There’s an implication in the novels that a “bigger picture” perspective can reverse these extremely complex psychological problems. I doubt that global awareness alone would be enough to change an anorexic's or self-injurer's self-destructive patterns, but it’s refreshing to see protagonists dealing with these issues in plots that go beyond a problem novel set-up. Partial proceeds from the books are donated to the National Eating Disorder Association and self-injury prevention organization To Write Love on Her Arms, two causes I wholeheartedly support.
So far, the Horsemen protagonists have been Horsewomen, with psychological issues primarily (but certainly not only) afflicting teenage girls, but both secondary characters Death and Pestilence have male incarnations. I’m curious about their back stories—particularly that of the enigmatic Pale Rider, who bears an uncanny resemblance to a long-dead icon of the grunge era (complete with a tendency to break into “Come as You Are”)—and interested to see how the change of protagonist gender may influence the narratives. Loss, starring Pestilence, will be out next year; it looks like I’ll have to wait even longer to get the whole scoop on Death.
In the meantime, Kessler’s “characters strike back” in an interview with the author by Missy and Lisa. And Death himself chats about life, “little-d death,” and rock ‘n’ roll with other protagonists of YA novels at the “call-in radio show”–style blog Post Mortem.
ETA: See Jackie Morse Kessler's response to The Wall Street Journal's "Darkness Too Visible" article here.