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Better Practices

for Considering Mental Health When Portraying Challenging Topics

Got a project containing sensitive themes or subject matter?

Feeling unsure about how to support your team and audience?

This guide is for you!

Below you’ll find a list of themes, depictions, and onset situations which may warrant specialized considerations and support. By following our recommendations for these interventions, you’ll be enhancing your performance and production quality while lessening the negative impact on your cast, crew, and viewers. We’ve found the use of these supports not only provides for more accurate, authentic, and meaningful storytelling but also increases the efficiency of production.

Always disclose the content fully, specifically, and at the beginning of any process.​ You might refer to a content note guide (available from AMHC), or work with another professional to do this.

Be authentic to ethical and accurate representation as outlined by mental health professionals, medical professionals, and those with lived experience. Avoid relying on damaging stereotypes and depictions instead of seeking authenticity.

 

Don’t fall for the “generally crazy” tropes: do your research! Reach out to advocacy organizations and those doing work with portrayed experiences. They are a great resource. 

Assume that there is lived experience in the room, and treat the material with respect, dignity, and care. Choose language intentionally both on and off camera: from call sheets to final cuts. 

 

For example, doing your research beforehand and presenting appropriate language to the creative team will help avoid titling scenes, “the crazy scene”, or labeling a shot list with “Character goes psycho”. 

Integrate care & support across the project from start to finish. 

Using access surveys, concern navigation pathways, adequate break times, and disclosing rehearsal or shooting content are just some of the ways to integrate care and support across the process. 

Allocate more time for scenes that depict challenging material: this will alleviate some of the pressure in crafting these stories. 

Finally: we invite you to consider prescriptive behaviors.

Research shows that more than one in four Americans has a mental illness (Johns Hopkins Medicine, 2019), meaning one in four of us (our audience and our creative team) might be extra vulnerable to prescriptive behaviors. Prescriptive behaviors mean that someone experiences depiction of risky or harmful behavior in a specific way that psychologically primes them to engage in that behavior and/or thinking pattern. For example, systematic reviews have found overwhelming evidence that portrayal of suicidal behaviour in the media may have potentially facilitate suicidal acts by people exposed to said media (Hawton, 2002).  


Fortunately, prescriptive behaviors can also be a force for good! Prescriptive behaviors can also help people understand how to seek help, use coping skills, or talk to loved ones about their experiences (Niederkrotenthaler et al. 2010). For example, when working on a project which includes depiction of an Eating Disorder, consider showing characters asking for help, engaging in treatment, and recovering. Research shows viewers can learn about their own capacity for healing by observing others’ journey. Your project could be an opportunity for so much good when you consider prescriptive behaviors that support health and wellbeing.

Topic Breakdown

Below is a list of content types which could warrant additional support in creative spaces in the form of a collaborator or a consultant. Please note that some topics require even further expertise.

 

Content Notice: This list contains academic and philosophical discussion of dozens of distressing topics, and words are spelled out in their entirety in order to address appropriate content disclosure. Some umbrella topics include mental illness, trauma, violence, identity motivated violence, suicide, sexual assault, suicide, discrimination/bigotry and death.

Intimacy and Relationships:

  • Nudity - Intimacy Coordinator

  • Intimacy/Simulated Sex - Intimacy Coordinator

  • Simulated Non-Consensual Sex Acts - Intimacy Coordinator who specializes in this portrayal or IC and Mental Health Coordinator

  • Sexual Violence -  Intimacy Coordinator and Stunt Coordinator/Fight Director who specializes in this portrayal while assessing for the need of a Mental Health Coordinator

  • Domestic/Intimate Partner Violence - Intimacy Coordinator and Stunt Coordinator who specializes in this portrayal or Stunt Coordinator and Mental Health Coordinator

Mental Health and Emotional Well-Being:

  • Death/Grief/Loss - Assess for the need for a Mental Health Coordinator (Is there a minor involved? Is someone onset actively grieving or experiencing trauma in their lives? Are there pre-existing mental health concerns or communication difficulties among cast/crew? Has someone requested additional mental health support for the project?)

  • Death/Grief/Loss of a Child/Infant- Mental Health Coordinator 

  • Depiction of Mental Illness/Crisis - Assess for need Mental Health Coordinator

  • Suicidal Ideation/Suicide - Mental Health Coordinator

  • Portrayal of Addiction - Mental Health Coordinator

  • Overdose- Mental Health Coordinator

  • Simulated Substance Use- Assess need for Mental Health Coordinator 

  • Self-Harm/Non-Suicidal Self-Injury - Mental Health Coordinator

  • Minors Onset - Mental Health Coordinator

  • Bullying/Harassment- Asses need for Mental Health Coordinator 

  • Depiction of Birth, Breastfeeding, Abortion, or Birth Trauma - Intimacy Coordinator who specializes in this portrayal, Medical Consultant, and Mental Health Coordinator if needed

  • Portrayal of Disordered Eating - Mental Health Coordinator

  • Shooting/Threat of Mass Shooting - Mental Health Coordinator

  • Child abuse- Mental Health Coordinator 

  • A cast or crew member whose real-life experiences are mirrored by the project (i.e., pre-existing mental health concern, trauma, disordered eating, etc.) - Mental Health Coordinator

  • Intensely Vulnerable, Hyper-Exposed, Emotional Moments - Assess for the need of a Mental Health Coordinator

  • Intensely Vulnerable, Hyper-Exposed, Emotional Moments for Minors- Mental Health Coordinator

  • Depiction of Panic Attack- Assess the need for a Mental Health Coordinator

Violence and Trauma:

  • Abuse or Death of an Animal - Assess the need for a Mental Health Coordinator

  • Use of Prosthetics Attached to a Performer’s Body- Assess for the need of a Mental Health Coordinator, Disability Specialist 

  • Substance Use - Assess for the need of a Mental Health Coordinator

  • Blood - Assess for the need of a Mental Health Coordinator

  • Torture - Assess for the need of a Mental Health Coordinator, Stunt Coordinator

  • Stalking - Assess for the need of a Mental Health Coordinator

  • Police Brutality/State Violence - Reps on Set, Cultural Consultant, and/or MHC

  • War- Assess need for Mental Health Coordinator

  • Kidnapping/Abduction - Assess for the need of a Mental Health Coordinator

  • Use of a Theatrical Firearm/Prop Gun - Armor, Gun Wrangler, Assess for the need of a Mental Health Coordinator (considering potential secondary trauma)

  • Use of a Prop Weapon - Assess for the need of a Mental Health Coordinator, Stunt Coordinator

Cultural and Social Themes:

  • Anti-Semitism - Cultural Consultant and/or Mental Health Coordinator

  • Religious Abuse or Trauma (Weaponization of Religion) - Cultural Consultant, Reps on Set, and/or Mental Health Coordinator

  • Racism - Assess for the need of a Mental Health Coordinator or a resource like Reps on Set

  • Ableism - Cultural Consultant, assess for the need of a Mental Health Coordinator

  • Hate Crimes - Cultural Consultant, Reps on Set, and/or Mental Health Coordinator

  • Fatphobia- Assess need for Mental Health Coordinator 

  • Trauma associated with the trans*, nonbinary, or other gender expansive experiences- Reps on set, assess need for Mental Health Coordinator

  • Discrimination- Cultural Consultant, Assess need for Mental Health Coordinator

  • Abuse of someone of a marginalized identity - Cultural consultant, reps on set, assess for need for Mental Health Coordinator

Medical and Health-Related Topics:

  • Medical Trauma, Crisis, or Abuse by a Medical Professional - Both Medical Consultant and Mental Health Coordinator

  • Setting of the Story in a Therapy or Mental Hospital/Institution - Mental Health Coordinator or Consultant

  • Blood - Assess for the need of a Mental Health Coordinator

  • Mental Health Treatment- Assess for need of mental health coordinator 

Not sure if your project needs additional support?

That is okay!

The Association of Mental Health coordinators offers FREE 15 minute consultations on your project to help you decide on the support that you need.

CLICK HERE to get started.

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