13 Reasons: How TV can be smart about mental health

May 20, 2017 | By Craig and Marc Kielburger

Celebrity Demi Lovato openly discusses her mental health experiences. She continues to break stigma by serving as executive producer on documentary Beyond Silence which tells the stories of three individuals living well and thriving with mental health conditions. (Photo credit: WE Charity archives)

Thrashing and screaming, a girl is hauled away by orderlies in white coats. Nurses follow, sedative needles ready. Watching this scene in the film Girl, Interrupted, Emily Nicholas Angl wondered, “Will that be me?”

As a young woman, Nicholas Angl grappled with severe depression and anxiety. In TV shows and films she saw only stereotypes and extreme cases—straightjackets and asylums. She has long since overcome her challenges, but still remembers the fear that media clichés provoked.

The Netflix series 13 Reasons Why has sparked an international controversy for its depiction of teen suicide. But the hit drama has become a scapegoat for an entire industry that, experts say, could do better in its depictions of mental illness. Hugely influential, especially for youth, entertainment media has a responsibility to treat potentially harmful topics with sensitivity. The flurry of public attention around 13 Reasons is a chance to examine how entertainment media can more accurately represent mental health issues.

“The biggest problem facing people with mental health challenges is stigma. The biggest fuel for stigma is media portrayal,” says Bill Lichtenstein, a Boston-based producer of award-winning radio, TV and film documentaries about mental illness.

He says fictional portrayals can reduce stigma by avoiding extreme stereotypes in favour of characters living with mental illness, but not defined by it. Lichtenstein points to the drama Homeland, whose character Carrie Mathison copes with bipolar disorder, but remains a competent CIA agent.

Suicide makes for dramatic television, but viewers should know it’s not the only outcome. Characters, like real people, can get help and successfully overcome mental illness, says Lichtenstein. A positive outcome on TV offers encouragement to those coping with mental illness in real life.

This is especially critical for young people, says Nicholas Angl, now Director of Health Engagement and Communications for Toronto-based Reframe Health Labs. “Most young people don’t have the life experience to look back and remember a time when things got better,” she says.

Youth first look to other sources, like their favourite movie, to learn about recovery and resilience.

Additional information and resources are also necessary. “Entertainment by itself is not enough. It has to be paired with literacy,” says Dalhousie University professor and youth mental health expert Dr. Stan Kutcher.

Shows or films that want to stoke productive conversations can run help line numbers and web links at the end of programs. A long-running series could develop their own microsite to offer expert advice for parents to talk to children. The producers of 13 Reasons Why created Behind the Reasons—a companion documentary featuring the cast and mental health experts discussing the issues raised in the series.

Finally, our sources suggest thinking beyond ‘expert’ consultations. Don’t just ask the PhDs. Producers should engage with people who have lived with mental illness, or organizations that work with them, to create more authentic characters and deliver healthier messages.

In the past, entertainment media has played a powerful role in driving social progress, on issues from AIDS to gay rights. It can help break the stigma surrounding mental illness.

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