Mental healthcare in fiction

[DokiDokiTsuna]

Note the specificity in the title: I'm not just talking about fictional characters with mental health issues (which is like 75% of all fiction anyway ^^; ) I'm talking about fictional characters who actually seek help with their issues, or give that help to others, as a significant part of the plot.

What are the pros and cons of depicting this subject matter? Which stories do you think do this particularly well, or poorly? How do you tackle it in your own stories?? I will be listening and taking notes

I'm bringing this up because I recently started rewriting a story where the first half inadvertently turned into a "superhero/villain mental hospital" concept, which is SO surprisingly unique and intriguing that I'm seriously considering reworking the rest of the story to lean into it further. It's ridiculously fun; I don't think I've ever read or heard of a story that did anything like this.
Like, actually focusing on the therapy aspect and the emotional journeys of the characters; how they feel about their self-images and loss of autonomy; what they choose to show or hide during therapy in order to protect themselves...how much of their "therapy" is actually propaganda concerning their 'proper place' in society; whether or not they realize this, how this might possibly relate to therapy IRL...

...y'know, as opposed to just doing edgy 'insane asylum' schtick. And I am doing a little of that; I'm not better than anybody (¬‿¬) But there's so much more that I want to explore...

Anyway, to answer the other part of the prompt, I got some shows that have definitely already influenced me in this endeavor:
For instance, there's Undone (rotoscoped animated series starring Rosa Salazar; it's really cool and you should watch it), which approaches the topic of schizophrenia from pretty much every possible angle. ^^; And although Season 2 focuses more on the fantasy story-driven aspects of the plot, it also includes a stark look at what mental healthcare was like during much of the 20th century. Yeah, it's just a third of a single episode, but it's done really well, and its placement in the story gives it a feeling of tension that's just ~chef's kiss~ perfect. I have a feeling Season 3 will be a textbook example of what I'm looking for in this thread; I really hope they're working on it...

There's also Nikita (non-animated series in a totally different genre starring Maggie Q; it's also really cool and you should watch it) which is probably influencing my writing much more heavily. The way the antagonists approach desperate young people and mold them into loyal agents through training and "therapy", teaching them to find strength and self-actualization in their ability to complete difficult missions; exploiting their weaknesses, fears and traumas in order to control them, while presenting themselves as saviors, guardians, teachers, parental figures...it's great. ^^ A little campy, but solid character writing.

Because, as you might have guessed, I'm going for a 'toxic therapy' angle in my own story, the second example is much more relevant to the writing of my own antagonists. But the first example, showing how people can struggle with severe mental illness while still being relatable main characters, has helped a lot in the writing of my own MC's; I don't think the story would be the same without that influence.

Besides, I don't want to make the issue black and white...although it will be difficult, I'm striving towards an angle where the characters realize they were being manipulated and psychologically tortured, but still take some of the lessons they learned in "therapy" with them, recontextualizing them in a non-toxic way. Like, learning to open up to others, be vulnerable, analyze your thoughts and behavior...those are legitimately good things to do when you don't have an abusive authority figure trying to use them to brainwash you. ^^;

[BoomerZ]

This really comes down to are you writing this for yourself or for an audience? This is very niche and the audience I don't think is there. Have a character with a illness might work, but it usually can't be the actual plot or most audiences will never relate to it. Fight Club is a story about a guy with a severe mental issues, but it's not about that. I think this can be a side plot of characteristic of a character, but an entire story about it won't be compelling to a large crowd.

[annuskabriar]

honestly, i can barely even think of fiction with a focus on mental health treatment. the show Lucifer has the main character, Lucifer, go to therapy, and i think its presented okayish - its definitely presented positively, which i appreciate, but Linda frankly is not a good therapist. highly unethical lol. i dont think theres an issue showing bad therapy, and bad therapists, but i think the problem is when that bad treatment is treated (pun not intended) as being good within the fiction.

i dont really have characters in my comic that go through mental health treatment - or many characters in general (during the plot at least) - because their behaviours would change and would no longer push the plot in the same way. I mean, if the protagonist of my comic, Gray, went to therapy growing up, she probably wouldn't have gone to juvie! thats a big part of her character. and thats just one example; if they were regular, functioning people, the plot just... wouldnt be plotting. but i do, in another story (my main story - unpublished atm) have some characters who either go get treatment after the plot is done, or in some cases, during the plot. with them, its usually part of their character arc, in one case part of a characters redemption arc, and i try to portray the mental health field as realistically as possible in that regard. its not the main part of the plot, but rather an aspect in their character arc.

[BoomerZ]

sopranos had that same beginning.

[DokiDokiTsuna]

This is very niche and the audience I don't think is there.

...Do you ever give reasons for these "criticisms", or is originality all it takes for you to shoot down an idea...? I start these threads to talk to fellow artists about art, not to talk to marketing executives about my chances of success with the consumer base.

Like, for future reference, just pretend that I AM writing all these things 'for myself', if that's what you need to believe in order to actually analyze an idea and give a thoughtful response. Just say what you would say in that specific case. If anything...

I mean, if the protagonist of my comic, Gray, went to therapy growing up, she probably wouldn't have gone to juvie!

That's actually one of the ideas I want to deconstruct: contrary to popular belief, therapy doesn't magically fix people and erase any negative behaviors. Like, maybe she wouldn't have gone to juvie...but maybe she still would have. :T It happens every day. Plenty of people go in and out of therapy relatively unchanged; some people even come out worse.

It depends on so many factors-- the quality of the therapist, the strength of their relationship with the patient and their mutual trust, whether the patient actually wants to be changed, whether their environment/living situation allows for meaningful change.

That isn't to say that it's a pointless thing to build a story around; just that it can coexist with conflict and enhance the plot, just like any other professional relationship in fiction.

[BoomerZ]

Like, for future reference, just pretend that I AM writing all these things 'for myself', if that's what you need to believe in order to actually analyze an idea and give a thoughtful response. Just say what you would say in that specific case. If anything...

In the future I'll just ignore you, it's easier than trying to have a conversation with you.

[annuskabriar]

That's actually one of the ideas I want to deconstruct: contrary to popular belief, therapy doesn't magically fix people and erase any negative behaviors. Like, maybe she wouldn't have gone to juvie...but maybe she still would have. :T It happens every day. Plenty of people go in and out of therapy relatively unchanged; some people even come out worse.

I say that because I know the specific issues causing her to have acted out on, and I definitely agree that it isnt a magic fix - I'm severely disabled, including psychologically, and have been in mental health treatment for yearsss with little improvement! but in her case, a good therapist would have helped her, while not fully fixing her issues, in manners that would have given her a way to avoid to juvie, basically

also, for what its worth, i think there'd be people interested! even niche stories get audiences, aha

[vapidink]

Thinking about it, I can't really come up with any stories that deal with mental health. At least not in a realistic way where that's the focus. A lot of media is more or less about characters who have mental health issues but deal with that by becoming a vigilante or solving mysteries. Reminds me of Dexter and how he channeled his murderous instincts. So yeah, not the best representation, lol.

One of my old stories is actually about depression and loss, and while I haven't experienced a great loss I based a lot of it on my depression. It's mostly a commentary on the way society and those we love--and who love us--often push us to be happy because they have a very shallow understanding of what depression is. Basically, I'm tired of the tropes of love curing depression, therapy being a fix-all and forcing yourself to be happy being the solution to depression.

So, in the story there's a fantastical aspect to it, but at its core it's about finding our own ways to grieve and move on. I wanted the MC to accept themselves as they are in the end and recognize that they aren't okay but that they will be with time. Kinda take that big step forward without being magically cured by the end.

[cherrystark]

I have only seen a few instances of mental healthcare in fiction that's actually interesting. The first one was Harley Quinn in "Birds of Prey" from the early 2000s. She's using her practice to manipulate Batman and Catwoman's daughter and be a front for her criminal empire. Harley is also trying to get revenge on the Batfamily for Joker's demise. It's pre-Smallville and the OG Alfred reprises his role from the Tim Burton Batman movies. It's campy, but great. She's honestly far more interesting in that show than she has been in many of her current incarnations.

From my own work, I have a character who is a licensed psychiatrist, but she's also a former conwoman who has mind control powers.

I know this goes off topic, but I'm kinda tired of seeing mental healthcare representation in fiction. Don't get me wrong, if you want to write about a character with a mental health condition finding love or a character who has to attend court-mandated therapy to do their job - write it.

I am tired of mental health conditions as character traits. For example, if a writer wants an easy way to make a character relatable, they have anxiety and or depression. It's almost always that they get nervous and sad sometimes, so they don't go out for X thing they want. No one nails depression the way Stephanie Meyer did in "New Moon" or how debilitating anxiety can be. Or they go for the classic "I have nightmares so I drink alcohol." There's also the classic, "Here's a list of conditions I have, so I'm strong."

As a reader, I'd rather be "shown" a character realistically living with the condition and having to adapt. There's a version of Sherlock Holmes I adore where he's openly autistic with ADHD. The show perfectly captures all the nuances of those conditions without ruining the character or trying to rip-off Cumberbatch. Give me characters like him, Mr. Monk, or even Shaun Murphy who are multi-faceted characters over Character Name who has XYZ conditions.

[LunarScyphozoa]

Not everything is meant to be compelling to a large crowd, ever hear of making art for fun, or cult classics? Lots of stories don’t have large audiences, most really good stories don’t appeal to most people. Also:

most audiences will never relate to it

Relatability is not the be all end all of what makes something compelling. If you think someone needs to be relatable to be an interesting character, you’re just wrong and I’m sorry. There’s lots of stories meant to be highly marketable with a huge audience, the concept that @DokiDokiTsuna is describing is clearly not meant to be one so “This isn’t relatable and doesn’t have broad appeal” is like complaining about a lack of cheese in a vegan restaurant.
Also, “most audiences will never relate to it” and what about the ones that do? Why can’t they have a story for them? There’s a million stories for everyone, and barely any that touch on this subject matter. Why is one audience considered less important just because they’re smaller?

[jwabeasley]

Your angle sounds fine, while I think there has been a lot of crossover between superhero stories and mental asylums (thanks, Batman), usually therapy is either an excuse for a single-character deep dive or it's a vehicle for the story to be told via flashbacks or something along those lines rather than the mental health journey itself. That could be fine, having never officially gone through therapy or been a therapist (my exposure to that kind of thing is only online pop-therapy) I don't know how a compelling narrative would be constructed, or at least one that would be as entertaining as a character working out their issues via punches.

What gets my goat lately in media is an over-reliance on therapy speak, especially by characters who have no access to therapy-type resources (like they're medieval fantasy people, or they're from a background where mental health access is unlikely) and to the exclusion of other ways of processing or talking about feelings, like via religion or occultism or art or even punches. Not that melee combat is effective for working out mental issues IRL, but it sure is entertaining in a comic.

That and it seems like everyone on the internet is some combination of depressed/anxious/ADHD/etc. and I've found comics that focus on depression or social anxiety to be tiresome and repetitive. I get it already, you're afraid of leaving your tiny bedroom or talking to people or doing literally anything! Hikikomori wish fulfillment seems like it's becoming it's own genre.

[DokiDokiTsuna]

In the future I'll just ignore you, it's easier than trying to have a conversation with you.

I asked you to just ignore me 2 years ago; and you still insist on being the first reply to many of my threads. So...you may want to review the definition of 'ignore', because you're clearly not doing it correctly...

I am tired of mental health conditions as character traits. For example, if a writer wants an easy way to make a character relatable, they have anxiety and or depression. It's almost always that they get nervous and sad sometimes, so they don't go out for X thing they want. No one nails depression the way Stephanie Meyer did in "New Moon" or how debilitating anxiety can be.

Hmm...so the main POV character for my own story is supposed to have pretty bad anxiety (oddly enough, I specifically wrote it to make her less relatable); I'd appreciate some tips if you got 'em. That's the first time I've ever seen someone present Stephanie Meyer as a positive example... ^^;

Also, “most audiences will never relate to it” and what about the ones that do? Why can’t they have a story for them? There’s a million stories for everyone, and barely any that touch on this subject matter. Why is one audience considered less important just because they’re smaller?

You worded that a lot better than I did 2 years ago

Your angle sounds fine, while I think there has been a lot of crossover between superhero stories and mental asylums (thanks, Batman), usually therapy is either an excuse for a single-character deep dive or it's a vehicle for the story to be told via flashbacks or something along those lines rather than the mental health journey itself.

See, that's exactly what I was thinking about when this story first started to take shape; Arkham Asylum and everything Batman's rogues' gallery has going on...the story even starts out as a couple of semi-narrated flashbacks.

It's when it started to grow beyond that, and I actually started to like the dynamic between the MC and her "therapist" that I felt like I'd struck gold. ^^ Like I said; there's just so much more to explore with the concept.

I get it already, you're afraid of leaving your tiny bedroom or talking to people or doing literally anything! Hikikomori wish fulfillment seems like it's becoming it's own genre.

It is basically its own genre, and one that I also hate, admittedly. ^^; But that's probably why I keep trying to play with it and morph it and do more interesting takes on it.

Probably my second 'struck gold' moment was getting to write this MC's self-destructive moments; I really enjoy setting up the usual "meet cute" "star-crossed-lovers" opportunities between her and her love interest and just watching her handily ruin every chance she gets. ^^; Like, not in a funny way; it's more like a sad way where she almost seems like she's being mean, even though she's clearly just overwhelmed by the pressure of talking to someone she likes, and trying to escape the situation. And by the way she acts, the things she ends up saying and the negative reactions of those around her, you can see how her condition is actually making her life worse and why she has such a poor self-image.

I think anxiety can be really interesting when you actually use it to portray a psychological dynamic; to illustrate clear avoidance of specific triggers for a specific character, rather than generic "sadness" or "unfairness" or general misanthrope.

[kyupol]

How I've portrayed mental health care...

School counselor...

Hospital where it's very impersonal you're just a number...

And of course, do it yourself...

[MelancholicOtaku]

I think if done correctly then mental health in stories could be beneficial. Perhaps the person reading said story takes the first step and gets help
For example my Mc has depression which I also have ,it’s sprinkled in and it’s not the main focus of my novel. Maybe a reader might get help because one of their favorite characters inspired them to do so.

[cherrystark]

Hmm...so the main POV character for my own story is supposed to have pretty bad anxiety (oddly enough, I specifically wrote it to make her less relatable); I'd appreciate some tips if you got 'em. That's the first time I've ever seen someone present Stephanie Meyer as a positive example... ^^;

I really don't have any aside from writing a person and writing their natural reactions to situations. To me, that's the best way to "show" a mental health condition. You won't make everyone happy with how you portray them, but at least, you're showing them as human. Accurate portrayals are important to me, especially with relatively "common" issues like anxiety and depression, because I have seen mean girls get their way because they have "anxiety" and girls who are stressed to the point of a breakdown in crowds be told to "suck it up and deal with it.".

As for Stephanie Meyer, I think people just love to hate her. Her work isn't bad and is fun in a pure campy enjoyment sense. Its far better than other stuff done in the vampire/werewolf/shifter romances.

[CarltonIsaac]

In the future I'll just ignore you, it's easier than trying to have a conversation with you.

My sentiments exactly. Been there.

[saejin]

I'm actually quite drawn to this style, and I find myself a little curious about your portrayal. I think the concept has a lot of potential to explore deeper themes. That said, I’ve noticed that many stories (whether novels, manga, manhwa, or comics exploring this) often lean heavily into angst or prolonged depictions of depression.

Personally, I’m more drawn to narratives that focus on evolution, like the steps one takes toward healing. There’s a bl manga called Ten Count by Rihito Takarai that explores OCD. It’s for mature audiences, but I think it handles the topic well. The main character follows ten steps in his recovery process and each one brings a deeper understanding of himself.

What I really find to be rich and meaningful is that slow unfolding, the learning, the overthinking, the delayed progress in the story. I’m more interested in that journey than in just watching someone be stuck in pain.