One South Is a Well-Intentioned But Shallow Look Into the U.S. Mental Health Crisis

The statistics are alarming: one out of 10 young adults in the United States are diagnosed with a serious mental illness. This information, disclosed during the opening of the first of the two episodes of HBO’s One South: Portrait of a Psych Unit, helps usher the viewer into the reality of the titular psychiatric hospital, one of the only inpatient units in the United States specializing in treating college students for serious mental health issues.

Located in Queens, New York, the One South is a temporary home to young people hospitalized following either attempted suicide or grave suicidal ideation. Directors Alexandra Shiva and Lindsey Megrue (also the doc’s producers) chronicle the routine of the hospital as a team of doctors, social workers, and nurses work around the clock to not only help patients steer away feelings of self-harm but also assist in giving them the confidence to face the world following a traumatic event. It is a well-meaning, albeit undaring effort that sets out to offer an inside view into an increasingly concerning health crisis but with a certain rigidity that makes it difficult to establish an emotional connection with its subjects.

Patients at One South suffer from a series of mental illnesses including depression, anxiety, personality disorders and psychosis. Their suicidal ideation stems from wide-ranging causes, from overwhelming moments of transition — such as moving countries for college — to the end of a relationship or a breakdown following years of emotional struggle with family and close social circles. These are all deeply relatable human hardships, and yet the documentary keeps the viewer at arm’s length, often seesawing between stories before allowing enough breathing time for the specifics of a particular patient to settle. 

Despite spending considerable time with some of the main subjects, Shiva and Megrue barely seem to scrape the surface of their stories. This whiplash does little justice to the people who have so kindly — and bravely — allowed a filmmaking team to capture the pained reality of their hospitalization. The instances that do make it into the final product are often seen through the precarious lens of isolation, which not only amplifies this sense of disconnect but comes far too close to counterproductively creating the space for a slithering sense of judgement to creep in. 

Admittedly, it is no easy task to paint a fully formed picture of someone during one of the most sensitive periods of their lives, but this disconnect between what we see on screen and what the documentary sets out to tackle makes the 161 minutes go by at a languid pace that edges far too close to a muted educational video. Shot in a fly-on-the-wall style, One South: Portrait of a Psych Unit is at its best when it focuses on the team of psychiatrists working at the hospital, perhaps because their predicament, although far from desensitized, isn’t quite as grave as the patients they see day in and day out. The dichotomy between the toll the job takes on the doctors versus the gratification they get from assisting patients on their road to recovery makes for an interesting balance to observe.

In this sense, it feels a little like a missed opportunity that the documentary fails to dedicate more time to the state of American health care, particularly when it comes to a still painfully divisive issue such as mental health provisions. We get a glimpse of how overworked some of the doctors are, a tiredness not all that dissimilar to the one experienced by their patients. There is this lingering sense of pointlessness that threatens to obscure the importance of their work, but the One South benefits from a strong sense of camaraderie and community among their staff, and the documentary hits a good stride whenever it observes these dynamics. 

Tangentially, it is compelling to learn more about how doctors approach recovery at the unit, particularly knowing the average length of a stay at One South ranges from seven to 10 days, with some patients staying for slightly longer periods. Bearing witness to these treatment techniques, ranging from aromatherapy to Dialectical Behavior Therapy, allow Shiva and Megrue to narrow into conversations such as suicidal behavior as a dangerous pattern of addiction and the very specific type of trauma experienced by those who spent most of their childhood around hospitals and find in mindfulness a precious escape valve. 

These glimpses of raw, moving honesty remind us of why documentaries like One South: Portrait of a Psych Unit are so vital in destigmatizing the difficult dialogue surrounding acute mental illness. It is a shame such moments are so rarely interspersed within a wider work that seems so intent on diluting their potency. 

One South: Portrait of a Psych Unit premieres June 25 at 9:00 P.M. ET on HBO and Max. 

Rafa is a film programmer and journalist with words on Variety, BBC Culture, Sight & Sound and more. You can find her @rafiews.