Depicting Perinatal Mental Illness in Hollyoaks – Diane and Liberty's Plotline Analyses

AIMS: The 2018–2020 MBRACE report highlights that 1.5 women per 100,000 die by suicide during pregnancy or up to 6 weeks postpartum in the UK, a threefold increase since the 2017–2019 report. Raising awareness of the variety and severity of perinatal mental illness is vital in order to reduce stigma and ultimately save lives. Hollyoaks is a soap opera with a target audience aged 16–24 years. In 2020 the show aired the storyline of Liberty Savage, a woman whom developed postpartum psychosis. In 2021 the show aired the story of Diane Hutchinson as she develops symptoms of Obsessive Compulsive Disorder (OCD) during her pregnancy. In this article we analyse both storylines for clinical accuracy and consider the impact that this may have. METHODS: EC and AS held structured discussions in order to assess the accuracy of the portrayal of each illness, comparing each presentation to diagnostic criteria. Further discussions were held to establish themes and to consider the impact of the information/misinformation delivered to viewers. RESULTS: The production team worked with the charity Action on Postpartum Psychosis when producing Liberty's story. The storyline addresses that Liberty hallucinates, although creative licence is used. She is emotionally labile and highly anxious with a fixation on her baby's well-being. Unfortunately there are many elements of Liberty's storyline that do not accurately portray post-partum psychosis. She has no delusional beliefs, no thought disorder and is fully orientated. Liberty is consistently immaculately presented and while there is mention that she is sleeping poorly this is not explicitly seen. We do not see any interaction with a psychiatrist and Liberty is not admitted to hospital. Diane's story begins when she falls pregnant during the COVID-19 pandemic. The production team worked with the charity OCD UK. Diane's presentation is focused around contamination. Her intrusive thoughts are voiced out-loud for the viewer to hear yet are distinguishable from the spoken dialogue. Her intrusive thoughts escalate during labour and in the immediate postpartum period and her distress is palpable throughout these scenes. Diane's storyline concludes with an evaluation from a supportive psychiatrist who gives a clinically accurate explanation of her presentation and offers reassurance. CONCLUSION: The mainstream media can provide a useful tool to raise awareness of perinatal mental illness in the general population and may play a vital role in reducing stigma. However, variations in clinical accuracy are likely to be present, even within the same television programme, limiting potential positive impact.