DENNY CRANE calls it "mad cow," but viewers of "Boston Legal" know William Shatner's character is in the early stages of Alzheimer's disease. Another character on the show, Jerry Espenson (played by Christian Clemenson), has strange tics, can't keep his hands off his thighs, but, despite having obsessive-compulsive disorder, makes his living as a lawyer.
Mental illness, long taboo or distorted by the media, is making its way into the fictional lives of television characters. Once, mentally ill people were commonly portrayed as homicidal maniacs, evil seductresses and assorted buffoons. Sometimes, they are still. But they are also lawyers, doctors, mobsters and detectives -- not always lovable folks, but increasingly understandable human beings.
The shift in television characterizations might be a result of pressure from groups such as the National Alliance on Mental Illness, which sends out monthly newsletter alerts praising or panning entertainment portrayals of mental illness. Or maybe it's the fact that more than one-fourth of Americans, according to the National Institute of Mental Health, suffer from a diagnosable mental disorder every year. No doubt, a lot of Hollywood insiders can relate.
The more accurate portrayals might even be because creative folks are getting tired of the same old stories. "It's become cliched, the crazed gunman, the mad flasher. And cliche is anathema to writers," says Barbara Demming Lurie, director of the Mental Health Media Partnership. "Many shows have taken the cliche and turned it on its head."
Who wouldn't like a detective who compulsively avoids stepping on cracks, yet solves every case thrown his way? Adrian Monk, played by Tony Shalhoub, is a detective on the crime comedy "Monk" whose mental illness is not a back story. It's the story. "It's integral," says the show's executive producer, David Hoberman. "The idea was that a brilliant detective has severe OCD and phobias. That was the pitch. Despite himself, he is able to solve a case every week." Without Monk's OCD, there would be no show.
Sometimes, an accurate portrayal can point to a difficult reality. Mental illness carries a stigma that can force secrecy. That was shown to be true even at the highest levels when President Bartlet (Martin Sheen) on "The West Wing" called for the services of a psychiatrist. The therapist sneaked into the White House with a code name and a cover story, because even fictional politicians can't admit to needing mental health counseling.
But psychotherapy got a boost when mobster Tony Soprano sought treatment for panic attacks. Lorraine Bracco, who plays Dr. Jennifer Melfi, his therapist on "The Sopranos," showed Freud's talking cure as it actually happens -- weekly, over a period of years. It was so accurate, and so long-awaited by the much-mocked profession, that the American Psychoanalytic Assn. invited her to speak at its 2001 annual meeting. Hundreds of psychiatrists and psychologists gave her a standing ovation.
When the drama "Cold Case" incorporated a character with schizophrenia, Lurie assembled 14 writers and four people with schizophrenia, and they talked for four hours. "The writers asked a lot of questions," she says. " 'What do the voices sound like? What are they telling you?' "
Truthful portrayals of mental illness and its treatment may be getting better, but television still has a long way to go. Prime-time television overestimates the occurrence of violence in people with mental illness by a factor of 20, according to a 1997 study in the Journal of Community Psychology. Such portrayals have an effect, according to a 2002 study in the Journal of Mental Health Counseling. Researchers found a correlation between hours of television watched and intolerance toward people with mental illness.
Despite recent infusions of realism, it's still often true that when people with mental health problems are not being murderous on the tube, they're punch lines. "Since 2000, the industry has been improving. But just when we think there's been a breakthrough, something bizarre or awful gets put on the air," says Bob Corolla, director of media relations for the National Alliance on Mental Illness.
Among the recently awful, according to NAMI, was the sitcom "Crumbs," in which the character played by Jane Curtin, after a failed suicide attempt, is released from a psychiatric hospital only to become the ongoing butt of her family's jokes.
"The problem is, television doesn't accurately portray the pain and suffering (of mental illness) for the person, family, co-workers and friends," says Daniel Reidenberg, executive director of Suicide Awareness Voices of Education. "Rather, the illness gets portrayed as comedic -- people looking for attention."
The trick in doing a comedy with mental health issues, Hoberman says, is to respect the character. "I'm thrilled that there's a proliferation of shows dealing with imperfect human beings," he says. "The more we can portray damaged people as heroes, the better off we'll all be."
If a guy like Monk can make it through the day, and capture the bad guy to boot, just think what any of us might do.