A Million Little Things' Romany Malco Hopes Rome Eases Stigmas About Men with Depression

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[Trigger warning: This story discusses suicide. If you feel like you might be at risk of hurting yourself please call the National Suicide Prevention Lifeline at 1-800-273-8255.]

Men take their own lives at a rate four times higher than women, and ABC's A Million Little Things leaned into that alarming statistic in its very first episode. The pilot opened with Rome (Romany Malco) nearly swallowing a mouthful of pills in an attempt to end his life. Then the phone rang and he spit them out.

His friend Gary was calling with the news that their mutual friend, Jon, had died by suicide. So Rome washed the medication down the sink and decided to give life another try, despite the hopelessness that made him feel like the world would be better off without him. Rome decided to live not just for himself or his kind-hearted wife, but for his friend who had chosen death.

A Million Little Things is one of a growing number of TV series casting a spotlight on how men deal with depression and other mental health issues. This Is Us has endeared viewers to Randall Pearson (Sterling K. Brown), who is a dedicated father, husband, and son, but also a man who is still learning to understand and manage his anxiety. Over on FX's Pose, Pray Tell (Emmy-winner Billy Porter) becomes depressed because of his HIV status and the death of his lover, and he self-medicates with alcohol. His nurse and his friends intervene (not to mention a few ghosts), and Pray begins to find his way out of the darkness. And on Atlanta (FX), Bryan Tyree Henry earned an Emmy nomination for playing a man lost in a forest of sorrow and anguish in the 2018 episode "Woods," a performance that channeled the real-life grief and depression the actor was experiencing after his mother's death.

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These depictions take on another layer of complexity when the central characters are African American. The U.S. Department of Health and Human Services reports that African Americans are more likely than white Americans to experience serious psychological distress, but they're far less likely to seek treatment for mental illness. Historically and currently, African Americans have had to contend with prejudice in the health care system, socioeconomic barriers, and cultural and faith traditions that make seeking medical treatment for mental health taboo, according to the National Alliance on Mental Illness.

Those cultural realities come into play on A Million Little Things when Rome confides to his father that he's going to therapy and taking medication to manage his depression, only to have his father criticize his choices.

"The scene of Rome talking to his dad about counseling was a big deal for us," Malco told TV Guide. "Our show's creator, DJ Nash, wanted to do the most authentic depiction possible as depression in the black community is often seen as a blemish on one's character. Admitting to being depressed often results in rejection. Many believe depression is something you could just snap out of. There are even those unwilling to admit having bouts with depression for fear of being made fun of."

It's a stigma Malco has witnessed in his own life. "To this very day, I have family members who see being depressed as a demonic attack and not a mental condition," the actor said. "These same family members see psychotherapy, yoga, etc. as things not of Christ."

Malco also pointed to the work of Terrence Real, a family therapist and the author of I Don't Want to Talk About It: Overcoming the Secret Legacy of Male Depression. In his book, Real argues that most women who are vocal about having depression are met with love and support from those close to them, but most men who speak up about their depression feel shunned or ostracized.

Exposure and education are integral to overcoming cultural barriers that keep men -- and specifically black men -- from seeking treatment, noted Dr. Judy Ho, a clinical neuropsychologist and a co-host on the syndicated talk show The Doctors. Ho pointed to prominent figures, including Jay-Z and basketball star DeMar DeRozan, who have been outspoken about depression and men's mental health issues, and said fictional characters matter, too.

"They serve as an aspirational model for viewers and a great starting point for destigmatizing mental treatment," Ho said. "It is important for this topic to be broached on a show like Atlanta which has a large black viewership, and also espouses cultural values that are consistent with black identity and highlights the lives, achievements, and struggles of African Americans in the country."

As more and more shows incorporate men's mental health into storylines, they're eschewing the "very special episode" format (in which a character deals with a serious issue but resolves it by the end of the episode) in lieu of ongoing examinations of how mental health is intertwined in characters' lives and choices. For example, now in the second season of A Million Little Things, Rome has come a long way: He's not only feeling better about himself, but he's volunteering at a hotline for suicide prevention. Though he initially worried that he might say the wrong thing, he is now relaxing into his role and becoming so confident that he's even considering fatherhood -- something he hadn't previously thought possible. Rome's realistic storyline conveys the hopeful message that his depression is something that can be managed.

Malco is optimistic that his portrayal of Rome might be a saving grace for people by putting a face on something men experience but may not be able to name, let alone talk about. "As a man who grew up in the black community, I can attest to a fair level of intolerance," the actor said. "Seeing Rome willing to be vulnerable, seek counseling, take medication, and pursue alternative steps to getting better helps to break the stigma."

A Million Little Things airs Thursdays at 9/8c on ABC.