Ken Burns’ “Hiding in Plain Sight…”: Candid Interviews, Canned Conclusions

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EDITOR’S CORNER

A few months back, I reviewed a small, independent film called “Just Like You: Anxiety and Depression.” It was designed to educate youth, teachers, and families about teen mental health in hopes of busting stigma, stirring compassion, and “saving lives.” But it mostly served to reinforce biomedical-model myths and misinformation that encourage teens to view themselves as incurably ill.

Now, with the debut this summer of the Ken Burns-produced “Hiding in Plain Sight: Youth Mental Illness,” a four-hour PBS documentary with similar goals and a better pedigree, I was hoping for more accurate representation. What I saw instead was a glossy patchwork of mixed messages.

Storms and Survival

“Hiding…” is the capstone of the Well Beings Youth Mental Health Project, a collaboration among PBS and other major media launched in 2020 and funded by Otsuka America Pharmaceuticals, Kaiser Permanente, the American Psychiatric Association Foundation, and others. It is divided into two parts.

Part 1, “The Storm,” offers an unvarnished look at the lived experience of more than 20 diverse, articulate young people aged 11 to 30-something. Through interview clips shot in the intimacy of their own homes, the youth (and sometimes family members) talk candidly about their emotional distress, self-destructive behaviors, and extreme states. It isn’t pretty: They face bullying, racism, and homo- and trans-phobia; parents who are divorced, addicted, ill, absent or in jail; being adopted or in foster care; and physical and sexual abuse. They feel unbearable sadness or crippling fear, starve or cut themselves, abuse drugs and alcohol, have “manic episodes,” and battle voices and visions only they can perceive. Yet they’ve felt they must mask their misery, fighting alone as best they can.

This section, and the rest of the film, also tell us how to interpret these stories. It presents an “Adolescent Psych 101” survey of mental health topics from anxiety to suicidality, complete with definitions on PowerPoint slides and commentary from adult experts: a kindly therapist, a pragmatic child psychiatrist, a neuroscientist, peer and school counselors, and mental health advocates.


The trailer for “ Hiding…” captures its form and content well (it begins at 1:40, after Burns’ introduction).

Part 2, “Resilience,” is about reaching one’s breaking point, seeking help, and coming out the other side with the tools and relationships to “manage” one’s condition. Here, we’re shown and told about the process of diagnosis via the DSM (“a glossary”), the purpose and types of psych medication, and the experience of undergoing inpatient “treatment” in hospital psych wards and youth residential centers. Later, the film delves into society-wide issues that don’t seem to fit elsewhere (the criminal justice system, “double stigma,” and the rise of youth suicide).

Pros and Cons

At its best, the film conveys vividly how hard it is to be a young person today, building its narrative around the interviewees’ personal arcs, which culminate in hard-won recovery. Intentionally or not, it makes clear that, given the limits of our current mental health system and its treatments, finding what works for one person versus another is mostly about trial, error, and finding those key, supportive adults to confide in. But when you do, it says, thriving is possible: You, too can pursue school and a career and feel more confident in being your unique self.

At worst, the film restates the trite and potentially disempowering advice we always hear: Recognize mental illness “symptoms,” tell someone about them, and get vectored into the mental health system. Don’t choose suicide, because you matter. If we vocalize our struggles, stigma will end. If you need help, contact the National Suicide Prevention Hotline or NAMI. These recommendations reinforce the problem of youth “mental illness” as a pathology within individuals.

Conflicting Ideas

Given these conflicting perspectives, we’re left with a patchwork of mixed messages. Here are two important examples.

Sources of Distress

“Hiding…” starts off with a not-what’s-wrong-with-you-what-happened-to-you? overview of the types of stressors that can lead to overwhelm.  It’s not nature versus nurture that “set the stage for mental illness,” we’re told, it’s their interplay. Adverse childhood experiences, the pandemic, toxic social media, and social oppression can trigger psychosocial dysfunction in vulnerable individuals, especially those in unstable family situations. It’s also insightful on how severe stress shows up in young people (anxiety can manifest as school avoidance; depression as rage; coping as self-harm or substance use, etc.). As child and family counselor Kee Dunning puts it, we adults need to engage kids in facing their demons; then, “It can be worked out.”

On the other hand, such perspectives are bracketed by other, more dire statements: According to the faceless, baritone narrator, “mental illness” shows up for different reasons and looks different in each person, but “it is, in fact, a DISEASE: …the place where sadness leaves off and depression begins….where nervousness becomes anxiety…where excitement becomes mania…and habit becomes addiction.”

Similarly, advocate Patrick Kennedy talks about being “highjacked by a brain disorder,” and two young women who self-identify as bipolar talk about their “chemical imbalance.” Throughout, we’re bombarded with gloomy stock photos, clips of stormy seas, and ominous mood music that creates a sense of fear. (Still, the narrator reassures us, “Help is available, and with the right treatment, you can feel better.”)

 Psychiatric Drugs
The film’s classroom-style survey of mental health topics includes definitions.

The “right treatment” for just about all of the youth profiled seems to include a drug prescription (even if, like Maclayn, a sad boy who’s just come out of the closet, you’re only 11 years old). “We do need medication,” says creative and quirky Amethyst, 15: “…the symptoms are too intense.”

And yet, some of the “meds’” biggest adult boosters are quite frank about their limitations and potential harms. After lauding the variety of drugs out there, brain scientist Thomas Insel states, “None of the medicines we have are curative. None of them are perfectly matched to the problem at hand. All of them have side effects.” Parent and advocate Pete Earley even talks about how those on antipsychotics die years earlier than their peers. Some of the youths are ambivalent about their pills: Samantha (diagnosed with agoraphobia and GAD) shares that some antidepressants made her feel suicidal, but no one listened. Kevin (Pete’s son, diagnosed with schizoaffective disorder) believes that while he must stay medicated to function, antipsychotics can leave you “a shell of the person you were.”

Hidden Identities

While “Hiding…” is about shining a light on today’s youth and speaking openly about mental health, the film stays mum about the full identity and potential conflicts of interest among some of its celebrity adults. They include:

  • Thomas Insel, who admits that he didn’t realize his own daughter had an eating disorder, is not just any psychiatrist but the former longtime head of the National Institute of Mental Health. He famously left the agency for Silicon Valley, frustrated by the lack of progress made in the biomedical research he funded. “I should have been able to help us bend the curves for death and disability,” he wrote recently. “But I didn’t.”
  • Patrick Kennedy has a diagnosis of bipolar disorder and a history of Oxycontin addiction. This lived experience isn’t mentioned, though. Moreover, he is a member of a political family associated with both psychiatric abuse and a vision of community-based mental health care that never materialized. (His aunt, Rosemary Kennedy, was involuntarily lobotomized, and his uncle was President John F. Kennedy.)
  • Pete Earley, the journalist, is presented as Kevin’s loving dad, bemoaning how psychiatrists treated his son like a number and offered doom-laden prognoses for his future. Hiding in plain sight are Earley’s controversial books and blogs, which advocate for forced treatment of those with “serious mental illness” and belittle the belief that their civil rights matter. (We do get a hint of this when he tells the camera that he tried to hide Kevin’s medication in his cereal.)

“Hiding” also lets us think that none of these youth know each other, but as we learn toward the film’s end, six of them go to the same Rhode Island high school and started a support group after a mutual friend died by suicide.

Impacts

So, can Hiding In Plain Sight help “save lives”? Maybe, but only if those who identify with the youth and their families decide now is the time to address the personal and societal issues that are causing them so much distress. And to explore solutions beyond drugs and therapy (which the cast agree can be useless if you see the wrong practitioner). I like the message offered by Alexis, a 21-year-old Chippewa tribe member who adopts Indigenous healing practices like immersion in nature. “Not only is trauma embedded in my DNA,” she says, “but so is resilience.”

You can watch the whole thing here. I’d love to hear your thoughts.

 

 

 

 

 

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

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15 COMMENTS

    • I didn’t actually get that sense from the film–instead, it gave the message that the combination of life stressors plus some inherent vulnerability can lead to “mental illness.” Nobody understands what that inherent vulnerability is, though, since the “it’s in the genes” hypothesis hasn’t really panned out.

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      • Anytime someone can postulate “mental illness”, then the subject will be presumed as needing Treatment, Therapy, and Recovery. So they will be presumed as illegitimate if they attempt to restore their social and civil standing, presumed as needing more treatment and therapy until they stop resisting.

        I have no doubt that all these life stressors are very real, and that young people today are facing some extreme challenges, but painting it as “mental illness” is just the final layer of abuse.

        And what qualifications do the therapists have, Law Degree? Mike Collins’s 12 Apostles? Spanish Civil War? John Brown’s Raid?

        When times are tough, people need to stand up and restore their legitimacy, and stop being used as fodder for Therapy and Recovery, because these are what sustain the de-legitimation.
        https://www.youtube.com/watch?v=vlWVV5imXSM

        Joshua

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  2. Something I never see mentioned is selection bias in these sorts of things. Who gets interviewed? People in programs, participating in an acceptable way, referred. What do they say? Certainly nothing that invites potential consequences.

    In ostensibly anonymous interviews in literature, it always seems to be the case that many respond that they learn, essentially, to “smile and nod”, else risk the ire of their treaters, more drugs, being labeled low insight, loss of rights etc. Others regurgitate what clinicians tell them, perhaps having internalized it. Many report that drugs do some very contrived thing on prompting for the thing, like sedation “helping with sleep”, but not more than that. Superficial or nonexistent exploration to their thinking and emotions or experiences or circumstances. It’s worse still in institutions, where it is literally part of the process: The only way out is to validate (or else). I’ve seen it. I participated in it, prompting a relative to voice agreement to a psychiatrist nodding her head up and down as she asked a question that we all knew was wrong.

    Canned conclusions indeed. The whole thing is canned.

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    • I think you nailed it, George cLoony! Who do they choose to interview, and why? From what I could tell, some of the kids featured happened to be patients of the therapist named Kee, and half a dozen of them all went to the same school and belonged to the same mental health support group that formed after a popular student died by suicide. So yeah, it wasn’t random.

      I think this could have been a better film if, instead of Ken Burns-ing it, the Ewers brothers had just curated a collection of interviews and maybe let the viewer draw their own conclusions. I’d love to know what was said that wound up on the cutting room floor.

      One of my favorite kids featured was Yanerry, who had both all kinds of life challenges and a variety of psychiatric “symptoms” including hearing voices and seeing hallucinations. They actually kept in where she says that this is just a trait she has that’s part of her and she’s learned to co-exist with it.

      There is going to be a follow-up live panel with some of the interviewees (including another of my favorites, Billie) on September 8. I’ll be very interested to see what they say after the fact.

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  3. We expect, despite the fact that education on the issue of these illnesses (no I will not call them “mental”) falls far short of need, accuracy. Without far better education not even Ken Burns can provide that accuracy.

    First “mental illness” is not “AN” illness, were that so, then “physical illness” is “AN” illness. What it is is a questionable category. It is false rhetoric. Schizophrenia is as real an illness as pneumonia.

    Second, under no circumstances is it either moral or ethical to tell anyone, children of whatever age, included, to place in their minds, that there is a “stigma” (sic) to these illnesses. It is false rhetoric. We educate youth, not alienate them, as we have allowed ourselves to alienate and be alienated.

    Third, Mr. Insel had every opportunity to both set and achieve goals of educating the public proplerly and fully while at NIH. He did not. He still has that opportunity. He is not seizing it. Patrick Kennedy and Pete Early, also, having the public eye, and public attention, have that opportunity. They are not doing so. And those are not ad hominem arguments. They are realities.

    Will we one day turn the corner and start addressing these illnesses with the same rigor we addressed polio, TB, and are addressing cancers, heart diseases, and covid? That corner is not yet on the horizon. It is not presently in our vision medically or politically.

    Harold A Maio

    Harold A Maio

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  4. Ken Burns as a filmaker is just more suited to history and political science than psychiatry/psychology. I have not see this film, but in my opinion, he has veered off his lane. We all do it at times. But unfortunately, psychiatry/psychology being the convulated subject it is, it might do more harm than good. I know Ken Burns did do something on “cancer.” I did not see that, either, but “cancer” despite its issues still lacks the utter confusion that surrounds the subject of psychiatry/psychology. But, in analysis, Miranda Spencer probably got it right as far as the “mixed messages” aspect. In truth, the “mixed messges” aspect is not only indicative of psychiatry/psychology, etc. but of most all media; which is a reflection of society, etc.
    I did not see in Miranda Spencer’s analysis of this film a reeinforcing of some moral defect that some call sin. I just see that “mixed messages” issue which is a million miles distant from sin, but reflects the utter confusion we have in our society about almost everything. Thank you.

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  6. This is a classic and well-crafted example of propaganda aimed at the “sophisticated” people who are drawn to PBS programs. They like to have their liberal values respected and their scientific assumptions left unquestioned. There is no room in their minds for a new way of thinking about mental health. And so they are told that mental health issues are “diseases” which must be treated by doctors administering drugs.

    I have seen at least one of these episodes (2 I believe). They could have covered the large and ever-growing community of people who disagree (with very good reasons!) with the corporate narrative. But of course, then it would have been an actual documentary instead of a carefully crafted piece of propaganda.

    In viewing it as propaganda rather than real journalism, we can wonder if it is preparing us for the next big move in this field. And if I read the indicators right, that would be psychedelics. When you are dealing with the PBS crowd, you are dealing with a not of people who are involved in New Age thinking. This includes an element of spirituality. And that could easily get out of hand. Admitting that a spiritual existence could be the first step towards discovering some very disturbing facts about our situation here on Earth.

    So we see here a very controlled dip into the ocean of spiritual thinking, reminiscent of the original Vedic “teachings” which New Age thinkers tend to espouse. We hear talk of being on a “journey” and learning our “lessons” and of a great sense of love and “oneness.” The actuality of spiritual life is a lot less sweetness and light than these New Age platitudes would suggest.

    In the old days, thought leaders could hit us over the head with Karma or The Bible and other such dogmas. Today, as we enter into our Space Age, we have become more sophisticated than that. And some of us, amazingly, have moved beyond the old paradigms entirely into a whole new way of looking at our world. One key factor in that new way is the concept of freedom as good and desirable in life. And this is a central problem for the propagandists: To convince us otherwise.

    The better we understand freedom and why those who wish things continue to go their way fear it, the better chance we will have at eventually elevating it to its proper level of seniority in the games of life. Though Ken Burns and his crowd may be unwitting accomplices in this propaganda war, I really wish that people of his caliber could be convinced that they are being controlled so as to keep our blinders on. The truth is really very different than what is being portrayed to us, regardless of the number of beautiful personal stories we are exposed to. All you have to omit is a few crucial personal stories to skew the whole picture, and that certainly has been done in this series. I cannot celebrate it as a step forward in our cause, though it may be a step forward in the cunning art of persuasion.

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    • Yes, I felt it was less a documentary than a packaged message (though I’ve seen worse from PBS–see “Mysteries of Mental Illness” from 2021). It’s too bad because there was so much rich material in the young people’s interviews…although they were obviously carefully selected individuals.

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      • Now I have just watched the first two hours of “Hiding in Plain Sight.”

        It is indeed a field trip in Empathy. But in understanding it gets us nowhere. The “experts” are all convinced (or want us to be convinced) that these people have diseases of the brain. This false understanding will NEVER get us where we want to go.

        Perhaps at this point what many people still need is the simple realization that the “mentally ill” are people, too. But that’s not what the reform community needs. It needs real answers!

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  7. There are life stressors that can come into play in the life of an adolescent.

    One of them is that they could come to feel that they are transgender.

    I am not taking a position on this because I do not know enough about it.

    But here I post a video of the CA State Senate 8/31/2022, the last day of the legislative session.

    They are discussing Senator Scott Wiener’s (D) SB-107. It is about protecting parents and doctors from prosecution under out of state laws for allowing their child to receive “gender affirming care”.

    Now I know this is just a small facet of a much larger subject, and I am not clear that anyone could be prosecuted under out of state laws anyway.

    My real question is, what can a minor consent to? And consider that minors are not allowed to consent to sex.

    I have heard from gay activists that one cannot develop a gay identity until they are of legal age, because developing that identity would mean they have to have sex, and with adults.

    So should we lift the age of consent laws?

    I also find this interesting because usually it is the left that wants to protect children from their parents. But here it seems to be the right that wants this protection.

    And then, what about protection from excessive doctors?

    Now, the Left does accuse the Right of using rare, unusual, and false stories in their opposition to this. And that would be very serious. The same day on the PBS Newshour they said that the Right was using false data.

    Speaking in opposition is Senator Melisa Melendez (R)

    Senator Pan (D) a pediatrician, speaks in favor of the bill. He says that there is no recommendation for surgery on minors. But then what is the legal standard? If it is just left to the medical profession, then you have the same sort of situation you have with the Mental Health Industry.

    Senator Min (D) speaks in support of the bill, and he says he has a trans nephew age 12.

    Senator and Candidate for Governor Brian Dahle (R) asks a question of the author, at what age can a minor consent to these things?

    Wiener does really answer this, saying that it is a medical decision. He says that there are standards and ages of consent, but that parents can also consent.

    Well doing it that way, with no external legal boundaries, sets up something like the Mental Health and Autism Industries, a complete abomination.

    And I don’t think these puberty blocking drugs are some minor thing either.

    I post this though because I want to learn more about it, not because I am trying to advance a position.

    https://www.senate.ca.gov/media/senate-floor-session-20220831/video?time%5Bsenate-floor-session-20220831%5D=8278.396902

    Joshua

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