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13 Reasons Why: An Australian Psychologist & Suicidologist’s Perspective

13 Reasons Why is certainly an addictive show and representative of our era; graphic, thought-provoking and at times shocking. However, suicide is a difficult topic to tackle without being sensationalist or reductive, unfortunately both of which 13 Reasons Why is. From one perspective, yes, there are many lessons that one can take from this series; however, there are also many problems which risk the lives of some of the viewers. As the President-Elect of the American Association of Suicidology said recently “the genie has escaped from bottle; all we can do now is contain it”.

Discussing suicide, whether in real life or the arts, is a balancing act of risk versus gain. As someone who has worked with suicidal people and those who have lost someone to suicide for 18 years, I believe 13 Reasons Why poses more risks to those who are young, vulnerable or have experiences of trauma, than what we gain in insight. Overall, the series is contributing to suicidality and not in a prevention-minded perspective and we as a society need to protect the most vulnerable. You may disagree, which is your prerogative; however I have provided you with my rationale for my conclusion.

Here are some points from my clinical and academic experience and having spoken to people who have watched the episode and previously experienced suicidality (those who have had suicidal thoughts, those who have attempted or those who have lost someone to suicide).

It can be about who you identify with
The Performing Arts hope to get its viewer to connect, engage and identify with characters. All great actors and performances do this, which is why the impact is so lasting. In 13 Reasons Why you are forced to walk in the shoes of the characters, which it does very well, and there are a few camps which you might settle in and characters you connect more with than others.
If you walk in the shoes of Hannah’s classmates you may start to reflect upon your treatment of others, which is a good thing; that is reviewing our actions and making positive changes within ourselves. However, if you walk in the family’s shoes, the unanswered question of ‘why’, that many survivors are left with, may be exacerbated and painfully relived. Then, most problematic of all, is if you identify with Hannah, for whatever reason which is where significant risk begins: being the new kid at school, bullying or harassment, experiencing a sexual assault, experiencing normal stuffs ups (like losing the days takings). You will follow Hannah on the path to her death, which is portrayed as inevitable and a natural progression. When in fact, there were and are many opportunities to change the end result. The show failed to insert factors or model alternatives to its viewers.

Where is our brain development up to?
13 Reasons Why offers little education and insight into the psychological or sociological perspectives of suicidality. In a healthy frame of mind, you may think that this show has a lot to offer but for someone is in so much pain; their brain can misguide them and give them the wrong messages about this show.
Three of the biggest variables with suicide generally are 1) impulsivity, 2) impaired problem solving and 3) feelings of hopelessness. These three variables can be momentary or enduring characteristics of a person. The adolescent brain is naturally impulsive because the brain’s growth and structural development continues until around the age of 25. For a young person in a moment of crisis, this series has seemingly provided them with an option to permanently ‘solve’ a whole range of problems when they have lost hope, and their frontal lobe may not yet be capable of ‘pumping the breaks’ to think through the situation clearly without acting upon their thoughts or impulses.

Fundamental rules have been broken
13 Reasons Why breaks a fundamental rule in suicidology – don’t look for external causes or circumstances that could happen to anybody when you’re dealing with the topic. The important message is not to present suicide as a reasonable, if extreme, response. Young people are more at risk for attempted and subsequently dying by suicide than children or adults. In reality, ninety percent of teenagers who die by suicide have a psychiatric disorder. This series however, depicts suicide as a reasonable response to a set of challenges that anybody might experience.
13 Reasons Why can send the message to people that there is something tragically poetic about suicide. Particularly, if one is seeking affirmation about themselves. As people are often celebrated at the time of their death, this series glorifies the suicide by way of its memorialization and remembrance of Hannah. If you are unheard in life, your voice becoming amplified in death is a strong message. The finality of the action in the series can be lost on the vulnerable mind, sending the message that concerns about social status is the catalyst for her death. The reality is many suffer with psychological problems in ways that most can’t understand. As one person I have worked with stated “it’s actually like my brain is trying to kill me when I am feeling suicidal”. Also, suicide is rarely, if ever, a revenge act or a “stuff you” to those in your lives. Representing it as such with the catchphrase (that is becoming meme-worthy) ‘welcome to your tape’, places an untrue and unnecessary infliction on those left behind.

When educating young people about suicide, which understandably although misguidedly, several parents are wanting to do by exposing their teenagers to this program, it is well known that when working to prevent suicide in a school aged population we work very differently than we would with the adult population. To be specific, content for school age people should focus on enhancing resilience, dealing with interpersonal issues, grief and loss and mental health literacy. 13 Reasons Why fails to meet any of these components.
Contagion, a cluster or series of copycat suicides, is a large problem for the adolescent population. When young people are thinking about suicide, certain portrayals make contagion more likely to occur. The 13 Reasons Why series has many of the variables that are clearly identified on the ‘do not’ rules list.
Where is the responsibility?

Mindframe Guidelines for Australian Media exclusively dictates how the media should discuss suicide in an effort to keep all our community safe. These are not flippant recommendations, rather the guidelines area based on extensive research and knowledge in the area. A really good example of a show discussing suicide whilst adhering to the guidelines is Australian Story’s ‘The Girl Least Likely’. The show is based on the real life story of a 17 year old girl, also ironically named Hannah, who died of suicide in the mid 2000’s. The show almost goes as far as performing a Psychological Autopsy on the young person’s death with the family’s permission, and in comparison there are not the problems that there are with this series.

13 Reasons Why not only discusses the means which Hannah took her life, it also graphically depicts this. And yes, creators are stating it’s to shock people out of taking this action. In reality this almost never works. Even though we are all aware of several ways that one may choose to take their life, this series graphically depicts the means and leaves little room for error. Whilst I won’t go into too much detail, many people have an idea in their head about how acting upon means would transpire. Nonetheless in most cases there still remains a high margin for error, leaving opportunity for survival and intervention. The fact that there are 100 suicide attempts for every death by suicide in the teenage population demonstrates this. The graphic nature of the show leaves little room for error. Therefore the show has reduced those chances for survival.

Triggers
There are insufficient notifications for triggers, not just suicide, but sexual assault, drug use and physical violence. Obvious triggers, such as in this show can be avoided if they are plainly labelled. However, if one has Post-Traumatic Stress Disorder, this series can bring back strong memories and cause a person to feel like they are reliving their trauma again. This can be true of many groups in our society including those who have previously attempted, rape survivors and even emergency services professionals. But, it is not even just resigned to this group. If you, as a mentally healthy adult, watched the series in its entirety you will be exposed to around 13 hours of footage, and if you’re like many people you may have a propensity to binge watch addictive Netflix shows. Being exposed to the themes can be psychologically and emotionally overwhelming for the general population who may not be prepared for this. Several adults have reported that they felt negatively impacted on because of this and had to speak with someone to debrief afterwards.

Help-seeking minimised
Current Australian contact numbers for help-seeking are not listed as is required by Australian Media Laws, therefore I have included these below. To specifically quote Mindframe: “While health promotion is not the media’s primary role, to help ensure stories about mental illness do not impact negatively on people who are vulnerable, add help-seeking information offering immediate support and information.”

13 Reasons Why doesn’t show what people can do to help prevent a death by suicide. There isn’t any one thing that should have been shown, but there are a lot of things that could have been shown to help support people with suicide risk and the series failed to model this in line with Australia’s clear media guidelines.

Just ask
If I can turn one negative comment many make about this series into a lesson, it is to ask specifically about whether someone has thoughts of suicide when you think that there is something happening for them or that they are declining in their mental or physical health. It will not encourage the person to act upon it, but rather act as a diffuser for their psychological pain and provide an opportunity for the person to be supported in any number of ways. Many can identify the missed opportunity that Hannah presented to the School Counsellor for a suicide risk assessment to take place, so please take this lesson on board yourself and ask your family and friends! RU OK? Day shouldn’t just occur once a year, it needs to occur every day as part of typical conversation.

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13 Reasons Why: An Australian Psychologist & Suicidologist’s Perspective