When all seven episodes of the S-Town podcast — from the team behind Serial and This American Life — were released on March 28, it immediately became mandatory listening.
What started as an investigation into a possible murder ended up turning into an investigation into the life of John Brooks McLemore — an eccentric antique clock restorer from Woodstock, Alabama, or as he refers to it “Shit Town.” As host and reporter Brian Reed uncovered parts of McLemore’s past, it became evident that McLemore was dealing with some serious mental health issues.
Listening to the podcast as a journalist, bioethicist and someone with my own mental health challenges, I was left with a lot of questions, including — as Vox’s Aja Romano raises — whether it should have been made in the first place.
In order to get a better grasp on the possible wider mental health implications of S-Town, I spoke with several professionals in the area about how the show handled mental illness and the major takeaways.
WARNING: SPOILERS AHEAD
1. Suicide threats should be taken seriously
Listeners quickly find out that the podcast is, in fact, about a death, but not an unsolved murder as we were initially led to believe. McLemore’s suicide was shocking but not entirely unexpected, even given the limited knowledge we, as the audience, had about his mental state at that point in the show.
Getting a glimpse into McLemore’s mind, as well as the involvement (or lack thereof) of his friend/son figure Tyler Goodson and town clerk Faye Gamble might prompt some people to take others’ suicide threats more seriously, according to Gennifer Morley, a therapist in Boulder, Colorado.
“John took many actions prior to his death that signaled the seriousness of his suicidal ideation, including disclosing those thoughts and feelings to a wide community of individuals, writing and sharing a suicide note and talking openly about what to do with his possessions following his death,” Dr. Danielle Keenan-Miller, director of the UCLA Psychology Clinic told SheKnows. “It’s important that listeners of the podcast know that even if someone brings up suicide in a way that seems incidental or even humorous, it’s important to take that risk seriously.”
Dr. Ryan Hooper, a clinical psychologist practicing in Chicago, thought S-Town did a remarkable job connecting listeners to the individuals discussed in the podcast, which included how they handled McLemore’s suicide.
“The gravity and seriousness with which S-Town examines John’s suicide finds a balance of appreciating his life while also stating the serious consequences of his mental health struggles,” Hooper told SheKnows. “The undertone through much of the podcast is the tragic outcome of his death and a wanting desire to not only understand John but to help him.”
2. There is a strong need for improved mental health care, especially in rural areas
“I think the lack of mental health services, education and support throughout the country speaks to a sad political state that does not value helping people as much as it could,” Morley told SheKnows.
If the story was to make some change, Morley hopes it would illuminate the need for access to mental health in rural areas.
“When John was in college in a bigger town, he got some support — although it didn't work for him — I imagine he may have made more efforts if there were options closer,” she noted.
Keenan-Miller stressed the importance of considering seeing a therapist over the phone or internet if you live in an area where mental health services aren’t easily accessible.
Therapists practicing in rural areas also have the challenge of potentially knowing their clients personally, which could be off-putting in tight-knit communities.
“Seeing someone remotely through technology can enable those seeking services to find someone unaffiliated with their community or someone who shares their particular world view,” Keenan-Miller added.
3. Mental illness diagnoses are complex
There really is no such thing as a straightforward mental health diagnosis. Every person is multifaceted and unique with different contributing experiences, making one-size-fits-all diagnoses impossible. This was certainly the case for McLemore.
“A diagnosis often makes us feel like things made sense when they didn't,” Morley said. “John's life as reported was challenging and confusing, as many are.”
She went on to speculate that McLemore likely would not have wanted a complete diagnosis, and given his worldview, it probably wouldn’t have saved him anyway. So would it have helped anyone? As Morley put it, “Do we as listeners or even family have a right to seek a diagnosis for someone who does not want it for themselves?”
Hooper praised the podcast for how it handled the complexities of McLemore’s condition.
“I thought S-Town did a tremendous job of describing John in both his triumphs and struggles while also adding context including his mental health diagnosis and suicide,” he said. “We are human and therefore our experience of mental health symptoms and their appearance to others can be confusing and uncertain. S-Town is a triumph as a real-life presentation of someone’s mental health struggles, including how they impact other people.”
4. It could make people feel less alone
McLemore made no secret of the fact that he was lonely and looking for companionship, and the more Reed dug into his past, the more this became apparent.
“We hear John share honestly about his struggles with his hometown, but you could also hear the struggles in his voice,” Hooper said. “Because of this, I believe that we were able to understand and relate to John... and we can bridge the empathy gap. One of the best predictors of having compassion towards any particular struggle or issue is if it affects us or someone we know. I believe that the intimate story-telling and open book approach of John in S-Town allows many of us to relate to John. That connection can raise awareness to help us better understand the complexity and challenge of living with a mental health disorder.”
Suicide is the second-leading cause of death among certain age groups and the 10th leading cause of death overall, and in 2015 alone, more than 16 million Americans experienced a major depressive episode. This is no small problem.
5. Caring for — or about — people with mental health issues is complicated
Anyone who has had a friend or loved one with mental illness knows that there is no easy way to “help,” and it’s frequently difficult to tell what exactly “helping” constitutes. Does it mean forcing your way in when a person wants to be alone? Does it mean respecting their self-imposed boundaries? The only consistency is that it’s never easy.
"I appreciate that it showed that John had the freedom to live and die as he wanted to despite that fact that it made other people uncomfortable — without actually hurting them,” Morley said. “This is real. The impulse for us to 'rescue' people from their own life can be more of a reflection on how distressing the person is to us rather than anything they are actually wanting out of.”
6. Finding the right mental health provider is hard, but crucial
Like so many people, McLemore did seek mental health treatment during college, but chose not to continue with it after not finding the experience fulfilling or helpful. Finding a therapist isn’t like finding a general practitioner — of course it’s important to be comfortable with both, but there are different types of therapists with different styles, and it’s so important to find one that works for (and with) you.
“We know from a large body of research that one of the most important factors in treatment outcome is the quality of the relationship with the treatment provider, so it often takes several attempts to find the right person,” Keenan-Miller said. “It’s hard to keep searching and holding on to hope for treatment when one is feeling depressed, but friends and family can facilitate the process by helping to identify potential providers.”