When “Jersey Shore’s” Ronnie Ortiz-Magro got into an on-camera fight with his sometime-girlfriend Jen Harley a few years ago, words quickly grew heated.

“You’re driving me crazy,” Ortiz-Magro yelled at Harley in the show, an episode of the spinoff “Jersey Shore: Family Vacation.”

“ 'Cause you’re a [bleep] psychopath,” she shot back.

This might seem like standard dialogue on the fireworks-heavy MTV franchise. But that’s exactly what makes it such a huge problem, says, of all people, the executive in charge of airing it.

Chris McCarthy, the president of MTV Entertainment Group and overseer of numerous ViacomCBS cable networks, believes such language contributes to a stigmatization of mental health and leads to fewer people seeking help. So he’s about to offer a rare mea culpa — and undertake an ambitious plan to remake programming at MTV and sister units, including Comedy Central, VH1 and even Paramount Plus.

“Having reality stars say someone is ‘really messed up’ — well, that’s not the proper way to reflect that story. It sends the wrong message about somebody’s mental health,” McCarthy said in a phone interview, adding that he believes it makes people less likely to take struggles seriously in their own lives. “We need to do better.”

With mental health again in the headlines — Meghan, the Duchess of Sussex, recently told Oprah she had suicidal thoughts, and studies show depression levels have continued to rise during the pandemic — McCarthy says the timing couldn’t be better to take on a sadly timeless challenge.

His plan, which is expected to be announced by ViacomCBS on Thursday, is to turn all negative portrayals of mental health challenges on his networks’ shows into positive ones, then double those number of instances. Instead of characters slinging around clinical terms in an argument, for example, they’d acknowledge a person is struggling and want to know more. Such portrayals would make viewers feel more comfortable with their own conditions, McCarthy says, and do more to combat them.

The effort is an unusual one, eschewing Hollywood’s usual coin of fundraisers and specials to burrow into mainline storytelling itself. But it also could raise questions over whether those moves would be effective or even attempt to legislate behavior.

Television’s serious treatment of mental health isn’t new. It was on “The Sopranos” way back in 1999 that Tony Soprano started seeing Dr. Melfi as the HBO series turned a taboo over mental health into its own dramatic plot point. In the past few years, even broadcast hits like ABC’s “The Good Doctor,” about a young surgeon with autism and savant syndrome, are unafraid to tackle these challenges.

But McCarthy, 45, looked at what his networks were doing and saw misrepresentation and underrepresentation, particularly in the realm of reality television that is MTV’s forte. The executive, who says he experienced mental health struggles himself when he was younger, approached the University of Southern California’s Annenberg Foundation, which had previously researched the issue on TV generally. McCarthy commissioned a study of many ViacomCBS programs.

Researchers then studied the first two episodes of recent seasons of 29 different shows across MTV and sibling networks such as Comedy Central and the Paramount Network; among those scrutinized were “Black Ink Crew: Chicago,” “Younger,” “The Hills: New Beginnings” and “Jersey Shore: Family Vacation.”

They returned with results several months ago. Their findings reveal many shows feature mental health disparagements. On nine occasions, for instance, a character called another such terms as “psychopath” or said they were “out of [their] mind.” In 10 instances, meanwhile, someone tossed off a reference to mental illness such as “I moved into a house with crazy people” with no response or acknowledgment of the seriousness of the issue from another character.

The study, which The Washington Post has viewed data from, also found representation of people with mental health disorders was lacking. While an estimated 21 percent of Americans suffer from a mental health disorder, according to Annenberg’s research, only 9 percent of series regulars on the ViacomCBS shows did — and only 3 percent of all characters.

“There is a significant disconnect between screen storytelling and what’s going on in society,” said Stacy Smith, a professor at Annenberg and founder of the school’s Annenberg Inclusion Initiative who headed the year-long study. “These are characters viewers identify with, and that means there’s a real missed opportunity to connect.”

USC’s Katherine Pieper, who worked on the study with Smith, added, “And the individuals who are shown can be perpetuating negative stereotypes.”

While there are some encouraging signs — among the characters with mental health struggles, 59 percent mentioned therapy at one point — there remained much work ahead, the pair said.

After seeing the study — and further motivated by the pandemic lockdowns’ negative effect on mental health; depression levels tripled at one point during the crisis — McCarthy decided to change his networks’ ways. Working with the Jed Foundation, a mental health nonprofit geared toward young people, the executive and his team have begun crafting a guide specifically aimed at Hollywood storytellers on the most sensitive ways to portray mental health.

ViacomCBS also has started to hold internal workshops with writers and producers on how to address these issues in the writers and editing rooms. A summit with other networks and companies will be convened later this spring to discuss the guide and broader issues.

The company will be making dozens of movies for Paramount Plus, ViacomCBS’s new streaming service. If a script doesn’t pass muster on the mental health front, McCarthy says he will ask executives not to buy it.

McCarthy says he doesn’t imagine weighing in on every creative choice. But he wants producers in the editing room, where much of reality television is crafted, to include “fuller context” when a character does seem to be lashing out — either by showing them getting help or with additional footage that explains their behavior instead of simply exploiting it.

And if that footage doesn’t exist? “We need to cut the scene,” he said.

One question with reality TV, though, is existential: Can you cut back on dysfunction and still be worthy of the genre? Even “The Real World,” the groundbreaking MTV reality show touted for breaking taboos of race and homosexuality when it began airing in the 1990s, came to feature copious amounts of shouting. (Paramount Plus is currently airing a reunion series, “The Real World Homecoming.”) The formula has been replicated in various ways across the dial, as with Bravo’s popular “Real Housewives” franchise. “Healthy reality-television characters” could be a contradiction in terms.

McCarthy maintains reality TV doesn’t need to fundamentally change to accomplish his goal.

“There can still be conflict,” said the executive, who has a track record of pushing for social change on-air; he spearheaded an effort last spring to pause programming across ViacomCBS networks for eight minutes and 46 seconds after the death of George Floyd. “Real life is filled with conflict. What we’re trying to do is represent and show positive behavior when possible.”

He said one model would be the VH1 tattoo-artist reality series, “Black Ink Crew: Chicago,” where Ryan is shown going to a therapist when he faces mental health challenges.

Too much packaging of mental health stories could also seem heavy-handed or preachy. But those charged with carrying out the task say they see many paths forward.

“My team and I have been very conscious of this issue,” said Trevor Noah, the host of “The Daily Show with Trevor Noah,” who has made mental health coverage a priority on his show and is a key part of McCarthy’s effort. “It’s not about preaching or assigning blame. It’s about putting out the information. Like if I’m doing something about the solar system and there are solar flares, they’re not good or bad; they’re just solar flares. Sometimes it’s just about giving you a little bit of insight you might have been blind to.”

Noah, who has been open about his own mental health struggles, said he thinks TV representation is only slowly making progress.

“When I watch TV, a depressed person is often a glum person. It doesn’t cover the spectrum of what depression actually is,” he said. “I think that’s what makes it shocking when we hear someone committed suicide. We say, ‘They seemed so happy,’ as if a depressed person is always a negative person. It’s because shows contribute to misconceptions of what someone struggling with mental health really is like.”

Some experts, however, remain uncertain of the depth of the danger, particularly when it comes to inappropriate language.

“There are certainly potential benefits to having a guide and support system for content creators,” said Dan Reidenberg, the executive director of suicide-prevention group SAVE and an expert on mental health depictions in Hollywood. (Reidenberg has consulted for many entertainment companies on their mental health portrayals and also worked with ViacomCBS on its initiative.) “But how big a problem this is and what the impact of that problem is — that’s not so clear.”

He said he has yet to see data persuading him language makes a major impact on consumers: “The vast majority of people hears things being said in shows or movies and they could care less.”

He added that he feels a lot of reluctance about any attempts to reduce on-screen messiness.

“A fear of mine, quite honestly, is that efforts can go the wrong way and all of a sudden in our stories everyone is happy and healthy and rosy,” Reidenberg said. “You need to be able to depict those parts of life that are harder and more ugly.”

McCarthy says the aim is not whitewashing but explaining why characters feel the way they do.

“We’re trying to make stories more meaningful. If we do our jobs, viewers won’t even notice,” McCarthy said.

He paused.

“Programming 40 years ago looked very one-note. And now we have a diversity of characters. It all started because someone said this isn’t accurate. That’s what we’re saying here.”