Art and Mental Health

Reuben ruminates on what three artworks about mental illness and suicide can tell us about art and mental health.

This essay discusses suicide, self-harm, sexual assault, and mental illness. It is not suitable for everyone; you may choose not to read this. Help is available if you need it. Please see the SOS hotline below.

Years ago, I read The Catcher in the Rye, a novel by J. D. Salinger. This piece of art saved my life.

Living with mental illness, you find yourself having to describe your illness a lot. Walking out of a classroom due to a spontaneous out-of-the-blue panic attack? That absence will possibly become the topic of an upcoming conversation. Going for a job interview? Experience tells me that it is more helpful if you are upfront with your prospective employer about your illness. Making friends? They too will eventually ask about your mental illness. Explanations are a mixed bag. It is an exceptionally lovely gesture for someone to show they care and are concerned about you, but it also gets frustrating. How do you explain mental illness? Putting it in clinical terms in terms of thought processes and psychology – distracts from how it feels to live with it, yet the point is lost when you leave them out. Comedian Neal Brennan puts it this way:

“And the reason I itemise it is because when you have any kind of mood disorder, it’s not provable to people. All I have to show you is my work. I had 45 half-hour sessions. It’s really aggravating when you have a mood thing. You can feel people’s suspicion. Imagine if you had a cold, and people were, like, ‘He doesn’t really have that cold. That stuffiness is a choice.’ It’s really frustrating. It speaks to people’s ignorance about depression.”

Artistic works, however, may serve as an indispensable repository of the multitudes of human experience. I quote Mr Antolini in The Catcher in the Rye:

“Among other things, you’ll find that you’re not the first person who was ever confused and frightened and even sickened by human behavior. You’re by no means alone on that score, you’ll be excited and stimulated to know. Many, many men have been just as troubled morally and spiritually as you are right now. Happily, some of them kept records of their troubles. You’ll learn from them—if you want to. Just as someday, if you have something to offer, someone will learn something from you. It’s a beautiful reciprocal arrangement. And it isn’t education. It’s history. It’s poetry.

Something else an academic education will do for you. If you go along with it any considerable distance, it’ll begin to give you an idea what size mind you have. What it’ll fit and, maybe, what it won’t. After a while, you’ll have an idea what kind of thoughts your particular size mind should be wearing. For one thing, it may save you an extraordinary amount of time trying on ideas that don’t suit you, aren’t becoming to you. You’ll begin to know your true measurements and dress your mind accordingly.”


1. Catcher in the Rye

When read literarily, Catcher is pretty dull. The book has no real narrative arc; it merely follows 16-year-old Holden Caulfield as he experiences a mental health crisis. During this crisis, he impulsively quits boarding school and flees to his hometown of New York City. From here, the story follows Holden around as he calls upon every one of his few acquaintances in the hope that someone can rescue him.

Catcher is widely regarded as the progenitor of Young Adult Fiction. This rather harmless label, however, disguises how controversial Catcher was and remains to this day. You may expect that the only people who hate this novel to be those Foucault-reading high-brow literati snobs.

There are, to be sure, many haters of Catcher in that vein. More controversially, however, Catcher has a notorious reputation as the favourite book of lone wolf assassins. John Lennon’s murderer was arrested with a copy of Catcher inscribed “THIS IS MY STATEMENT”. Catcher was also found in the hotel room of the person who shot Ronald Reagan.

Holden Caulfield, the protagonist of Catcher, is a kindly soul who sought beyond all else to save children from the innocence-destroying forces of adulthood. Salinger, however, was no stranger to violence. He was an infantryman who fought at Normandy and the Bulge. He liberated concentration camps and personally interrogated Nazi camp wardens. His other works are shockingly violent: A Perfect Day for a Bananafish is about a family’s ordinary beach vacation for all but the last paragraph, during which the protagonist, a veteran, abruptly pulls out a pistol and kills himself. I will not spoil For Esmé – With Love and Squalor, but it involves a soldier recovering from post-traumatic stress disorder. Although initially reluctant, Salinger wrote several essays about the Holocaust.

Although Catcher never explicitly references mental illness or suicide, it is obvious that Holden is ill and desperately needs help. We learn, from the first page, that Holden does get the help he needs in the end. The story is a first-person retelling of how and why Holden found himself becoming institutionalised at a rehabilitation facility in California. My reading of the story has always been that Catcher’s strong sense of empathy and humanitarianism stems from Holden’s personal voice. Holden is crass and thinks everyone is a phony, sure, but he sees people not as complete souls but as injured and broken persons worthy of empathy. In other words, mental illnesses are the norm and not the exception.

At no point does Holden, as the narrator, make an explicit reference to his mental illness. Persons experiencing mental illness can rarely separate themselves from their illness, so Holden just told the story as anyone will do, without mentioning his mental health. It is hard – personally, I believe it to be impossible – to decant the influence of faulty brain chemistry from your psyche.

Salinger takes the reader through the exact thought processes and emotions felt by someone during a crisis of post-traumatic stress, anxiety, and depression. Because Catcher walks the reader through how it feels to be in a crisis, people who are facing a mental health crisis might find a third-person account of their own rojak of thoughts, feelings, and impulses. Seeing oneself in a narrative mirror rarely triggers neutral responses when one is in a crisis. Readers of Catcher have killed others and themselves.

 In my case, Holden’s sweet nothings convinced me to continue fighting and not give up.


Testimonies are, by their nature, graphic and deeply personal. Hearing people’s testimonies is powerful, whether the account is real or fictitious, biographical or literary. One may choose to deliberate afterwards, but testimonies are unique in being told uninterrupted. Testimonies are unique in the way they subdue the impulses of criticism and reaction that are too common in the current epoch. But because testimony is the empathetic art form, it rarely elicits neutral responses from those who experience similar pains. To hear your pains retold to you is to wallow in it existentially.

Everyone experiences mental illness in their own unique way. But certain tendencies are more common than others. Probably the most important in my affliction of anxiety and traumatic stress is that of rumination; of recursive thoughts which become more catastrophic with each inward spiral. “The thing about a spiral is, if you follow it inward, it never actually ends. It just keeps tightening, infinitely,” John Green wrote in Turtles All The Way Down. Like a black hole, there is an event horizon at which the crushing force becomes too much to resist. To live with anxiety (and depression) is to fight against this force of gravity day and night. There will be some days when you’re more successful than others. But you’re still outside the event horizon; that is all that matters.

Yet the key to overcoming it is not in avoiding and repressing it. The way out, in my experience, has been a similar but categorically different process: introspection. I am doing it while I am writing this very essay. Introspection allows you to identify illogicalities and triggers and work towards resolving and deciphering them. Testimonies can help in this process, by removing oneself as the subject of introspection.

But beyond the sufferer, testimonies also do public good by creating empathy. There are not many ways for psychic pain to be expressed to others. Most people have a general sense of how physical ailments feels like. But some illnesses, including mental illnesses, do not lend themselves to simple clinical explanations. Clinical terms are analytical tools. Clinical indicators fail in explaining how psychic pain can become so excruciating and exhausting that one chooses to end it through immense physical pain.

But art – specifically, first-person narrative storytelling – does an exceptional job of expressing the multitudes and intensity of psychic pain. Inner monologues are particularly good at articulating feelings like paranoia. Testimonies capture the agony of not knowing how to make the pain stop; they also capture the deeply human instinct to fight and to survive against our innermost demons. They perfectly capture the speed at which your brain’s memory runs and overflows during such a panic attack (and crises more generally). Testimonies also describe the nuances otherwise lost in clinical description.

The (mainstream) news industry is extraordinarily sensitive when reporting on suicides. Public figures are often beloved individuals. Their deaths pose an acute risk of a contagion effect. Every major news publication has a special set of norms and style guides for these reports. The International Center for Journalists provides the following guidelines:

1.         Avoid phrases like “commit suicide” or “successful suicide”

2.         Do not give too many details on suicide methodology

3.         Always provide helpline information

4.         Do not suggest that suicide was caused by a single event

There have been some outstanding works of art that meditate on this theme of Young Adult mental illness in recent years. This is both touching and worrisome. I will restrict this essay to young adults because they are often the most vulnerable.

Two works of art about mental illness and suicide have stuck with me over the last year: Dear Evan Hansen, a Broadway musical, and Thirteen Reasons Why, a teen drama series produced by Netflix.


2. Dear Evan Hansen

Dear Evan Hansen is a high-school Broadway musical about the suicide of Connor Murphy. The musical is about how the protagonist, Evan Hansen, forges correspondences and letters with and by the deceased Connor Murphy. He becomes close to Connor Murphy’s sister whom he fancies. Evan, from a single-parent household, also desires to have the nuclear family Connor Murphy had. Both Evan and Connor experience anxiety and depression, and each attempted to take his own life. Connor passed away. Both Evan and Connor are developments on the character trope of Holden Caulfield; Evan inherits the social awkwardness and anxiety of Holden, while Connor takes on Holden’s darker cynicism and misanthropy.

Connor was considered a “freak” at school before his passing, but after his death, he became commemorated as a martyr for youth isolation and alienation. Evan, trapped by a series of increasingly unfortunate lies, eventually finds himself compelled to start a remembrance project for Connor Murphy. The musical’s apogee finds the entire company singing:

“Even when the dark comes crashing through

When you need a friend to carry you

When you’re broken on the ground

You will be found

Well, let that lonely feeling wash away

Maybe there’s a reason to believe you’ll be okay

‘Cause when you don’t feel strong enough to stand

You can reach, reach out your hand

And oh, someone will come running

And I know, they’ll take you home”

I love the musical and its optimism, but the musical’s narrative is a collective fantasy imagined by the community to absolve itself of its alienation of Connor when Connor was actually alive. The third-last song of the musical details Evan’s friends abandoning him as he was having a meltdown. During a dark night of the soul, not everyone has access to friends who can and will carry them through crises. Friendships and relationships are strained, often broken, by having to taking care of someone else. Depressed people are just not enjoyable to hang around, much less help.

The musical doesn’t really explore the psyche of suicide. It is thus disappointing when Dear Evan Hansen is heralded as a play about suicide. Rather, it is a play about remembrance. Remembrance is important, but it does not provide testimony. It is surely important for people to be reminded that they must act to try to support their fellow human beings, before it is too late and all there is to do is remember. But it must be as important to treat victims of mental disorders as persons and not as subjects to act upon.


3. Thirteen Reasons Why

Thirteen Reasons Why, an episodic high school drama by Netflix, takes the opposite route when discussing suicide. Hannah Baker was bullied, stalked, sexually harassed, slut-shamed, and raped. Before taking her own life, she made thirteen cassette tapes. Each tape is addressed to a person whom she believes caused her death. Each tape contains one reason why. Thirteen Reasons Why takes the technique of literary realism pioneered by Catcher to its logical endpoint: nothing in the sequence of the events leading to the death is left to the imagination. The most controversial scenes involve on-camera rape and suicide.

The show’s protagonist, however, is a Holden Caulfield-type character who finds the tapes on his doorsteps in the days after Hannah’s death. He listens to the tapes in order, and the show’s meta-narrative centres around the guilt (or lack of guilt) experienced by each person named in the tapes and their attempts to remember Hannah.

Like Catcher, Thirteen Reasons Why has been extraordinarily successful with its targeted demographic of youths. But social mores have changed in the interceding fifty years between the publication of The Catcher in the Rye and the release of Thirteen Reasons Why. We now know that works of art depicting suicide, even fictional ones, lead to real-world death either through the contagion effect or the phenomenon of suicide clusters.

Criticism of Thirteen Reasons Why chiefly recalls public panic about The Catcher in the Rye. Mental health experts have criticised Thirteen Reasons Why. Epidemiologists have studied and found evidence that Thirteen Reasons Why is attributable to increased Google searches for terms related to suicide. Even the American National Association of School Psychologists has issued advisory memos on the television series. Parent groups have attempted to delay the release of the second season until episodes were re-edited or re-shot. A school in Canada tried to ban students from talking about it. A TIME magazine columnist opined: “What It Feels Like When All Your Parental Nightmares Are Rolled Into One TV Series”. Even the Christian socially conservative, anti-abortion, and anti-LGBTQ advocacy organisation Focus on the Family has written a parental guide suggesting parents spin it into a conversation of the excesses of youth culture.

Perhaps the show is uncomfortable because characters internalise the controversial stance that everyone is culpable in the suicide of a friend by their actions or inaction. “We all killed Hannah Baker,” one character proclaims when trying to absolve herself of personal guilt. This is a troubling stance because it is extremely difficult – even impossible – with current techniques and technology, much less human intuition, to determine why someone takes their own life. Persons who do so often have a history of troubles with mental health; it is an assertion as preposterous as declaring that The Catcher in the Rye is singularly responsible for the murder of John Lennon.

But this is not the focus of the essay, and I will leave this question to be resolved by the reader.


When Nietzsche talked about the void staring back, he probably did not imagine that the void would be in the form of a book and an audio-video presentation that can be accessed on your phone and which only costs $10. David Foster Wallace sort of predicted this in the eponymous movie of Infinite Jest, but not quite in the form of an unapologetically trashy teen drama targeted at teens – the opposite of an avant-garde art film if there was ever one.

Watching Thirteen Reasons Why, I knew that the show was actively injuring me. I knew going in that it was not a show I should watch – but curiosity got the better of me in a Bird Box sort of way. I took off my blindfold and started watching. I did not stop until the end of the first season, thirteen hours later. I had opened old wounds in my head, and I had physically started hurting myself.

Thirteen Reasons Why tapped on my tendency to ruminate about my past and triggered post-traumatic stress. It’s an odd feeling when a piece of art starts narrating your fears, regrets, and traumas back to you. The traumatic memories lodged in your hippocampus become activated alongside the intensity of emotions associated with them. But as with all good art that speaks to you, you can’t stop taking it in. It began to tear open previously closed scar tissues. I started thinking about every incident in my life when I had let myself or others down. The pangs of guilt triggered a further surge of memories, which in turn triggered more guilt. Self-flagellation is not a pretty process.

But I am glad that Thirteen Reasons Why exists, much as I was thankful to Salinger for writing Catcher. It is a work of art that provides me with the vocabulary to describe how I feel. And like Catcher was to me, I am sure it helped someone somewhere during their time of need. I am also sure it has hurt people. Talking about suicide and self-harm is hard. During the rare times when we find the mental courage to talk about it, we subconsciously sanitise and censor the story. I never quite found a way to tell the whole truth, even to those who rescued me. Even to my doctor. But I reserve those most painful of thoughts and memories to me and me alone. A fictionalised testimony that speaks true to the emotions but not to the fact is perhaps a second best, at least until the time is right.

It’s my hope, at any rate, that Thirteen Reasons Why – amongst other shows – helps more of us understand the thought processes of the psychologically vulnerable. I remain conflicted, however, between the artistic impetus to show psychological pain in its darkest manifestations and the ethical responsibility of the media to avoid pushing vulnerable persons over the edge. Censorships seems a blunt instrument not suited to the epoch of #MeToo, when testimony is to be heard in full and when inconvenient truths and unsaid secrets are to be confronted openly. But the trigger warnings at the start of Thirteen Reasons Why did not stop me from watching it.

Maybe we can resolve this by weighing harms, in the way advocated by John Stuart Mill; consumption of Thirteen Reasons Why is producing real and measurable harms – human suffering – at a level considerably greater than other works of art. But the harm of censoring testimonies seems comparatively incommensurable. There is a third option available, pioneered by #MeToo and apologists for The Catcher in the Rye: celebrating testimony and emphasising it as something to be learnt from. That seems a far way off, though.


Samaritans of Singapore: 1800-221 4444 (a 24-hour hotline)


Composite image by the author.


About the author

While not buried under books, you will find Reuben digging the depths of Wikipedia and Reddit for the most obscure of trivia facts. He would like for you to know that his major, Geography, is not only about rocks.