Portraying mental illness on the small screen
Fictional characters with experience of mental illness are often one-dimensional,
frequently disappointing and regularly offensive.
If we were to take these portrayals as gospel, it would be impossible to imagine a person
affected by mental health problems who wasn’t either helpless and pitiable, or
Let’s not forget violent too. Thanks to director Alfred Hitchcock, the character of
Norman Bates in Psycho
could be, for many people, the quintessential crazed killer. Remember that scene? Bates,
in a woman’s dressing gown, creeping towards the shower curtain. The curtain is wrenched
aside, there’s a bloodcurdling scream, frenzied arm strokes and splattered blood. A
deranged man with mother issues and a penchant for cross-dressing. A ‘psycho’, through
Stigmatising portrayals of mental illness have been done on a grand scale on the big
screen, but they can be equally damaging on the more intimate, and arguably more
accessible, medium of television. Both serve to reinforce many of the stereotypes
associated with mental illness and are barriers to social inclusion, acting against the
work of Like Minds, Like Mine, Time to Change, Mindframe, Bring Change 2 Mind, and many more
Character portrayals are improving
However, headway has been made with TV producers in New Zealand, across the Tasman and
particularly in the UK, which has seen more realistic portrayals of characters living
with mental illness and enjoying fulfilling lives. Like Minds looks at how portrayals of
characters experiencing mental distress have improved over time, what the research tells
us about the effect TV has on public opinion, and ways to continue the gains made.
Research shows power of TV
A number of studies in Australia and elsewhere in the world have shown a strong link
between the portrayals of people with mental illness on the small screen, and public
attitudes to people with lived experience of mental illness.
A 2005 report by mental health organisation SANE
Australia looked at consumers’ impressions and responses to TV and movie
depictions of mental illness and suicide. The majority of people who participated in Make
it Real! believed that inaccurate and stigmatising portrayals of people with
mental health problems were far more common than informed representations, and that the
examples had a lasting impact.
This included reinforcing stereotypes and negative labels, and increasing the self-stigma
for people living with mental illness.
“I don’t know much about it [the portrayal of mental illness in TV dramas],” said one
respondent. “Just what I see on TV, and they’re always psycho killers.” Another
said: “They only care about creating a big drama to get ratings up, not how this
In the same year, a University
of Melbourne study reviewed the research literature around fictional film and
television portrayals of mental illness. This found that the portrayal of mental illness
is “extensive and, predominantly, perpetuating myths and stereotypes”.
The report says: “People with mental illness are most commonly shown as being violent and
aggressive, but they are also frequently depicted as eccentrics, seductresses (in the
case of women), self-obsessives, objects for scientific observation, simpletons and/ or
failures.” The study also found that, perhaps contrary to popular opinion, entertainment
media may have a greater influence on community attitudes towards mental illness than
However, not all of the findings from the research mentioned were negative.
On the positive side, participants in Make it Real praised the portrayal of selected
characters in the Australian TV shows, Neighbours and Stingers. “Stingers was good
because it showed [a character] dealing with bipolar over a long period of time, not
just a once-off,” said one participant. Another said the portrayal of Boyd from
Neighbours was “pretty cool” – “he was such a popular guy, so normal, and he got so much
support from his friends and family”.
Some success over the ditch
Australian mental health initiative, Mindframe, was established in 2000 to
provide information to various groups on how to responsibly and authentically report on
or portray issues around suicide and mental illness.
Amy Visser, of the Hunter Institute of Mental
Health, which manages Mindframe, says television drama plays an important role
in influencing people’s attitudes. “There is a demonstrated link between negative
portrayals of mental illness in the mass media and negative beliefs among people in the
community,” says Amy. “In short, this can lead to stigma and discrimination towards
people living with a mental illness. It’s not so much the instance of these portrayals
as the way in which they are presented that can influence outcomes for people who are
vulnerable, and community understanding generally.”
In 2007, Mindframe turned its attention to fictional portrayals of mental illness, with
the launch of its stage and screen project. “From the very beginning, we’ve had positive
engagement with people working in television, film and theatre,” says Amy. “The Hunter
Institute of Mental Health partnered with the Australian Writers’ Guild and also engaged
individual consumers from the SANE Australia speakers’ bureau, all with the aim of
informing the project and making it accessible to the entertainment industry and the
mental health sector.”
TV programmes that have taken on-board Mindframe’s guidelines and anti-stigma messages
include Home and Away,
“We consulted with the Neighbours story department on developing a character with bipolar
disorder, in collaboration with SANE Australia and a person with lived experience,” says
Amy. “We also consulted with production team members for Dance Academy on a storyline
involving the issue of eating disorders, linking in with the Butterfly Foundation for
direct information and follow-up support. “In each case, the most important factor has
been linking creatives with real-life stories, either by face-to-face contact with
people with lived experience, or through the many other story sources we provide.” While
old stereotypes are being challenged more often, negative depictions of characters with
mental illness are still all too common on Australian television screens.
“There are still many myths and misconceptions being perpetuated in the name of ‘drama’.
Mental illness is often easy fodder for creating characters with bizarre and eccentric
behaviours and the conflict that ensues, with little explanation as to if, how or why
someone living with an illness would behave this way. However, increasingly these
clichés are being challenged as writers seek out new and exciting stories.”
The English experience
In the UK, positive portrayals of mental illness on screen are not as unusual as they
once were. Anti-stigma programme Time to Change has commended a number of local
television shows for their handling of stories featuring people experiencing mental
The Spring 2013 issue of the organisation’s Speak Out
magazine delves into some of its most successful work with Eastenders and Emmerdale – two long-running UK soaps, which
also air in New Zealand.
Jenni Regan, who runs Time to Change’s Media Advisory Service, says Eastenders approached
them in 2012 for help with a depression storyline for Ian Beale, a major character on
the show. She advised the writers that symptoms should build up over several months and,
rather than the story reaching the usual dramatic violent ending, having the character
simply walk away from his life was a much more realistic peak.
Eastenders also had guidance from Kevin Shepherd, a Time to Change media volunteer who
has lived experience. He worked with scriptwriters by sharing his own insights on how
Ian may feel or react. Jenni script-checked the results and provided feedback around
Ian’s symptoms, treatment options and the way he interacted with others. “It was a
unique opportunity to show millions of people the reality of living with a mental health
problem,” Jenni says. “Our role with this storyline means that we have been able to
ensure as much accuracy as possible.”
Emmerdale character Zac Dingle also experienced a mental health crisis in 2012. The
show’s writing team was blessed with a writer, Bill Lyons, who was keen to get it right
and had done quite a bit of the initial research himself, and a producer who wanted to
keep the story as true to life as possible. They, like Eastenders, also worked with a
Time to Change media volunteer, Lol Butterfield, who advised on the storyline.
Lol shared his experiences of depression and, as a qualified mental health nurse, could
look at the plot from both angles. Emmerdale researcher Fiona McAllister says Lol was
invaluable because of “his openness about his own experience”, which “really fed into
the script and informed the excellent performance”.
“Showing a patriarchal figure like Zac Dingle going through a period of mental
distress is a really tough call, and we’re still showing the reality of his
long-term recovery. I think it was dramatically brilliant and also did its bit
Emmerdale scooped a 2012 Mind Media Award
for their storyline, while actor Adam Woodyatt, who played EastEnder’s Ian Beale, was
nominated for an award for his portrayal of depression.
Path opens for consultation
Back in New Zealand, Kiwi soap Shortland
Street beams into thousands of lounges each week and is nearcompulsory
television viewing for many Kiwis. Like Minds, Like Mine National Contract Manager
Katrina Mathers has been watching the show since it started and has generally been
impressed with its portrayal of minority groups and sensitive social issues. So, when
the storylines started to stereotype and stigmatise characters living with mental
illness, she was disappointed and compelled to act. “There seemed to be a tendency to
fall back on mental illness as an excuse for episodes of violence,” explains Katrina.
“One of the characters, Bree, had previously been placed in care following an attempt to
kill her sister.
She was reintroduced to the show, but it soon became clear this was only to provide a
culprit for an unsolved murder. “There also seemed to be a tendency to ship people off
when they had mental health issues. The character, Dayna, ‘disappeared’ into care the
moment she was diagnosed with bipolar disorder. For months on end, nobody even talked
about her. It implied that when a person has a diagnosis of mental illness, you can wash
your hands of them and hand them over to authorities. This completely goes against our
‘be there, stay involved’ message.
Judi Clements, Chief Executive of the Mental Health Foundation (MHF), sent a letter to
the Shortland Street writers, voicing these concerns and suggesting ways the
organisation could help inform more positive storylines.
A reply was received soon after from the show’s producer, Simon Bennett, who suggested a
meeting to discuss better ways of portraying people experiencing mental illness. Simon
says the “credibility and authority of the MHF” was enough for him. “If the MHF thinks
that there are problems with what we’re doing, we respect that,” he says. “In making the
show, we don’t try to be irresponsible and we have a responsibility not to misrepresent
things or perpetuate stereotypes that could be damaging. “We are very aware that our
viewership is wide and influential, so we try to get the medical aspect of what we’re
doing right. We have a nurse advisor, but she doesn’t specialise in mental health.
That’s why it’s been great to have the MHF to call on.”
Katrina, and others from the MHF who attended the meeting, says it was productive and
“positive all round”. “I was encouraged that they seemed to be so open to our suggestion
that we could help them develop more positive storylines,” says Katrina. “It was great
to see they had gathered the entire writing team too – I thought we’d just be meeting
with a couple of people. The writing team seemed genuinely interested in what we had to
say and surprised and moved by some of the things we told them.”
Since then, a positive working relationship has been established between the MHF and
Shortland Street, which has seen more positive storylines develop for Dayna. “They
aren’t mentioning her diagnosis anymore, which I think is great,” says Katrina.
“Before she just seemed to be ‘the bipolar girl’, but now she’s just Dayna. I think
they’re doing really well.”
Working with television – the way forward?
Dr Fincina Hopgood, Sessional Lecturer, School of Culture and Communications at the
University of Melbourne, sees the future success of fictional TV characters lying in
their ability to engender empathy in their audiences.
Earlier this year she convened a symposium in Melbourne called Try
Walking in My Shoes: Empathy and Portrayals of Mental Illness on Screen to
discuss how mental illness is represented in film and television and what the
implications are for mental health awareness in the community. “The idea for the
symposium grew out of my PhD research project and that of a colleague, Patricia Di
Risio,” she says.
“We wanted to explore the emotion of empathy
and how this can be elicited through film and television – and had the support of The Dax Centre and ARC Centre of Excellence for the
History of Emotions.”
Fincina says discussion about this issue was important because “cinema and television can
be quite influential in shaping people’s attitudes”. “While most of us know that films
and TV shows are not ‘real life’, their emotional appeal means a negative portrayal of a
character with mental illness can have a greater impact on social attitudes than a
well-informed newspaper article or an anti-stigma campaign.
“It’s also important for people with lived experience [of mental illness] to see
themselves on screen, to feel validated by having their stories told, rather than
feeling invisible, as if they don’t exist, or, worse, being demonised. “What matters is
the intention of the filmmakers and producers in creating a character with mental
illness – is it for sensational effect? Is it just lazy scriptwriting – eg. when a crime
happens, pull out the stereotype of the psycho killer? Or is it to create a character
with depth and complexity that audiences can relate to?
“The critical and commercial success of TV shows like United States of Tara,
Homeland and The
Bridge show that filmmakers and TV producers are looking for different stories,
more complex characters, and are willing to ‘take risks’ by having their main character
living with a mental illness – and those perceived ‘risks’ are clearly paying off.
“Armed with accurate
information and valuable research material about mental health, writers can now
create more complex, authentic characters that go beyond stereotypes and clichés.”
The shift towards developing empathetic characters on TV lies in the flexibility TV has
to establish and deepen connections with the audience over several episodes. Fincina
thinks the key to destigmatisation lies in developing characters and storylines that
"tap into our potential to empathise with another human being". “It allows audiences to
go on a shared emotional journey and makes the experience of living with a mental
illness accessible and relatable,” she says.
“Whether filmmakers/producers consult with mental health organisations or talk to people
with a lived experience, that research will pay off in producing a film or TV show that
is compelling and resonates with audiences.”