Horizon: how offensive are you? [UPDATED]

October 31, 2008 at 10:16 pm (Bad Science, Media) (, , )

[See bottom of post for update] I saw an advert for this programme last night and my heart sank. It is called Horizon: How mad are you? and I groaned inwardly thinking of the way the clumsily worded title reminded me of oh so many media reports of how many mentally ill patients murder people or front page headlines referring to some celebrity losing it. Not to mention the BBC getting someone to speculate on the Prime Minister’s health. [Gimpy] Unlike the vast majority of the complainants in the Brand-Ross-Sachs fiasco (I’m guessing here), I don’t complain about things I haven’t watched or heard but I can hardly wait to find out more about this show because I was already nervously pondering (having seen only a snatch of an advert and remembering nothing but the title) just how bad it could be. I think I may be worrying unduly. I hope so.

The BBC press office* described the programme as addressing profound social stigma and this is what they are going to show:

The programme features 10 volunteers; half have psychiatric disorders, the other half don’t – but who is who? […] Watching the volunteers are three leading experts in mental health who accepted the challenge to work out who is who. This is something they have to do every day, but this process of observation turns out to be far harder than any of them expected. […] Horizon’s own series of tasks, conducted by psychologist Professor Peter Kinderman, probes the line between “normal” and “mad”. But will the individuals who have been affected by mental illness reveal themselves?

I’m uncomfortable with the idea of showing mentally ill and normal** people on national television and having experts playing what seems like a parlour game, trying to guess who’s mad. I’m also uncomfortable with the press release referring to the line between “normal” and “mad”. I’m definitely going to watch the show with interest and I hope my dismay at the title and my prejudice against the idea will not lead me to unfairly judge the programme. I also hope that the Horizon team have managed to find a way to address the stigma of mental illness and that the provocative title will do nothing more than encourage casual viewers to watch the show and perhaps challenge their own ideas about what it means for someone to be mentally ill.

* BBC press office

**In the immortal words of Jimmy from Quadrophenia: “Oh, yeah? What’s normal, then?”

Further Reading: Links

2004 story in the Indy on discussions regarding a draft Mental Health Bill. BBC account of an IoP report that found “Mentally ill unlikely to commit murder”, according to the headline. Abstract of a 1985 study in the AJP on the same subject. Interesting piece in the Guardian about difference in views on how to deal with “the dangerous mentally ill”. Stigma of mental illness campaign. DoH paper on attitudes to mental illness. BBC report on campaign.


It’s on BBC iPlayer, for those that can get it. More here from the BBC. Includes video links. The show was apparently inspired by the work of Dr David Rosenhan – who conducted an experiment in the Seventies where sane patients faked symptoms to gain admission to psychiatric hospitals. Apparently, nearly two million watched the first part of the show. Sam Wollaston’s review is interesting and can be seen here: last night’s tv. Discussed on the totally excellent Bad Science forums here. Also blogged by aethelreadtheunread, Horizon: How mad are you?.

One issue that the programme dealt with was trying to diagnose mental disorders on limited evidence. The psychologists on the show referred to the difficulty of doing so, which might make you wonder why they agreed to be on the show in the first place. It also reminded me of previous issues of diagnosing on limited evidence – often without the psychologist / psychiatrist in question actually meeting the person in question. This isn’t something that tends to happen in ‘real life’ as far as I know, but in celebland it is not uncommon.

Something I found interesting was the segment where Yasmin, the experts having missed the fact that she had a psychiatric disorder, spoke of her surprise that it wasn’t obvious that she had a disorder. This is something that’s cropped up before in various places – I’ve noticed that some people who have a psychiatric disorder such as depression seem to feel that people can tell just by looking at them. I know when I’ve been depressed I’ve found that I’m less likely to meet someone’s gaze and I think it’s perhaps because I feel that if they look me in the eye they will be able to tell how I feel. If I’m down I don’t necessarily want anyone else to know about it, not least because I believe there is a social stigma to psychiatric disorders. I hope the programme will have a positive effect in terms of getting people to address the stigma of psychiatric disorders, but I’m not sure the way they’ve gone about it was the best option they had available.

Just to illustrate the media’s thoughtful, sensitive and considerate approach to mental illness, I’ve decided to include links to a couple of pages that show use of pejorative terms relating to mental illness. Here, Paul Hayward decides to label Joey Barton a violent sociopath and refers to NUFC fielding 12 players – ten “normal ones” and two Joey Bartons. The accompanying picture is captioned “headcase”. Nice. “Nutter” is the chosen epithet of the Paisley Daily Express. Very sensitive.


  1. puzzlehead said,

    I totally agree with your article. I have OCD and Depersonalization and Derealisation Disorder and every time the advert for this program comes on TV my heart sinks. The title strikes me as completely devoid of any sympathy, and seems to be presenting itself more as a game.

    Is this the BBC trying to be ‘edgier’ but also trying to educate? I don’t know if it’s as innocent as that. I will also be watching with baited breath. I hope they give the subject the serioiusness it deserves.

    It’s like a Guess Who of mental patients, making a mockery of the seriousness of the subject. As you said, we haven’t seen it yet so I’m not going to jump to conclusions but I’ll be nervous as to how the subject and people is/are treated.

  2. The Gonzo Girl said,

    It’s so silly to use the word mad in this context, even if it’s just tongue in cheek.
    Everyone already knows the difference between being “mad” and having a real mental disorder, like when somone asks “are you mad?” it’s obvious they refer to eccentric, or unusual behaviour.
    There isn’t even stigma attached to being mad, it’s become an equivalent to “interesting” and a lot of arty types proudly claim they’re mad.
    I hope they manage to make the point, that people with mental disorders can’t be spotted in a crowd, but then again, even if you could, so what?
    I’m gonna have to check YouTube, I’ve absolutely got to see this for myself.

    “Watching the volunteers are three leading experts in mental health who accepted the challenge to work out who is who. This is something they have to do every day, but this process of observation turns out to be far harder than any of them expected. […]”
    What strange wording, they make it sound, like it’s the job of a health professional to spot who’s who.
    Someone should tell them that their job is not a game of “spot what kinda loony this patient is”, but to help people individually, and sticking a label on them is not top priority.

  3. Neuroskeptic said,

    I’m not going to comment until I see this but I’ll be watching with interest, thanks for the tipoff. It looks like it could well be a complete trainwreck.

    Does anyone know of any TV shows about “mental illness” that weren’t trainwrecks?

  4. djbarney said,

    Read “Psychiatrists: The Men Behind Hitler”. That’s a program I’d like to see. One that shows how the NAZI T4 program carried on straight after WW2. What they were doing for the NAZI’s they still do today.

  5. jdc325 said,

    Thanks for the comments all.

    Barney – are you seriously telling me that psychiatrists are, in this day and age, involved in eugenics-by-euthanasia? Evidence please…

  6. trollbychoice said,

    I hate to be a forum troll and jump on your band wagon to try and knock out the driver and derail your rantings but an argument needs two sides so here’s the flip side; if you suffer from mental illness you cannot talk for all sufferers. I think I suffer with mental illness but I don’t want help I’m sure I can handle my own mind. It feels like I have manic deppression but how can I identify myself without having these benchmark programmes. If you can benchmark mental illness at all. You don’t like the sound of this programme then simply do not watch. I really wish people would tune out rather than complaining. I’ll have nothing to watch or listen to if the complainers continue. Appologies for coming off thread.

  7. jdc325 said,

    “if you suffer from mental illness you cannot talk for all sufferers”
    Good point. I hope I don’t come across as doing so.

    “It feels like I have manic deppression but how can I identify myself without having these benchmark programmes.”
    I think this may be where your devil’s advocate position becomes untenable. You are trying to tell me that diagnosing yourself with an illness using a populist TV programme is better than going to a mental health professional? I don’t think so.

    “You don’t like the sound of this programme then simply do not watch.”
    Ah, no – it’s not that I’m personally offended by the way people with mental illness are portrayed and I want to censor TV. I would prefer to improve the way that mental health is covered by popular media outlets.

    “I really wish people would tune out rather than complaining. I’ll have nothing to watch or listen to if the complainers continue.”
    I’d hate that. However rude or offensive someone is accused of being, I think that sort of thing should be dealt with appropriately and with a sense of proportion. For my money, the fuss about the Brand-Ross-Sachs fiasco (or the Queen’s haunted minge, or Jeremy Clarkson’s murderous truckers) is absolutely ridiculous. Basically, I think the Mail on Sunday is in the business of perpetrating shrill, hypocritical and moralising witchhunts.

    Thanks for the comment.

  8. soveda said,

    I was going to blog this because the advert looks to of like the worst line of sensationalist claptrap.
    There is nothing suprising about being unable to diagnose a mental illness just by looking at someone and most mental health professionals would say the same.
    I haven’t seen the programme yet so it may be quite different from the advert, I may blog it anyway!

  9. Peter said,

    I’m currently reigning in the urge to put fingers to keyboard and write a very strong letter to my MP. However I have the feeling, that come Tuesday evening after it broadcasts, I will be even more outraged. Since the broadcast date is so close I shall (probably) hold fire until seeing the actual programme.

    Having said that both the title and what is advertised as the concept of the programme are both offensive and potentially dangerous. I think most of the UK are very much enlightened when it comes to mental illness; the act of broadcasting a misguided bandwagon for the tiny minority of idiots to jump on will not improve matters for anyone – although it may gain the BBC some temporary viewer ratings.

    The concept could be damaging in a number of ways:

    – it is going to encourge DIY diagnosis, something which may be good as an incentive to go and see a doctor but harmful if it goes nowhere;

    – there is a clear danger that if the “experts” don’t actually pick up on a diagnosis correctly (fair chance in these situations and what the BBC is probably aiming at), then are we to beleive the person doesn’t suffer from that illness to begin with… after all the “experts” in the sharp suits should know best;

    – it trivialises (spelling?) mental illness;

    – it again makes a distinction between mental illness and a physical illness (although the point could be argued that there technically isn’t one), would you expect to see a programme with 10 people in wheelchairs and for the hosts to guess what the biological causes were — of course not, there would be a public outrage;

    In regards to trollbychoice’s comments, if you think you have bipolar disorder then get your GP to refer you to a psychiatrist as soon as you can – they are the only people who are properly qualified to deal with this. I’m speaking from experience here – if you are suffering from bipolar disorder the idea that you are “sure I[you] can handle my[your] own mind” is simply ill-founded. Without help you will reach a point, whether that be next week or years down the line, where you will become seriously unstuck. It may also be the case that you don’t suffer from bipolar disorder, in which case you’ve had a lucky escape.

    Anyway, back on topic – if this programme is as offensive as it promises to be I won’t be letting it drop anytime soon.

  10. jdc325 said,

    Thanks for the comments all. I was worried by the title and description of this show, but am reserving judgement on the actual content until I have actually seen it! Tomorrow will be “judgement day”.

    There’s now a thread here on teh BBC forums: Message Board.
    Also featured in the Guardian. twice this last week or so.

  11. Neuroskeptic said,

    The sad thing is even if this is stupidly offensive it’ll still only get 10% of the complaints that Russel/Ross did.

  12. jdc325 said,

    Well, I watched part one. Like the curate’s egg, one could argue that it was good in parts. Personally, I think the most offensive thing about the show is the conception and titling. I suppose if I’m feeling generous I could say that the execution wasn’t all that bad – but my problem really is that the premise for the show seems to me to be crass. I’ve made some brief notes on part one (which are at home and thus useless to me right now) and I’m looking forward to part two next week.

  13. soveda said,

    I’m impressed you managed to watch it, I couldn’t get past the first two minutes before suffering from cringitits and changing channel!

  14. soveda said,

    Oh and on all in the mind one of the panel talks about why he did the programme.

  15. Is madness all in the mind? « Musings of a phenomenologist said,

    […] a more measured post have a read of JDCs blog, and while you’re there read all the other posts, there is quite some thinking going […]

  16. fleetwood said,

    I don’t have a mental illness but I don’t think this programme told me anything I didn’t know. I thought it was crass to say the least. And the psychiatrists involved didn’t exactly convince that it would be worth seeking their help if I ever have a breakdown. Have a look at this justification for the show by one of the producers, called I’m a psychiatrist..get me out of here – http://blogs.bmj.com/

  17. Neuroskeptic said,

    The justification is rubbish – he doesn’t respond to this criticism, which I think is very true:

    “Mental health all too rarely gets a fair deal on our TV screens and I think Horizon gets it wrong here, veering toward exploitation for the sake of entertainment. This programme risks trivializing mental illness. Social anxiety means you don’t fancy being a comic, sticking your hands in dung will be difficult with OCD, and depressed people tend to be rather gloomy”

  18. jdc325 said,

    “This programme risks trivializing mental illness.”
    Agreed – this was something that also concerned Peter (in one of the above comments). In the BMJ blog, Steven Reid also calls the programme crass (exactly the term I used – fleetwood too) and makes the following point: the producers have rejected the considered investigation that the subject merits and instead invite viewers to indulge in a ‘Spot the Screwball’ contest. Link.

    I felt the show was crass and an inappropriate way to approach the topic. I think that there were a few good points and it may be possible that the show will actually help to get people thinking about the stigma of mental health. As I commented on Soveda’s blog:
    The show had good and bad elements, I thought. One thing that was said at the end of the second show was that for people who have had an episode of some psychiatric disorder, we should not look at all their future actions in the light of “a poorly understood label”. If this is the sort of thing people take from the show then it may have been worthwhile. Still feels a bit inappropriate to deal with the stigma of mental illness in the context of a show such as this one, mind.

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