The consequences of publicizing that celebrities deal with a mental illness has long been thought to spread enlightenment. Early in its history, the National Alliance on Mental Illness (NAMI) honored Patty Duke for a forthright discussion of her struggle with bi-polar disorder. NAMI also topped a list of people suffering from depression with a picture of Abraham Lincoln. When John Nash won a Nobel Prize for economics in 1994, his struggle with schizophrenia was front and center. And after starring in Canvas, a movie about a family comping with mental illness, actor Joe Pantoliano formed an advocacy organization, No Kidding, Me Too!

Now Glenn Close joins the list of talented and poised celebrities who acknowledge there is mental illness in their families. This month, AARP salutes Close with an "Inspire Award" saying she is the epitome of people who "use their passion and their creativity to make the world a better place." Specifically AARP points to her work to de-stigmatize mental illness.

Putting Glenn Close on the cover of a national magazine is just one example of the good year for media attention. Elsewhere there have been stories about soldiers and their families suffering consequences of PTSD, t acute shortages of housing, the lack of medical care for chronic, and deteriorated health, and prisons and jails which are crowded with people suffering from a mental illness or a substance use disorder,

And controversy is back. If this sounds like a re-run, it is. Wonderland, the putative sit-com staged in a psychiatric emergency room, has returned on DirecTV after an eight-year interlude.

In 2000, producer Peter Berg was sure that a drama based on "a close-up portrayal of the daily workings of a psychiatric ward" would draw. Apparently the first episode did just that with 13 million viewers. But by the middle of the second episode, half the audience had tuned out. Was it gratuitous violence, which even those who consider it "intelligently written and acted with conviction and passion'' do not minimize? That ABC abruptly yanked Wonderland after only two episodes was attributed to opposition by mental health advocates plus ABC's poor scheduling, which forced the fledgling show to compete with ER.

Mental health advocates who united in protest in 2000 argued that Wonderland exaggerated violence and contributed to stigma. As all know so well, stigma is a barrier to treatment. This isn't just today's thinking. Stigma was identified as a barrier in the late 1970s when the Task Panel Reports, assessing mental health practice and policy, became the backdrop for expanded services in President Jimmy Carter's landmark 1980 mental health systems law. Short lived, the law was axed when Pres. Ronald Reagan folded it into the Omnibus Budget Reconciliation Act and reduced spending.

Some accuse Wonderland of poor taste. Others insist it is a recognizable setting where they, or those they know, ended up while in an emergency. But taste is not the only issue. It would be unfortunate if the viewing public, known to assume that actual medical situations resemble those they see on television, thought Wonderland representative of the context of a true psychiatric emergency. And even more unfortunate if it drove stigma. An article in the January 20th issue of Advance Access Schizophrenia Bulletin indicates that for people with schizophrenia stigma "leads to negative psychological outcomes . . . including lowered self-esteem, diminished self-efficacy, and more depressive symptoms."

Today there is a growing crisis in psychiatric emergency rooms. It is more extreme in poor communities, and exacerbated in places where there is an absence of community services and/or a shortage of beds. All agree that there is crisis of overcrowding with long waits, as Dr. Anthony T. Ng wrote, lasting up to several days. People may come for treatment but some, like Esmin Green at King's County Hospital last year, also die waiting.

All this brings us back to "Wonderland," a name given to something beyond the realm, an imaginary destination, one that is perhaps terrific but in the context of psychiatric emergencies, not likely to be so. As Jean Arnold, chair of the National Stigma Clearinghouse, notes at Stigmanet.org, where clips of the 2000 controversy can be requested, Wonderland's return "opens old wounds." And it will take a mighty effort by people like Glenn Close to see them closed.