The Film
The film opens with journalist Steve Lopez
falling off his bicycle and sustaining nasty grazes to his face.
Wounded and in need of a story for his newspaper column he
encounters Nathaniel Ayers in a Los Angeles park, beside a statue
of Beethoven, playing a violin with only two strings on it. As they
start to talk it becomes clear to Lopez that all is not well in the
mind of Ayers but he also hears from him that he was once a student
at Juilliard, the highly prestigious New York music school. After
some research and further meetings with Ayers on the streets of LA,
Lopez begins to write a regular newspaper column detailing their
encounters and their growing friendship. This attracts much
interest from the public who send in musical instruments for Ayers
to play. Lopez uses the lure of a cello, given by a member of the
public, to persuade a reluctant Ayers to abandon his homeless
location in the road tunnels of LA for a room in the sheltered LAMP
community. Lopez begins to make an effort to connect Ayers with the
classical music community based at the Disney Concert Hall in LA
and they go together to see a rehearsal. During this visit, when
listening to the orchestra, Ayers experiences a marked increase in
the voices that he hears, affecting his ability to concentrate on
the music. The film uses flashbacks to tell us more about Ayers’
childhood and his huge potential as a musician, leading up to the
point at which he develops schizophrenia at Juilliard and drops
out.
Lopez also tracks down Ayer’s sister, long time
estranged from him, and eventually succeeds in getting her to visit
her brother in LA. As the ties of friendship and family increase,
Ayers seems to respond positively, although his lack of insight
about his illness remains. This provokes an incident of aggression
toward Lopez when he brings some legal documents for Ayers to sign,
which state that he has a diagnosis of schizophrenia. It is then
that Lopez truly realises that schizophrenia cannot be cured by
friendship alone; although he sees that stable human connections
can provide the opportunity for some progress toward social
recovery.
Relevance to the field of Mental Health
The Soloist, with its basis in a real life
story, offers a tremendous opportunity to examine a number of very
important issues in the long-term management of schizophrenia. The
film gives us a good example of the effect the illness can have on
the words, thoughts, perceptions and behaviour of sufferers and
highlights the fluctuations that occur naturally in the disorder.
It also raises the topic of treatment and the individual’s right to
choose whether or not to take medication. As a teaching tool, this
film could provide a wonderful starting point for a discussion
about when the use of the Mental Health Act (in the UK) becomes
appropriate and when we must respect a person’s right to choose
their treatment options.
At its core this film also explores the role of
kindness and compassion in the treatment of those suffering from
chronic psychotic illnesses and the power of the social environment
to aid recovery in such disorders. The Soloist examines
the effect of a stable, consistent friendship in supporting and
promoting recovery in an individual with schizophrenia. It shows
that a trusting relationship must be developed before any attempts
can be made to engage Ayers in any treatment services (in this case
the acceptance of shelter rather than living on the streets). The
film highlights Ayers’ loss of contact with his family when he
became unwell, his relocation far away from the family home, and
the subsequent alienation he experienced. But more than anything
this film focuses our attention on the reality that it is
individuals within societies who suffer from schizophrenia and that
each of them has a personal story. If we can see someone who has
schizophrenia as a person not a disease, society might begin to
lessen some of the stigma of mental illness that is so often
present.
It is interesting to note that Ayers and Lopez
are still friends several years after their first meeting and now
campaign for better housing for the mentally ill in America (as
seen in this short
video made in 2011). As mentioned in that short
video, Ayers was invited to play for President Obama in 2010 to
commemorate the 20th anniversary of the Americans with Disabilities
Act at the White House.
In broader terms The Soloist
challenges the viewer to consider mental health as an important
public health issue, consistently associated with low income,
unemployment, and poor physical health. I have previously discussed
the topic of homelessness and mental illness in an earlier Minds on
Film blog about the film The
Christmas Choir. But for a
greater understanding of the more general topic of public mental
health there is the recent editorial in Advances in Psychiatric
Treatment by Professor Sir Michael Marmot, entitled Health
inequalities and mental life (APT
(2012)18: 320-322). In
addition, a detailed position statement by The Royal
College of Psychiatrists, published in October 2010, is available
to read on the website by following the
link to No health without public mental health.
• More information about The
Soloist is available at IMDB as
well as a short trailer.
• The film can be purchased at
amazon.co.uk
• Minds on Film is written by consultant
psychiatrist Dr Joyce Almeida.
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