessive amount of wrong that upset him)
  • Being irresponsible. (He cares for his mother and others deeply until he transforms into Joker. He is also dedicated to his job and loses it for reasons beyond his control)
  • Inability to maintain healthy relationships. (This is definitely Arthur, but perhaps not because of his personality disorder. Another mental illness may have caused the awkwardness that isolated Arthur and caused the radicalisation that leads to the other problems)
  • Lack of regard for rules or societal norms. (The most interesting item – Arthur is aware of the rules, as when he receives the gun from his coworker, and seems to want to conform to them. He fails in some social situations, but attributes this – as will many audience members – to the other person. He rails against societal norms by the end, but, once again, this seems like the result of radicalisation rather than mental illness)

My sense watching the film was that Arthur was not a sociopath or psychopath. He struggled with a mental illness and then got hammered by society until he broke. Another person with the same mental health issue(s) and perhaps even the same amount of tragedy in their life with an adequate support system does not become Joker. Several pieces had to fall into place and Arthur resisted it every step of the way.

Even after the remorseless killing of the Wall Street guys, Arthur discusses getting further treatment with the Arkham clerk. When the clerk suggests that he cannot be committed but might seek other services, Arthur “jokes” that all of those programs were cut. He desperately seeks help over and over throughout the movie.

How long does he resist it? I think right up to the moment he shoots Murray:

“I hope my death makes more cents than my life.”

Deliberate typo included, Fleck scribbles this line in his joke notebook. While rehearsing “normal behaviour” for his appearance on the Murray show, we see him hold a pretend interview where the audience encourages him to share a joke and Fleck’s punchline is shooting himself in the head.

Backstage, just before going on stage, we see Joker again holding the gun under his chin.

When the moment finally arrives, Joker retrieves his notebook from under his jacket and proceeds to look for a joke to tell. We get a brief over-the-shoulder shot of Joker looking at the notebook and his eyes fix on that line. Murray interrupts his thoughts with a glib remark about taking his time and Joker lets out an annoyed sigh before turning the page.

The first time I watched the film, I thought Joker went on the Murray show specifically to kill him. Upon second viewing though, it occurred to me that Joker intended to kill himself until that very moment. The mounting frustration of the moment shifts Joker’s focus to the new plan. He adds a might-as-well second shot before he sits back down and awaits the police.

Even with the killing of the Wall Street guys. They accost a woman on the subway and Arthur begins his burst of ironic laughter. He doesn’t find the men funny, he finds the situation uncomfortable. They respond by jumping him as he tries to explain the laughter and he kills two of them quickly in self defence. As we see, at least part of the city responds favourably to the act.

What makes it grey is that Arthur does go after the third man. In a case of self defence, who cares if there is a witness? Arthur is no longer standing his ground when he pursues the injured man. As we learn from Joker, he hated the men on principle. Not quite a true matter of self defence then, but still not something attributable solely to his mental health.

Something to be said there about gun ownership as well, I imagine.

The Lone Wolf

I have written previously about the tragedy that is the lone wolf in our society. Like Arthur, they often present as awkward or suspicious in nature; they do not have an innate charm that makes people gravitate towards them – though, ironically, sociopaths and psychopaths can at least fake this well. No one wants to associate with them and they become isolated, which makes them less desirable to others.

“Joker” is filled with uncomfortable humour. When Gary, the little person, sees Arthur murder Randall, he understandably panics. Arthur reassures him that he’s safe and free to go, so Gary hurries to the door but cannot leave because Arthur secured the top chain. There is something uncomfortably comedic in the moment. A man wants to escape the presence of someone who just committed murder but, being short, finds himself foiled by a simple chain. Arthur gets up and has to undo the chain for him (after giving him a quick scare).

Am I laughing at Gary’s height? Not directly – the situation is funny, not the fact that Gary is short. Still though, it’s only funny because of Gary’s unusual height. To some degree my laughter comes at his expense and I must square with that. This is all the more visceral in the context of this movie.

Arthur loves Penny, wants to make Bruce laugh – wants to make everyone laugh – cares about his job, and wants Thomas Wayne’s approval.

He has to return the sign stolen and then used to beat him in an alley to the store owner because he complained. Arthur points out that he does not have the sign because of the battery. “Why would someone jump you over a sign?” his boss asks. When Arthur replies to his boss’ insistence that he return the sign with, “Why would I take his sign?” the boss gives a callous, “I don’t know. Why does anybody do anything?”

On the Murray show, he receives the expected backlash for killing the three men on the subway. Because Thomas Wayne appealed for them on television, asks the broken Arthur of the audience before pointing out that had he been murdered no one would care. These were important Wall Street men; he was no one.

It hearkens back to Ledger’s Joker making the comment about a truckload of soldiers blowing up versus the threat to kill the mayor. Soldiers die – it’s sad but society presses on because we expect it. Mayors are above that. To even threaten a mayor induces a social panic.

The maladjusted conclusion of this is, “No one should be upset that I’m threatening the mayor,” as some fans of the character are wont to do. The healthy social conclusion is, “Why does no one care more about the soldiers? Those are human lives, too. Why is this one worth more than the rest?”

The latter is the question Arthur begs before giving in fully to Joker as the audience and Murray bear down on him. Three Wall Street men behaving horribly receive all the pity in the world, but to that same world Arthur was invisible for all his effort to bring it happiness.

As in ‘The Killing Joke’, alluded to several times throughout the film, it suggests that “one bad day” is all that separates any given person from the unthinkable – “but for the grace of God go I” is another way to phrase it.

Arthur Fleck is not someone with a defective mind wired to commit the atrocities we associate with Joker, and I believe that was the main point of the movie. Arthur was a decent man with some degree of mental illness radicalised by a society that forgot about him. As the audience we have a front row seat to observe all the ways in which Joker might have been avoided rather than our usual news media seat where we see only the consequence and aftermath of a lone wolf’s actions.

We, as a society, like to reduce the causality to something simple like mental illness. It’s not only unfair to the person at hand but to everyone dealing with mental health issues because it paints mental health as something heinous.

One of the benefits of modern psychiatric study is the identification of mental health issues as diseases with real symptoms and physiological issues. They are not “faulty wiring” or “chemical imbalances” any more than arthritis or asthma. Society’s strict definitions of what is normal or permissible though, that can drive an individual who does not conform to those ideas to acts never thought possible.

The voices telling people like Arthur to do things like he does in Joker are not creepy voices in one’s mind – they are literal voices on the street and on the Internet. Sometimes they are the absence of voices offering any sort of support or counselling. This has become a more dangerous issue in the digital age as early-stage radicals find one another online and form echo chambers where the only “support” they receive is positive reinforcement from others with a similar sense of disenfranchisement.

I enjoyed the film because at its heart I saw an honest take on mental health, the lack of adequate, available resources, and a cautionary tale about social radicalisation (which also tackled other social issues) in a compelling way.

Perhaps the most compelling of the questions left with me after viewing it the second time was, “Would this have the effect it did if Arthur Fleck was simply Arthur Fleck and not the Joker? Did it take making it a character study of one of media’s most prolific villains to awake people to what is happening with people all over the world?”

And it’s in that last line of thought I feel that “Joker” may have the effect of reducing real world violence by showing a degree of compassion and understanding to audiences who need it most and might look to a character/film like Joker simply to grant them permission. Unlike the Murray audience in the film, “Joker”, I think, sends a message that there are people in this world who care and are devoted to raising awareness and making resources available.


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