Words and photographs by Madeline Di NonnoPPRESIDENT & CEO | GEENA DAVIS FOUNDATION
Mental health challenges among young people in the United States have reached unprecedented levels, exceeding those experienced by previous generations. Considering this growing crisis, the Geena Davis Institute conducted a comprehensive analysis of mental health representation in scripted television programming targeted at children and adolescents- “Are the kids all right? Portrayals of Mental Health in TV Watched by Children and Teens”. The study emphasizes the vital role of television as a cultural and educational tool capable of shaping understanding, reducing stigma, and promoting help-seeking behavior among young viewers. The findings reveal a concerning underrepresentation of mental health issues and call for a more inclusive, intersectional, and explicit approach to portraying mental health in youth media content.
Introduction
Recent years have witnessed a significant increase in reported mental health issues among children and adolescents in the United States. According to various public health sources, this trend reflects both heightened psychological stressors and greater awareness around mental well-being. Given the pervasive influence of television and media on young audiences, the entertainment industry holds the potential to serve as a powerful intervention tool. When mental health is depicted accurately and empathetically on screen, it can help normalize the conversation, provide language for self-expression, and encourage viewers to seek support from trusted adults.
In response to this context, the Geena Davis Institute on Gender in Media undertook a detailed content analysis of mental health representation in the most-watched English-language scripted television series in the U.S. for viewers ages 2 to 11 and 12 to 17. This report covers programming from 2021 and 2022, utilizing Nielsen audience metrics to determine the shows with the highest viewership in each demographic. This research was made possible through the generous support of Regina K. Scully and the Artemis Rising Foundation.
Methodology
The study applied a content analysis framework to a sample of top-performing scripted television series distributed via broadcast, cable, and streaming platforms. The episodes analyzed were selected based on Nielsen data reflecting the most-watched shows among the targeted youth age brackets (2–11 and 12–17) during the years 2021 and 2022.
Characters were coded for explicit or implicit representation of mental health issues, as well as for key demographic attributes including age, gender, and sexual orientation. Narratives were assessed for themes of help-seeking behavior, self-harm, substance use, and mood disorders, among other indicators. The analysis also considered the intersectionality of characters’ identities, particularly in relation to the LGBTQIA+ community and people of color.
Key Findings
1. General Underrepresentation of Mental Health Issues
Only 17.4% of all episodes reviewed included at least one character with an explicit mental health issue. Mental health narratives remain largely absent from the media, which children and adolescents mostly consume.
2. Rarity of Characters with Mental Health Struggles.
Merely 1.3% of prominent characters were portrayed with an explicit mental health condition, and 2.1% were characterized with implicit indicators of such struggles. This suggests an overwhelming normalization of characters without emotional or psychological complexity.
3. Neglect of LGBTQIA+ Mental Health Representation
Despite the well-documented mental health crisis disproportionately affecting LGBTQIA+ youth, the study found no representation of LGBTQIA+ characters experiencing mental health challenges in the episodes analyzed.
4. Age-Based Disparities
Among prominent characters, those aged 50 and older were most frequently portrayed with explicit mental health conditions (3.5%), followed by children and teens (each 1.7%) and adults aged 20–49 (0.7%).
5. Gendered Trends in Mental Health Portrayal:
- Male characters were approximately twice as likely as female characters to be depicted with substance use disorders.
- Female characters were 12 times more likely than males to experience self-harm and about three times more likely to be portrayed with mood disorders (e.g., depression, bipolar disorder).
- Among characters with explicit mental health conditions, 50% of female characters engaged in help-seeking behavior, compared to only 21.3% of male characters.
Recommendations
To address the severe lack of accurate and inclusive mental health representation in youth programming, the study proposes several targeted recommendations for media creators and industry stakeholders:
1. Increase Representation of Characters with Mental Health Conditions
Introduce more characters who experience psychological challenges across genres and age groups. These portrayals validate viewers’ lived experiences and create pathways for conversations between young people and caregivers.
2. Adopt an Intersectional Casting Approach
Accurately reflect real-world mental health statistics by representing those most affected: girls and women, LGBTQIA+ youth, and communities of color. Highlight intersecting identities to avoid one-dimensional portrayals.
3. Avoid Stigmatizing Narratives
Depictions should refrain from moralizing or placing blame on characters with mental health conditions. Instead, narratives should illustrate external causes such as social pressure, trauma, systemic inequality, and under-resourced support systems.
4. Ensure Clarity and Intentionality in Mental Health Storylines
Ambiguity around mental health issues can contribute to stigma and misunderstanding. The study calls for explicitly naming conditions, recurrence of mental health storylines across episodes, and integration of medically accurate portrayals.
5. Promote Help-Seeking Behavior
The media has the potential to influence behavioral norms. Characters – especially youth – seeking professional or peer support should be normalized and portrayed positively. Writers and producers must consult mental health professionals to ensure accuracy and impact.
Conclusion
This research underscores a critical gap in media representation that, if addressed, can significantly improve societal understanding of mental health and its impact on young audiences. As television continues to play a formative role in shaping cultural narratives, its power must be harnessed to promote empathy, awareness, and action on one of the most urgent issues facing the current generation of children and adolescents.
By amplifying authentic mental health stories and centering marginalized identities, the entertainment industry has a unique opportunity to become a catalyst for healing, connection, and long-term social change.
About the author
Madeline Di Nonno is the President and CEO of the Geena Davis Institute, the only global research-driven advocacy organization working within the entertainment and media industry to foster authentic storytelling in global Entertainment media. The Institute was awarded the prestigious Governor’s Award Emmy from the TV Academy for its profound, transformational, and long-lasting contribution to the arts and science of television. Di Nonno leads the Institute’s strategic direction, research, financial, and programming initiatives.
Di Nonno is an executive producer for the Emmy-nominated television series Mission Unstoppable on CBS and the award-winning feature film This Changes Everything. Di Nonno has served in executive leadership positions at Hallmark Channel, Universal Studios Home Entertainment, and Nielsen Entertainment. Di Nonno, a U.S. State Department Specialist Speaker, has spoken at the White House and the United Nations. Di Nonno has been featured in Ad Age, Fast Company, Good Morning America, The Guardian, The Hollywood Reporter, The New York Times, The Washington Post, Vanity Fair, and Variety. Di Nonno holds a bachelor’s degree from Boston University. Di Nonno serves on the Board of Directors for the Venice Chamber of Commerce.
