On Monday, the New York Times posted “To Fight Stigmas, Start With Treatment,” an interesting article about a semi-recent British reality show called “How Mad Are You?” As the title suggests, the show was about mental illness.

Very simply put, for one week “How Mad Are You?” grouped together 10 people – five with histories of mental illness and five without – and put them through a series of challenges designed to draw out mental illness symptoms.

At the end of the week, three experts in mental health – a psychiatric nurse, a psychiatrist, and a psychologist – were put through another kind of test: Identify the participants with mental illnesses.

Did they succeed?

Not really, according to Sally Satel, M.D., the writer Times article:

They could not. After watching hours of videotape, the experts correctly identified only two of the five people with a history of mental illness. And they misidentified two of the healthy people as having a mental illness.

The point was made: even trained professionals cannot reliably determine mental illness by appearances alone.

That’s interesting stuff, especially when you think about all the doctors out there who pretty regularly diagnose celebrities based solely on what they see on or read in the news.

While the show’s producer, Rob Liddell, feels this inability to accurately determine which person has a mental illness and which one doesn’t shows “that having a mental illness doesn’t have to become your defining characteristic and that it shouldn’t set you apart in society,” Satel believes any re-examined preconceptions about people with mental illness should not lead to the “belief that people with serious mental illness are no different from everyone else.”


At first, you might think that sounds a bit offensive. I did. But after I thought about it for a while, I decided that, yes, people with serious mental illness are somewhat different.


Well, because we are all different from each other. People with serious mental illness have to manage mental illness. They take prescription medications, attend therapy, and make changes in their lives to avoid triggers. Not everyone does.

At the same time, people preparing to compete in the Olympics engage in rigorous daily training, follow strict diets, and sometimes bring home a fancy medal to show off.

Not everyone does that, either.

However, Satel’s argument doesn’t really have anything to do with my “we are all different” point; rather, she wants the credit for breaking down stigma to go to successful treatments instead of a psychiatrist’s failure to point out who has a mental illness based on simply viewing some video footage.

“Antistigma campaigns are well-meaning but they lack a crucial element. No matter how sympathetic the public may be, attitudes about people with mental illness will inevitably rest upon how much or how little their symptoms set them apart.”

An excellent point all its own (especially given that the five people with mental illness were treating their symptoms), and once again, I agree with her.

Think about it: If you see a person with mental illness – who is treating that mental illness – living an active, healthy, and happy lifestyle and fairly indistinguishable from people who didn’t have mental illness (even by doctors), wouldn’t you be more likely to stop fearing mental illness and start accepting that conditions like depression, bipolar disorder, obsessive-compulsive disorder, and even schizophrenia are all treatable, manageable mental health issues?

I think so.