Authentic portrayals

Rosa Cheesman and Alicia Peel (King’s College London) tune in to the BBC series ‘Mental Health and Me’.

The BBC’s recent series of documentaries triggered public discourse about life with mental health conditions. Anxiety and Me tracked Nadiya Hussain’s journey from Googling her symptoms through to starting cognitive behavioural therapy. Depression and Me followed Alastair Campbell trialling a range of more novel treatments for depression, including transcranial magnetic stimulation, and exploring the link between depression and the immune system. In Psychosis and Me, David Harewood pieced together what led to a previous psychotic episode, and learned about others’ experiences. The films encouraged people to openly talk about their mental health, and to seek treatment if they are struggling. In addition, the series provided a window on these conditions, framed from the perspectives of the individuals involved. The huge, positive reaction on Twitter highlights the general desire there is today to open up the dialogue about mental health.

As these documentaries were designed for the public, not for psychologists, it is important to review them from that perspective. Despite high levels of support from viewers, criticism ensued on Twitter, primarily from psychologists and mental health professionals. These focused on the language used and the advice provided to the celebrities. However, as has been argued previously by Vaughan Bell and others, individuals should be allowed to speak for themselves and tell their personal stories, even if aspects of these are specific to their own experience.

Indeed, the reason why these documentaries are so powerful is that they are so deeply personal. They give us access to the private lives of household names, highlighting that what we see on the outside – confidence and success – does not necessarily reflect how people feel on the inside. These authentic portrayals help us all to see how impairing depression, anxiety and psychosis can be. Presenting such honest accounts of these conditions is a huge step towards increasing general knowledge and understanding of mental health. Whether these presentations fall in line with the beliefs of all mental health professionals is less relevant to the impact of this series than their overall positive influence on the public.

The films effectively communicate the complexity of the conditions and that they involve many risk factors. Collectively, they cover how genetic risk and experiences, including trauma, can all influence our mental health. Alastair Campbell and genetic counsellor Dr Jehannine Austin discuss the ‘jam jar’ model for vulnerability and resilience to mental illness. In this model, mental health is represented by a jam jar. At birth, some genetic risk factors are already present in a person’s jar. Throughout life, environmental adversities also start to build up. Once the jar is full and a person has no more room to cope with environmental stress, a psychiatric episode is experienced. Crucially, the model incorporates the ability to increase the size of the jar, by adding protective factors such as exercise, sleep and social support that enable us to cope better with environmental adversity.

Nonetheless, the intense focus of these films on individual experiences also poses challenges. The experience of a psychiatric disorder is rarely the same for any two people. If the aim of this series is to increase awareness and understanding, then it is important to address how differently these conditions can present. Although Nadiya mainly struggles with panic, other anxiety disorders including generalised anxiety, social phobia and obsessive compulsive disorder are also highly prevalent. Knowledge of their specific symptoms and difficulties could go a long way towards reducing stigma. Hopefully with the increasing popularity of these programmes, other stories will be told which cover different manifestations of anxiety and depression. This will ensure that viewers can understand the huge diversity, even within conditions under the same name.

David Harewood’s Psychosis And Me presented different manifestations of psychosis experienced by individuals attending an early intervention group. This segment of the programme showed a greater appreciation of the possible range of psychotic experiences. The difficulties discussed by those interviewed brought to light the reality that many do not only experience one episode of psychosis, as he had. Rather, most suffer with more chronic and debilitating manifestations. Including these individuals helped to portray that mental health difficulties encompass a full spectrum of symptoms, ranging from individuals who may experience subclinical symptoms with minimal impact on their functioning, to those with more severe mental health conditions who may face daily battles with their mental health.

A clear take-home message from the films is that it is good to seek help. Having been part of these documentaries, Nadiya and Alistair had the opportunity to try numerous treatments, expanding public knowledge of standard and novel therapies and research directions. Yet, beyond these programmes, many people in need of mental health services still face barriers to accessing treatment. These documentaries should lead us to think not only about what the individuals themselves can do to support their own mental health, but what can be done at a societal level to reduce these barriers. Recently, major progress with this has been made with the NHS Improving Access to Psychological Therapist service (IAPT), with 89 per cent of patients seeking support for anxiety and depression starting treatment within 6 weeks.

Thanks to the bravery of these celebrities mental health is on the agenda more than ever before. With documentaries like these receiving ever-increasing support from the public, future programmes have the scope to address more nuanced aspects of mental health.

Available to watch on BBC iPlayer now.

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