Can a play change attitudes about depression?

Inside a coffee shop, a 20-something aspiring actor with depression and zero confidence strikes up a conversation with a woman – as an assignment from his therapist.

"Uh, beautiful weather we're having at the moment," he says to the blonde-haired stranger, who clearly would rather be left alone to continue with her writing.

"I don’t really do small talk," she responds dismissively.  "Plus, this is Los Angeles. The weather’s always beautiful."

The scene could be taking place in just about any Southern California coffee house. But this particular tête-à-tête is in a make-believe café, during rehearsal for a play called "The One With Friends." 

While it is a work of art, the play is also part research project that seeks to uncover scientific evidence that theater can reduce the stigma associated with depression.

"The One With Friends" features two main characters who struggle with depression and must deal with a host of challenges that touch on friendship, on work, on access to medication and on the difficulties posed by people who don't understand the illness. 

"In the play I show how much support someone needs," says playwright Joseph Mango, who wrote the piece to educate people about depression – a condition he, too, has struggled with.

Analyst by day, playwright by night

Mango, a graduate of NYU film school, isn’t your typical playwright.

By day, he’s a senior public administrative analyst at the UCLA Center for Health Services and Society, a mental health research program at the school's Semel Institute for Neuroscience and Human Behavior. Mango co-directs the "Narratives Project," which explores ways the arts can combat the stigma of mental illness.

This past summer, the center partnered with the Pacific Opera Project in Los Angeles to perform "The Center Cannot Hold," an opera about schizophrenia based on the best-selling memoir of the same name by USC law professor Elyn Saks.

The production focused on the period of Saks’ life when she was hospitalized with paranoid schizophrenia.

The opera shows in detail "what it’s like to be in restraints … for hours and hours at a time and how dehumanizing it is," says Dr. Kenneth Wells, its composer and lead librettist. He's also director of the Center for Health Services and Society at UCLA.

A post-performance talk with the audience after the opera, Mango says, underscored for him how deeply people can be moved by the arts.

"One person I remember said, 'I never knew what my cousin went through living with schizophrenia until I saw this opera today, and now I understand,'" he says.

Yet when Mango set out to find scientific data that backed up what he and others had experienced, he came up dry.

"Very little research"

"The assumption is that the arts is a powerful way to move people … but very little research really supports that," says Dr. Bonnie Zima, associate director of the Center for Health Services and Society.

In an effort fill that data gap, Zima says she’s been helping Mango use his play as a research tool to measure whether and how the arts can change perceptions about mental illness.

Together they researched and chose scientifically-sound measures of stigma and crafted two surveys for those who attend the play. The audience will be asked to fill out the first one before the performance and the second one after it ends.

"The question," Zima says, "is just in that one-hour play, can we find a statistically significant difference in change in stigma around mental illness, particularly depression?"

The audience will also witness the ways in which friendship and support help the characters cope with depression, Mango says, adding that the play ends with a message of hope.

"As with depression, though, it’s not a quick fix," he says. "So, I didn’t want to give that off in the play – that this character is going to be better by the end. But I wanted to give some type of hope."

After crunching all of the survey data from this weekend's performances, Mango and Zima hope to publish their findings in a peer-reviewed journal.  

"The One With Friends" will be performed at the Ronald Reagan UCLA Medical Center’s Tamkin Auditorium on Oct. 7 at 8 p.m. and on Oct. 9 at 2 p.m. Admission is free.