There was a time when the biggest stars of reality TV were characterised by their ordinariness – Craig Phillips, the winner of Big Brother 1, was a chirpy Scouse builder who gave his prize to a young girl who needed a life-saving operation, while Steve Brookstein, the victor of the first run of The X Factor, left certain women weak at the knees with his cheeky smile and approachable manner.
Back then, it was often the newness of the shows that was most mesmerising to viewers rather than the singularity of the people taking part. But 10 years after Big Brother ushered in the era of wall-to-wall reality TV, broadcasters now have to battle to keep audiences interested by pushing boundaries.
Transsexual Nadia Almada won Big Brother in 2004, followed two years later by Pete Bennett, who has Tourette syndrome, while blind Mikey Hughes took part last year. Other, more vulnerable people have also appeared, sometimes with distressing consequences. Susan Boyle, who despite having learning disabilities wowed audiences on Britain's Got Talent, collapsed after the final in May and was admitted to a private medical clinic with exhaustion, and Sree Dasari was taken to hospital after self-harming after his eviction from this year's Big Brother.
Last week, the producers of The X Factor announced they would boost the provision of psychological help on this year's run, which began on Saturday and will include a young man with Asperger's syndrome. But where do producers find the balance between introducing boundary-pushing people and safeguarding their welfare? And how do contestants cope when they are suddenly thrust into the media spotlight?
Car-crash TV
Those who have seen at first hand the impact of overnight fame on them say that contestants, particularly those who are more vulnerable, need a lot of support. "It seems there is hardly a show that goes by without someone who can't deal with the fallout," says Jo Hemmings, a behavioural psychologist who has assessed psychometric testing on Big Brother.
"That kind of thing has to be taken seriously. People watch reality TV because it is car-crash TV. It is unpredictable and that is why people enjoy it. However, I don't think people enjoy seeing people fall apart emotionally or psychologically. It is an absolute duty [for production companies] to have people monitoring contestants.
"Far be it for me to say that anyone who has got a disability shouldn't be able to go on these shows – it is wonderful to open up these opportunities, but if you are going to do that there is even more of a duty of care."
Chris Thompson, chief medical officer of the Priory clinic, where Boyle was admitted, voiced concerns at the time about the level of care provided for contestants, saying that sudden fame could destroy self-esteem if adequate support were not given and that exposing people to such public attention could be "terribly risky".
But the Britain's Got Talent judge Amanda Holden defends the show's treatment of Boyle, saying the pressure she came under was totally unexpected. "Everyone is very mindful of the potential stresses involved and it is a very caring show," she says. "The thing to remember is that this phenomenon had never happened before – it made history. And there was no warning – [with] Paul Potts, the previous year, there had not been the frenzy that there was with Susan. It seemed to feed on itself and just get bigger and bigger – mostly in a really positive way until that last week. But now that things have calmed down I think she will go on to enjoy what it was all about for her in the first instance – the singing."
The X Factor judge Louis Walsh admits that some contestants can't take the strain of appearing on the hit ITV1 talent show and says that 21-year-old Scott James – who told the judges he didn't leave his house for seven years because of his Asperger's syndrome – initially didn't know what he was letting himself in for.
When asked if someone like James can take the strain, Walsh told Radio Times: "I don't think they can, if I'm honest. People don't realise the pressure that these acts are under. It's very gruelling, and it's 10 weeks of very intense performance. Everything you say and do is being watched." But Walsh denies it is unfair to allow James to appear. "Nobody forces anybody to go to an audition. Is he under too much pressure? I think it has to be his choice."
According to a survey by the US website thewrap.com, there have been 11 deaths involving reality show contestants, including the American Idol auditionee Paula Goodspeed, who was found dead in a car near the home of former judge Paula Abdul last year, and the runner-up in ITV2's Paris Hilton's British Best Friend, Kat McKenzie, who was reported to have killed herself last month. Abdul said Goodspeed had been stalking her for 17 years and that she had begged producers not to let her audition, but they went ahead for "entertainment value". "It's fun for them to cause me stress," Abdul was reported as saying. "This was something that would make good television."
Most shows have robust procedures to screen out those deemed unsuitable as well as to look after those who get through, but former contestants admit the sudden attention can still be difficult. "When The Apprentice started, so did the melee – journalists phoning you and feeding the beast that needs to be fed," says the former Apprentice contestant Raef Bjayou.
"For that period, you are very much in demand and that kind of slaps you across the face. People would come up saying they thought it was great. As nice as they were, it made simple tasks incredibly daunting. You always hear it from A-listers who can't stand things that come from fame, but when you experience just a little bit of that you start to appreciate that it is incredibly burdensome."
While Bjayou says he has no complaints about his treatment, he is one of the lucky ones who have gone on to further media work (he has a forthcoming Channel 4 documentary on manners) – most get few opportunities. "It is quite tough for a few people who expected to be more successful, especially in this economic crisis," Bjayou adds. "I remember the days of Jade Goody when vast sums of money were thrown at people. I had this conversation with some of the apprentices this year and they felt a bit disillusioned."
Christopher Biggins, who won the ITV reality show I'm a Celebrity … Get Me Out of Here!, says he found it hard to acclimatise after leaving the Australian jungle, but believes it is easier for celebrities who have experience of dealing with attention than for ordinary members of the public. "I have been in the business for 44 years and I am quite sane and together, but for people going on shows such as Big Brother, they are looking for their 10 minutes of fame and it can cause considerable grief," he says. "They are put into a false sense of a comfort zone which is not really there."
Phil Edgar Jones, the creative director of the Big Brother producer Brighter Pictures, part of Endemol, insists the wellbeing of contestants is of the utmost importance. "We are very mindful that we are taking people into an unfamiliar world," he says. Potential housemates are subjected to three interviews with various levels of producers and undergo sessions with a psychologist and a psychiatrist to see if they have the ability to take the pressures.
"After 10 years of Big Brother, people are more savvy and know more about what to expect, but they don't really know until they have done it," says Edgar Jones. "We give them the 'talk of doom' where we go through all the bad things that can happen. Part of our job is to manage their expectations for when they come out and try to explain that most people who do Big Brother or any of these shows don't achieve lasting fame."
Edgar Jones is convinced it helps that contestants now have a greater awareness of what to expect, and Bjayou agrees: "I think it helped that the series I applied for wasn't the first or second," he says. "I knew a little about what one could expect post the show and during the show by talking to past contestants. It wasn't like the people who applied in series one who didn't have any clue what it would to do them."
Psychological trends
While contestants are cosseted during their stay on the shows, with support from producers and psychologists, it is when they leave that the real issues often become apparent. Dasari was alone in his university hall of residence when he self-harmed, seemingly upset that little had happened since his eviction. "I think he was just sitting on his own and his phone wasn't ringing," Edgar Jones says. "He was watching the show and felt a bit low and wanted to see somebody. As soon as we got a phone call we got him into our care. He is fine now and was on Big Brother's Big Mouth the same night."
Edgar Jones points out that support for Big Brother contestants continues after they have left, with counselling offered immediately and then six months down the line. However, how they deal with things is down to those taking part – "ultimately people have to take responsibility for themselves," he says.
Former Apprentice candidates are also given initial support after leaving, such as help in securing media deals and agents. "But when that ends you find there is no one who wants to take an interest because, rather cynically, there is no more money to be made," Bjayou says.
With the reality genre now so established – and discredited, to some – what makes people continue to apply for an experience that will often leave them damaged in some way? "There are some interesting psychological trends that drive people who want to be recognised," Edgar Jones says. "Some people apply [to Big Brother] just for the experience, but I have noticed that roughly 80% of women or young girls who apply have absent fathers or have never met them – going on the show is a 'look at me' thing for them."
Biggins says he took part in I'm a Celebrity … Get Me Out of Here! simply "to make a pension. I loved every moment and would not have missed it for the world, but I wouldn't do it again."
• Surviving Reality TV is one of the sessions at this year's Media Guardian Edinburgh International Television Festival. For more information visit mgeitf.co.uk
