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LOS ANGELES (Reuters) - Television talent show contestants fantasize about fame and fortune but for some people, an appearance on one of the shows only leads to real problems of stress, anxiety, depression, even suicide.
But who is to blame when an everyday person becomes an overnight TV sensation and can't cope -- when Susan Boyle falls ill after failing to win "Britain's Got Talent" or when "American Idol" fan Paula Goodspeed, who was teased after a poor tryout, commits suicide outside the home of a judge?
Boyle was again making headlines on Monday when she was forced to cancel a performance over health concerns while on tour with other "Britain's Got Talent" performers.
TV producers and industry watchers vary in opinion, but they all say networks who air the shows, companies that make them and contestants themselves shoulder some responsibility.
Emotional stress can depend on "baggage (people) bring into a show," said John Lucas, an assistant clinical professor of psychiatry at Weill Cornell Medical School.
Some contestants may already be vulnerable to depression or expect a show "will change others' perceptions of them or ... their ability to contend with their ordinary day-to-day existence," Lucas said. "And neither is likely to happen."
Networks ask producers to screen potential contestants for mental health issues, said David Broome, executive producer for "The Biggest Loser," on which contestants lose weight. It enters its eighth season on U.S. network NBC this coming fall.
The types of screenings vary, but people who live isolated in small groups for weeks, as in hit shows "Survivor" or "Big Brother," go through more rigorous tests than contestants on talent shows such as "Idol" or "Britain's Got Talent."
Pre-show screenings tests for red flags like clinical depression, tendency toward anger and if someone has been abused physically in their past.
"Biggest Loser" contestants undergo in-depth psychological and medical tests, and producers expect some mental health issues to arise because "almost 100 percent of the time, weight is an emotional issue," Broome said.
While taping a program, TV networks often require producers to hire psychological experts and counselors to be available if contestants have a breakdown.
Yet, while psychological screening and counseling can identify obvious mental issues, it is impossible to determine exactly how people will react to finally realizing their bubble of celebrity has burst when a show has ended.
"When you take regular people and suddenly put them in the spotlight, you never know what's going to happen," said Bob Thompson of Syracuse University's center for television and pop culture.
"I don't know that ... we can really point the blame at anyone unless you indict the notion of celebrity. And that eliminates these kinds of shows entirely," he said.
But yanking TV contests off the airwaves seems impossible, for now, because the shows are among the network's most-watched and they bring in millions of dollars of advertising revenues.
Moreover, for every Susan Boyle, there is a Clay Aiken, a runner-up who went on to a successful life and new career.
In fact, experts say contestants bear some responsibility to protect their emotions and decide if they can tolerate fame, but they seemed to agree that TV networks and producers must fully explain what stardom can mean.
Reporting by Laura Isensee, editing by Bob Tourtellotte