Four seasons in, Netflix’s The Crown is as fascinating as ever to watch—juicy and provocative, with storylines often centred around real events that the British royal family have worked hard to keep private and, one might infer, would prefer not to remember. How about the disastrous 1969 BBC Royal Family documentary that the Queen wanted to bury? Or the rumours that a KGB spy worked at Buckingham Palace? And, of course, the imperfect marriages. It’s the reason the show is so compelling—there is no end to the hunger for royal family intel and much of what is dramatised in The Crown feels like information we shouldn’t have.

Lots of this season’s scandal involves mental illness and what’s revealed are perhaps the darkest and best kept royal secrets of them all. They are also by far the most relatable—after all, nearly one in four UK adults and one in five US adults live with a mental illness. In fact, it would be more shocking to learn that the royal family had somehow managed to avoid mental illness entirely.
And yet, we see their desire to keep its occurrence well under wraps. First, in their reaction to Princess Diana’s bulimia, which we’re introduced to in episode three when a clearly distraught and confused princess-to-be binge eats desserts from the palace refrigerator then throws them up.
What is actually real in The Crown?
Although Diana spoke about her illness publicly and candidly in real life, it’s important to remember that The Crown is not a documentary, rather a dramatic interpretation of history. Diana’s younger brother, Charles Spencer, 9th Earl Spencer, used a recent television appearance on ITV’s Love Your Weekend with Alan Titchmarsh as an opportunity to remind people that The Crown is fictional, featuring “a lot of conjecture and a lot of invention.”
But the actual events regarding her illness do not seem so far off from the dramatised ones, nor out of line with what we know about the royal attitude towards anything “untoward”, a bucket into which they clearly put mental illness. Throughout season four, Diana’s bulimia is depicted, at times in graphic detail, as one of her and Prince Charles’s many marital problems—a cause, to be clear, and not a symptom—despite the fact that there were many strains on the marriage that might well have exacerbated her condition, including Charles’s clear love for another woman.
It was said by Diana herself that the Queen and other royals had blamed many of the couple’s troubles on her eating disorder. Diana told her biographer Andrew Morton that “[the Queen] indicated to me that the reason why our marriage had gone downhill was because Prince Charles was having such a difficult time with my bulimia.” Diana also told Morton that her bulimia began early on in her relationship with Charles, recalling an incident in which “my husband put his hand on my waistline and said, ‘Oh, a bit chubby here, aren’t we?’ and that triggered off something in me—and the Camilla thing, I was desperate, desperate.” On her honeymoon, she was vomiting three or four times a day.
The ongoing mistreatment of mental illness
The royal family’s lack of compassion may not be surprising. Eating disorders are still treated today as if they represent a defect of the person suffering from them—not that they are a symptom of a disease or a byproduct of a bad situation. It could even be argued that The Crown’s creator Peter Morgan was more interested in and more sympathetic to another revelation involving royal mistreatment of mental illness than he was to Diana’s eating disorder.
Consider the Queen’s “secret cousins” Katherine and Nerissa Bowes-Lyon. In episode seven, Princess Margaret visits a therapist on the suggestion of Prince Charles. She’s struggling—feeling irrelevant, feeling out of place. It’s through this that she discovers she’s far from the only member of the royal family to have come up against mental health issues. It turns out that five of her and the Queen’s cousins suffered from developmental disabilities—decades earlier, they had been put into a mental hospital and publicly declared dead, erased from the public record. In the show, Margaret confronts the Queen Mother, who rationalises it away, explaining that hiding the evidence of mental illness was necessary in order to protect the integrity of the royal bloodline.
Here, the real-life events do not seem so far off, nor out of line with the royal way. The story of the cousins remained a secret until 1987 when UK tabloid The Sun broke the news. It’s a shocking revelation—yet in the context of the royal family and the era, maybe not entirely surprising.

For decades, people believed that if one had a child with a learning disability, there was something wrong with the bloodline, and there is no family for whom bloodline is more important than a royal one. As the Queen Mother tells Margaret in the episode: “Their illness, their idiocy and imbecility, would make people question the integrity of the bloodline. Can you imagine the headlines if it were to get out? The hereditary principle already hangs by such a precarious thread… Throw in mental illness, and it’s over.” One 1987 report by Thames News even described that what happened to the cousins was “fairly standard practice all those years ago. People went into long-stay mentally handicapped hospitals, and to all intents and purposes, they were dead.”
We also see the “under the rug” approach taken in episode five, which tells the story of Michael Fagan, an unemployed decorator who became infamous for breaking into Buckingham Palace. On the show and in real life, Fagan was diagnosed as schizophrenic and sent away to a mental hospital “indefinitely”, although he spent only three months there since he wasn’t actually schizophrenic at all.
Is the stigma around mental illness any better today?
Of course, we know now that the worst way to treat mental illness is to pretend it doesn’t exist or to shove it under some imaginary rug. For example, a 2019 study from the University of Michigan found that half of American children with mental health disorders are not treated, owing to the ongoing stigma surrounding mental illness and the false hope that if it’s not addressed it may simply go away. It doesn’t and it won’t.
As we learn most clearly from season four of The Crown, mental illness does not discriminate, even from princesses living in palaces and it won’t resolve itself magically. What’s more, mental illness is not absolute: Diana’s bulimia was a physical manifestation of a psychological disorder, but it was also triggered by real events—and therefore possibly largely preventable. That may not be how the royals saw it then, but looking back on it now, even in its fictional form, it’s certainly hard to argue otherwise.
If you or someone you love is struggling with mental health problems, please contact Mind