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The Royal College of Psychiatrists Improving the lives of people with mental illness

The Soloist

Introduction

The Soloist is a film based upon the true story of Nathaniel Ayers, a musician who suffers from schizophrenia, and Steve Lopez a journalist for the Los Angeles Times, who befriended the then homeless Ayers when he was living on the streets of LA. Lopez was a journalist in need of a story, but soon became drawn in to a closer involvement with Ayers, fascinated by how mental illness had affected the life of such a talented musician. In the process Lopez wrote a regular column in the newspaper about his encounters with Ayers and subsequently published a book called The Soloist: A Lost Dream, An Unlikely Friendship, and the Redemptive Power of Music. These form the basis of the film. The background to their meeting and friendship is told in a short documentary made for CBS in America in 2009.

The Soloist was directed by British filmmaker Joe Wright (who had previously made the very different Pride and Prejudice and Atonement) and was released in 2009. Robert Downey Jr. and Jamie Foxx play the parts of Lopez and Ayers respectively and their real life counterparts have publically appreciated their performances.  The film presents a realistic portrait of schizophrenia and the associated problems of homelessness. Using a significant number of the mentally ill homeless population of Los Angeles as extras gives the film an authenticity that is unusual for a Hollywood production.

The Soloist

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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About this blog

 

Minds on Film is a monthly blog that explores psychiatric conditions and mental health issues as portrayed in a selection of readily available films.

Please note that this blog may contain plot spoilers. Any views expressed are purely my own.

Dr Joyce Almeida
Dr Almeida is a consultant
psychiatrist working in the private sector in the UK.