You walk into a Halloween store with your child and find it on the back wall: a straitjacket splattered with fake blood, in a bag labeled “Psycho Patient.” If you love someone living with a mental health condition, that bag can land like a punch.

You have more company than you might think. Mental health advocates have pushed back on Halloween’s “asylum” theme for at least twenty years. By 2006, NAMI volunteers were tracking these haunted houses and costumes across the country, and news coverage that fall described the pushback as a fight advocates took up each October.

Over those years, some companies changed course when people spoke up, and others held firm. You’ll find real progress below, along with the places where we all still need to stay watchful.

The Progress We’ve Seen

Local chapters won some of these changes one haunted house at a time. In October 2006, NAMI’s DuPage County chapter reached out to the Jaycees in Wheaton, Illinois, about their “Insanitarium” haunted house, and the group renamed it the Wheaton Jaycees Haunted House. By 2009, NAMI was issuing a national Halloween alert that urged families to call and write to the stores and sponsors behind “asylum” attractions.

Retailers have shown they’ll pull these costumes when shoppers object. In 2013, two of the UK’s biggest supermarket chains took down “mental patient” and “Psycho Ward” costumes after complaints poured in on social media, and one pledged a donation to a mental health charity.

Theme parks have changed course too. In 2016, families and advocates pushed Knott’s Berry Farm to close a virtual reality ride named for California’s code for an involuntary psychiatric hold. That same fall, Six Flags New England replaced its “asylum” haunted house with a different theme after people called and wrote to the park.

Some companies held firm. ABC reran a Modern Family Halloween episode built around an “insane asylum” in 2015, despite a joint request from NAMI and five other national organizations to pull it. Our founder, Janine Francolini, had called out the episode in her 2014 HuffPost piece, Not Such a Modern Family, and we joined the protest against the rerun. Parents used the moment to share what portrayals like that one meant for their own kids.

People with lived experience are also telling more of the story themselves. This year’s documentary, The Haunting of Pennhurst, follows disabled performers who work at a haunted attraction on the grounds of a former Pennsylvania institution. On the same site, the Pennhurst Museum teaches visitors what residents lived through.

Where We Still Need to Stay Watchful

The “asylum” theme still shows up each October. The Pennhurst attraction opens each fall on land where people with intellectual and developmental disabilities once lived with neglect and abuse. Disability advocates such as Alex Green argue the act still trades on harmful tropes, even with disabled performers in the cast. We looked at the harm these haunted houses do in our 2024 post, Rethinking Scary.

Big parks still build “asylum” mazes, too. This season, Six Flags Great Adventure in New Jersey runs a maze called Asylum as part of its Fright Fest.

Keep an eye on costume websites as well. Shoppers found the 2013 costumes online, and a seller can post a new listing well before anyone complains.

Your Turn This October

The families behind this progress used the tools in their pockets, from a tweet to a letter to a park president. You have the same tools. If you spot a “psycho patient” costume on a shelf or an “asylum” maze on a flyer, tell the store manager or leave a note on the product page. Keep it short and personal, and mention the person you love.

Start at home, too. Kids repeat the jokes they hear, so talk with yours about the real people behind the “crazy person” costumes. Our guide to a calmer, more welcoming Halloween has costume ideas for kids who want to dress up without the gore. 

Keep your Halloween as scary as you like, and leave the straitjacket on the rack.