David Monico, MPH
Public Health Program Analyst

Television can captivate a wide audience; it can also serve to educate viewers about important topics, like mental illness.

Single episodes may be dedicated to a character addressing a challenge. In other shows the main characters regularly experience mental illness or interact with the treatment community. Monk connected us with a detective battling Obsessive Compulsive Disorder (OCD). The Sopranos brought you inside the subconscious through the psychoanalysis of a mob boss. Utilizing drama and humor, these shows allow us to see not only recovery and acceptance, but unfortunately can also reinforce stigma.

The new Fox drama Empire is one of the latest examples to attract viewers. From the heated confrontations to the music, there is something for everyone. We can hardly forget that the story has roots in our own backyard, here in Philadelphia. Lucious Lyon, played by Terrence Howard, came up from poverty and advanced through music. Now on the eve of taking his music empire public, Lucious is faced with one crisis after another.

What is most interesting is not the storyline, but the challenges faced by characters throughout this first season. Early on in the series, for example, we learn of Lucious’ son Andre’s mental illness. Living with bipolar disorder, the changes to the company become too much for Andre to manage. His father’s criticisms lead him away from treatment and support. His mood rapidly destabilizes, his anger increases, and he returns to outrageous spending habits, all warning signs that we learn contributed to his first treatment experience.

As Andre’s symptoms progressed Lucious was not what we would call “a support.” He became an antagonist, and withdrew his trust from Andre. Like many in today’s society, Lucious berated and distrusted Andre over an illness, despite the valuable contributions he had made to the company while his symptoms were managed.

These common reactions pose many challenges to successful recovery. Recurring trauma, ongoing stress, and feeling outcast may cause mental illness to develop or worsen. Those who have developed an illness may avoid or leave treatment because of the reactions of family, friends, and coworkers.

Lucious’ stigmatizing attitude causes havoc throughout the season, however, we see areas for hope in other characters. Reactions to Andre’s mental illness were not all negative. Andre’s wife, Rhonda, struggled with internal conflict about his mental health, but she remained by his side. When confronted by Andre in the elevator, his brothers could have made the situation worse by arguing or threatening. Instead, they spoke calmly and used the power of song to de-escalate him. (Learn more tips from Mental Health First Aid.) Later, the family decided to call a crisis team. While their methods of completing this were not perfect, sometimes a high level of intervention is needed.

Shows like Empire can serve to change or further impact stigma. As we become more aware about the negative impact of stigma, it is our hope more television writers will echo this understanding by depicting mental health accurately on-screen. When we get together to chat about these shows, we are reevaluating our thoughts and feelings around mental illness and how people should be treated. With the help of the entertainment industry, characters do and will continue to serve as catalysts to shattering stigma—helping us to see their growth and change.

— Contributed by David Monico, MPH, Public Health Program Analyst, Mental Health First Aid (MHFA), DBHIDS

— Photo: EMPIRE’s Andre Lyon (portrayed by Trai Byers) with his wife Rhonda (Kaitlin Doubleday), in music therapy. (Courtesy of FOX)