As if you needed another reason to mourn the demise of One Day At A Time, a new study conducted by Dr. Stacy L. Smith and the USC Annenberg Inclusion Initiative hammers home just how valuable that show’s careful, sensitive depiction of mental health conditions was in the larger context of Hollywood.
One of the most compelling and emotional storylines in Netflix’s cancelled reboot of Norman Lear’s classic 1970s sitcom was protagonist Penelope Alvarez’s (Justina Machado) struggle with debilitating anxiety. Season 2’s “Hello Penelope,” and season 3’s “Anxiety,” in particular handled this mental health condition, which affects 40 million adults in the United States every year, without stigma or judgment. Even more groundbreaking, the show centered around a Latinx woman, a group that has historically been overlooked in the few portrayals provided of people living and coping with mental health conditions.
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The study, conducted in partnership with the American Foundation for Suicide Prevention (AFSP) and funded by the The David and Lura Lovell Foundation, analyzed 100 top-grossing films and 50 TV series, and found that less than 2% of film characters and roughly 7% of TV characters experience mental health conditions on-screen. For reference, the study claims that close to 20% of the U.S. population experiences mental health conditions per year. (The definition used by researchers was kept purposefully broad, and included mood disorders, anxiety, PTSD, addiction, suicide, autism spectrum disorders.)
“Entertainment is once again completely out of step with reality,” Dr. Smith said in a press release relaying the findings. “The prevalence of mental health conditions among the audience far outpaces the characters they see on-screen. This presents a distorted view of the world for those who live and thrive with mental health conditions but never see their stories represented in popular media.”
Most worryingly, the study found that some of the most at-risk groups are routinely ignored. Stories about mental health conditions overwhelmingly focused on straight white men, with addiction and PTSD making up the two most common conditions seen on-screen in both film and TV. Only eight LGB characters with a mental health conditions were shown in the 50 most popular shows of the 2016-2017 season shows, and none at all on film in 2016. (In 2017, that number rose to one.) No trans characters with mental health conditions were portrayed in either medium that year, despite the fact that nearly half the trans population in the United States has grappled with anxiety and/or depression. A 2014 study by the AFSP found that 41% of trans men and women in America had attempted to die by suicide, a rate that’s nine times as high as that of cis-gender people.
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And though 20% of U.S. teens experience mental health conditions, only 7% of characters with mental health issues in film were teens, and only 6% on TV. That low number means that shows like Netflix’s 13 Reasons Why, which has been heavily criticized for its handling of suicide, sexual assault, and mental health struggles, stand out even more, as teens who may be seeking to see themselves represented on-screen have few other options to turn to. In fact, the report highlights suicide and suicidal ideation as one of the most sensitive and potentially harmful mental health conditions to get wrong.
“There are significant discrepancies in suicide portrayals in film and television. The majority of people who experience mental health crises and suicide attempts live through them, find hope and support, and don’t go on to die by suicide,” Dr. Christine Moutier, Chief Medical Officer, AFSP said in the press release. “Including portrayals of mental health and suicidal experiences in film and television is important in creating a culture that’s smarter around these issues. The real opportunity is in making sure it’s accurate, nuanced and hopeful, and portrays the issues in a way that is safe and responsible for viewers.”
As for diversity, it is basically non-existent here. The report found no one of Middle Eastern or North African descent, Native American or Hawaiian Pacific Islanders in film experiencing any of the mental health conditions analyzed, and only 4 Latinx characters, making a show like One Day At A Time, starring and produced by Latinx women, an even more precious commodity.
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The study adds that when mental health conditions are in fact shown on screen, it’s often in a negative light. Some of the most common words associated with mental health on screen are “crazy,” “weird,” “psycho,” “scumbag,” “monster,” and “freak,” and 46% of film characters with a mental health condition were framed as being violent. That kind of messaging contributes to the dehumanization and stigmatization of people experiencing mental health issues.
Too often, mental health and addiction were used as punchlines, as in this section pulled from the script for 2016’s Bad Moms:
“Gwendolyn’s admission that she is addicted to painkillers starts out very serious. Amy asks her, ‘Gwendolyn, what could possibly be wrong?” Gwendolyn attempts to hold back tears and says, ‘Okay, well. For starters, my husband was just arrested for embezzling $100 million from a children’s charity.” Then her voice starts to get extremely high pitched and squeaky as she cries, ‘And I have night terrors. And I have to take Vicodin every 20 minutes and I’m not in any pain. I’m just addicted to them now. I’m pretty sure my brother-in-law just joined ISIS, and he’s a Jew! Oh and also, my DVR just stopped recording Castle. Just out of nowhere. And I am the only thing holding my family together.’”
So, what can be done to remedy this?
Dr. Smith and her team end the report with a list of suggestions for content creators to help improve representation of people experiencing mental health conditions in future pop culture portrayals. Ask yourself: Why am I telling this story? Is the mental health condition used as a plot device? Is it played for laughs? Is there unnecessary stigma? Is the character seeking help?
That last part is especially important. Bringing it back to One Day At A Time, Penelope, a veteran of Afghanistan, was often shown coping with PTSD and seeking help with therapy and a weekly support group, a positive example of available resources available for people who need them. Only 5% of film and 9% of TV characters were shown to be in treatment. More encouragingly, however, 22% of film character and 62% of TV characters were shown in or mentioned therapy.
The shows and movies that get it right are still too few and far between. We can’t afford to overlook the rare, inclusive, and comprehensive portrayals of mental health conditions. In other words, someone, please, bring back One Day At A Time!
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