In response to concerns raised by educators, TeenMentalHealth.Org and the IWK Health Center have created this resource addressing the issues raised by the recently released Netflix series “13 Reasons Why”.

Why the concern?

This series portrays suicide in a teenage girl in a manner that scientific research has shown could contribute to contagion and increase risk of self harm and suicide for vulnerable and “at risk” youth.

Many young people are watching this show.  It is receiving a great degree of attention from the media, and many youth discussing it on social media. It is important for educators to be aware of this so that they can appropriately support students when talking about their opinions and emotional reactions regarding this television series.

While most young people who are exposed to this series will not act in a manner that will threaten their life, it may lead to significant emotional distress for any viewer. Youth who are struggling with suicidal thoughts and distressing life situations, as well as those who have experienced loss by suicide, may be at increased risk of self-harm and suicide due to distress arising from identification with the main character of the story, as well as the images and content in this series

What does the concern arise from?

This series goes against recommended media guidelines for suicide portrayal (see below) that have been created to help address this important topic in a manner that can be more likely to reduce risk and present information about suicide responsibly.

Concerns about suicide portrayal in the series:

  1. Romanticizes suicide, and suggest that a young person’s death by suicide will raise their status in the eyes of their peers.
  2. Presents death by suicide as a rational response to the behavior of others and does not offer suggestions of helpful alternatives.
  3. Visually presents the method and act of suicide graphically.
  4. Portrays responsible adults as unhelpful and even potentially contributory to suicide.
  5. Portrays others as either responsible or unwilling to help, or unknowing about highly problematic events.
  6. Oversimplifies suicide and does not address mental illness. Suicide is most often associated with the presence of a mental disorder, such as Depression.   Suicide can not be simply explained. It is an outcome that arises from the interplay of complex forces that most often include the presence of a mental disorder.  This reality is not presented in the series.
  7. Does not provide information about how to seek help and what to do if you or someone you know is contemplating suicide.

What can schools do?

What is needed is a thoughtful approach that respects the ability of many youth to appropriately deal with the series and concurrently be aware of the risks and provide the support that vulnerable youth may need.  Talking about suicide responsibly may not increase the risk of suicide.  However, sensationalization of the school’s response to the series may have the effect of increasing the probability that vulnerable youth will seek it out and may exacerbate its potential negative impact.  The following are suggestions at the school level for the focus of discussion between the school principal, student services providers and teachers resulting in a coordinated and respectful intervention that fits the environment of the school and can be tailored to the needs of students in their community.

Suggestions:

  1. Do not sensationalize your response to the series, keep the discussions low key, and avoid creating an environment of alarm.
  2. Share the above information with teachers so that they are aware of how the series creates messages around the portrayal of suicide that may result in more distress and negative outcomes for vulnerable students.
  3. Teachers can pass on this information to students if asked, but this should be in direct discussion with an individual or small groups of students and not just given as a handout.
  4. Ensure that teachers know how to respond if concerned about a student and how to involve student services personnel (eg: counselor; social worker; psychologist; etc.) if needed.
  5. Teachers and school staff should identify if there are students they are concerned about and arrange for check-ins with appropriate student support providers. However, it is not helpful to go around asking students if they feel suicidal or are thinking of self-harm out of context.
  6. Do not hold assemblies or large group sessions to discuss the series. If a student wants to talk about how they are feeling in watching this series, this should be supported appropriately.  However, be aware to not draw extra attention or sensation to the series, and that some students will not have watched it.
  7. Since many vulnerable youth are already known to teachers or student support providers make time to quietly and individually touch base with them to “see how you are doing”.
  8. If students in a class raise the issue of “13 Reasons Why” – use the information above to support and direct a discussion of the series and ensure that the students are informed as to where they can obtain help in the school or in their community should they need it and that they have the kids-help-phone crisis number. Keep your comments general and neutral with only basic information about the series and focus instead on help seeking. Note that if any student is concerned that a friend or peer is struggling with suicidal thoughts that they are helping if they share that concern with a teacher or student support provider.

Examples of Media Guidelines on Responsible Suicide Reporting:

Canada: http://suicideprevention.ca/understanding/for-media/

World Health Organization: http://www.who.int/mental_health/prevention/suicide/resource_media.pdf.

Resources:

13 Reasons Why- Beyond the Reasons” on Netflix- behind the scenes interviews with producers, mental health professionals and cast and includes some background of the series, helpful messages for youth and those working with youth and promotes help seeking.

Dr. Stan Kutcher and Dr. Alexa Bagnell
IWK Health Center
Halifax, N.S.

Both Dr. Kutcher and Dr. Bagnell can be contacted through the mental health program of the IWK Health Center or through the Department of Psychiatry at Dalhousie University.

13 Reasons Why – Talking Points (PDF)

13-Reasons-Why