In the Netflix series, 13 Reasons Why, a high school student who has killed herself has left 13 tapes, one for each person who nudged her toward taking her life. Near the end of the season, the suicide is graphically carried out.
The death scene is stomach-wrenching, heart-achingly gruesome, made even more impactful as each person’s contribution to Hannah’s wrist slitting is flashed back.
Is the portrayal of the event as well as the motivations that lead up to it an important conversation-starter for a country that is in the midst of a suicide epidemic?
Or does the storyline glamorize the option?
The show is glamorizing suicide.
popularity of the show
13 Reasons Why has became the most-tweeted about show of 2017.
After the show ran, Google searches about suicide went up by 20 percent in 19 days. Although an increase in searches does not necessarily mean an increase in suicide attempts, researchers say there can be a correlation.
worse when binge-viewed
When TV can be binge-watched, especially for teenagers, there can be a public health concern.
An editorial was published by JAMA (Journal of American Medical Association) that said that teens are particularly vulnerable when it comes to binge viewing. “This immersion into the story and images may have a particularly strong effect on adolescents,” it argued, “whose brains are still developing the ability to inhibit certain emotions, desires, and actions.”
suicide contagion is a real phenomenon
Exposure to suicide within a group or through the media may increase suicidal behaviors, according to the US Department of Health and Human Services.
12- to 13-year-olds who were exposed to a classmate’s suicide were five times more likely to have suicidal thoughts, according to a study in the Canadian Medical Association Journal.
The more detail that is shown in the suicide, the greater the chance that someone can identify with the person who commits the suicide, and the more copycat behavior we see explains Dr. Victor Schwartz, a psychiatrist and chief medical officer at The Jed Foundation, a suicide prevention nonprofit.
The conversation the show has started is irresponsible. The destructive narrative is about the ability to be popular after death, along with the inability of people around you to help, notably counselors, parents and teachers.
“None of the criticism of 13 Reasons Why means that we shouldn’t talk about suicide; we should. In fact, it’s critical that we do,” wrote mental health advocate Mark Henick. “But we need to do it right. We know that contact-based education — when people share their personal stories of struggle and recovery — is by far the most effective way of breaking down stigma surrounding suicide, which is the primary reason people don’t speak up or get help.”
But, Henick continued, shows like 13 Reasons Why — in which a girl who dies by suicide is celebrated as a heroine and her death is shown in explicit detail, and none of the people to whom she reaches out, including her school counselor, are equipped to help her — can do more harm than good. It can create the idea that suicide will lead to a kind of popular immortality, and that sometimes it’s the best solution to a problem.
We have a suicide problem in the country, and the show starts a needed conversation on it.
the conversation can help
Netflix commissioned a study by Northwestern University, in which three professors with backgrounds in communications and psychology, found that the conversation about the show’s content was mostly beneficial.
The study surveyed over 5,000 teens, young adults, and parents and, from this, argue that 13 Reasons Why created a conversation about suicide among other things. “Adolescents reported that the show helped them feel more comfortable talking about these difficult topics [bullying and mental health] with friends, parents, counselors, and teachers,” the study said.
In addition to starting a conversation, the study indicates that viewers “reported helping others and engaging in other empathetic behaviors after watching.”
The show also takes this position: In one episode, the tapes from (main character) Hannah are made public by Clay, and the school principal reprimands him for it.
“Suicide contagion is a real thing,” the principal says, “and we need to take steps to protect you kids.”
“I don’t understand,” says Clay. “How does silence protect us?”
the conversation, elevated
The American Foundation for Suicide Prevention published a 13 Reasons Why discussion guide to help lead the national conversation on suicide.
The guide includes, according to their site:
…the common risk factors and warning signs everyone should be familiar with; that the best way to talk to someone you’re concerned about is to be compassionate and direct; strategies for having a conversation with those who are struggling; and how to connect them to help.
It is our hope that by sharing accurate information, we may guide others in understanding their role in mental health and suicide prevention.
blaming the show versus blaming healthcare
Stunningly few doctors and less than half of mental health professionals are trained in suicide prevention.
According to the American Association of Suicidology (AAS), only 50% of psychology training programs, less than 25% of social work programs, 6% of marriage and family therapy programs, and 2% of counselor education programs teach students how to evaluate risk for suicide and how to stop people from choosing this path.
In 2017 California passed a law requiring suicide prevention training. To get a California license, a psychologist must complete six hours of education in suicide risk assessment and intervention. Nine other states have similar laws, and another four encourage this type of training without requiring it, according to the American Foundation for Suicide Prevention.
Washington State requires all health workers, including doctors, nurses, and even dentists and naturopaths to have this training, and is the only state to do so.