Reality TV has captivated audiences for decades, but what viewers see on screen is only part of the story.
While the genre has become a major source of entertainment, it has also prompted growing concern around contestant welfare, particularly when it comes to mental health. That issue is examined in Prime Video’s documentary The Curse of Love Island.
People hoping to appear on reality programs typically go through a detailed casting process, including psychological assessments, before being approved. Many productions now also provide mental health support both during filming and after a series ends. In ITV’s Love Island duty-of-care framework, that can include pre-filming psychological and medical assessments, support from a mental health professional throughout the series, and aftercare once participants leave the villa.
Psychologist Steven Stein, who has worked on shows including Big Brother Canada and Bachelor in Paradise, said that wasn’t always the case earlier in his career.
The documentary also looks at the deaths of former Love Island UK contestants Sophie Gradon and Mike Thalassitis, as well as former host Caroline Flack.
After those tragedies, reality TV figures urged producers to strengthen the support available to participants. ITV later updated its duty-of-care procedures and said contestants would receive ‘enhanced psychological support’ before and after filming. The broadcaster says its Love Island welfare process is regularly reviewed and has continued to evolve with each series, including training around social media, behaviour, and financial management.
Stein stressed that continued support can make a significant difference for contestants once filming stops and episodes begin airing.
“Mental health support during and after the show has been found to be very important. When I started working in this area over 20 years ago support was rarely provided postproduction. I work on many shows now where I provide weekly support, debriefing upon exit, and follow-up when the show actually airs.”
He also explained that psychological screening is a routine part of the casting process for reality television.
“The pre-show psychological screening usually includes a battery of psychological tests, demographic profile, and an interview with a psychologist,” Steven told us.
According to Stein, those checks can cover a range of factors, from overall mental health to substance use, resilience under pressure, and emotional intelligence.
He added that the exact testing depends on the type of show involved and the specific demands contestants are likely to face.
“For example, we may assess anger expression, cognitive intelligence, stress coping strategies, etc,” he adds.
On long-running formats such as Love Island and Big Brother, where new casts arrive every year and sometimes even more frequently, fame can be intense but short-lived.
Contestants who leave the villa or house, especially finalists, can suddenly find themselves thrust into the spotlight. But that attention can quickly fade once a new series begins and fresh personalities take over the headlines.
For some, that can also mean opportunities becoming harder to find.
“As part of the selection process, I always ask candidates why they are motivated to be on the show,” Steven says.
Stein said many applicants are excited by the possibility of a very different future, but they are also aware of the risks that come with appearing on such heavily watched programs.
One of the biggest worries, he said, is being remembered or judged for a single moment captured under pressure.
“It’s not easy to be fully in control of everything you say or do while under surveillance 24 hours a day with pressure as part of the game,” he says. “More and more candidates try to prepare for this. Those who care about whether they are perceived negatively spend time focussing on how they can prevent this. It’s not easy to be fully in control of everything you say or do while under surveillance 24 hours a day with pressure as part of the game.”