Hollywood’s Mental Health Crisis: Four On-Set Therapists Offer Advice Amid Industry Contraction

Editor’s note: The latest in a series of Deadline reports looking at how the current upheaval in the media & entertainment industry is impacting mental health.

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On the heels of Covid and with an ongoing contraction following last year’s double Hollywood strikes, it’s a particularly tricky time to maintain mental health for those working in production.

Sarah McCaffrey, a UK therapist well versed in the demands of life on set, notes that entertainment is an industry offering its predominantly freelance workforce “low certainty and low control” to begin with. Throw in the turbulence of recent years, and anxieties are heightened across the board.

McCaffrey, founder of mental wellness company Solas Mind, which has worked on everything from Netflix’s Heartstopper to the Hugh Jackman drama The Son and Apple TV+’s Slow Horses , says that looking to the future, “People are anxious about: ‘What will the industry look like? Will I get another job? Is this contraction going to last forever?’ ” As some consider whether to remain in the field, others return to work on set and face a tough “readjustment,” she says, “kind of remembering how stressful and difficult” their line of work can be.

According to Noelle Adames, a therapist working with Lou Platt’s UK-based The Artist Wellbeing Company ( I May Destroy You ), there can be a feeling of “imposter syndrome” in making such a return, for “people who feel a bit rusty at what they’re doing.”

Given these heightened tensions, therapists we spoke with argue that there perhaps has never been a more urgent moment to have a clinician on set who can help ground those struggling. As Adames explains, the role of the on-set therapist is to “provide a safety net” for anyone “feeling any kind of a wobble,” across the cast and crew.

The ways their expertise can benefit the individual, not to mention the collective, are myriad.

Los Angeles-based Barton Goldsmith, a veteran of the space who’s been working in production since 1985, notes that therapists can be of use, for starters, in navigating emotionally-charged material, whether that be a storyline involving domestic violence, teen pregnancy, or the end of life. In his mind, there should be a therapist on every set, particularly if “children, anything romantic, [or] anything dangerous” are involved.

On a secondary level, McCaffrey says, therapists can be helpful in processing the toll of production itself. As she highlights, production is typically “very intensive and the hours are incredibly long.” With this in mind, she stresses, “it’s very, very difficult for people to find any semblance of work-life balance because there just isn’t the time.”

McCaffrey adds that given the limitations on free time amid production, on-set therapists often wind up standing in for the therapists creatives see in their day-to-day lives. Says Goldsmith, “Wherever there’s pressure, we find a way to let it out” whether it be concerning family, finances, relationships or an unexpected tragedy.

While the work of The Artist Wellbeing Company is primarily done virtually, Adames says therapists for films and TV shows tend to work hand in hand with both HR and intimacy coordinators, meeting with producers in prep to ascertain challenges particular to a production. “We’ve read the script, we’ve been included in things, we’ve gone to the table reading if possible,” she says. “So when we show up, we might have an idea of where some of the snags or the wobbles could be.”

Tending to make herself known on set early on by hitting common areas like the craft services table or the makeup and hair trailer, Adames says the work when actually on set is a balance of “really being there and being present” without being “intrusive.”

A range of tools can be useful in working with clients, as in any therapist’s office, whether that be visualization, breath work or grounding exercises. What’s most important in the end, Goldsmith says, is helping people to develop a “skill set” that can help keep them in “a positive state of mind,” even if coping with the challenges they face may be easier said than done, “especially in Hollywood.”

As would be the case for any therapeutic practice, working to maintain the confidentiality of the client is also imperative. Adames always makes sure the client is well aware her company stands apart from the production itself. While providing information to the production about the number of people participating in therapy, Artist Wellbeing never divulges names or any further specifics.

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“We kind of think of ourselves as, if the production is the world, we’re kind of the satellite that’s going around. So they have the ability to reach out to us on email or phone confidentially and say, ‘Can I have a session with you?'” she explains. “[If] we have a safeguarding concern, [if] we’re concerned for their welfare, then we’ll have to break confidentiality. But otherwise, we don’t.”

“Such A Tiny Cost…But So Impactful”

While on-set therapy is a growing field seemingly practiced more today in the UK than in the U.S., the therapists we spoke with agreed access is still not common no matter who you’re working for or where you’re shooting. As someone who’s received glowing feedback to her work — sometimes, from people who’ve gotten to experience therapy for the first time on set — McCaffrey hopes producers across the industry will get more into the practice of considering the mental health needs of their teams from the outset.

“I think the whole industry is so reactive,” she says, “and we need to revert to being proactive, building in a bit of time to consider these things.”

Adds Adames, “I would just keep in mind that creative people are giving of themselves when they come on set, and people [are] able to give the best that they can do when they feel like they are held by something. Wellbeing is not there to get in the way of the process. We are there just to help people to be able to reach their full potential.”

A key point McCaffrey, Goldsmith and Adames hope to leave producers with is that rather than representing a significant cost to production, therapy can actually be an asset as it saves the team time and money. Says McCaffrey, “It doesn’t have to cost a fortune. I think they would be surprised how it is such a tiny cost, but it’s so impactful in the wider picture.”

In a moment where budgets are being tightened rather than padded, Adames advises that at a bare minimum, producers should consult with a wellbeing practitioner while in pre-production, where they can help assess the challenges presented by their project and what they mean for their team. “[They] could say, ‘This is the content of your production. This is how big your crew is, this is the location. It’s going to be all-night shoots. What are the stressors that kind of add to this production?'” she explains. “‘And how can we help you look to make that the least difficult for everyone as possible?'”

“ People Need To Advocate “

In terms of advice for film and TV professionals suffering mentally who lack access to professional help, each therapist we spoke with had different recommendations. For McCaffrey, what’s most critical to “mental health and resilience is connection … so that would be my top tip, really, is just connecting with others who understand and are experiencing the same as you.” (In that vein, Solas Support, a wellbeing app geared specifically toward the creative sector from McCaffrey’s Solas Mind, launches this month).

Adames advised taking an honest personal inventory of one’s feelings and finding a way to process them, whether that be by journaling, sensory work or talking with peers going through something similar. “Not comparing yourself to others, not getting on social media and looking at what everybody else is doing — keeping the focus on yourself, on what you need,” the therapist says. “Make sure that you are getting enough rest, staying hydrated, surrounding yourself with positive things that lift you up — taking care of your body, taking care of your mind.”

“Make sure that you are getting enough rest, staying hydrated, surrounding yourself with positive things that lift you up — taking care of your body, taking care of your mind.”

– Noelle Adames, The Artist Wellbeing Company

Zuri Pryor-Graves, an Atlanta-based therapist and intimacy coordinator who has worked on projects like Netflix’s forthcoming August Wilson adaptation The Piano Lesson , advises film and TV professionals to “know that help is available and ask questions” — to investigate the mental health resources afforded to them by the production and their union , whether they include on-set therapy or not.

“Give yourself permission to do that and to advocate. I feel like people need to advocate if that’s something that they want,” the therapist continues. “The reason why intimacy coordinators have been able to stick around is because people are like, ‘Wow, this is actually really great. This is really cool, and I feel better. I can do better work.’ “

In the end, says Adames, what’s important to recognize is that despite the present challenges facing the industry, they too shall pass. Even if people need to pick up a side gig that can help them continue to feel “nourished and fulfilled” while working their way back into production on a consistent basis, she offers, “This time right now might be a little bit bumpy, but keep going.”

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