A statement on the Netflix Series ‘13 Reasons Why’

Dr Alys Cole-King and Dr Stanley Kutcher
May 08 2017

Dr. Stan Kutcher, Sun Life Financial Chair in Adolescent Mental Health and the Director World Health Organization Collaborating Centre in Mental Health Policy and Training at Dalhousie University and IWK Health Centre in Canada. He is a renowned expert in adolescent mental health and leader in mental health research, advocacy, training, and policy and has been involved in mental health work in over 20 countries.

Dr Alys Cole-King is Clinical Director, Connecting with People

This blog is in response to the growing media and social media coverage of the Netflix Series ‘13 Reasons Why’. We are keen to ensure that adults are alert to the situation whilst not being unduly anxious. Many international mental health and suicide prevention experts have already published guidance, position statements and blogs on the programme (see below for links).   One theme that is consistently found in these documents is a significant concern that 13 Reason’s Why inaccurately portrays youth suicide and contains many of the elements that research has identified as impacting on increased rates of suicide through the contagion and copycat phenomena that irresponsible media portrayal of suicide can have on vulnerable young people.

We are also dismayed by  ‘13 Reasons Why’ as it either ignores or breaks national and international media guideline on suicide safety and responsible media portrayal of suicide, is overly sensationalist and ignores all the expert advice provided before the show was made. It glamorises suicide, suggests that suicide is a plausible solution to life problems, presents suicide as a means of gaining peer respect and does not accurately portray the common factors that underlie suicide in young people.  Thus it contains the very components that research has identified as contributing to suicide contagion and increasing rates of suicide in young people, particularly those who may be most vulnerable.  However the programme is here and has probably already been ‘binge watched’ by hundreds of thousands of teenagers around the world.

Our aim now, is for damage limitation and for all viewers, especially vulnerable young people to know that suicide is preventable with early identification, intervention, hope and removal of access to means. Young people need to know that others will listen when they share their distress, that it's never to late to seek help, and there is always hope. 

The majority of young people who end their lives by suicide are not in touch with mental health services around the time of their death, even though many are suffering from problems that would benefit from receipt of mental health care or support. However, most are in contact with someone who could provide an opportunity to support them and who can help them access the care that they need.  For those young people at risk of suicide, connecting with an empathic, confident and competent person could be their tipping point back to safety, when they start to receive and accept help to deal with their problems and find a way forward.

Remember suicide is tragic but rare event and we must keep this in perspective. Young people need to know that thousands of people become distressed and have thoughts of suicide but with the right support they can get through tough times. People need to know what they can do to help themselves and others. Dr Cole-King, Clinical Director, Connecting with People states that “We wish we could reach every young person who is thinking that life isn’t worth living and help them to see that their feelings are a sign that they need to change something in their life, not to end their life”. 

Encouraging help-seeking behaviour, rapid access to effective treatments, hopefulness, identifying reasons for living, and removal of access to means can contribute to suicide prevention. It is essential that health care providers be available to give the help and support needed.

Dr Cole-King  said “It’s key that every young person considering suicide needs to know they can be supported through tough times. If they are considering suicide, they should have a Safety Plan with details of what they can do to help themselves and who they can contact for support when they need it. Information about how to make a Safety Plan can be found in the ‘Feeling Overwhelmed and Helping You Stay Safe’ resource. This is an online resource for anyone struggling with suicidal thoughts, designed  to offer hope, compassion and practical ideas on how to find their way forward http://www.connectingwithpeople.org/StayingSafe

Since the program is now widely available and the media attention to it may be having the impact of fuelling viewing rates, it is necessary to share what can be done by those who are concerned. Here are some tips for parents, guardians, teachers, youth workers and concerned adults to help address this issue and how to have a conversation with young people about the series.   

  • Keep calm and do not panic - remember the majority of young people may not be unduly affected
  • Have a conversation with the young person watching the series and to discuss their feelings and thoughts and open up a channel of communication in case they do become affected or concerned, so that they know they can talk to you
  • Let them know they can ask you any question now or in the future if an issue crops up
  • Reinforce the reality that ‘13 Reasons Why’ is a made up story and not based on a real person and that the majority of people who experience bullying, the serious injury or death of a friend, a sexual assault or any other life adversity do not think about suicide nor do they take their lives 
  • Reinforce the message that people think about suicide when they are in a huge amount of emotional pain and they don’t know what else to do - but that actually there are so many things that they could do – if only they knew who to contact for support or what to do
  • The most important thing to do is to speak to someone - and that they can speak to you any time now or in the future
  • Suicide is not a solution to problems and that help is available. This is particularly important for adolescents who are isolated, struggling, or vulnerable to suggestive images and storylines.
  • Thousands of young people experience thoughts of suicide every day, but they find ways to cope with these intense feelings. Like them, your child or the young person you care about, can get the help they need to deal with their feelings

Advice if the young person is actively distressed or talking about suicide:

  • Reassure them that you are taking them seriously and that you will be there for them

  • Reassure them that there is help and they will not feel like this forever

  • Avoid statements that they could perceived as minimising their distress such as “surely it’s not that bad” or “Come on now... you need to get over this.”
  • Provide support and supervision as required
  • Never agree to keep suicidal thoughts a secret and always support them to seek support or seek assistance on their behalf
  • Do not leave the person alone until you think it is safe to do so:
    • You have concrete evidence and reassurance and you are convinced that their distress or intent to self-harm or attempt to take their life has passed 
    • Once they have received additional support or an assessment from a suitably qualified person.  Take them to a health care provider who has the skills needed to help.  In a crisis this may be your closest A and E Department
    • See http://www.connectingwithpeople.org/StayingSafe for specific advice and guidance on who to approach if you are worried about a young person in distress

Self-help resources

Connecting with People have produced a series of leaflets on behalf of the Royal College of Psychiatrists, providing information for both individuals experiencing suicidal thoughts and those who are concerned. These are available through the Royal College of Psychiatrists or the Connecting with People website: http://Connectingwithpeople.org/ucancope

For guidelines on best practice in talking about suicide in the media or social media

Articles outlining concerns about ‘13 Reasons Why’

With thanks to Professor Siobhan O’Neil for reviewing the draft and for her helpful suggestions.