Experts say one thing is clear: Do not let TV do it alone.
Since Netflix began airing the series “13 Reasons Why,” a fictional show that revolves around suicide, in March, the internet has been full of critics and viewers debating whether the show is the appropriate catalyst to start conversations about mental health, depression and suicide. Some have warned the series could be seen as glamorizing suicide.
Based on the novel of the same name by Jay Asher, the on-demand streaming series focuses on the suicide of the main character, a high school girl, and the events that led to her decision. While “13 Reasons Why” focuses on such important issues as school bullying and social pressures that often contribute to suicidal thoughts among young people, some mental health professionals have cautioned that watching the series without adult supervision and discussion could inspire copycat behavior or self-harm among vulnerable youths.
And that goes for school settings, too.
Due to the graphic portrayal of sexual assault, self harm, bullying and suicide, many organizations, including the Tennessee Suicide Prevention Network and the American School Counselor’s Association, have cautioned that this material isn’t appropriate for classroom discussion.
The TSPN advises against screening the show in class, and urges that conversations about it should be on a student-to-student bases since classwide discussion can be triggering and traumatic for students, according to professionals.
Greg Wallace, supervisor of safety and mental health for Johnson City Schools, said he agrees with the TSPN’s take on the matter. For one, scenes in the show can be traumatic for children and teens, especially for those who struggle with depression or have been sexually assaulted. Secondly, while all state teachers are required to have suicide training, Wallace said conversations surrounding suicide and depression should be limited to professionals with training in mental health.
“It's not something for a casual observer to be having an in-depth conversation (about),” he said. “It's not something you'd want to sit around and have a group discussion with a teacher who's an expert in math for example because it's a very serious issue.”
Thanks to the far reach of social media, the show and its content has made its rounds, with people on both sides of the issue chipping in their opinions, including teens. While suicide is the leading cause of death for people between the ages of 10 and 34, Wallace said it’s important to have these discussions, but it’s just as important to have these discussion in the right conditions. The mass information presented by social media coupled with online bullying presents different hurdles when discussing mental health that weren’t there 15 years ago.
“Suicide rates haven't dramatically changed, it's a critical issue and it's been a critical issue for a long time,” he said. “But now things get passed around so quickly and how some of that mass information can be damaging.”
According to data from the Washington County Health Department, 17 people died by suicide in 2014, and the suicide rate in the county is 13.5 per 100,000 people. Statewide, suicide is the leading cause of death for Tennesseans between ages 15 and 34.
WCHD Public Health Educator Sarah Lovelace, who is also a member of the TSPN, said that Question, Persuade, Refer training is part of the TSPN’s program and health departments’ efforts to reduce suicide in the state. The QPR Gatekeeper Training for Suicide Prevention program is a tool for health department officials and school faculty to learn how to recognize the signs that a person is in crisis.
Netflix has defended “13 Reasons Why,” saying the show has been a “valuable driver” for starting important conversations among families. In May, however, the video streaming service added a warning before the first episode and “also strengthened the messaging and resource language in the existing cards for episodes that contain graphic subject matter.” The series has been renewed for a second season.
Lovelace said she stands by TSPN’s recommendations on ‘13 Reasons Why’ and said that kids and teenagers shouldn’t watch the show without supervision.
“Although the show has provided a spark in starting conversations about suicide, teenagers drawn to watching the show should not do so without a parent or guardian present,” she said, adding that statistics have shown an increase in suicide among juveniles in Tennessee in recent years.
As far as school systems go, Wallace said most Johnson City Schools are equipped with mental health facilities to help students with their mental health and crises. He said the important thing is to offer guidance to children and teens who may be depressed, take their concerns seriously and not be afraid to refer them to a mental health professional.
“Every school is going to have resources,” he said. “Every school system is going to have a counselor, every school is going to have a caring adult.
The National Suicide Prevention Hotline is 1-800-273-8255, or those with suicidal thoughts can text “TN” to 741-741 for assistance.
By the numbers:
— Suicide is the second-leading cause of death for people between the ages of 10 and 34
— Someone dies by suicide every 12 seconds in the United States
— One in 16 people diagnosed with depression will die by suicide
— Suicide is the 10th leading cause of death in Tennessee
— 950 people per year die in Tennessee by suicide
— In 2014, the rate of deaths from suicide in Washington County was 13.5 per 100,000 with a total number of 17 suicides. (Sarah Lovelace, Public Health Educator with the Washington County Health Department)
— Death from suicide remains among the leading causes of death in Tennessee young adults ages 15-24 and among adults ages 25-34 (Lovelace)
Signs that a teen or child is suicidal: (from National Institute of Health)
— Loss of interest in things they used to enjoy
— Irritability, frequent tantrums
— Little or no energy
— Self harm, harming others
— Engages in risky behavior
National Suicide Prevention Hotline: 1-800-273-8255