Reality TV psychologists reveal how shows assess contestants' mental health, the aftercare they offer - and how it can be improved

But by exposing contestants to fame (or infamy), we also make them vulnerable to the potential downsides of stardom – trolling, financial difficulties and the comedown as the public's interest fades – which may all be contributing factors to future mental health issues.

• Who’s going to be on Love Island 2019?
• Emma Willis pays tribute to Celebrity Big Brother in the week it would have started
• If this is the end, remember: Big Brother is still the godfather of reality TV

The suicide of Love Island series three star Mike Thalassitis – less than a year after series two contestant Sophie Gradon apparently took her own life – is the most recent high-profile example of a reality star's struggles with such issues, but it's far from the first.

So how have reality shows assessed the mental health of prospective participants in the past? What aftercare have they offered, and how effective is it?

We asked four psychologists who have worked on reality series to share their experiences and opinions about a TV genre that shows no signs of slowing down.

Pre-show assessments

Gladeana McMahon was the lead psychologist on the first two runs of the original Big Brother. As something of a pioneer in this field, she explains that she wrote an exhaustive list of guidelines for other production companies to follow.

“When you look at assessing people for reality TV, you’ve got to look at their psychological resilience,” she says. “I would check their motivations for entering the show, their history, their strength and how they could handle rejection.”

McMahon adds that a good psychological assessment observes a hopeful’s viewpoint of fame and their grasp of reality.

“You look at who they are and what has shaped them,” she says, “as well as why they’re doing the show and what they hope to get out of it.

“You have to also look at how they’re going to cope if it all goes tits up.”

McMahon’s assessments would include a psychometric questionnaire and a face to face interview. After evaluating their responses, she would write a separate report on each individual for the production company.

Duty of care psychologist Jo Hemmings, who has worked for production companies including Endemol, which makes Big Brother, and Boundless, which is behind The Apprentice, believes in giving contestants a firm reality check before they sign up for a show.

“I sometimes give them the talk of doom,” she says. “It’s the one that says, you don’t know how popular you’re going to be or how much attention will be paid to you afterwards.

“I also ask what they expect to do after the show – that’s often very revealing. Some think they’re going to just go back to their job after having tried a different experience, others want to be the next Rylan.”

The industry needs enforceable standards

It’s currently not compulsory for production companies to give participants a pre-show psychological assessment – they’re required only to ensure that individuals are over 18, can make autonomous decisions and have given informed consent to take part. Reports from psychologists are advisory only, with the final decision resting with the production team.

“If the production company choose to ignore [my advice], I can’t do anything about it,” says McMahon. “Most of them do not.”

The lack of standardisation is something Hemmings sees as problematic, and has led to her now working with the British Psychological Society to provide updates for recommendations to broadcasters and production teams. But she admits that even this has its shortcomings.

“Unless [broadcasting watchdog] Ofcom come on board, which is the ideal scenario, it can’t be enforced,” she says.

TV psychologist Honey Langcaster-James, with previous credits including the second series of the original, celebrity-infused, Love Island and Channel 4’s recent sleeper hit The Circle, agrees that a set of official and enforced guidelines would benefit the industry.

“Part of my role is to assess the demands that will be placed on that individual during the show and therefore what do we need to factor into our assessment,” she says.

“A welcome change to the industry would be some standardisation of processes and guidelines for production companies.”

A lack of an enforced, standardised approach has seen media psychologist Emma Kenny, who previously worked on Big Brother, refuse to do assessments for reality shows.

“The bar for reality shows is lower,” she says. “If I was working with you and you were showing vulnerabilities that I genuinely believed would put you in a position that would cause you more harm than good, I would not let you in.

“It’s why [production companies] don’t use me because I fail people who they don’t think necessarily should be failed.”

Hemmings argues that a balance has to be struck when assessing who’s resilient enough to enter reality shows, and who will make good television.

“You don’t want 12 people getting on marvellously because it doesn’t make for good viewing,” she says. “It’s finding a middle ground between people who would pass a psych test with flying colours in every way and getting people who will cause some conflict and some reality TV entertainment.”

Aftercare

But these days it’s not just how reality show participants cope with their time on a show that’s the focus, it’s also what happens after they leave that bubble and begin to experience the trappings of overnight fame, particularly when that fame starts to fade.

Reality stars need aftercare. But amongst the psychologists we spoke to, there is not a consensus about exactly what it should entail or how long it should go on for.

McMahon believes that three months of aftercare is appropriate for a residential reality show. “Because after that, life gets in the way,” she says. “You have to look at what’s fair and what’s reasonable.”

Hemmings and Langcaster-James disagree; they both believe a far longer period of aftercare is necessary to help contributors cope – in large part due to the influence of social media, which can see reality stars exposed to potentially horrific online trolling, as well as the ‘highlight reel effect’ of others’ seemingly perfect lives.

“We talk about the struggles overnight fame can cause, but also need to be looking at what to do once it’s gone,” says Langcaster-James. “Social media makes it harder for people to go back to an ordinary life.”

“Other contestants may all look like they live a fabulous life because that’s the social media personality they have to create for themselves,” adds Hemmings. “It can be very isolating if [some contestants] are not feeling that way.”

Hemmings believes aftercare for residential shows like Love Island should be available for at least a year, with a psychologist making contact during potentially difficult periods.

“Trigger points are Christmas, the next series of the show being cast and broadcast, personal things happening in their own lives,” she says. “But make the accessibility there for as long as people need it and be more proactive in monitoring them when they come out.”

Kenny argues that rigorous fame coaching is now essential for those who embark on a career in the reality TV circuit.

“We need to look at what fame really is and look at the picture 12 months later,” she says. “Are you likely to be famous? No. Rich? No. Are we giving you a real opportunity to be fully informed, because I don’t think you can be until you see the reality of the collateral damage.”

But despite their best efforts to ensure the safety and well-being of participants on reality shows, psychologists can’t always successfully predict just how individuals will respond at the end of the process – nor force aftercare on those who don’t feel they need it.

“As a psychologist, it wouldn’t be right or ethical to keep bringing people in for psychological services,” says Langcaster-James. “It can be destabilising for an individual who doesn’t want or need it.

“It would be as unhelpful for an individual to be forced to talk about their feelings and life experiences as it would be if they couldn’t access that support [when they wanted it].”

A wider crisis

Langcaster-James also points out that struggles with mental health are a problem not just for reality shows but for society as a whole.

"Yes, we do have to look at provisions of care on reality TV,” she says. “But we have to bear in mind that suicide is a much bigger issue in terms of mental health."

According to the Mental Health Foundation, suicide is the biggest killer of men under 49, and one in five of all adults have considered taking their own life.

In a world that’s often far crueller outside the bubble of a structured TV production than it is inside it, perhaps the reality is that we should be practicing a little more kindness to people – whether we’ve seen them on our TV screens or not.