Experts Speak Out Against '13 Reasons Why' In the Name of Suicide Prevention
Selena Gomez, executive producer for the series, says controversy is inevitable when talking about suicide, but the mental health community disagrees.
If you watch Netflix or read the news, you've probably heard about the new Netflix show, 13 Reasons Why. Not only was the series produced by Selena Gomez, pretty much ensuring that it would be buzzed about, but the subject matter of the show itself has proven to be highly controversial. In the past year, Gomez has been vocal about her struggle with mental health and how important it is to her to raise awareness (remember that AMA speech?). This show seems to be a continuation of her efforts to bring these important issues into the spotlight.
The only problem? Experts say the way the show deals with suicide isn't really all that helpful, especially for the young audience it's geared toward. If you haven't watched the series (spoilers ahead), the main character, Hannah, dies by suicide, and the depiction of her death is quite graphic. "Teenage suicide is contagious," Harold S. Koplewicz, M.D., president of the Child Mind Institute, told the TODAY show on Friday. "We know for over three decades that when kids watch television where they depict a suicide, they're more likely to attempt and they're more likely to actually (kill themselves)." In fact, he thinks the show should be pulled off the air altogether.
There is a substantial amount of data around how coverage and depiction of suicide affect those who are vulnerable. Just this week, a new study published by the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) revealed a significant spike in suicide rates the month after 13 Reasons Why's release in March 2017, specifically among boys aged 10 to 17. Researchers analyzed suicide data from the Centers for Disease Control and Prevention between January 2013 and December 2017 to gauge the rates over an approximately five-year period, according to The New York Times. After taking into account seasonal effects and an underlying, increasing trend in monthly suicide rates, researchers found approximately an 30 percent increase in suicide rates among people aged 10 to 17 (with boys amounting for most of the increase) in April 2017, the month after 13 Reasons Why came out.
Netflix addressed the new research in a statement saying: "We've just seen this study and are looking into the research, which conflicts with last week's study from the University of Pennsylvania. This is a critically important topic and we have worked hard to ensure that we handle this sensitive issue responsibly."
The "conflicting" study in question from the University of Pennsylvania, published in the academic journal Social Science & Medicine, looked at both "harmful" and "helpful" effects of watching the second season of 13 Reasons Why. Researchers recruited a sample of over 700 young adults aged 18 to 29, who completed surveys shortly before and one month after the release of the show's second season. The results showed that those who didn't watch the second season "exhibited greater suicide risk and less optimism about the future" compared to those who did watch the season, according to the study's abstract. Moreover, young adults who watched the second season reported declines in suicidal ideation and self-harm, as well as an increased interest to help others dealing with suicidal thoughts, compared to those who didn't watch.
Of course, the study from the University of Pennsylvania is different from the JAACAP research in several ways: The sample size was smaller; the duration of the study was much shorter; it only focused on the effects of the second season of the show; it's unclear which underlying factors, if any, were taken into account that may have skewed the results.
All of this research is no doubt highly concerning. However, Matthew K. Nock, a psychologist at Harvard University (who was not involved in either study), told The New York Times that even though the JAACAP study may suggest an association between 13 Reasons Why and suicide rates, it's important not to "draw causal conclusions from correlational data."
Still, research like this is the main reason so many in the mental health community are not huge fans of the show. "The 'copycat' effect occurs when suicide is reported in a way that contributes to another suicide," explains Ash Nadkarni, M.D., director of digital integrated care in psychiatry and an instructor at Harvard Medical School. "Studies indicate that the risk of suicide increases when graphic details of suicide method are released, dramatic headlines or images are used, and media coverage sensationalizes or romanticizes a death." 13 Reasons Why, critics argue, does exactly these things.
For her part, Gomez says that she and the team behind the show were above all trying to stay true to what happened in the book the series is based on. "That's originally what Jay Asher (the book's author) created-a beautifully tragic, complicated, yet suspenseful story," she told the Associated Press. And of the backlash against the series, Gomez said, "That's going to come no matter what. It's not an easy subject to talk about." (Related: Did You Know There Are 4 Different Types of Depression?)
While it's true that suicide isn't an easy thing for many to talk about, mental health experts note that while raising awareness is important, it's also important to present options other than suicide, which the series fails to do. "13 Reasons Why makes it seem like suicide is a perfectly viable option, without emphasizing the permanence of taking one's own life," explains Jennifer Wolkin, Ph.D., licensed psychologist and clinical neuropsychologist who practices in NYC. "The show can be credited with starting an important conversation about suicide in general, and teen suicide more specifically. But - and this is a big but - the conversation needs to happen in a more real and efficient way. The show fails to discuss in depth the very real mental health issues that Hannah is facing, and ways she might address them in a healthy and adaptive way."
So how could they have done better? "I know this is a show and not every show has to have a 'happy ending,' but if the intention was to bring awareness, it should have provided HOPE for those struggling with depression, suicide, sexual abuse, substance abuse, and/or bullying," says Kenny Tello, L.C.S.W., a mental health therapist at the Howard Phillips Center for Children and Families. In other words, raising awareness is important, but it's not the be-all end-all. Providing hope for those who are struggling with mental health issues is a key and necessary part of the equation.
If you are struggling with thoughts of suicide, you can contact Crisis Text Line by texting "START" to 741-741 or call the National Suicide Prevention Lifeline at 1-800-273-8255. For more information on suicide prevention and awareness, visit the American Foundation for Suicide Prevention.