Strait jackets. Lobotomies. Scary nurses reminiscent of Nurse Ratched. Audiences are both freaked out and captivated by psychiatric hospitals. That’s probably why it’s one of the most popular settings for a horror movie—even when not set in one, raging axe-toting chainsaw-waving murderers often seem to be escapees from them.

From the fictional Smith’s Grove Sanitarium, to the very real Eastern State Hospital where John Carpenters The Ward was filmed, audiences can’t help but feel drawn into the psychiatric hospital setting, which promises both physical and psychological scares. In the realm of horror, psychiatric hospitals are referred to by their outdated, and now unused (or at least they should be) names like “mental institution” or “insane asylums,” most likely because those names are evocative of a time where psychiatric hospitals were a place of real-life horrors in the form of severe human rights abuse, major discrimination and stigma, and experimental treatments that tended to worsen mental illnesses or turn the patient into a vegetable.

Notorious psychiatric hospitals like Bethlem Royal Hospital,  once nicknamed bedlam, even functioned as a sort of zoo, where the public would come to observe the patients, or “inmates”, as they were often called. It was a terrible practice, and one that hasn’t entirely gone away. We don’t visit the hospitals anymore, but we do watch them through film. In some ways this practice has simply manifested itself into a more convenient technological form.

I’ll admit that I’m a sucker for any film set in an abandoned psychiatric hospital. Why? Because it scares me. Everything about it scares me. The film could be kind of awful and it would still scare me, mainly because it relies on actual terrible things that happened in the past, that make the word “asylum” automatically scary for people the images it conjures of padded cells and shock therapy.

But so much of the creepy atmosphere of the psychiatric hospital, abandoned or not, is because of the depiction of the patients: completely lost, drooling and spaced out or sadistic and hostile, prone to violence and rage and sexual perversion at any moment. Many horror movies and thrillers alike show scenes where patients are let out of their rooms or “cells” and wreak havoc upon the hospital, murdering orderlies and leaving a path of destruction.

It makes me question why I fall for the eerie allure. What does the horror genre obsession with psychiatric hospitals and mental illness say about the way we perceive those with mental illnesses? Does it scare us because we actually think that people with mental illnesses, especially those in psychiatric hospitals, are seriously dangerous? It’s right for us to think that psychiatric hospitals were really awful places in the past, and some still are today, but it seems like our idea of them is that they house people capable of extreme violence, people who are “sick and twisted” deviants of society.

The truth is, the patients aren’t like that. At least, not the great majority. In fact, people with mental illnesses tend to be a more of a danger to themselves than to others—think self-harm, substance abuse, and suicide. So no, the patients at a psychiatric hospital are not likely to be the next Michael Myers, and no, borderline personality disorder does not mean you have two utterly opposing good vs. evil personalities that rapidly switch back and forth between each other.

These are all misconceptions that horror movies rely on to deliver scares. The latter image, or some variation of it, is especially popular as a horror movie ending cop-out:  the main character is actually just “insane” and it’s all in their head (which, by the way, is very ableist language, so don’t use it!). In reality, people with mental illnesses like, for example, schizophrenia or dissociative identity disorder can live happy, functional lives when receiving adequate treatment—much like any physical illness.  While there definitely are cases of people with certain mental illnesses committing acts of violence, it’s important to note that this is not the dominant or driving force behind violent crime—not in the slightest.

Though I’ve questioned why I find these problematic films so appealing, I’ll admit that it hasn’t stopped me for being lured in by horror films with scenes in psychiatric hospitals—even if they aren’t entirely set there. But that’s also a part of engaging in any kind of media; we can’t always expect ourselves to banish all problematic media, because it’s an unrealistic expectation, We do, however, have to openly acknowledge what makes it problematic. In this case, while psychiatric hospitals are a certifiably scary setting sure to give anyone the creeps, viewers need to push themselves to not internalize the misconception that actual patients in these hospitals are sadistic serial killers.

Next week, I look at the problematic racist elements of horror movies that use histories of colonization and enslavement as their themes.