{"id":50511,"date":"2021-06-24T18:48:52","date_gmt":"2021-06-24T17:48:52","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=50511"},"modified":"2021-06-29T11:13:15","modified_gmt":"2021-06-29T10:13:15","slug":"how-well-can-reality-tv-shows-assess-the-risks-to-contestants-mental-health","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2021\/06\/24\/how-well-can-reality-tv-shows-assess-the-risks-to-contestants-mental-health\/","title":{"rendered":"How well can reality TV shows assess the risks to contestants&#8217; mental health?"},"content":{"rendered":"<p><em>In the wake of criticism, the reality TV show Love Island introduced stricter mental health checks for its contestants. But even in clinical settings, risk prediction is an uncertain business, finds Ian Hamilton<\/em><\/p>\n<p><span style=\"font-weight: 400\">After a break of 18 months, the hit reality TV show <\/span><a href=\"https:\/\/www.bmj.com\/content\/362\/bmj.k3226.full\"><span style=\"font-weight: 400\"><em>Love Island<\/em><\/span><\/a><span style=\"font-weight: 400\"> is set to return for a seventh series next week. The show\u2019s successful six year run has been blighted by the suicides of two previous contestants, Mike Thalassitis and Sophie Gradon, and accusations that the welfare of those participating has been neglected. Responding to this, ITV announced an enhanced support package for contestants in 2019, which it <\/span><a href=\"https:\/\/www.itv.com\/presscentre\/press-releases\/love-island-confirms-duty-care-protocols\"><span style=\"font-weight: 400\">confirmed again earlier this month<\/span><\/a><span style=\"font-weight: 400\">.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">The welfare of reality TV contestants has come under the spotlight in recent years. In the wake of greater public and parliamentary scrutiny, <\/span><a href=\"https:\/\/www.ofcom.org.uk\/__data\/assets\/pdf_file\/0027\/209565\/statement-protecting-participants-in-programmes.pdf\"><span style=\"font-weight: 400\">Ofcom issued new rules<\/span><\/a><span style=\"font-weight: 400\"> on producers\u2019 obligations to protect reality TV participants, which came into effect in April 2021. ITV\u2019s protocol takes up Ofcom\u2019s charge that broadcasters follow a clear standard of care: their announcement recognises the negative as well as positive fallout associated with appearing on the show, including <\/span><a href=\"https:\/\/www.researchgate.net\/profile\/Waseem-Akram-19\/publication\/323903323_A_Study_on_Positive_and_Negative_Effects_of_Social_Media_on_Society\/links\/5ab1c064a6fdcc1bc0bfefef\/A-Study-on-Positive-and-Negative-Effects-of-Social-Media-on-Society.pdf\"><span style=\"font-weight: 400\">critical social media<\/span><\/a><span style=\"font-weight: 400\"> and the psychological impact this can have. What\u2019s changed with this support package is the idea that these conversations should take place with potential contestants in advance of the show, rather than waiting for things to go wrong during or after the series has aired. The show has also placed a greater emphasis on aftercare, with the offer of at least eight therapy sessions after filming and a promise to provide \u201cproactive contact\u201d for 14 months after the series has finished.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Potential contestants will receive \u201c<\/span><span style=\"font-weight: 400\">thorough pre-filming psychological and medical assessments,\u201d presumably with the aim of highlighting any psychological vulnerability. <\/span><span style=\"font-weight: 400\">\u00a0<\/span><span style=\"font-weight: 400\">ITV doesn\u2019t, however,<\/span> <span style=\"font-weight: 400\">say how they will<\/span> <span style=\"font-weight: 400\">act on the information these assessments might reveal and who ultimately decides a potential contestant\u2019s fitness to be on the show. In the past, <\/span><a href=\"https:\/\/www.theguardian.com\/tv-and-radio\/2019\/mar\/20\/reality-tv-must-do-more-to-protect-mental-health-of-participants\"><span style=\"font-weight: 400\">mental health professionals working on other reality TV shows<\/span><\/a><span style=\"font-weight: 400\"> have aired their concerns that their advice was overruled when it came into conflict with the pursuit of providing entertainment.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Any attempt to predict the potential risk for suicide in an individual is also <\/span><a href=\"https:\/\/bmcpsychiatry.biomedcentral.com\/articles\/10.1186\/s12888-018-1693-z\"><span style=\"font-weight: 400\">known<\/span><\/a><span style=\"font-weight: 400\"> to be difficult, as any mental health professional will attest to. Even though <\/span><a href=\"https:\/\/www.rcpsych.ac.uk\/docs\/default-source\/improving-care\/better-mh-policy\/college-reports\/college-report-cr229-self-harm-and-suicide.pdf?sfvrsn=b6fdf395_10\"><span style=\"font-weight: 400\">previous<\/span><\/a><span style=\"font-weight: 400\"> suicide attempts are a useful indicator, this relies on an individual sharing this or confirmation from a collateral source such as their GP. Given the motivation of those applying for a place, it is also questionable as to how likely and willing they would be to give an accurate picture of their mental health, knowing that any negative assessment findings could jeopardise their chance of selection. Some candidates will simply give the answers they think the assessors want to hear and that maximise their chance of securing a much coveted place.<\/span><\/p>\n<p><span style=\"font-weight: 400\">For decades, mental health services,<\/span> <span style=\"font-weight: 400\">just like TV broadcasters<\/span><span style=\"font-weight: 400\"> now<\/span><span style=\"font-weight: 400\">, have sought to control risks to those they\u2019re looking after, including the risk of self-harm and suicide. But risk is messy and riddled with uncertainty;<\/span> <span style=\"font-weight: 400\">there\u2019s a danger that completing a <\/span><a href=\"https:\/\/www.hqip.org.uk\/wp-content\/uploads\/2018\/10\/Ref-70-Mental-Health-CORP-Risk-Assessment-Study-v0.2.docx.pdf\"><span style=\"font-weight: 400\">checklist<\/span><\/a><span style=\"font-weight: 400\"> or assessment gives producers false confidence they have<\/span> <span style=\"font-weight: 400\">mitigated<\/span> <span style=\"font-weight: 400\">this risk when the reality is that they can\u2019t completely.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">What is predictable is the hostile media, including social media, attention that will be directed towards some of these contestants. Even if a person<\/span> <span style=\"font-weight: 400\">starts the process with optimum levels of confidence and wellbeing, this can evaporate quickly when they are on the receiving end of relentless and all consuming negative attacks. The impact this will have will be variable:<\/span> <span style=\"font-weight: 400\">while some people may be able to handle <\/span><span style=\"font-weight: 400\">this attention, it\u2019s more likely to play into existing negative thoughts and problems with self-esteem. Candidates\u2019 motivation to apply is most likely fame, money, and possibly meeting a new partner. But even with the strongest of motivation, nothing can truly prepare these young people for the hostile personal attacks that can be directed towards them.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Of course, it\u2019s not just prospective contestants who have a potential conflict with how they handle information about risk. The<\/span> <span style=\"font-weight: 400\">producers of reality TV <\/span><a href=\"https:\/\/blogs.bmj.com\/bmj\/2019\/06\/05\/penelope-brown-safeguarding-the-welfare-of-reality-television-participants\/\"><span style=\"font-weight: 400\">rely<\/span><\/a><span style=\"font-weight: 400\"> on characters that engage viewers: having a group of well balanced participants who all get along will not always bring in record numbers of viewers. The formula relies on in-fighting, back biting, and challenge\u2014for some, these ingredients have the potential to trigger a rapid deterioration in mental health. Will producers with an eye on ratings and the pressure to bring in revenue always be able to resist stoking<\/span> <span style=\"font-weight: 400\">this type of drama at the expense of the individual contestant?<\/span><span style=\"font-weight: 400\">\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">It\u2019s welcome progress to see television producers not just recognise the risks to participants\u2019 mental health, but to try and mitigate them. This is a goal we also strive for in clinical practice when assessing people who are struggling with their mental health, but the lesson we can share is that risk is individual and guidelines, by their nature, are general. If understanding this helps us all move beyond a checklist mentality and appreciate the individual, that\u2019s the kind of love I\u2019d like to see.<\/span><\/p>\n<p><em><strong>Ian\u00a0<span class=\"il\">Hamilton<\/span><\/strong>\u00a0is an academic at the University of York with an interest in addiction and mental health. He previously worked as a mental health nurse with people who had combined mental health and substance use problems.\u00a0<\/em>Twitter:\u00a0<a href=\"https:\/\/twitter.com\/ian_hamilton_\"><span class=\"css-901oao css-16my406 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0\">@ian_hamilton_<\/span><\/a><\/p>\n<p><strong>Competing interests:<\/strong>\u00a0None declared.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>In the wake of criticism, the reality TV show Love Island introduced stricter mental health checks for its contestants. But even in clinical settings, risk prediction is an uncertain business, [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/06\/24\/how-well-can-reality-tv-shows-assess-the-risks-to-contestants-mental-health\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":419,"featured_media":50512,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223],"tags":[],"class_list":["post-50511","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-guest-bloggers"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>How well can reality TV shows assess the risks to contestants&#039; mental health? - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/06\/24\/how-well-can-reality-tv-shows-assess-the-risks-to-contestants-mental-health\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"How well can reality TV shows assess the risks to contestants&#039; mental health? - The BMJ\" \/>\n<meta property=\"og:description\" content=\"In the wake of criticism, the reality TV show Love Island introduced stricter mental health checks for its contestants. 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