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:

Establishing Dr. Gallager from Generic Prescriptions on Vimeo.

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:

Medical Deities from Generic Prescriptions on Vimeo.

… 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:

He's gonna need drugs from Generic Prescriptions on Vimeo.

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.

Elective Mutism, Conduct Disorder from Generic Prescriptions on Vimeo.

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!

Conner's Diagnosis from Generic Prescriptions on Vimeo.

“There is no cure, as such”

There is no cure, as such from Generic Prescriptions on Vimeo.

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

You can't ignore the symptoms from Generic Prescriptions on Vimeo.

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].

2 Responses to “Mad Men, Women, and Children”

  1. PipeBomb
    October 14th, 2009 | 9:57 am

    With the mainstream movement happening with mental health seems to be more for the benefit of pharmaceutical sales then actual patients. As it was proclaimed in the ABC Outsiders program that viewed about mental health ‘depression should be seen as sexy and popular as erectile dysfunction’ (paraphrased). Knocking down the wall for people to talk openly about mental health is a good thing, but this movement I believe is just clearing the forest so big pharm can build a new market. There is no talk of any other solutions to mental health but medications.

    I am a combat vet from the Gulf War (Desert Storm) and I’m currently on a voluntary team helping returning vets from Iraq and Afghanistan now. Many of these people are being diagnosed with Post Traumatic Stress Disorder and the automatic response is to give them drugs. There is no guidance on how to handle nightmares or flashbacks of battle, just drugs. Drugs that alter the mind are giving to these people and sent back to their families to try to live the way that they were before the war.

    I am finding that the majority of these people just need someone to talk to and have a place to express their feelings and frustrations. They have a lot of bottled up stress and need to vent it out. The drugs just numb them to it so they never really face the issues. What is going to happen 20 or 30 years from now when these guys are no longer taking the drugs and one night all of the horrors of war reappear to them? They’re not going to have the tools that they need to cope with the issues.

    Drugs are not a solution for everyone. People need to know what other options there are so they can find what works for them. With just about every other medical issue out there, we are given choices to make, meds, surgery, radiation treatments, and the list goes on. Why are we forced into only one treatment for mental health? Why are we not even told that there are alternatives? We have to keep these things in mind when they are trying to feed us the hype by big pharm.

    Member of The Icarus Project

    P.S. Thank you for bring up this issue and I like your take on it.

  2. Susan Gurney
    December 13th, 2010 | 8:31 am

    Could we work for a law that all interactions between examining admitting psychiatrists
    and involuntarily committted patients are video-taped and free to be accessed under the
    freedom of information act?
    Thanks, Jonah,

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