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TV Creators Tackle Mental Health

Specificity can be key to portraying serious issues in skeins

Although debates about gun control gained more traction in the wake of shootings at a Newtown, Conn., elementary school in December, the issue of mental illness also re-entered the public conversation. In primetime, mental illness has been in the mix of social issues showrunners address head-on in serious dramas.

“There are still shows that focus simplistically on making ‘crazy’ people violent or comedic,” says Dr. Carole Lieberman, a media psychiatrist who’s also been a consultant on TV shows, including daytime soaps “The Young and the Restless” and “The Bold and the Beautiful.” “Other shows make the effort to go beyond the stereotypes and create characters with specific mental illnesses.”

Lieberman says symptoms don’t appear out of nowhere, and TV shows that explain how they developed — in childhood trauma or through specific adult experiences — paint a more realistic picture.

Former “Homeland” writer Meredith Stiehm says she read popular and medical literature about bipolar disorder, an aspect of the show’s Carrie character (Claire Danes). Stiehm also attended a symposium at Princeton and spoke with Kay Jamison, a Johns Hopkins professor and leading expert on bipolar disorder.

“I feel a lot of responsibility about it,” says Stiehm, who co-wrote “The Vest,” a first-season segment in which Carrie experiences a manic episode. “I ended up doing the research, and I’m pretty interested in it. I know a lot about it — I have it in my family so by default, I became the de facto expert on Carrie’s bipolar disorder.”

Psychiatrist Dr. Eric Hollander of New York’s Montefiore Medical Center praises Homeland for mostly getting its depiction of bipolar right.

Claire Danes did a terrific job in terms of depicting what it’s like for someone with bipolar disorder in a pretty realistic fashion,” says Hollander, “and showed a pretty broad range of symptoms, from mild hypermania to full psychosis.”

His only criticism was the way the show portrayed electroconvulsive therapy at the end of season one.

“When people have ECT, they’re given a muscle relaxant, so essentially they’re asleep,” he says, “and the only way you can see somebody having an induced convulsive seizure is small movements in their fingers or toes. They wouldn’t appear to be having a full seizure, but I can understand why they did that to dramatize that she was having ECT.”

Hollander also praised NBC’s “Parenthood” for its depiction of an adolescent with autism spectrum disorder, as seen in the character of Max Braverman (Max Burkholder). Parenthood exec producer Jason Katims says he was inspired to include a character with autism because of his own experience with his 16-year-old son, Sawyer, who is on the autism spectrum.

“I didn’t have any kind of noble reasons behind (including the character),” Katims says. “I did it because when I was coming up with the pilot episode of ‘Parenthood,’ I was trying to explore things I felt were relevant today.”

Katims adds that he’s happy more TV shows now identify characters with autism, rather than just present the characteristics of autism without naming the disorder.
“Television in general is getting much more sophisticated,” he says. “It not only allows for you to be more accurate when exploring issues of mental illness, it demands it.”

Carlton Cuse and Kerry Ehrin, exec producers of A&E’s “Psycho” prequel “Bates Motel,” independently asked doctors about the Norman Bates character and what Norman could be suffering from, and both heard the same condition: dissociative identity disorder. The show has yet to diagnose Norman with that degree of specificity — a recent episode featured school authorities expressing concern about Norman’s “emotional instability” — but it could happen “maybe way downstream,” Cuse says.

“It would have to come from a doctor,” he notes, “and it’s so much the story of people who aren’t dealing with doctors, so I don’t know if it would happen. But the way we’re writing it is dissociative identity disorder.”

To balance an accurate portrayal with dramatic license, “Bates Motel” producers break their stories first and then consult with a medical authority.

“If we were doing ‘ER’ or ‘Chicago Hope,’ we would need to be held to some standard of medical veracity,” Cuse says. “This is a fictional show, and I think we’ve given ourselves an enormous amount of license to make the story play. Norman Bates is based on a character in a movie that was taken from a book that was based on a previously existing serial killer, so we’re now four steps removed from that. Right now our concern is about making Norman Bates a compelling character. That’s far more important to us than telling a medical story.”

“That being said,” Ehrin adds, “we do try to have some semblance of reality for the symptoms of the disorder and how it works. It’s not like we’re just making up stuff.”

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