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13 Reasons Why - 2
13 Reasons Why: An Opportunity for PreventionQ&A
13 Reasons
Why: An Opportunity for Prevention Last year, the Netflix show 13 Reasons Why made quite an impact. Teens and young adults were mesmerized by a show that tackled the issues of bullying, sexual assault, and suicide head-on, and in graphic detail. Parents, schools, and suicide prevention professionals were frustrated that the show took a potentially unsafe approach, worried about the show’s impact on suicide risk for young people in their community, and were unsure in many cases how to respond. Yet, this is not the first time that TV or movie content has raised concerns about safety and potential harm. Now that 13 Reasons Why is back for a second season, I encourage us all to use it as an opportunity to strengthen efforts to prevent suicide and other forms of violence among young people. First, remember that suicide is complex. The way the series portrays suicide and the unhelpful reactions of some adult characters may be unsafe for young people who are already struggling with thoughts of suicide. Last year, news reports popped up about young people who had died by suicide after watching the series. However, we know that watching a television show on its own does not cause suicide—there are likely many other factors at play in these tragedies. If a suicide death or attempt in your state or community is rumored to be connected to 13 Reasons Why, work with your local prevention partners to find out the facts—this is the first step in an effective postvention response and helps prevent false narratives from spreading. Encourage your partners to join you in emphasizing to the public and news media that suicide is complex, and there is no single cause. Second, let’s use the public conversation about the show to share prevention stories and helpful resources. The show will likely be the subject of news and social media buzz for several weeks, which is an opportunity for us to help shape the conversation. Reach out to your state or local news outlets to let them know about your prevention activities, including any information you have about how your work is making a difference in the community. Offer to connect reporters to teens who have struggled with thoughts of suicide and found help, or to adults who saw the signs and connected young people to help. Share the Recommendations for Reporting on Suicide, and encourage reporters, bloggers, citizen journalists, and public commentators to include contact information for the National Suicide Prevention Lifeline and the Crisis Text Line 741741 in their coverage, as well as any state or local resources that may be available for teens and parents. Third, let’s offer prevention resources to schools, parents, and other members of the community who work with young people. 13 Reasons Why shows a fictional school and community responding to a suicide loss and other forms of violence, often not in an ideal way. Fortunately, there are many resources available for school staff and administrators, including the recently updated After a Suicide: A Toolkit for Schools, which helps schools prepare to respond appropriately should a tragedy occur in their school community. Also available are a number of supports for parents who may be concerned about their child. And SPRC has put together a list of resources to help people in a variety of roles respond to the series, including parents, school staff, community leaders, and members of the media. Finally, let’s leverage this moment to make a connection with related prevention fields. 13 Reasons Why brings up issues like substance abuse, violence, sexual assault, and bullying, all of which share risk and protective factors with suicide—and many of which may add to suicide risk. The buzz around the show is a good moment to connect with partners working in these areas, not only coordinating our efforts to work with media, schools, parents, and communities, but also identifying other ways in which our prevention efforts intersect. Working together can help us pool limited resources and promote each other’s efforts. Many in our field, including the
National Action Alliance for Suicide Prevention’s
Changing
the Conversation Priority Workgroup,
are working hard behind the scenes with the entertainment
industry to change the national narrative around suicide.
Their aim is to ensure that future content in movies and
television promotes help, connectedness, social support,
resilience, treatment, and prevention messages and stories.
In the meantime, 13 Reasons Why is not the first
entertainment product that’s caused concern. Let’s
seize these opportunities to tell people about helpful
resources, promote stories of hope, and engage schools and
communities to help them respond safely, compassionately,
and effectively. Commonly
asked questions about 13 Reasons Why -
5/18/18 SPRC has received many questions about the Netflix series 13 Reasons Why (13RW). We list the most common questions from parents, schools, media, and community leaders below, with resources to help you talk about the series and suicide risk and prevention. If you are thinking of hurting yourself, or if you are concerned that someone you know may be suicidal, contact the National Suicide Prevention Lifeline by phone Call: 1-800-273-TALK (8255) or chat or text "SOS" to 741741. Why is there concern about the
series? Why is there concern about the series?
I am a parent. How do I talk with my child about 13RW?
I work with students. What can schools do to keep students safe?
I work in the media. How do I talk about 13RW in my article or reporting?
I lead suicide prevention efforts in my community. How should I address 13RW?
8 Things to Remember
if You Just Watched '13 Reasons Why' (Season 2) from
CisisTextLiine.org Take warning signs of suicide seriously. If someone you care about is showing warning signs of suicide, take action. Start by talking to them about what they’re going through and let them know you care. Listening non-judgmentally and sharing your concern can help them stay safe. There are people who want to - and can - give support. While many of the adult characters on 13 Reasons Why struggle to give meaningful support, seeking help is valuable and life-saving. And even if someone doesn’t know the best way to help, they can help you find someone who does. Talking helps. It may not seem like much, but talking about how you’re feeling or what you’re going through. goes a long way. Whether it’s to a friend, parent, or anyone else you trust, telling someone that you’re struggling means not having to be alone in your pain. Struggling isn’t weakness. The issues that characters face in the show - including mental illness, bullying, and sexual assault - can happen to anyone. Talking about them, coping with them, and recovering shows immense strength. Death by suicide is irreversible. Hannah Baker remains present in the lives of her classmates after her death, but this doesn’t happen in real life. The loss survivors left behind by a suicide can experience intense grief, including feelings of guilt, shame, anger, and helplessness. There is always hope. If you’re struggling, know that how you’re feeling now isn’t how you’ll feel forever. It’s always still possible to recover and have a full life. We’re here for you.
Trained Crisis Counselors are ready to support you, 24/7.
Text SOS to 741741 for free crisis support. Netflix
criticised over return of suicide drama 13 Reasons
Why Mental health experts have criticised the return of the Netflix drama 13 Reasons Why, expressing concern that the second series of the drama about a teenager’s suicide is due for release as summer exam stress peaks. The story of 17-year-old Hannah Baker’s life and death continues on Friday 18 May when the second series is made available online just as UK students are doing their GCSEs and A-levels. The Royal College of Psychiatrists described the timing as callous, noting that suicide rates among young people typically rise during exam season and warning that the Netflix drama could trigger a further increase. Teachers’ leaders said the show’s return was disturbing and regrettable, particularly given ongoing concerns about a crisis in young people’s mental health. The US-based series was a big hit for Netflix despite – or perhaps because of – the controversy surrounding the suicide storyline. The first series of 13 episodes depicted Hannah’s friends listening to tapes she had made for each of them explaining the difficulties she faced that had prompted her to kill herself. The second series uses Polaroid photos as a framing device, and has the tagline “The truth is developing”. Responding to concerns from mental health campaigners, the makers of the series have produced a videothat will play at the start of the series, warning viewers about the challenging nature of some of the themes and directing them to sources of help. “By shedding a light on these difficult topics, we hope our show can help viewers start a conversation,” says Katherine Langford, who stars as Hannah Baker, in the video. Alisha Boe, who plays Jessica Davis, says: “But if you are struggling with these issues yourself, this series may not be right for you, or you may want to watch it with a trusted adult.” Supporters of the first series said it was an accurate portrayal of high school life that would spark conversations between parents and their children and encourage viewers to seek information on depression, suicide, bullying and sexual assault. Critics accused the series of romanticising and sensationalising teenage suicide. The Samaritans, psychiatrists and mental health campaigners all said it could prompt troubled young people to copy the suicide of its central character. Dr Helen Rayner, of the Royal College of Psychiatrists, said she had the same concerns about the second series and was particularly alarmed by the timing of its release. “It’s well known within children’s services that there’s an increase in completed suicides and suicide attempts during the exam season. This could cause an increase in suicide rates,” she said. “I feel extremely disappointed and angry. This glamourises suicide and makes it seductive. It also makes it a possibility for young people – it puts the thought in their mind that this is something that’s possible. It’s a bad programme that should not be out there, and it’s the timing.” Geoff Barton, general secretary of the Association of School and College Lecturers, said the new series and the timing of its release in the UK raised questions about broadcasters’ responsibilities. “This is grim. I would share the concerns of parents and teachers, given that we already know the levels of anxiety young people feel during the exam season.” Research has shown that suicides among children and young adults peak at the beginning of exam season. A decade-long fall in the number of youth suicides has reversed in recent years and more young people now die that way than from any other cause. A total of 922 people aged 25 and under took their own lives in England and Wales in 2014 and 2015. Suicide now accounts for 14% of all deaths among 10- to 19-year-olds and 21% of deaths among 20- to 34-year-olds. The NSPCC urged young people with concerns to contact Childline on 0800 1111 or visit . Ged Flynn, the chief executive of Papyrus, a charity that seeks to prevent suicide among young people, said parents needed to be alert. “If a person is already considering suicide, a depiction of suicide can validate their thinking and make suicidal behaviour a legitimate option for people,” he said. “The problem with Netflix is that it’s online. You can’t regulate it. Social responsibility should have been part of their risk management. They should ask the question: why are we making this film if it’s not to save lives but to sensationalise suicide? It’s irresponsible.” Flynn also expressed concerns about the timing of the series launch. “The timing of the second season is particularly unfortunate for a UK audience, with most of our young people entering into exam season. “Papyrus has a clear message for exam season – #NoSilencePlease. If you see a young person who may be thinking about suicide, break that silence and ask them openly, directly and with respect and care: are you thinking about suicide? It can help to save a life.” Netflix were unable to provide a statement in response to concerns raised about the new series, but highlighted a recent blogpost by Brian Wright, vice president of Netflix original series, in which he details additional resources which have been made available to support viewers of the second series. These include a set of videos featuring cast members addressing topics depicted in the show; a downloadable discussion guide for parents and teenagers, and an after-show discussion including actors and experts in fields of suicide prevention and sexual assault which will play automatically after the last episode of season two. • In the UK and Ireland, the
Samaritans can be contacted on 116 123. Papyrus can be
contacted on 0800 068 41 41 or by texting 07786 209 697 or
emailing pat@papyrus-uk.org.
In the US, the National Suicide Prevention Hotline is
1-800-273-8255. In Australia, the crisis support service
Lifeline is on 13 11 14. Hotlines in other countries can be
found here. How
Netflix's '13 Reasons Why' addresses suicide controversy, Me
Too movement in Season 2 Netflix's high-school drama — which quickly became 2017's most tweeted-about show when it debuted last spring, according to Variety — unleashed a storm of controversy for its graphic depiction of the suicide of 17-year-old protagonist Hannah Baker (Katherine Langford), who leaves behind a series of tapes describing the events and people who led her to take her own life. The new season, streaming Friday, aims to rectify that from the get-go. It begins with a cast-led public-service announcement urging viewers to seek help, watch with an adult or not at all if they are struggling with suicidal thoughts, sexual assault or substance abuse. And creator Brian Yorkey has said the series won't depict another suicide. Instead, new episodes focus on the aftermath of Hannah's death, as Clay Jensen (Dylan Minnette) and classmates testify in court when Hannah's parents sue the high school for neglecting their bullied daughter's requests for help. The season also explores how Jessica (Alisha Boe) comes to terms with her rape last season, and features a timely new storyline about a series of sexual assaults connected to one of the school's athletic teams. Yorkey chats with USA TODAY about the 13 Reasons' backlash and how the drama addresses the Me Too movement and a potential school shooting. Q: Hannah's death impacts everyone in different ways when Season 2 picks up. How big of a role will she play on and offscreen? A. She is very present in flashbacks, but every one of those kids on each tape has their side of the story to tell. Hannah stars in those stories, and we'll also see some things that Hannah didn't tell us that happened in the past. At the same time, Hannah is a presence in Clay's life in the present day, as he's working to get to that point in the grieving process where he can forgive her for the choice she made and say goodbye. Q: You started writing this season last spring, months before sexual assault and harassment allegations made headlines. Did you go back and rework any storylines in light of Me Too? A: All of those things that are in our season were written before any of this happened. We follow these characters (and) want to bring into their lives issues young people are facing. The fact that those issues have also moved to the forefront of the real-world conversation is a great thing. We're all about starting conversations and keeping them going. Q: What kinds of research did you do to better understand young people's experiences with sexual assault? A: We have a number of different consultants we work with, one of whom is a lawyer who is an advocate for many young people who are victims of sexual assault in high-school settings. We also have an adolescent psychiatrist and psychologist, who talk a lot about what the survivor experience is. Unfortunately, there's a tremendous amount of news reports in recent years of young people facing sexual assault, and those were all things that we discovered in our research and that made sense for us to write into the show. Q: Last season, we also saw that Hannah's friend, Tyler (Devin Druid), has guns and ammunition stashed in his bedroom. Could he be planning a shooting? A: With Tyler, we are very interested in trying to understand the mindset of a young man who has been bullied, is suffering from severe social isolation and might be thinking about making a tragic choice in response to those feelings. Without giving anything away, we're much more interested in exploring his experience than we are in expressing the worst possible outcome. Q: The show received its fair share of criticism for its depiction of suicide in Season 1. Do you feel that any of the backlash was A: This is
going to sound like a political answer, but I truly believe
that all conversation is good. I would be lying if I said I
wasn't affected by some of the strongly negative reactions
to the show, because it's a show I'm very proud of. But in
the bigger picture, positive or negative, there were really
intense conversations happening, and many of them were not
happening before the show. You can't have that kind of
impact without some real polarity in the opinions, and I'm
grateful for all of it. Doctor
visits about suicidal thoughts rose with '13 Reasons Why.'
Handle Season 2 with care On March 31, 2017, Netflix released the series 13 Reasons Why, a program documenting events leading to the suicide of a fictional teen. The series generated enormous debate over whether its graphic content could spur self-harm among vulnerable viewers. And rightly so. One study demonstrated a 19% increase in Google searches related to suicide after the show’s release, including "how to commit suicide," "commit suicide" and "how to kill yourself." The study suggests that the show might have raised awareness of suicide but could also have led some people to actively contemplate suicide. With the arrival of Season 2, is there renewed cause for concern? We believe so, based on our study of millions of doctors’ visits by 14- to 20-year-olds during the weeks before and after the release of Season 1 on March 31, 2017. Using electronic health record data from AthenaHealth, an information technology company that supports more than 4,500 physician practices nationally, we analyzed the proportion of doctor visits that were for suicidal ideation. We hypothesized that visits for suicidal ideation would increase in the months following the release of 13 Reasons Why (we compared January-March 2017 with April-June 2017). We also studied the identical periods in 2016 because a similar increase in doctor visits after March 31, 2016, wouldn’t be expected to occur. The proportion of visits involving suicidal ideation was stable between January and March 2017 (about 0.19% of all visits). Following the release of 13 Reasons Why, the proportion of visits involving suicidal ideation increased sharply to 0.27% of visits in April and 0.29% of visits in May — a more than 40% relative increase. A similar pattern wasn’t observed in 2016. These findings are worrisome. To be sure, the observed increase in doctors’ visits for suicidal ideation could reflect an increase in the number of teens seeking help as a result of viewing the show. Even so, when the increase is taken together with the documented jump in online searches for ways to commit suicide, the alternative explanation of contagion in suicidal thinking is impossible to ignore. Unfortunately, national mortality statistics lag by several years, so we don’t know whether actual suicides increased after the show’s 2017 release. The World Health Organization has recognized the importance of careful depictions of suicide by the media and has published suicide prevention guidelines that specifically oppose realistic portrayals of suicide. To its credit, Netflix has responded to these and other concerns of health professionals by commissioning research to produce a better understanding of how teens and parents related to the original 13 Reasons Why series — and to inform how Season 2 can be most safely presented. Among several initiatives, cast members in Season 2 will come out of character at the start of the season to discuss issues of depression, suicidal thinking and how to get help. That’s good, but it’s not enough. Health care providers, particularly those caring for vulnerable teens, should be aware of the Season 2 release and the impact it might have on suicidal thinking and behavior. Some have recommended that at-risk youth not view the show — which could well be good advice. Everyone should agree that better data are also critical. We do not yet know whether Season 1 actually increased suicides or suicide attempts. But the current evidence, including our own, offers reason for concern. It justifies a general warning for both disseminators and viewers of shows of this kind: Handle with extreme care. Anupam B. Jena teaches at Harvard Medical School. Josh Gray directs research at AthenaHealth. Cass R. Sunstein teaches at Harvard Law School. Follow them on Twitter: @AnupamBJena, @JoshGray_hit and @CassSunstein You can read diverse
opinions from our Board of Contributors and other writers on
the Opinion front page, on Twitter @usatodayopinion and in
our daily Opinion newsletter. To respond to a column, submit
a comment to letters@usatoday.com New season of
'13 Reasons Why' still targeted by doctors who say it
glamorizes teen suicide Data show the teen suicide rate rose by more than 70% between 2006 and 2016 with black teen suicides increasing far faster. The renewed criticism comes despite the series' new embrace of suicide prevention, which includes a collaboration with the American Foundation for Suicide Prevention (AFSP). Some critics of the series, which showed a suicide and sexual assault in graphic detail, blame the first season for glamorizing suicide. The proportion of visits involving suicidal thoughts — known as "ideation" — jumped by more than 40% last April and May compared to the weeks before the release of the series' first season on March 31, 2017, according to a study of millions of doctors’ visits by 14- to 20-year-olds. A Northwestern University study commissioned by Netflix found more than 70% of viewers thought the show should have provided more educational resources. Netflix responded by including extensive resources and an "after show" on prevention that airs after the final episode in each season. But executive producer Brian Yorkey said Thursday that Netflix "stands by" the first season. While medical reports disagreed with the portrayal of suicide, Yorkey says Netflix felt it was the "most truthful portrayal" they could do. "I believe we did the right thing," he said Thursday. It's not enough to try to educate, says emergency doctor Paul Kivela, president of the American College of Emergency Physicians. "My concern with this whole show is the kind of glorification of suicide," says Kivela, who is based in Napa, Calif. "The problem here is that the producers of the show may not understand the unintended consequences of their show. "They may be trying to educate but may be having the opposite effect," he says. The new season also introduces a second black female teen, played by Samantha Logan, which helps illustrate the universality of mental illness and trauma. Logan, like actress Alisha Boe, was sexually assaulted, but chooses to downplay the trauma in an unhealthy way. "It's important for viewers of all different backgrounds to see themselves in this," says Yorkey. "They might have some different cultural pressures in how they deal with some things." To underscore that the actors are only playing troubled teens, Netflix is releasing a set of videos starring cast members out of character addressing many of topics in the show. This "discussion series" will be available in the Netflix “Trailers and More” section and on 13ReasonsWhy.Info starting Friday. The series includes information on how to spot depression, understanding sexual consent, drug and alcohol abuse, bullying, and self harm. The new Beyond the Reasons after show featuring actors and experts in suicide prevention, sexual assault and other problems will play automatically after the last episode of the second season. Rhode Island child psychiatrist Karyn Horowitz, a Brown University associate professor, says it should run after every episode and questions whether teens will view the online resources. Psychiatrist Christine Moutier, AFSP's chief medical officer, collaborated with Netflix on a resource page and discussion guide. AFSP, Netflix, and other organizations created public service announcements with cast members. AthenaHealth and researchers on the doctor visits study acknowledge the increase for suicidal ideation visits could actually show that more teens are seeking help after viewing the show, which is a positive development. Some of the criticism of the series highlights disagreement over the effect publicity has on behavior - and the level of accountability the media and entertainment should have for actions stemming from their work. But Horowitz, who heads outpatient child psychiatry and behavioral health services for the Rhode Island health system Lifespan, cites research showing teens exposed to suicidal behavior were at least three times more likely to attempt suicide. "With fear of talking about suicide in the name of protecting against contagion, do we also bring stigma and shame?," asks Yorkey. Horowitz says the attention shouldn't be on the act, but rather the prevention of suicide. Non profits and medical groups have guidelines for how the media reports on suicide, which includes not disclosing or showing where the death occurred or how it was done. In Washington, Judy Davidson welcomes the attention to suicide, especially in the African-American community. Still, she hasn't been able to bring herself to watch the series. Her son, Alvin Conrad Layne II, nicknamed “Momo,” died by suicide in 2016, a year after he was robbed on the street, shot twice and became paralyzed. And African Americans supposedly didn't kill themselves, or so the thinking goes. In fact, some people even told Davidson that her son would go to hell because suicide is a sin, something experts say leads to a code of silence that worsens the problem. "It’s like a sign of weakness," says Davidson. When talk turns to suicide, "People will say, 'Give them a shower and a nice clean shave and pray about it.'" She felt ostracized when she first wore an "RIP" tee shirt for her son as people suggested she should quickly get over the his death as it was suicide. No wonder many people don't want to talk about it: "They’re shamed and they’re ashamed," says Davidson. "It's worse in the African-American community," says motivational speaker Willie Jolley. "They don’t talk about mental health and very rarely admit to getting therapy." Suicide, he says, stems from hopelessness, adding that he tells audiences, "Some of you are struggling in life and you need therapy, you need help." That's a message Horowitz hopes anyone
who watches season 2 of 13 Reasons Why will heed if they are
suffering from mental illness, self harm or suicidal
thought. Most of all, she says she's one of the "many child
psychiatrists who are disappointed there is a season 2
because of the negative impact of season 1."
Source: www.usatoday.com/story/news/politics/2018/05/18/13-reasons-why-stop-teen-suicides-doctors/613316002/
Here’s What 7
Mental Health Experts Really Think About ‘13 Reasons
Why’ The series, based on the YA novel by Jay Asher, is about the reasons why high schooler Hannah Baker (Katherine Langford) decided to take her life, as explained in 13 audio tapes she recorded before her death. Many viewers praised the show for shedding light on the traumatic experiences young people face, such as bullying and sexual assault. And while some mental health experts commended the show’s handling of those issues, other voices in the suicide prevention community found its depiction of suicide to be inaccurate and potentially dangerous. Ahead of the second season, the network worked to show audiences that they’ve taken this criticism seriously and will be equipping viewers with adequate resources to help make the show’s impact a productive one. Some may be wondering why Netflix decided to continue a show that produced such controversy. As a spokesperson for Netflix explained to SELF, showrunner Brian Yorkey as well as other key players behind the show believed that there was much more to unpack regarding the untold stories of many of the secondary characters. 
2:017 Mental Health Tips Therapists Actually Give Their Patients As Yorkey told Entertainment Weekly last year about wanting a second season, “We really have characters who, after 13 episodes, are just beginning the process of recovery and the process of coming to terms with what part they might’ve played in Hannah’s death and how Hannah’s death will change their lives going forward. I think that there is so much that’s fascinating about the way we grieve, the way we recover, the way we learn to take better care of each other.” For example, a few months ago, the company released the results of a multinational survey (16 page PDF) commissioned by Netflix and conducted by Northwestern University that examined how 5,400 parents and teenagers in five countries (including the U.S.) received the show. They found that the majority of the adolescents who watched the show felt its level of intensity was appropriate. But parents and younger viewers thought that the show should incorporate more discussion about how to support someone who may be suffering and also have mental health support throughout episodes, possibly in the form of mental health experts or cast members providing resources at the end of certain episodes. Based on that feedback, the team behind 13 Reasons Why produced content to supplement season two. In March, they released a PSA featuring cast members (out of character) warning viewers about the show’s content and advising them to reach out for help. Netflix will also release another episode of Beyond the Reasons, which was a special TV-short that aired after the season one finale featuring producers, actors, and mental health experts discussing scenes that dealt with sensitive issues, including sexual assault and depression. Netflix producers also collaborated with suicide prevention groups to beef up the crisis resources available on 13reasonswhy.info, including a new viewing discussion guide (you can see last year's here 8 page PDF) created in collaboration with the American Foundation for Suicide Prevention (AFSP), which put out its own guide last year. The network is also launching a 13 Reasons Why video discussion series starring cast members out of character addressing topics in the show. (It will be available in the Netflix “Trailers and More” section and on 13reasonswhy.info when the new season becomes available.) Netflix account holders will also be able to create a pin code to control viewing access, according to a Netflix announcement. For example, if parents want to watch the series first and determine if it’s appropriate for their kids or other people with access to their account, they can do so. These efforts are designed to equip teenagers and their support systems (such as parents and school counselors) “with an understanding of what the season contains, so they [...] can be prepared for all of the dialogue that will probably flow from watching the show,” Brian Wright, vice president of original series at Netflix, explained at a panel last month, during which Wright and experts from AFSP, the American School Counselor Association, and Northwestern came together to discuss the survey findings. “We really do want to put our best foot forward in helping there be a really safe and vibrant and productive conversation in the world.” The good intentions of Netflix and the 13 Reasons Why writers and producers (driven by ratings and profits-Ed) are clear—but the show’s role in suicide prevention is less straightforward, some experts argue. While these new efforts are a step up from what was deemed a lackluster response to the season one backlash (which mainly consisted of adding a content advisory warning before the first episode), are they enough? To help answer that question, SELF asked seven mental health professionals for their thoughts on the show. We asked these experts—as well as the Netflix spokesperson—to weigh in on the four most common critiques of the show after the first season and the new initiatives that Netflix will be implementing in season two to facilitate safe and productive conversations. (Of course, these seven perspectives only represent a small number of mental health and suicide-prevention experts.) Critique #1: The plot conflated suicide with a teenage revenge fantasy, which may send a dangerous message to potentially impressionable viewers. “Revenge as a motivation for suicide is not the kind of message that is healthy or productive to send,” psychologist Kelly Posner Gerstenhaber, Ph.D., director of Columbia University’s anti-suicide initiative The Columbia Lighthouse Project, tells SELF. This romanticized representation is also not entirely accurate. “That way of portraying suicide doesn’t really match what we typically see in clinical practice,” John Ackerman, Ph.D., the coordinator at Nationwide Children’s Hospital’s Center for Suicide Prevention and Research, tells SELF. “Hannah responding to these individuals who caused her harm, or perceived harm, in a very vindictive way plays into a teen fantasy and promotes a misconception that suicidal behavior is selfish." Someone considering suicide typically feels more hopeless and burdensome than vengeful, he explains. “And it would be hard to motivate the energy and planning necessary to craft that elaborate set of responses that she did.” Another storyline that experts took issue with throughout the 13 episodes was Hannah’s narrative from beyond the grave, which sends the dangerous message that suicide is a way for someone who is suffering to gain agency. “13 Reasons Why is a series about how you can [influence] people’s thoughts and feelings and actions after you’re dead,” Gene Beresin, M.D., director of The Clay Center for Young Healthy Minds at Massachusetts General Hospital, tells SELF. Dr. Beresin explains that the message being passed on to adolescents is, “‘All of the things that I wish that I could change when I’m alive and couldn’t, I can when I’m dead.’ And that’s just wrong.” The spokesperson for Netflix told SELF that Hannah’s behavior was not meant to characterize suicide as a vengeful or selfish behavior—it was meant to portray a teenagers’ tendency to act out of emotion and not necessarily think things through. And “by no means” was Hannah’s suicide meant to imply that suicide is a method of getting revenge, he said. Critique #2: The show missed an opportunity to educate people about the most common risk factors of suicide as well as strategies that can help reduce suicide deaths. “They missed opportunities throughout the show to provide this information to the viewer, and that was unfortunate,” Jonathan Singer, Ph.D., a professor at the Loyola University Chicago School of Social Work who serves on the American Association of Suicidology (AAS) board of directors, tells SELF. One example is the decision to completely attribute Hannah’s suicide to the actions of other people instead of exploring the main risk factors for suicide. “They only show interpersonal stressors between kids, and we know that a lot of other factors lead to suicide,” Dr. Beresin explains, including prior attempts, mental illness, substance abuse disorders as well as a family history of any of those things. While the traumas Hannah experienced could indeed contribute to her suicidal state of mind, “to say that a sexual assault or bullying is a direct line to suicide is just wrong,” Dr. Beresin says. The series also neglected to inform viewers about the warning signs of suicide. “For example, in the very first episode, the teacher says, ‘Let’s go over some warning signs for suicide,’ and I was stoked,” Singer recalls. “But instead of going over the warning signs, what Netflix did is focus on [Clay’s] face—the sound fades out and he has a flashback. They could’ve spent 10 more seconds talking about the warning signs.” According to the Netflix spokesperson, the show's creators incorporated a few other, more subtle, warning signs in season one, like Hannah suddenly changing her appearance by cutting her hair, after learning that teenagers may not always outright say that they are having suicidal thoughts. For Hannah to go to Clay and say, “I am depressed and feeling suicidal,” may not have come off as authentic, the Netflix rep explained. That said, the spokesperson for Netflix said that the network and show team understand that viewers and parents would have wanted the show to take that extra step of calling out those concerning behaviors during or after the episodes. That critique influenced their decisions to commission the survey on how the show was received and to add more informational content with season two. Critique #3: The show didn't encourage people who are having suicidal thoughts or dealing with depression to seek help; it only depicted how reaching out for support could go wrong. Hannah attempted to talk to her school counselor, Mr. Porter, about being bullied and sexually assaulted; she even expressed suicidal thoughts. But Mr. Porter’s response was concerning to experts, who fear it could deter young people from seeking help if they are watching and can to relate to the content. “It was cringe-inducing,” Phyllis Alongi, a licensed professional counselor and the clinical director of the Society for the Prevention of Teen Suicide (SPTS), tells SELF. Ackerman agrees that Mr. Porter was portrayed as “completely incompetent.” As Ackerman explains, “Not only was he not compassionate or emotionally available to students, but he was clearly neglecting the ethical responsibilities of his profession, and doing things that would likely violate school policy and the law.” It’s worth keeping in mind that 13 Reasons Why is, of course, a television drama—and it can be argued that this was a creative choice meant to further the plot. But some experts were concerned that a viewer who may be in a similar situation as Hannah, who has suicidal ideation, may feel discouraged by the show and shy away from talking to a parent, guardian, or counselor. To this point, the Netflix representative directed SELF to Wright’s previous commentary on this particular criticism during the March panel: “We’re storytellers,” Yorkey explained, “so we often tell the story of when it doesn’t go right, in hopes that we can watch that story and we can be moved by it and then we can talk about how things can go right in our real world.” Apparently, this is a point that will be explored more in season two. Wright explained during the panel that “Mr. Porter in particular will be coming to terms with the mistakes that he made, with the ways that he let her down and will be very determined not to let any kids down in the future. And we'll see a man who is determined to reach every kid who needs to be reached and help every kid who needs help, whatever it takes [...] I do think that, as it happened in the conversation around Mr. Porter season one, we talk about what's the best version of this, what could he have done differently, and certainly we see that in the character as well as in life.” Critique #4: The scene showing Hannah’s suicide was a graphic dramatization and went against the guidelines for covering suicide in the media. The most publicized flashpoint of the controversy was the three-minute long, shockingly graphic scene of Hannah’s death, a dramatization that went against the recommendations for covering suicide in media, which are based on conclusions drawn from 50 studies and intended to minimize the risk of suicide contagion (aka “copycat suicide”). Research published in JAMA Internal Medicine showed a spike in suicide-related Google queries in the 19 days after the show’s release, including a 26 percent rise in searches for “how to commit suicide.” At the same time, suicide prevention-related searches also increased, including a 21 percent uptick for the search phrase “suicide hotline number.” The researchers wrote that 13 Reasons Why “has both increased suicide awareness while unintentionally increasing suicidal ideation.” “That sort of graphic, sensationalizing portrayal is very dangerous,” Gerstenhaber says—which, she explains, is why those media recommendations caution against glamorizing suicide or explicitly showing or stating the method in detail. However, it seems the graphic nature of this scene was intentional. As the Netflix representative pointed out to SELF, in the novel, Hannah dies by suicide by taking pills. But, as the spokesperson explained, the writers and producers wanted to show that suicide isn’t easy; it’s painful and it’s scary and terrifying to go through with. This scene in particular was meant to exude “radical empathy,” the spokesperson described; the scene is meant to evoke emotion (be it positive or negative), and to shock and awaken people. The rep also pointed out that 67 percent of teen and young adult viewers in the Northwestern survey said that the graphic nature of Hannah’s suicide was necessary to show how painful suicide is, and about half reported reaching out to apologize for how they treated someone after watching the show. Looking ahead, experts do see promise in the efforts Netflix is making to bolster resources With season two, “there’s potential to do some remedy, to embed the appeal of the narrative in a different story, which is, ‘This doesn’t have to happen,’” Jerrold F. Rosenbaum, M.D., chief of psychiatry at Massachusetts General Hospital, Harvard Medical School professor, and AFSP board member, tells SELF. The AFSP’s involvement in the process is a good sign, Singer adds. “They put out lots of good educational resources, and they have a lot of integrity around that.” Several experts are also pleased about the season two edition of Beyond The Reasons. Christine Moutier, M.D., chief medical officer of the AFSP (who participated in Netflix’s research panel in March and spearheaded the season two viewing guide) tells SELF it is “an opportunity for each viewer, if they do watch that part, to reflect back on what they’ve just seen with this new framing, and maybe some guidelines and new information.” Dr. Beresin called the first season edition of Beyond the Reasons “excellent,” while Singer likes the idea of a “debrief on the issues to make sure that everybody understands the difference between fiction and reality.” Northwestern’s U.S. survey showed that 82 percent of those who watched Beyond The Reasons said it helped them understand depression and suicide better and process the difficult topics in the show. So far, experts are particularly impressed with the new PSA featuring Katherine Langford (Hannah), Dylan Minnette (Clay), and other stars. "It takes the right tone and it looks like it’s well thought out,” says Ackerman, who also likes how it encourages people to seek help. “I thought it was really well done,” Singer adds. He praises the fact that Alisha Boe, who plays Jessica, says in the video, “This show might not be right for you, and that’s okay.” That gave the viewer permission to not watch it, which “I thought was really nice,” Singer says. And Alongi is thrilled to see the actors step out of character—a move she was campaigning for from the outset. She thinks this may help adolescents who strongly identify with these characters keep things in perspective and remember that the show is fictional. Experts also acknowledge that 13 Reasons Why did come with teachable moments and opened a dialogue surrounding suicide and other difficult experiences that young adults face that often get brushed aside. The Northwestern survey indicates that over half of teenage viewers spoke to their parents about the issues brought up by the show. “From the parents’ perspective, they were able to get this window into what the world that their kids are living in may look like,” Dr. Moutier says. However, there isn’t evidence yet that increasing awareness of suicide through a graphic portrayal will lead to at-risk adolescents getting help, Ackerman argues. “The idea that the show created a dialogue, and that dialogue will lead to reductions in youth suicide—without providing the resources or the action steps for those in need—[is] overly optimistic." Ackerman wonders whether young people will take the time to consume the educational programming and learn more about these difficult topics. Northwestern’s study suggests that many won’t: For example, only 29 percent of people reported watching Beyond The Reasons after last season. Dr. Beresin adds, “The positive efforts that are made by Netflix are not necessarily being utilized.” Experts have a few additional suggestions for what Netflix could do to make season two as responsible as possible. Dr. Beresin recommends that Netflix put more work into marketing Beyond The Reasons throughout season two. Dr. Rosenbaum also acknowledges that the material may not reach everybody, but, “For people who are struggling and suffering, I think some percentage of them will at least click on the options to get help.” Beresin and Alongi both would like to see Netflix produce custom content advisories or PSAs to play before every single episode as well as short Beyond The Reasons segments immediately following each installment of the series as opposed to just one or two. “Any one episode could potentially trigger [someone],” Dr. Beresin explains. Viewers seem to endorse this suggestion, too. Over three-quarters of those surveyed (in the U.S.) thought Netflix should have provided more resources like Beyond The Reasons throughout the season. Alongi would also prefer Netflix release only one or two episodes at a time, in an attempt to prevent binge-happy teens from becoming overly engrossed in the narrative. Finally, Ackerman stresses that the suicide prevention community is in no way trying to censor talk about suicide. “That’s the exact opposite
of what we’re trying to do,” he says.
“We’re promoting responsible dialogue and helping
kids and their families know the realities of suicide, and
the many resources and hopeful messages out there. But we
are careful to do that in a way that doesn’t
inadvertently harm someone.” '13
Reasons Why' is even more insufferable in Season 2 We don't need 13 more reasons. The second season of Netflix's 13 Reasons Why (streaming Friday, ? out of four) is a tawdry, unnecessary exercise, a blatant grab for the headlines the teen suicide drama garnered last year when it premiered on the streaming service. How do you follow up on something that was as much of a lightning rod as 13 Reasons Season 1? The series was criticized for its graphic depiction of suicide and two sexual assaults, for potentially misinforming teens about mental health and suicide, and for sensationalizing its serious subject matter. Netflix responded by adding content warnings to the first season, and those warnings continue in Season 2. But the tendency to cheaply use an issue as serious as sexual assault just for drama's sake has also continued. In the 13 Reasons world, it's all just another plot device. It's not just the serious subject matter that didn't need to be revisited, but the plot itself. Hannah Baker (Katherine Langford) left behind cassette tapes detailing 13 reasons why she killed herself. The tapes are done. The story should be, too. And yet, here we are. Set five months after Hannah's death, the new season follows the civil trial as her parents sue the school district for its part in her death: not doing enough to curb bullying and sexual harassment at the school and ignoring Hannah's calls for help. Instead of focusing on one "reason" per interminable hour-long episode, each episode this season revolves around testimony from one of Hannah'sclassmates. It is, quite literally, a rehash of all the events we saw in Season 1. The show manages to shoehorn in the ghost of Hannah as Clay's (Dylan Minnette) talking hallucination and through further, completely unilluminating flashbacks to the time before she died. The writers also try to up the melodrama, spinning tiresome conspiracies and mysteries at the high school and putting the traumatized teens through more harassment and abuse than they were subjected to in Season 1. A rape victim finds a sex doll strung up on her front porch, duct tape over its mouth and "slut" written on its chest. And that's only in the first two episodes. The new season tries to make a point about rape culture, slut shaming and sexual harassment, but its depiction of these complex topics has all the subtlety of a sledge hammer. If it's meant to start a conversation, as the creators insisted that the first season was, it certainly isn't going to be a very nuanced one. It was difficult to get through all 13 episodes of the first season, and the new episodes are more difficult to watch. The pace drags, the dialogue is unnatural and cheesy, the plot is dull and absurd, and most of the characters are still abhorrent. Watching is a chore, but there's no benefit at the end. There are zero reasons to put yourself
through it. 13 Reasons
Why Tries Again Late in the second season of 13 Reasons Why, Clay Jensen (Dylan Minnette) has an altercation with his school principal, Mr. Bolan (Steven Weber). Bolan has imposed a new rule at Liberty High that anyone talking about the suicide of Hannah Baker (Katherine Langford) will be suspended. “Suicide contagion is a real thing, and we’ve got to take measures to protect you kids,” he says. Clay argues that Hannah’s death has started a conversation that the students desperately need to have, and that silence doesn’t protect them. “The most dangerous thing would be to believe Hannah’s suicide is more than a tragic death,” Bolan counters. “She’s not a hero. She does not have lessons to teach us.” The exchange feels like a mea culpa on behalf of the writers and producers of 13 Reasons Why, albeit a loaded one. The first season of the series landed on Netflix with little fanfare just over a year ago and quickly became a phenomenon among teens, garnering the word-of-mouth acclaim and viral social-media popularity that the streaming service prizes over ratings. Then came the backlash. Mental-health experts and suicide-prevention campaigners charged that the show glamorized Hannah’s suicide, presenting it as a revenge fantasy. They criticized 13 Reasons Why for portraying her death in graphic, gory detail, counter to media guidelines for tackling the subject of suicide. The show also faced accusations that it inspired copycat deaths, and in July, a study published by JAMA Internal Medicine found that the series’s release corresponded with a rise in online search inquiries related to suicidal thoughts and methods. Judging by the second season, which is released in its entirety on Friday, 13 Reasons Why has taken the criticism seriously, even if it still maintains that the show has started an important dialogue about mental health among teens. The back and forth between Clay and Mr. Bolan is just one instance of the series trying to redefine how the first season was interpreted. If Hannah was lionized in Season 1, both via her own narration and the way she was adored by her grieving friend Clay, Season 2 wants to complicate the narrative. In part, this is a practical decision. 13 Reasons Why—which was developed by the playwright Brian Yorkey and includes the director Tom McCarthy and the performer Selena Gomez as producers—found a compelling star in Langford, an Australian actress who brought sensitivity and magnetic screen presence to Hannah in Season 1. Clearly the show didn’t want to let her go. And Hannah’s death isn’t the obvious obstacle it might seem, given that the first episode began a few weeks after her suicide and proceeded to work backwards in flashbacks. In keeping with the book it was based on by Jay Asher, 13 Reasons Why structured itself around 13 tapes Hannah recorded before her death, assigning each one to a reason—a person—who was partly responsible for her decision to end her life. It was a dark and surprisingly toxic premise for a show targeting young adults. And it was meted out via cutesy analog technology and an awkwardly positioned romance between Hannah and Clay that had to be compelling enough to hook viewers but not so idyllic that it contradicted her tragic narrative. But the structure of the show worked; it spent each episode with a different character from Hannah’s tapes, and used Clay as the audience surrogate who was experiencing the tapes one by one. Season 2 tries to mimic the setup by organizing itself around a trial in which Hannah’s parents are suing Liberty High School, charging that it enabled the culture of bullying and abuse that led to Hannah’s death. Each episode deals with a different character’s testimony, re-creating events from points of view that often contradict Hannah’s. Is it an easy way for 13 Reasons Why to rebut criticism that her suicide was presented as heroic? Absolutely. Is it convincing? Not at all. In some ways, Season 2 feels like fan fiction, imposing an entirely different storyline retroactively on characters whose arcs were persuasively defined the first time. It’s also trying to tackle the revelation that the privileged athlete Bryce Walker (Justin Prentice) was a serial sexual predator, as a variety of different characters attempt to get justice for Hannah. For the most part, Season 2 is thoughtful in the way it handles its characters’ lingering trauma (with one exception so shocking and so violent that it’s hard to comprehend who okayed it). The language it uses about sexual assault, and the nuanced ways in which it illustrates how money and power can insulate abusers, can be surprising. “Hannah’s gone, and she was sweet, and sensitive, and white,” Jessica (Alisha Boe) says in one scene, regarding her reluctance to speak up about her own assault. “Look at what they’re doing to her.” Season 2 also sags less than the first season did, incorporating suspenseful subplots and side stories into the main arc of the trial. It still tends to feel like a fantasia of teenage life where 17-year-olds drive 1968 Mustangs, date adults, drink Scotch out of crystal glasses, and practice their street art in abandoned lofts, blissfully free of parental intrusion (they’re also all adorned with tapestries of tattoos). Grounding the absurdity is Minnette’s Clay, such a sweet and soulful kid that he sometimes feels like an empathetic alien or a particularly youthful-looking grandpa amid all the other teenagers at Liberty. Season 2 is a worthy attempt at a
do-over, if a flawed one. That’s until the final
episode, when a plotline that’s been building over the
past 12 episodes turns into a charged confrontation that
undermines everything 13 Reasons Why has spent its second
season doing. When a show demonstrates that it can listen,
can absorb criticism, and can try earnestly to be
responsible in the way it communicates serious issues to
teenagers, is it better or worse when it throws everything
out the window for the sake of a suspenseful cliffhanger?
It’s a shame, and it implies Season 3 will have more
criticism to plan its inevitable atonement around. If Your Kid Is
Watching ‘13 Reasons Why’ Then You Might Want to
Read This - May 18, 2018 Last year, parents and schools were caught off guard when suddenly teens and tweens were binge watching a new 13-episode series that included graphic rape and suicide content, including a prolonged and very bloody scene in which the main character takes her own life. As I began to hear of middle schoolers watching the series, I became concerned and curious and watched all 13 episodes over the course of two days. I subsequently wrote about the series in an effort to at least get the show on the radar of parents and school personnel. Season 2 of the series released today, and while it is clear that the producers of the show did consider much of the criticism and outcry by parents and mental health experts to heart, there is still reason for all of us to remain vigilant. In season 2, each new episode will be preceded by a “trigger warning” and followed by new after-show content titled “Beyond the Reasons,” in which actors, experts and educators will break down the darker plot threads of each installment. This appears to be an attempt by Netflix to help young viewers process what they have just seen and could prove to be especially important for viewers who are middle and high schoolers watching the series alone, perhaps without even the knowledge of a single adult. Obviously the hope is that viewers will stay tuned for the post-show discussions instead of just jumping to the next episode, though that is the very definition of binge watching so it’s hard to be optimistic. Global Concern Mental health experts across the globe have formed a coalition called SAVE (Suicide Awareness Voices of Education) and issued an international alert regarding the release of season 2. The statement says, in part: While we hope that the series will encourage important conversations and more positive, healthy behaviors, we also are concerned that the series could have negative outcomes for some youth. (The full statement can be downloaded here and additional resources can be found here.) The impetus for the alert and the “13 Reasons Why Toolkit,” at least in part, are the findings of a study published in The Journal of the American Medical Association that “found a significant increase in internet searches on suicide following the release of season 1.” According to The Atlantic, “Google queries about suicide rose by almost 20 percent in the 19 days after the show came out, representing between 900,000 and 1.5 million more searches than usual regarding the subject.” And from USA Today: The proportion of [doctor] visits involving suicidal ideation was stable between January and March 2017 (about 0.19 percent of all visits). Following the release of “13 Reasons Why, the proportion of visits involving suicidal ideation increased sharply to 0.27 percent of visits in April and 0.29 percent of visits in May—a more than 40 percent relative increase. A similar pattern wasn’t observed in 2016. So buckle up everybody. It’s hard to imagine that today’s release of season 2 won’t have people logging in to Netflix en masse and at least this time we know that that part of what makes the show so gripping—addictive even—is precisely the fact that it deals with topics that are difficult, dark, and yes, very real. Thankfully, teachers, parents, and school leaders will be better prepared this time around and Netflix’s efforts to do a better job in providing supports and resources for viewers are a welcome change. But at the end of the day, this show is no joke and we have an obligation to be plugged in and paying attention—and asking— if our kids and other kids we know and care about are watching it and the impact it may—or may not—be having on them. This will take a village. Erika Sanzi is a former teacher and
school board member, a mom of three boys, and a fierce
advocate for great public schools and the right of every
parent to choose their child’s education. Is Hannah A Ghost
In '13 Reasons Why' Season 2? New Photos Have Fans
Wondering The new still of Hannah and Clay together shows the two in Clay's room, but their interaction looks far from cozy. Clay almost looks confrontational, glaring at Hannah, whose face appears quite serene. Clay's anger in the moment definitely suggests that he keeps envisioning Hannah despite his desire not to revisit her. Seeing as 13 Reasons Why has yet to add "horror" to its own genre, I doubt that Hannah is necessarily a ghost in the moment, but given all that Clay has experienced, having hallucinations of Hannah is almost inevitable. Whether she's popping up as a ghost or as a figment of Clay's imagination, it seems that Hannah will still be quite the polarizing figure in Season 2. After all, Liberty High is understandably in shambles after her death, and while everyone else may not literally see Hannah as Clay does, the Season 2 trailer has confirmed that they're all still struggling with the tense atmosphere her suicide has caused. Actress Katherine Langford has remained tight-lipped about Hannah's role in the new season, but fans have guessed that she won't narrate as she did in Season 1. Speaking to Entertainment Weekly last December, Langford teased that we can expect a "different Hannah" in upcoming episodes, saying: It’s a different story than season 1 and I think that’s a good thing. This season we get to explore a lot more of the other characters and their journeys, which I’m excited about. As sad as it is, there is life after Hannah, and this season we get to see the effects it had on the people around her a lot more. You see a very different Hannah in season 2. I would prepare fans not to expect the Hannah from season 1 for a multitude of reasons. While there's always the possibility of Season 2 including flashbacks to when Hannah was alive, it seems that the majority of her scenes will be post-mortem and opposite Clay. The trailer shows her questioning him about a polaroid that reads, "Hannah wasn't the only one," and asking what he'll do about it. The footage later teases Clay seemingly pointing a gun at a teary Hannah, but earlier scenes essentially confirm that Clay is on a mission to avenge her death. Seeing how insane this season promises to be, it could be a fruitless quest, but perhaps that's why Hannah continuously haunts Clay. Could his inability to accept her death and move on contribute to his hallucinations? As Reddit user Kyle203 points out, if Clay is the only one to see Hannah, it just emphasizes how obsessed he is with the loss of her: I wonder if it's only Clay that can hear and see Hannah? If so, this is already sad tbh. Clay can't let her go, knowing what happened, so she's just always in his conscience. This season is already looking different, but I think it'll be just as special as the first. Other fans have theorized that Hannah's mother Olivia will also see her in visions, but as we're all different with our parents than we are with friends, this idea could entail Hannah guiding Clay and Olivia in very different, potentially dangerous directions. We have to wait a little longer to see if Hannah visits others, but fans are dying for more clarification about Hannah's status in Season 2. The saddest thing about 13 reasons why is, regardless of how many season they bring out it won't change the fact that Hannah is dead. Clay and Hannah ending up together will forever be the biggest "what if" of our generation. Regardless of the nature of Hannah's
new appearances, I'm ready to weep over her encounters with
Clay. Teen suicide is
soaring. Do spotty mental health and addiction treatment
share blame? The young men were as different as the areas of the country where they lived. But they shared one thing in common: A despair so deep they thought suicide was the only way out. The suicide rate for white children and teens between 10 and 17 was up 70% between 2006 and 2016, the latest data analysis available from the Centers for Disease Control and Prevention. Although black children and teens kill themselves less often than white youth do, the rate of increase was higher — 77%. A study of pediatric hospitals released last May found admissions of patients ages 5 to 17 for suicidal thoughts and actions more than doubled from 2008 to 2015. The group at highest risk for suicide are white males between 14 and 21. Experts and teens cite myriad reasons, including spotty mental health screening, poor access to mental health services and resistance among young men and people of color to admit they have a problem and seek care. Then there's the host of well-documented and hard to solve societal issues, including opioid-addicted parents, a polarized political environment and poverty that persists in many areas despite a near-record-low unemployment rate. And while some adults can tune out the constant scroll of depressing social media posts, it is the rare teen who even tries. Then there's the simple fact they are teens. "With this population, it's the perfect storm for life to be extra difficult," says Lauren Anderson, executive director of the Josh Anderson Foundation in Vienna, Va., named after her 17-year-old brother who killed himself in 2009. "Based on the development of the brain, they are more inclined to risky behavior, to decide in that moment." That's very different from how even a depressed adult might weigh the downsides of a decision like suicide, especially how it will likely affect those left behind. And sometimes life is so traumatic, suicide just seems like the best option for a young person. Carmen Garner, 40, used to walk across busy streets near his home in Springfield, Mass. when he was a teen, hoping to get hit by a car to escape life with drug addicted parents. "Our students are dying because they are not equipped to handle situations created by adults — situations that leave a child feeling abandoned and with a broken heart," says Garner, now a Washington elementary school art teacher and author. "Our students today face the same obstacles I faced 30 years ago." After the leaves fall November is an especially difficult time in the Adirondack mountains resort town where her family lives, says Laurie Schmid, Tayler's mother. As the seasons change, the trees are bare, it's bitter cold and the small community has shrunk after summer residents leave their lakefront cottages. In the weeks before he took his life the day before Thanksgiving 2014, Tayler seemed sullen but his family chalked it up to "teenage angst and boredom and laziness." It was likely "masking his depression he was dealing with the last few years of his life," she says. As her son moved through his teenage years, Schmid says she became less focused on getting her son in to see his pediatrician annually, because he didn't need shots and wasn't as comfortable with a female doctor. Besides, he got annual physicals at school to compete on the school soccer and track teams. Among the "what ifs" that plague her now is the question of whether the primary care doctor who had treated Tayler all his life would have picked up on cues about possible depression a new doctor missed. She had even tried to get Tayler to see a mental health counselor, even though finding one in their area of upstate New York wasn't easy. Once Schmid and husband Hans settled on one, Tayler refused to go. One positive has risen out of the pain. There are far more resources and awareness about mental health and the need for counseling in her area now, thanks in part to the family's advocacy through the "Eskimo Strong" group it started. A local counseling center even has an office at the high school now. Schmid speaks to schools and parents regarding signs of depression, to encourage counseling, and provide information for suicide hotlines and text lines. Her oft-repeated motto is "Say Something" and "Talk to Someone." Mental illness also needs to be covered by insurance at the same level as physical illness, says psychiatrist Joe Parks, Missouri's former medical director for mental health services. There need to be more psychiatrists (66 page PDF) and they also need to be part of primary care clinics, Parks said. At his community health center in Columbia, Mo., he screens those who may be suicidal and taught others to do it, too. Such "accountable care" was envisioned, but not fully realized, under the Affordable Care Act. Children and teens who aren't covered by their parents' insurance can at least rely on Medicaid's Children's Health Insurance Program. That's hampered by low reimbursement rates that mean few psychiatrists accept it, however. So, even children who receive mental health treatment, Parks said, may be in environments dominated by family members with drug, alcohol or domestic abuse issues. "Wouldn’t you expect that to increase depression in children?" he says. Suicide chic? If super skinny — or muscular — models aren't enough to depress a teen, flipping through social media feeds can prove misery loves at least digital company. Teens regularly post about hating their lives and wanting to kill themselves, so much in fact that Parks says it's almost like a competitive "race to the bottom." On one hand social media provides a place to vent and get advice, but on the other hand, as Anderson said, “if everyone is commiserating over everyone, is it really helpful?" Because teens are interacting in a way that isn't face to face, there’s less of a connection, so it’s hard to understand what, if anything, to say when someone says they want to die. Teens say they will see a post about depression or suicide ideation and sometimes just pass it off as relatable dark humor. A recent post in one Baltimore teen's Facebook feed: "Alright, so I will literally pay anyone to shoot me in the head. Who wants a go at it? Please." She included a smiley face emoji. Blacks do kill themselves Two African American preteen Washington charter school students killed themselves in the space of about two months recently, drawing attention to something not commonly thought of as a problem. "There’s been a lot of discussion about how suicide is potentially thought of as a white person’s issue," says Craig Martin, global director of mental health and suicide prevention at the men's health charity Movember Foundation. "As a result of that, less is being done in black communities to look at the issue of depression." There's also a more pronounced stigma in the African American community surrounding mental health issues. African American men have fewer mental health issues but more serious types when they are present. And they are far less likely to seek treatment, says New York City psychiatrist Sidney Hankerson. Then there's the trauma that comes with living amidst multi-generational poverty and addiction. A version of the much-publicized opioid epidemic in often-rural white communities has plagued inner city black families since long before Garner was a boy. Garner thought "normal" meant watching his mother shoot heroin and his aunts and uncles smoke crack. "I lived with rapists, murderers and drug dealers and gangsters," he said. Now, his students are his motivation. They and his family remind "me I don't have to try to kill myself anymore," Garner says. On a Monday night, Karen Ruf went to a Bible study and J.C. took his grandmother out for unlimited shrimp on a Red Lobster gift card. When he got home, he talked to some friends at about 7:30 p.m. No one heard anything different in J.C.’s voice. Karen returned around 9:15 p.m. to a quiet house. She called for her son, no answer. She came downstairs and found his body. Ruf knew J.C's death wasn’t an accident because her son left his phone unlocked so she could find his note: “Everything has a time. I decided not to wait for mine. They say we regret the things we do not do. I regret it a lot.” HOPELINE offers emotional support and
resources - via text message - in an effort to prevent
suicide. Text “SOS” to 741741. The Semicolon
& The Ripple Effect – How a Netflix Series is
Opening Dialogue about Mental Health What does the semicolon have to do with mental health? By definition, “the semicolon is to mark a break that is stronger than a comma but not as final as a full stop,” as defined by the Oxford Dictionary. The semicolon is being used in a suicide prevention movement — “Project Semicolon; Your Story is Not Over.” Life and its messiness, the struggle with how it affects mental stability — the semicolon can be a symbolic solution after a time of reflection and assessment of the next move. The in-between place of healthy and unhealthy mental states can be a tough place, a place that is hard to get out of. Questions arise such as: Did I cause that to happen? Why didn’t I help them? Why did I make that choice? Do I cause my family to fight? Will people accept me for who I am? The list goes on and on, the burden of these questions gets heavy if they go unanswered. All of the questions, the burden – then, the semicolon… pause, reflect; get help and with guidance finish your story! Unfortunately there are times when people do not choose a comma or even a semicolon, they choose a period. 13 Reasons Why A recent Netflix series, 13 Reasons Why, with Selena Gomez as an executive producer, has been a hot topic as of late. The book, 13 Reasons Why, written by Jay Asher, was the inspiration for the television series. Trying to understand why this series took off like wildfire with middle and high school kids, I chose to watch the series. I was beside myself. At times holding my breath, other times frustrated that these youths would behave in such ways to each other, and ultimately sad that this depicts reality. It made me think about the everyday life of our youth, not just here in Coronado, but world-wide. I sought out different perspectives regarding this series. For those of you who have not seen the series, I will give you a quick synopsis: The main character is a 15 year old sophomore in high school named Hannah. Life was good for her, until it wasn’t. There were situations that arose that she was a part of, or witnessed, that became her burden; a burden she chose not to carry anymore when she took her own life. One such situation was a rumor being spread around campus that she had been intimate with a boy, when she hadn’t. Then she could have done something to prevent a car accident in which one of her classmates dies, but she didn’t do anything about it. She also witnessed her classmate being taken advantage of after she had passed out from drinking too much, but she never said anything. Before she took her life (the suicide differs in the movie from the book, being more graphic in the tv series) she recorded her thoughts on 13 tapes as to the events, the what and the who, that led her to make the decision to end her life. While there are graphic scenes, the show really gave me and my daughter an opportunity to talk about the subject. We talked about the characters, the decisions they made, whether they were good or bad, and where we thought this girl’s mental state was and what led to her mental demise. With each tape something was revealed: a classmate, a situation, and her “truth” of the story. With Hannah’s voice-over and flashbacks, the story is unfolds. Part of me felt that having Hannah always in the story, even if in the flashbacks, it would seem to the viewer as though she was immortal, since she never truly disappears from the story line. My concern with this is that it may subconsciously give the sense that suicide may not be final. The parent’s perspective. I really wanted to get a well rounded perspective of this series, the book, and the after effects, so I asked others in our community. One mom that I talked to stated that she felt there was most certainly an age in which it would be inappropriate to watch this, her daughter being around twelve, and she thought it wasn’t a good idea. However, she felt that if a parent was willing to watch it with them and have a VERY open dialogue regarding the content it would be okay. Another mother I spoke to, who has children of varied ages, said that while watching this series she understood that this young girl was stuck in the middle of all of these situations and struggling to find a way out. It had forced her to look back on her high school years, and realized that it was all there then as well, and it is still there. The main character is struggling with mental instability and really is not sure where to turn. One comment that I received was very profound; she stated, “I think the scariest part of this show is that Hannah’s parents appear to ‘know’ their daughter and take an interest in her life. It may have other parents questioning whether or not they are doing enough, or even too much.” That is so true. Do we as parents know enough, do enough, say enough; or be sure to react in a way that will not shut down the line of communication? Other parents said that watching how the students treat each other made them sad, and they wondered why kids had to be so incredibly mean to one another. Why wouldn’t kids want to bring another person up? Instead there are times they choose to put them down, or bully them over social media, or even if something is said or done to another person….why can’t they stand up for each other? It is time for parents, students, schools, and communities to conquer the many different types of mental health disorders, by (not limited to) being kind, being a good friend, implementing the “see something, say something” model, perhaps by offering anonymity. Kids are often afraid of the backlash if they choose to do something about an issue or situation they are in. The educator’s perspective. A friend of mine who is a middle school teacher had stated that she felt the kids in her grade were obsessed with this series and thought that it was cool story, that they were not seeing the shock factor that many adults felt while watching it. Basically, not truly seeing the big picture; mental health and how it affects our lives on a daily basis. A young teacher that I spoke with, Bekah W., gave me such wonderful insight. The most notable perspective is how she was able to take what was going on in the story, and translate it into to real life situations. She stated, “Jay Asher handled the situations this high school student went through in the book 13 Reasons Why a bit differently. First he emphasizes the theme of what he calls ‘the snowball effect’ throughout the entire novel. Hannah’s goal is for her listeners to understand that their actions impact others. Even if they did something that we might consider relatively insignificant, like spreading a rumor, she explains how that rumor did in fact greatly influence how others treated her. For example, in the book she says, ‘A rumor based on a kiss ruined a memory that I hoped would be special. A rumor based on a kiss started a reputation that other people believed in and reacted to. And sometimes, a rumor based on a kiss has a snowball effect.’ Asher continues to return to this theme repeatedly, even having Clay (the other lead character) question Hannah’s actions several times. After listening to one tape, Clay thinks to himself, ‘You should’ve called the cops, Hannah. It might have stopped this snowball from picking up speed. The one you keep talking about. The one that ran over all of us.’ In this way, Asher affords for a discussion surrounding responsibility in these situations. It was a conversation, quite frankly, that it seemed many of them had never had. What responsibility do they have when it comes to the way they treat others, when it comes to standing up for other individuals, and finally when it comes to witnessing a crime? The discussion culminated at the end of the book with the question of what Clay should now do with the tapes.” She went on to state that there were other big issues handled differently in the book vs. the series. Notably, the graphic incidents that were detailed in the movie were not the same in the book. In the book, there was just enough information so that one would be able to imply what happened without the tough details to sift through or the graphic scenes. The last topic she discussed with me was the mental health of the character. Not only did they talk about mental health within the confines of the classroom, she had the counselor come in and talk about it with the students. I think that that was a very healthy approach, because the students were open to talking about it, and offer ideas on how they could make things better for students, themselves, and their community. What do we do next as students, as
parents, as educators, as a community? We start with how we
behave towards each other. Is sending that text, Facebook
reply, or Snapchat out to everyone worth the few chuckles?
Is it necessary to make people feel bad because they
don’t feel the same way about a picture on Instagram, a
political position, a social stance, the same extra
curricular activities, or even how others dress? Does it
matter, does any of it matter? The answer is NO, it really
doesn’t! Being kind to one another is what you want to
be remembered for. Being helpful to those who may be
privately and quietly in the midst of a battle. Being
compassionate to others who are dealing with inner turmoil.
We don’t know everyone’s story, but one thing we
can do is make sure their story goes on; and they can move
forward to share their struggles with others in hopes that
it could help another person, then that person could share
and help out another person…..a ripple effect of
goodness. Since its Netflix release in March 2017, multiple young people in Portland area hospitals have reported they watched the series prior to their own suicide attempt. While the series seeks to capture the agonizing challenges of sexual trauma, bullying and suicide, its content poses a significant risk to vulnerable youth, particularly in the absence of supportive peers and adults.
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