Mad Men, Women, and Children

This season Fox premiered a new television series called Mental (this post has nothing to do w/ AMC’s fabulous Mad Men):

a medical mystery drama featuring Dr. Jack Gallagher, a radically unorthodox psychiatrist who becomes Director of Mental Health Services at a Los Angeles hospital where he takes on patients battling unknown, misunderstood and often misdiagnosed psychiatric conditions. Dr. Gallagher delves inside their minds to gain a true understanding of who his patients are, allowing him to uncover what might be the key to their long-term recovery.

The show’s format (very) closely resembles the hit TV show House, except that Mental is set in a nuthouse. The show has received lukewarm reviews and mediocre ratings, but very well might get renewed. Mental health consumer advocates like (pharma funded) NAMI have not reached a consensus on how to respond to these pop culture representations, and even the some of the radical Icarus Project’s membership were (initially) impressed by the show’s message.

While this show might seem innocuous, it really deserves a careful, critical analysis. We seem to be approaching a turning point in perceptions around altered states, as powerful marketing forces are hard at work working to remove the stigma around mental “illness”.  Brittany Spears was the unpaid celebrity spokesperson for the normlization of psychiatric crises, but Glenn Close will soon be leading up the BringChange2Mind campaign.  Don’t get me wrong — removing stigma is generally a good thing, but if the stigma is removed in order to increase the legitimacy of pharmaceutical treatments, the message (and outcome) is mixed.  We are all dying, sick and crazy.

I am reminded of a fantastic book I read last year called Freaks Talk Back: Tabloid Talk Shows and Sexual Nonconformity.  In this work, Joshua Gameson examines hundreds of hours of trashy talk show footage from the 80′s and 90′s – Ricki Lake, Montell Williams, Phil Donaue, Jerry Springer, the works. During the period examined, LGBT guests were featured regularly on these shows, amongst some of the first representations of gay people in mainstream popular culture.

Gameson closely studies the controversy around these appearances. On the one hand, the guests were not always portrayed in the best light (to put it mildly). These shows thrived on sensational confrontations and humiliating storylines. On the other hand, alternative lifestyles were being featured and discussed on national television, and beamed into living rooms across the country. Is there ever such a thing as bad media?

What Gameson teases out of his exhaustive study are the subtle underlying ideologies these encounters embody. While homosexuals were often defended by the talk show audiences, trans and bi guests were often vilified.  He makes a convincing case that these shows endorsed monogamy and static identities, but were decisively hostile towards alternative lifestyles and choices that veered from these mainstream values.

Our critical “Mental” challenge is all about trying to tease out the underlying ideologies and unquestioned assumptions that permeate the storylines in this series. On the face of it, Mental offers a diverse range of voices and perspectives — from financially-motivated hospital administrator, to the confrontational interns, to the purportedly radical director – Mental gives watchers the impression that the mainstream is being represented, and challenged.

Consider Dr. Galleger’s establishing introduction:

He certainly seems like an alternative psychiatrist, who will do anything to help his patients. He even goes on to insist that patients participate in the staff meetings:

… a device that disappears immediately after its introduction. It doesn’t even come up in later meetings in this pilot, never mind later in the series. Here is the next meeting, where the shows truer colors begin to shine through – Drugs for life, no hope of a cure, and the problem lies with pharmas old drugs, like Haldol, but their new miracle treatments are a panacea:

The rubber really hits the road in S01E04 (Manic at the Disco) — about a young boy named Conner who is eventually diagnosed with pediatric bipolar.

The attending staff discuss Conner’s case and authoritatively toss around dozens of diagnoses, never questioning the legitimacy of pediatric bipolar — a diagnoses that is currently hotly debated, and does not (yet) even exist in the DSM!

“There is no cure, as such”

and of course, “you can’t ignore the symptoms.”

The decisive “evidence” of a broken brain was a brain scan – a technique which is highly controversial, profiled in the Frontline investigative piece The Medicated Child.

So much for alternative psychiatry.

Don’t get me wrong, I am in favor of treating people instead of bodies, but the psychiatrists on Mental still treat brains instead of minds.

I’m not sure if this kind of publicity is fooling anyone, but I am afraid it is. As folks like smartmeme describe, narratives are often far more persuasive than stats, facts, or logic.

We need to keep a close watch on shows and campaigns like these, that implicitly establish a baseline acceptance of disorders and treatments when there are vibrant alternatives to consider. People cannot make informed choices about their mental health if the questions they are deciding are deceptively framed. Mental is far more insidious than its seemingly innocuous plotlines and banal characters suggest.

[For more critical clips from Mental S01E01 and S01E04 see GenericPrescriptions].

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