Are US TV shows worse than UK shows when it comes to storylines around mental health issues?

US shows reduce mental illness to a spectacle and define characters solely by their illness while UK shows seem to depict real human beings struggling with a disorder
Netflix's 'Ratched' and HBO's 'I Know This Much is True' (Netflix/ IMDb)
Netflix's 'Ratched' and HBO's 'I Know This Much is True' (Netflix/ IMDb)

Fall television usually beckoned with a smorgasbord of shows as network shows came back from hiatus and spoiled us for choice. But with the pandemic, the glut of shows has narrowed to a trickle, leaving it to streaming services to keep us entertained as the second wave of Covid-19 spreads across the globe. One of the heavy hitters, coming this September, is Netflix's 'Ratched' based on the "Nurse Ratched" character in 'One Flew Over the Cuckoo's Nest'. As the pandemic sees mental health issues soars, 'Ratched' is an interesting reminder of how mental health has often been depicted on US TV shows and films. 

The Netflix show sees Mildred Ratched arrive seeking employment at a leading psychiatric hospital in 1947 "where new and unsettling experiments have begun on the human mind". The initial trailers and photographs see patients being dipped in ice baths and being medicated — all practices (including the lobotomy shown in the original film) were the norm not so long ago.

The show's look and feel seem to emphasize the horrors hidden within the brightly colored and cheerful mint green interiors of the psychiatric facility. Undoubtedly, the show will also show patients at the facility having breakdowns and other such histrionics — quite similar to how characters with mental health issues have often been reduced to spectacles — the 'side freak show' to the main storyline in many US shows.

Even more 'serious' attempts like HBO's 'I Know This Much is True' defaults in showing a more extreme form of mental illness. Thomas, one of the twins, is schizophrenic and is never shown as stable or speaking clearly or making sense despite the fact that schizophrenic patients can appear normal and speak coherently, even if they are "hearing voices" which they are trying to ignore.

Mark Ruffalo as Thomas in 'I Know This Much Is True' (HBO)

In the very first episode, we see Thomas hacking off his hand publically in a library in front of an audience. This self-mutilation is served up as a spectacle again and even in the scenes that follow in the hospital, the psychotic break is depicted in a gory and triggering way. But the truth is that even though there is a clinical correlation between violence and schizophrenia, a great majority of patients with schizophrenia have never been violent in their lives. 

With depictions like these being the norm on US TV, we have forgotten to expect better. But August also brought us a glut of British shows, thanks to Hulu's 'The British Binge-cation'. Two shows from the line-up, 'In My Skin' and 'Brassic' also dealt with mental illness, and both were drawn from real life, so to speak. 'In My Skin' writer and showrunner was Kayleigh Llewellyn, who based the story on her own experiences growing up with a mother who had manic episodes that were so severe that she was sectioned at the local mental health facility.

At no point does Llewellyn's writing and conception make a spectacle of the character of the Mother, which makes you empathize with her rather than distance yourself as the "sane" viewer. But she also doesn't sugarcoat what it is to be a teenage caregiver to a mentally ill parent. It has authenticity, without the spectacle, unlike US shows.

Similarly, co-creator and star of 'Brassic', Joseph Gilgun (who US audiences will recognize as vampire Cassidy in 'Preacher') has said that his character’s bipolar disorder is all based on his own real-life experiences. In an interview, Gilgun revealed that he "wanted to be very, very honest… and make it as autobiographical as I possibly could", explaining that the "mental health side of things is the most honest part of the show".

Joseph Gilgun in 'Brassic' (IMDb)

Touted as one the best UK shows this year, Gilgun's character Vinnie is a career criminal who has a co-dependent friendship with Dylan. While Vinnie's crew gets up to all kinds of illegal capers, the show also casts an unflinching look at the reality of Vinnie's bipolar disorder that sees him "down in the dumps" one minute and "f***ing up" in the next. But at no point is Vinnie defined by his diagnosis, even as he struggles. While the disorder is a constant part of him, it is not all that he is. This is the biggest difference between US and UK shows. US shows reduce mental illness to a spectacle defining characters and their behavior solely by their illness when the opposite is true. 

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