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Talking About 13 Reasons Why & Teen Suicide: Tips for Parents

When the Netflix series "13 Reasons Why" premiered in 2017, it quickly became one of the most watched—and most controversial—shows aimed at teen viewers. 

With its third season expected to release in 2019, the series continues to spark debate over how the show portrays teen suicide and its possible effect on viewers.

Raising Awareness–and Risk?

The drama centers on a high school student who died by suicide and leaves behind 13 audiotapes for people she blames for her action.

Fans of the series say it increases much-needed awareness about teen suicide, currently the second leading cause of death for children and young people 10 to 24 years old. In addition to graphic portrayal of suicide, the show also focuses on bullying and cyberbullyingunderage drinkingsexual assaultguns in the homeschool violence, and other discussion-worthy topics.

But some experts warn the show may do more harm than good. Although the series is fictional, teens can be impulsive and emotional. Watching a character decide to commit suicide might trigger them to do the same. After the show was released, medical and mental health professionals reported teens listing their own 13 reasons why they wanted to kill themselves. Some families said they believe the show triggered their children to actually take their lives. 

​According to Centers for Disease Control and Prevention 2017 youth survey results:

  • 32% of high school students experienced ongoing feelings of sadness or hopelessness

  • 17 % said they'd seriously considered attempting suicide.

  • 14 % made a suicide plan

  • 7% tried to kill themselves


Is Suicide "Contagious?"

Research suggests that exposure to a peer's suicide can, in fact, have a "contagious" effect—especially among 12- to 13-year-olds. After reviewing more than 50 international studies, a group of major health and media organizations developed recommendations that advise against "presenting suicide as a tool for accomplishing certain ends, such as revenge or recognition," or "glorifying suicide or persons who commit suicide."

Can exposure to a fictional character's suicide also have a "copycat" effect?  

Since the premiere of "13 Reasons Why," researchers have been trying to answer that question. Among the findings:

●   In the days following the premier of "13 Reasons Why," researchers found a significant spike in internet searches using terms such as "how to commit suicide" and "how to kill yourself."

●  A more recent study funded by the National Institutes of Health found a 29% increase in suicide among U.S. adolescents between ages 10-17 after the release of season 1. In April 2017, the month after Netflix released all 13 episodes for streaming, the teen suicide rate in this age group reached a 19-year high. It remained high the rest of the year, with 195 more suicides reported in this age group than would have been expected. 

●   Another new study found that students between 18-29 who watched the show's entire second season had fewer thoughts of suicide and greater interest in helping someone feeling suicidal than those who didn't view any episodes; however, the researchers also found students who watched only part of season 2 showed higher suicide risk and less optimism about the future.

How to Help Teens Process the Show in a Safe & Healthy Way:

Despite concerns about "13 Reasons Why," the show can serve as a powerful teaching tool with informed, adult guidance from parents, teachers, spiritual leaders, and others who work with teens.  

What parents can do:

 

●   Co-view. The AAP media use guidelines encourage parents to co-view programs with their children and discuss what they are seeing. This is especially important for shows such as "13 Reasons Why" with themes difficult to process and easy to misinterpret. Watching the show together lets parents pause and point out instances of cyberbullying, for example. Then parents can ask if their child has seen it happen at school, how he or she reacted, and what to do if it happens again.

○   Children in groups at a higher risk for suicidal thoughts and actions should not watch the show alone, said Cora Breuner, MD, MPH, FAAP, chair of the American Academy of Pediatrics (AAP) Committee on Adolescence. This includes kids with a family history of suicide, a history of physical or sexual abuse, mood disorders, and drug and alcohol use, and/or those who identify as lesbian, gay, bisexual, transgender or questioning.

●   Discuss reality vs. fiction. Explain that the show gives an unrealistic view of the help available for teens who may feel suicidal. In particular, the lack of effective mental health care provided to the central character, Hannah Baker, is both troubling and unrealistic. Statistics show that a large majority of the time, teens with suicidal thoughts and behaviors are in the grips of treatable mental illnesses, such as depression. In the show, Hannah voices clear suicidal warning signs to her school guidance counselor. Yet, the counselor failed to connect her with other professionals and resources for help and told her simply to "move on." Critics say this sends a dangerous message that adults can't help.

●   Play it safe. If your teen does watch the show, make an extra effort to watch him or her a little more closely afterwards—in a mindful, nurturing way. Know the signs of depression, such as withdrawing from friends or family, eating or sleeping less or more, or losing interest in activities.If you have a gun in your home, make sure it is stored unloaded and locked up separately from ammunition. Studies have found the risk of suicide is 4 to 10 times higher in homes with guns than in those without. And although Hannah Baker uses a different method to end her life, suicide by firearms is now the second leading cause of death among teens 15-19. More than 80% of guns used in teen suicide attempts were kept in the home of the victim, a relative, or a friend.

●   Don't assume your child isn't watching. "13 Reasons Why" is rated TV-MA (Mature Audience), appropriate for ages 17 and up, for its graphic violence, explicit sexual activity and crude language. But school officials and pediatricians say they're learning of children as young as elementary-school age who are binge watching the show—sometimes without parents knowing, because it can be streamed privately on their phones, tablets, and computers. Parents are often surprised to find out their child has watched the series.

○   As a parent, it is your job to counsel your children and teens about smart and safe media use. Dr. Breuner said she also asks her patients (and their parents) how much time they spend on screens and which shows they watch.

●   Provide access to help. Give your child suggestions for whom he or she can turn to in times of need—including you, as well as other trusted adults. Your pediatrician can also help. The AAP recommends all children over age 12 be screened for depression at their yearly checkups. For any immediate concerns about your child, call the National Suicide Prevention Lifeline at 1-800-TALK, or text START to 741741.

 

Even if your child hasn't watched…

Parents should be aware that their children may hear friends talking about the show at school or on social media—even if they haven't seen it themselves. Regardless, Dr. Breuner said the series is "absolutely inappropriate" for children under age 13.

If you haven't watched the show, look up episode summaries and be prepared talk with your child about the ways fictional shows don't always reflect reality. Use the show as an opportunity to talk with your child about the very real situations teens face—and how your child can come to you with anything he or she may face in the future.

Keep in Mind:

It may feel uncomfortable to talk with your teen about some of the difficult issues raised in "13 Reasons Why," but talking about tough topics with teens is every bit as important as making sure a baby's bath water isn't too hot.

Teen Media Quote - Dr. Cora Breuner 

Remember to talk with your child's pediatrician if you have additional questions or concerns about your child's media use or mental health.

Additional Information & Resources: 

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The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.