Rethinking mental illness on TV

08 October 2012
Posted in TV

Ming Ho reports from the Time to Change ‘Meet the Media’ Event

Mental health: does TV perpetuate negative stereotypes? That was the question posed by Time to Change, an anti-stigma programme run by the charities Mind and Rethink Mental Illness, at an event for television drama professionals held on 1 October at the Hospital Club in London.

The evening began with a new training film presented by broadcaster Alistair Stewart, which aims to promote good practice in the portrayal of mental illness, and includes interviews with writers and directors involved in high-profile stories such as the bipolar disorder of Jean and Stacey Slater in EastEnders and the breakdown of Dr Ruth Winters in Casualty.

Kate Rowland, BBC Creative Director of New Writing, then chaired a panel discussion with writers Danny Brocklehurst (Exile; Accused), Dana Fainaru (Casualty), and Bill Lyons (Emmerdale), and mental health nurse, Lol Butterfield, who had advised on Emmerdale’s Zak Dingle storyline.

Research into a three-month sample of TV drama, led by the Glasgow Media Group, revealed that 74 programmes contained storylines on mental health issues – and these featured 33 instances of violence toward others and 53 examples of self-harm. While almost half were deemed to be sympathetic portrayals, the characters tended to be shown as tragic victims; and 63% of references to mental health were thought to be ‘pejorative, flippant, or unsympathetic’. How can we, as writers, redress this disproportionate image of a link between mental illness and violence and dispel the fear that it engenders?

 Danny Brocklehurst ruefully admitted that a violent incident was the catalyst for his acclaimed episode of Accused, in which a bereaved teenager develops psychosis, believing that his new stepmother has murdered his mother. However, he pointed out that the format of the programme, like much of TV drama, requires a crime at the heart of each story, and he had initially wanted to explore the dynamics and complexities of a step family; the character’s mental condition had arisen from the natural development of that story – he had not set out to write an ‘issue drama’. He feels a responsibility to get it right and will research to check authenticity, but for him the story has to come first.

Dana Fainaru, on the other hand, is keen on extensive background research. When commissioned to write the episode of Casualty in which Dr Ruth Winters is admitted to a mental health unit, she went to the Nottingham NHS Trust on which the BBC had based its documentary series, Sectioned, and talked to recovering patients.

Was there anything she had wanted to include in her episode, but couldn’t, Kate asked? Dana said the original storyline had culminated with the deaths of a patient and nurse in a fire, inspired by an incident recounted to her, but she had decided not to use this, as it would have given too negative a conclusion and possibly have discouraged people from seeking treatment.

She too was conscious of a responsibility not to give the impression that mental illness always results in harm, but said that in her opinion all drama puts protagonists through a kind of crisis or 'breakdown' in the wider sense. She also spoke about her own experience of post-natal depression, a subject she explores in a new original project. Motherhood, she felt, 'has become a brand', and it’s hard to accept that some women can’t love their babies; there’s a correlation between high expectations of new mothers and their ability to cope.

Bill Lyons, a veteran of popular series from Z-Cars to EastEnders and now Emmerdale, criticised the current trend for melodramatic storylines that put characters through a rollercoaster of extreme incident with no lasting effect. He wanted to acknowledge the truth of such situations by allowing Zak Dingle to experience the natural progression to breakdown: 'What we have put this character through is more than anyone can take.'

There was some anxiety within the production that it might damage Zak’s popularity; but Bill felt it was his very down-to-earth appeal ('He would have thought mental illness was just an excuse to get off work!') that made Zak exactly the character to communicate this journey in a way that viewers would understand.

Bill had also worked on the mental crisis of Arthur Fowler in EastEnders (another Everyman figure), and recalled being keen to follow that through in the long term. Series creator Tony Holland, however, had warned him that there was a danger of boring the audience, and Bill conceded that there always had to be something to move on a story. The narrative demands are different in a one-off or short-form serial such as Exile, he thought; soap has to hold the attention over a much longer arc.

A questioner from the floor wondered if you could use mental illness as an ongoing factor, rather than a story driver – wouldn’t that be progress, for it to remain in the background? Danny queried how that would work in practice, when viewers have learned to expect that nothing is introduced without a reason or pay-off. Mental health nurse and adviser Lol remarked that if soap accurately reflected statistics, a quarter of characters would have some kind of mental health issue, and the panel felt it was just not practical to approach drama from a demographic point of view.

A story is most effective when portrayed by an established character the audience cares about, said Bill, not someone brought in specially for an issue; and writers should not react to the agenda of pressure groups.

The panel agreed that popular drama requires a balancing act between entertainment, information, and veracity, and that talking to those with direct experience of issues is the best preparation. Media volunteers from Time to Change were on hand to share their personal stories, and can be contacted via the organisation by anyone wanting to learn more to support their work.

Time to Change can also be followed on Twitter @TTCmediaadvice.