{shortcode-f7fbad0e3babf3c421e3c7ef852f3e78b52c4d2c}In a country where suicide is the tenth leading cause of death overall, where a suicide attempt is made approximately every 28 seconds, and where only 10 states mandate that healthcare professionals complete suicide prevention training, mental illness is a pressing concern. Unfortunately, it is also one of the most stigmatized. Though research on the topic is sparse, a 2007 survey demonstrates the pervasiveness of suicide’s stigma, expressions of which range from avoidance and unhelpful advice to the active blaming of victims or their families.

Professionally recommended methods of combating the stigma include talking openly about mental health and humanizing those afflicted by mental illnesses. Music has long been a favored medium for encouraging the abandonment of prejudices. So it is no surprise that artists have turned to musical theater as a forum for shedding light on these topics.

Since its Broadway debut in 2016, smash-hit “Dear Evan Hansen” has been hailed for starting conversations about suicide with potentially life-saving results. Featuring a main character who is in therapy for his severe social anxiety, the original musical unflinchingly addresses themes of perceived isolation, attempted suicide, and the innate desperation to be loved. Yet, while certainly important, the musical is not the first to tackle such subjects.

Before “Dear Evan Hansen” captured the national spotlight, “Fun Home” had garnered popular and critical acclaim as the hard-hitting, Tony-winning surprise of 2015. Whereas Evan Hansen grapples with his own mental illness, Alison of “Fun Home” — which is based on the life and memoir of Alison Bechdel, a cartoonist best-known for creating “The Bechdel Test” — attempts to come to terms with her guilt regarding the suicide of her closeted gay father, which occurs just months after Alison comes out as a lesbian to her parents. Structured around the adult Alison remembering her childhood and college years, the show is subtler than “Dear Evan Hansen” yet still delivers a poignant message of self-acceptance.

Still before “Fun Home” came “Next to Normal,” an influential show that the New York Times referred to as “Mental Illness, the Musical.” The eighth musical in history to win a Pulitzer Prize, “Next to Normal” premiered in 2009 to mixed reviews but a general consensus that the show was broaching new ground. Diana, a suburban mother, struggles to cope with worsening bipolar disorder, undergoing accurate treatments such as medication, psychotherapy, and electroconvulsive therapy. Her destructive behavior, suicide attempt, and memory loss are not romanticized whatsoever, although the show’s end shares a pragmatically hopeful tone with “Fun Home” and “Dear Evan Hansen.”

Acknowledging the importance of accuracy, the creative teams of “Next to Normal” and “Dear Evan Hansen” have emphasized their consultation of mental health experts and suicide prevention groups throughout the writing process, and many productions of “Fun Home” are accompanied by post-show discussions about mental health. Unlike shows such as “Les Misérables” and “Miss Saigon” — both of which use the suicide of a major character as mere plot points — these musicals unapologetically feature mental illness as an integral element of their stories. Each show has its own distinct tone, style, and appeal, yet they share a determination not to belittle, romanticize, or ignore the gritty reality of these themes. Instead, the musicals combine the compelling power of music with the influential platform of Broadway — as well as the now unlimited reach of cast albums via the internet — to create stories capable both of helping audiences rethink their preconceptions and of comforting those with personal ties to mental illness.

America seems to be at a turning point in its willingness to discuss mental illness. More TV shows are openly addressing mental health than ever before. Netflix’s “13 Reasons Why,” while problematic and heavily criticized by mental health experts, certainly sparked conversations. The CW’s musical comedy “Crazy Ex-Girlfriend” includes the respectful and very specific diagnosis of its main character with borderline personality disorder. Television reaches an even broader audience than does musical theater, and so the manifestation of these themes in such popular shows might suggest the nascent end of the stigma.

While progress has certainly been made, the stigma is far from broken. Even these niche musicals seem caught between fully embracing mental illness and appealing to a mainstream audience. Perhaps noting the instant branding of “Next to Normal” as “Mental Illness, the Musical,” the marketing teams of both “Dear Evan Hansen” and “Fun Home” initially universalized their taglines and advertisements to avoid being known as “the suicide musical” or “the lesbian suicide musical,” respectively. This does not necessarily represent a reluctance on the part of creators to defy stigma. Rather, the vague marketing strategies suggest something about their audience, reflecting a fear that to brand themselves as “suicide musicals” would be to dissuade some audiences from attending. Moreover, the goal of these musicals is to reach precisely the audiences who would rather avoid the theme.

Although public discussion of suicide and mental health is slowly and tentatively being normalized, continued efforts will be necessary to enact lasting change in research standards, legal policies, and America’s ingrained cultural mindset. The importance of spreading awareness and starting conversations must not be undervalued. If “Next to Normal,” “Fun Home,” and “Dear Evan Hansen” have been crucial steps in increasing suicide awareness, it is equally crucial that future works continue to combat the stigma.

— Contributing writer Jessica N. Morandi’s column, “The Might of Musicals,” explores the societal implications of musical theater, with a focus on Broadway and off-Broadway shows.