Mental health professionals have become increasingly concerned about the new hit Netflix show and its portrayal of the main character, Hannah’s, suicide. While I am very glad that the show can start conversations about bullying, sexual assaults in high schools, and teen suicides, I am also very concerned about how the show incorrectly portrays some facts about teen mental health and suicide in general.
Hannah’s suicide is portrayed as being caused by the actions of other people (bullies, friends, school counselor, etc). In reality, decades of research on teen suicide have shown that 90 percent of teen suicides are the result of mental illness. Teens first develop mental illness, such as depression, social anxiety, panic disorder, ADHD and then slowly, over time (1-2 years), become unable to cope with stressors in their lives. When a teen with mental illness encounters bullying, divorce, family violence, academic stressors, and other stresses present in teen lives, he or she develops thoughts of suicide and begin to contemplate ending life. This means that family, school counselors, pediatricians, mental health professionals are able to intervene and help the teen if symptoms of mental illness are caught early on.
Hannah comes to her school counselor for help and, while he recognizes her thoughts of suicide, he tells her to forget about her sexual assault and tells her she should get over her distress about the sexual assault. This is not a realistic portrayal of what would typically happen when a teen reaches out for mental health help. It is illegal and unethical for a counselor to behave this way. Mental health help is absolutely available for teens who have experienced sexual assault and are contemplating thoughts of suicide. The show uses this scenario for dramatization purposes and it’s not helpful for kids or parents to see this.
What I would really like for parents to know is that it’s really important to watch out for any signs that your teen may be struggling with mental health difficulties. Some of these signs are:
Any change in personality, behavior, appearance
Withdrawing from family activities the child previously enjoyed
Not wanting to spend time with close friends
Not wanting to go to school
Dropping grades
Sleeping all the time or being in his/her room all the time alone
Social media postings about wanting life to be over (or everything to be over)
Statements about the future being hopeless or not wanting to talk about future
Preoccupation with death or giving away possessions
Statements about not wanting to have pain or wanting to falls asleep and never wake up
If you notice any of these signs, please talk to your teen and take your teen to the pediatrician for a depression and mental health screening. If you are concerned about your teen, please insist on a referral to a mental health professional. Your teen may want to hide their symptoms from you to make sure you don’t worry. However, a pediatrician or a mental health professional are able to get them to open up. Suicidal thoughts are preventable if caught early on.
I strongly recommend for children under the age of 17 to watch the show with their parents only. The show also should not be binge-watched, but watched one episode at the time due to highly emotional dramatic content. If your teen has watched it already without you, please have a discussion with your teen about what they think of the show, of the main character and what the main point of the show was in their opinion. It’s very important to discuss with your teen that Hannah’s story is a fictional story, not a real story. In real life, teens don’t get to make everyone feel sorry for their death and don’t get memorials on their lockers.
The show depicts a violent death, as well as a violent sexual assault. Children are very likely to be strongly influenced by vivid depictions of suicide in the media. In fact, from numerous studies, we know that watching descriptions or depictions of suicide in the media increases the likelihood of “copycat” suicides. If your teen struggles with mental health, please mention to your pediatrician or the teen’s mental health provider that she has watched the show, so they can screen your teen for suicidal thoughts.
If your teen has been struggling with mental health difficulties, please seek help from your pediatrician or a school counselor.
If your teen is struggling with thoughts of suicide today, please call 911 or proceed to your nearest emergency room. You can also call the National Suicide Prevention Hotline at 1-800-273-TALK or text START to 741741 for immediate help.
For more information about how to discuss 13 Reasons Why with your child, please visit www.jedfoundation.org or www.nasponline.org.
Elena Mikalsen, Ph.D. Author/Psychologist 