Comedy has always pushed the boundaries of what is acceptable, but when it comes to mental health, even humour is treading unstable ground.
Back in 2011, controversial comic Frankie Boyle felt the wrath of mental heath charity Rethink when a sketch in his infamous 'Tramadol Nights' show parodied adverts which were intended to break down stigma surrounding conditions like schizophrenia.
The skit featured an actor looking to the camera saying: "I have mental health problems. There’s a lot of stigma attached to mental health, a lot of people are unfairly stigmatised when their conditions allow them to lead perfectly normal lives."
The camera then zoomed out to reveal four dead bodies in front of him and ended with the character saying "Who the fuck am I talking to?".
Rethink were concerned the sketch propagated dangerous ideas of all people with schizophrenia being violent. However, Channel 4 defended the joke, claiming it was a parody of incorrect stereotypes rather than a joke at the expense of people with mental illness.
Since that high profile example, other comics have also faced criticism for promoting myths, discrimination and stigma.
Left-wing comedian Jeremy Hardy came under fire and was admonished by Jeremy Corbyn in March for quipping that former Labour minister Kevan Jones’ support for the renewal of Trident "proved he had depression".
Around the same time, Democratic presidential candidate Bernie Sanders garnered criticism for claiming that the state of the Republican Party's presidential debates proved the nation's need to invest in mental health. While his intentions were clearly good and the remark prompted laughs from the audience, people with mental health issues weren't so pleased.
Writing in a HuffPost blog, journalist Ellie Williams said: "Every day, Americans use mental illness as shorthand for bigotry, for stupidity, for violence. For sure, violence can be a part of some mental illness. But for those of us inside mental institutions hoping to get out, we are not given the luxury of being angry like Trump or bigoted like Cruz."
But these unpleasant cases don't spell the end for jokes about mental illness - a growing number of comedians are using their medium to tackle the problems head on, engage in debate and break down societal barriers.
"People either don’t want to talk about mental illness or we only talk about it in very serious, respectful, reverent tones," comedian Felicity Ward told WOW 24/7. "Otherwise you’re seen as laughing at mental illness when actually, there is a lot about mental illness that is really funny."
Ward, who suffers from Irritable Bowel Syndrome as well as generalised anxiety disorder and evolving depression, dedicated an entire show to explaining how she started off ignoring the symptoms of her mental illness but eventually sought help and started to improve her life.
Although she didn't set out to make a huge difference to peoples' lives with the critically acclaimed show 'What If There's No Toilet?', Ward told The Huffington Post UK that her shows had had an unexpected effect on audience members.
"I've been inundated with emails and Facebook messages, and people have gone to see doctors after my show which is amazing," she said.
"I've had maybe three or four people say 'I'm writing this from a doctors' surgery, I saw your show yesterday'."
Felicity Ward and other comics like her who are finding nuanced ways to find laughter in mental illness all share a common theme - the jokes are coming from experience. They have all, at some point in their lives, suffered from mental health issues or experienced them very closely.
"In stand-up you have to bring truth to the stage. The comedy only works if it’s rooted in a reality and a truthfulness about the person," comedy performer Doug Segal told us in an interview.
"Any comedy that punches down rather than up is fundamentally a little bit dangerous. If you’re attacking the condition rather than the sufferer, that seems OK. You know, depression is a common enemy. It’s not our friend.
"If the punchline is a person with mental illness and it’s perpetuating myths about mental illness and discriminatory ideas about mental illness then obviously that’s not a good thing."
Fern Brady is another comedian who tackles subjects surrounding mental health from her own personal experience. She spent a period of her early life in a child and adolescent mental health services (CAMHS) unit and drew on her experience in the BBC pilot 'Radges', which followed a group of teenagers excluded from their schools due to social and behavioural issues.
The show was never picked up by the BBC, which Brady says was due to worries about offending people with mental illnesses.
"When I made my sitcom pilot," she told HuffPost UK, "the BBC kept trying to change it into a sitcom just about some normal school friends, not in a mental unit, and they were like ‘oh, we don’t want to offend any of the mentally ill’ and I was like 'I am the mentally ill!'"
“You’ve got to look at the dark side of things to be able to find the humour in life. Not everything can just be cute jokes about kittens.”
However, things aren't quite as simple as laughing at yourself. Mark Watson, who has suffered from depression, says it's important to avoid losing touch of the gravity of the situation.
"There’s no doubt that comedians’ tendency to make fun of stuff is a really powerful weapon against things like depression, but it can also end up trivialising it so it’s just about finding the right territory," he said.
“Mental health issues are best tackled by discussion, by dialogue rather than shutting them away.
"Comedy at it’s best doesn’t just play things for laughs but stimulates discussion, and debate, and exchange of ideas. Comedy’s in a good position to do that because it is fun so it can be a way into heavy topics which otherwise people shy away from.”
Amber Tozer, who published a memoir about her life as a comedian while experiencing alcohol addiction, says there can be pros and cons of joking about your own mental health.
She said: "When I'm feeling nuts or I'm in pain and I write a joke about it and people laugh - I feel like, 'Oh good. These people understand me and agree with me. Thank God! And they seem a little bit happier! Bonus!'
"On the other hand, self deprecating jokes have silently plagued me in the past. I used to joke about being a drunk and it made me think being a drunk was great. It also made me think I would have to drink so I could keep writing jokes about being a drunk."
“It's not cool to point at someone who is having a mental breakdown and laugh at them or to make jokes at the expense of someone else's pain (unless they are Donald Trump). But there is something magical about being in pain and turning it into a joke. It lightens everything up.”
Another clear reason for joking about mental health is that it can be cathartic for the people making the jokes.
Juliette Burton, who says she has "more labels than TK Maxx," uses the medium as a way of processing the things that go through her head on a daily basis.
"Comedy is a great place to deal with things that make you angry," she said. "And my mental health problems make me really angry. I wish they weren’t there, but equally I wouldn’t be me without them so one of my ways of dealing with them is to make fun of them.
"To be able to hear a room full of people laughing about what I’m struggling with in my own words, it makes me feel less alone.”
David Granirer, a counsellor who runs stand-up classes for people with mental health issues, feels much the same way.
"Joking about mental health is one of the most life-affirming ways of dealing with what is an incredibly painful condition," he says. "I think we’d really go nuts if we weren’t able to joke about it. There’s an incredible benefit to being irreverent towards the disorders that have caused us so much hardship. And we’re not making light of a serious issue, we’re telling our recovery stories through comedy which is a completely different thing."
Felicity Ward also spoke of the benefits of joking about mental health, citing the medium's ability to reach people in new ways who wouldn't normally hear about mental health through traditional media.
"Comedy is a great way to reach people in an accessible way, so if you’ve got people that are just telling their stories about mental illness in a non-funny way, then you’re gonna reach a certain part of the audience but another part of the audience will shut down immediately," she said. "That’s the upper hand that comedy has, that most people are probably willing to listen to you before you’ve said anything and then they’ll make their judgement afterwards.”
Several other comedians we spoke to voiced the unintentional benefits of talking about these issues in a funny way. John Robertson, who often incorporates the stories of several suicides that have affected him during his life into his comedy, spoke about a young girl who once asked him "is it better to stay alive?" after a show. The answer, he said, is always "yes".
John Ryan has also seen positive reactions after performing at 'Cracking Up' at the Redhill Theatre. He spoke about a friend of one of the performers who, in watching the show, realised they had a problem and went to seek medical help.
“I think if anybody is worried about what humour does, they have a problem.”
While these comedians are treading a fine line between trivialising mental illness and causing offence, cabaret performer Dusty Limits warns it's important to remember that offending one person doesn't de-legitimise an entire piece of work.
"If you are someone who consumes the arts and expects that all the arts will be sanitised just in case it offends one person, you might as well not bother leaving the house," he said.
"You’ve got to look at the dark side of things to be able to find the humour in life. Not everything can just be cute jokes about kittens."
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