Mental health in the film industry

Director Francis Ford Coppola on the notoriously chaotic set of Apocalypse Now. (credit: Zoetrope)

During my return to university to become a sex therapist, I also trained to become a certified Intimacy Coordinator for film and television. At the time (2019), ICs were a freshly new role in the industry, sprouting up in the height of the Harvey Weinstein scandal and the MeToo movement. ICs are brought on set to help directors and cast through vulnerable scenes like nudity, simulated sex and assault.

What I noticed during my time as an IC is the immense pressure cooker that set life is. Every minute counts and days are long as a result, often with millions of dollars at stake. Personalities are varied and strong, people are tired, and stress is non-stop. Someone is always yelling at someone else.

As a result of these intense days, disordered symptoms often arise in both cast and crew. Anxiety, depression, burnout, panic, isolation, substance misuse to help cope. And unless you have a partner that truly understands the business, relationships can become strained. Coupled with the instability of the industry (work solid for months, then work not at all for months more) and it’s a formula for a lot of hurt. Though it may look glamourous from the red carpet galas, actual filmmaking is quite the opposite.

While I was on set as an IC for scenes that involved nudity and/or sexual content, I also noticed a need for on-set therapists to address other issues. After describing my role to one actor in a prominent TV series, he half-jokingly quipped that maybe he could come talk to me when he wasn’t feeling so hot (hoping my expertise extended beyond intimacy), especially as his family was back home in another country. It didn’t help that his character was emotionally alone in the world, suffering from a struggle between power-based righteousness and empathy.

Every day I was on set, no matter what the production – from comedy to futuristic dystopia – there was tension somewhere. And I was there sporadically (only during certain scenes), my hours fairly short. I would leave behind the rest of the crew for their 12+ hour days that would carry on for months. Productions often offer info for cast & crew to access mental health care, through posted hotlines or reminders that union-members are covered by insurance for therapy. But this feels like an after-thought, more a due-diligence by productions. Sometimes the info is listed in 2pt type on the call-sheet, or occasionally buried in the Distro somewhere (the daily all-points-bulletins that gets sent out to the relevant departments). Mental health is not a priority in filmmaking.

As a result, I often hear about cast and crew who have faced mental health challenges on set, who were either ignored, bullied, exploited, abused. Most recently, Deadline (an industry publication) ran a story about Alyson Stoner's experiences as a child performer and the resulting trauma that came from her work. She now works as an onset mental health coordinator for kids.

I currently work with clients in the industry who are trying to navigate the inherent stresses of the job. But I’m a secondary call, by the person who has taken the effort upon themself to search for and reach out for help, often if/when they have some time away from work. I’d love to see productions prioritize mental health so cast and crew have first hand access to help. At the top of each set day, there’s a safety meeting led by the First Assistant Director outlining what to expect, emphasizing where extra physical care must be taken (e.g., ’we're hanging a bus partly off a bridge, DO NOT STAND UNDER IT;’ ’if you catch on fire, these are the protocols…’ etc, etc.). When I was an IC, I would be at the front of this meeting, introduced by the 1st AD. Crew were told of the intimacy protocols that day (e.g., a set closed to only required crew), and that they could come to me if they had any questions. It would be grand to have something similar for a set therapist, where the crew is told ’the set therapist is available today, please feel free to take some time and go speak to them about anything at all.’

But even that would be tough for some, those who don’t want to risk being seen as someone in need, or even taking time during filming to do so. I’d love for mental health care to become normalized for the industry, much like intimacy coordinating is becoming (the UK industry has a good head-start with this). Film and TV production could become leaders in destigmatizing healthcare-seeking, acknowledging the issues it causes while at the same time creating a set dynamic that holds their cast and crew with care.