Dr. Phil McGraw was a longtime guest of The Oprah Winfrey Show before launching his eponymous series in 2002. He has appeared on over 2,000 hours of national television programming, using his platform to highlight mental health issues. 

Harvard Political Review: How would you characterize your role in framing the national conversation surrounding mental health issues and their treatments?

Dr. Phil McGraw: Our goal has always been to take the stigma away from mental health issues because I think all the way back to the pre-Dorothea Dix era, there has been a stigma around mental illness. Prior to Dorothea Dix, we were chaining these folks up sometimes and even since then I think we’ve warehoused them and now sometimes put them in chemical straightjackets. It’s long been said that psychology works best for those who need it least.

We’ve tried to make it okay to talk about it by doing it in a public forum. I think I saw the statistic recently that over our 2,000 shows we had 1.4 billion viewers. Certainly we’ve touched a lot of viewers during that time talking about mental health in an open way. People have opened up about it not just because of The Dr. Phil Show, but I like to think that we’ve added to that in at least a small way by making mental health something that’s alright to talk about in polite society.

HPR: What do you think has been responsible for your success? Why do you think people are very comfortable talking with you about very private matters?

PM: I think we deliver very commonsensical, usable information to people’s homes everyday for free. If you think about it, we’re talking about things that matter to people who care. When I say things that matter, we’re talking about marriage, family, parenting, emotion, motivation, all of those things that kind of define the human experience. We’re talking about those things everyday to people who care about those things everyday.

And I take very seriously the things that I say. For example, if we’re talking about obsessive compulsive disorder or anxiety disorders or depression, we only talk about evidence-based therapies, and we try to break them down into ways that people understand.

HPR: How do you determine which topics or which health issues are going to appear on the show? And how do you account for commercial concerns—attracting viewers and ensuring the show’s success?

PM: Those two things actually are not at odds, fortunately for us. We let the viewers determine what we’re talking about. In a generation that is much more driven by the Internet than mine was, it’s easy today for us to know what our viewers are interested in. I’ve got millions of followers on social media platforms and the Dr. Phil message boards, and we choose our stories mostly from messages that we get of people asking for help.

If something is really capturing the attention of the American public, then we know that’s what our viewers are interested in so we’ll address that. If something is happening on the political landscape, I won’t deal with the topic on a political level, but I might be getting letters from parents asking, “What do we say to our children about this?” When we had that terrible shooting in Newtown, we had so many letters from parents saying, “My children are afraid to go to school. What do I say to them so I make them aware but not afraid?” And so we talked a lot about how to speak to your children about those things. That captured the attention of America, but rather than report on the facts of the story, we went behind the story and talked about how parents dealt with their children—about their fears, about how not to say too much, but to give them enough information to make them feel empowered.

HPR: Are there other conversations which you don’t want to host on your own show?

PM: We try to deal with a broad spectrum of human experience, but we place restrictions on ourselves. For example, we don’t book anybody on our show who is currently in therapy unless we’ve contacted that person’s therapist, explained to them what the show’s about, what we intend to do, and we’ve gotten their written permission for their patient to appear on our show. If we don’t have that written permission in hand, we just don’t book that person on the show. And there has not been one exception in thirteen years.

We don’t book people who have been institutionalized in any kind of recent past. If somebody’s been in inpatient care in recent past, my theory is they’re probably not the best candidate to put in a highly stimulating public forum—it could put a lot of stress on them. We don’t book people who have any type of active suicidal history or ideation, again because we don’t want to overstimulate them or put them in a situation that might not be in their best interest. We don’t book anybody who’s on any kind of major psychotropic medications because they wouldn’t be on these medications if there wasn’t a good reason. We put those restrictions on ourselves and we adhere to them very stringently.

HPR: Are there any new challenges or considerations that your show encounters today that perhaps weren’t in place when you started thirteen years ago?

PM: No question about it—we’ve seen things change since we started. Some things have come and gone, and some things have taken a vector and continued to evolve in a particular direction.

When we first went on the air, texting was not a big deal. There wasn’t any Instagram or Twitter. Now, the interactivity we have with our viewers commenting on our content during the show—they want that interactivity so we’ve had to make that a part of what we do.

We’ve seen viewer patterns change in that their willingness has changed to sit there and passively be fed content for an hour as opposed to selecting what they want to see, interacting with what they want to see. Our research tells us that 80 percent of the time that people are watching my show there’s a second screen up in the room. We’re having to make efforts to control that second screen by having content on our website that is congruent with what they’re seeing on the broadcast screen at the same time.

This interview has been edited and condensed.

Image credit: Office of Dr. Phil

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