Should I be concerned that an adolescent I care about is watching “13 Reasons Why”?

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May 3, 2017
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A few of you may be wondering why experts have raised concerns about the Netflix TV series “13 Reasons Why”.  This show depicts an adolescent’s suicide, with the show centering around uncovering of clues about why she killed herself.  Adolescent suicidality is a critical issue of our time, with one study in British Columbia indicating that 34% of surveyed Grade 7-12 students knew someone who had attempted or died of suicide and 16% had seriously considered suicide themselves1.  Suicide is the second leading cause of death amongst youth in Canada.
Research also tells us that media portrayals of suicide can have a dangerous impact.  While most of the research has focused on non-fictional media reporting of suicides, some studies have also involved fictional stories2.  Dating back to the 1970’s, research findings have shown that suicide rates increase following stories of suicides and that suicide rates decrease following a decrease in stories of suicide.   More dramatic headlines and stories are also associated with greater increases in suicide.  Teenagers may be particularly susceptible to contagion, with 1-5% of teen suicides occurring in “clusters” of proximity to one another.
To prevent these effects, most media outlets today follow careful guidelines for reporting on suicides that limit descriptions of the suicide behavior and avoid sensationalizing the behavior.  It is important to understand that talking about suicide is important and is a preventative measure.  Why then are media stories problematic?  It is because of the stigmatizing language that is used, the lack of full context and the sensationalizing that media representations can contribute to the increase in suicides.  Parents and others should talk openly and directly about suicide in a non-stigmatizing way that promotes help seeking behaviour.
In part due to the above research, mental health experts have expressed fears that exposure to “13 Reasons Why”, either by watching the show or by hearing friends talk about it at school, may put adolescents who are already vulnerable at greater risk of attempting suicide.  The show not only graphically depicts an act of suicide, but has also been seen by some as portraying the act as an effective means of retribution and vindication (which it is not).  There have also been concerns raised that the show depicts adults as incapable of offering effective support, with fears expressed that this could discourage teens from seeking help.  Netflix has responded by including trigger warnings before each episode, as well as including a separate program that addresses suicide and mental health issues.  But given the difficulty in controlling adolescent exposure to the show, what can concerned parents, caregivers, friends and educators do to support young people that they care about?
  • Talk with the adolescent in your life. If they have watched the show or heard about it from friends, have a conversation with them.  Let them know that you care and that you are there to help.   You can also let them know that suicide is not an effective way to deal with life problems and that help is available for people like Hannah, the character in the show.  The JED Foundation has outlined some excellent talking points to help you to address some of the issues raised in“13 Reasons Why”, which can be found here.
  • Know the warning signs of suicide. It is important to be aware of potential warning signs for suicide and to respond to these signs when you observe them.  Some signs include talking about death, dying, killing oneself, means of killing oneself, or expressions of hopelessness.  Others include sudden changes in behavior, including elevated risk taking or reckless behavior.  A complete list of warning signs can be found here.
  • If you notice any of these signs, ask the person you care about if they are thinking of killing themselves. Simply asking this question can potentially help to start an important conversation and, contrary to fears that some people have, does not make a person more likely to attempt suicide.
  • Take the time to listen to a person and to help them to feel understood. If they have thought about killing themselves, then chances are that they feel isolated, misunderstood, and hopeless and are in incredible emotional pain.  Recognize that people who contemplate and even complete a suicide don’t actually want to die.
  • Let them know that there is help. Most individuals who are thinking of killing themselves are also dealing with a treatable mental health condition (and all of them could benefit from help!).  Help to connect the person to a qualified mental health professional.  In British Columbia, this is often a Registered Psychologist, Registered Clinical Counsellor or Registered Social Worker. If you need help accessing resources, you can also talk with your family doctor or call 1-800-SUICIDE (that’s 1-800-784-2433 – it is also a crisis line resource for the person you care about).
  • If the individual you care about indicates that they are thinking of killing themselves in the next minutes, hours or days, accompany them to the nearest psychiatric emergency room or call 911. These actions are a sign of how much you care.
Hopefully this information and the suggested resources will help you to feel a more comfortable knowing what to watch for and how to have a supportive conversation with an adolescent in your life who may have watched “13 Reasons Why” or may have talked about it with friends at school.
Sources:
1Canadian Mental Health Association.  Suicide and youth.  Retrieved from http://toronto.cmha.ca/mental_health/youth-and-suicide/
2Gould, M.S. & Lake, A.M.  (2013). The contagion of suicidal behavior.  Retrieved from National Centre for Biology Information website: https://www.ncbi.nlm.nih.gov/books/NBK207262/
Written by:  Michael Mandrusiak, Psy.D., Registered Psychologist CPBC #1803 Burnaby Counselling Group
The team at the Burnaby Counselling Group provides professional clinical counselling services for a range of individuals including children, youth and adults who may be at risk of suicide, as well as survivors of suicide loss. 
We are currently developing a list of individuals wishing to enroll in our next Mental Health First Aid for Adults who interact with Youth course, which includes instruction on supporting individuals who may be considering suicide.  Contact us if you are interested in knowing once our next course is scheduled.