Photo credit: Beth Dubber/Netflix

The media have a powerful history of influencing culture and the development of our youth. Over the last several decades researchers explored how violence in television, film, music and video-gaming increases the presence of violent and aggressive behavior in youth.

Now Netflix’s new series, “13 Reasons Why” is met with controversy and has some mental health experts concerned. Media attention on suicide does not always promote prevention awareness, but rather tends to focus on sensationalizing the behavior. Hyping up stereotypes reinforces stigmas and does not represent the full scope of challenges for those with mental health issues.

The widely popular series, produced by Selena Gomez and based on a novel by Jay Asher, was released on March 31, and tells the tale of a teen’s troubled life and suicide. Through audio tapes she left behind, 17-year-old Hannah Baker explains the “13 reasons why” she did it. The series includes a graphic scene of Hannah’s suicide, and covers other sensitive themes, such as bullying, sexual assault and underage drinking.

Mental health experts suggest that the show may be perceived as glamorizing teen suicide and could leave a lasting impression on youth that a tragic, permanent solution is the only way to convey one’s emotional pain. Experts are concerned that the show depicts a calculated plan to obtain empathy or enact revenge, and does not bring awareness on managing the struggles with intense emotional pain or on how to seek help.

Supporters of the show argue that the show initiates important discussions about this serious public health issue. And by doing so, brings a subject that is often difficult to talk about out in the open.

Suicide is the 10^th leading cause of death in the U.S., and young people are not immune. In the state of Illinois, suicide is the first leading cause of death for ages 10-14, and the third leading cause of death for ages 15-24.

These figures are low compared to the number of young people who attempt suicide. A nationwide survey of youth in grades 9-12 found that 16 percent of students reported seriously considering suicide, and 13 percent reported creating a plan. Although more girls attempt suicide; boys are more likely to die from suicide, due to the aggressive nature of the suicidal behaviors.

Suicide does not discriminate, and anyone can be at risk. Critics of “13 Reasons” worry about suicide contagion, as one of the potential risk factors for suicide is exposure to others’ suicidal behavior (such as through the media).

Yet, suicide is complex, and many different factors contribute to someone making a suicide attempt. Most people most at risk tend to share certain characteristics, such as:

• Depression, other mental disorders, or substance abuse disorder
• Certain medical conditions, chronic pain
• Family history of suicide, a mental disorder or substance abuse
• Family violence, including physical or sexual abuse
• Having guns or other firearms in the home

Mental health experts want viewers to understand that suicide is not a normal response to stress. Suicidal thoughts or actions are a sign of extreme distress, and should not be ignored.

Hannah showed signs of depression before her suicide, but the signs went unnoticed. One scene shows a school guidance counselor failing to identify warning signs in Hannah. Also, throughout the series, Hannah’s mother asks herself, “How did I not know?”

Suicide has many warning signs. The American Association of Suicidology shares some that can be remembered with the acronym IS PATH WARM:

• Ideation - Threatening to hurt or kill him or herself, or talking of wanting to hurt or kill him/herself; and or, Looking for ways to kill him/herself by seeking access to firearms, available pills, or other means; and/or, Talking or writing about death, dying or suicide, when these actions are out of the ordinary.
• Substance (alcohol or drug) use
• Purposelessness; no reason for living or sense of purpose in life
• Anxiety, agitation, unable to sleep or sleeping all of the time
• Trapped; feeling like there's no way out
• Hopelessness
• Withdrawal from friends, family and society
• Anger, rage, seeking revenge
• Reckless or engaging in risky activities, seemingly without thinking
• Mood changes; dramatic swings between mood states

The media have the power to educate youth, rather than be seen as a negative influence. Most people are uncomfortable with the topic of suicide. As a result, we don’t talk openly about it.

When handled properly, shows like “13 Reasons” can give us a chance to drop the secrecy and have an open discussion about how to recognize warning signs and prevent more tragedies. Even if mental health experts disagree with the scripting of the show, we can all agree that the controversy is creating conversation.

How can we help teens who are watching “13 Reasons Why”know how to process it? The Jed Foundation (JED) and Suicide Awareness Voices of Education (SAVE) developed a list of 13 talking points for young adults and parents to discuss while watching the series.

As parents, we know our kids better than anyone else. Pay attention to changes in behavior. If anything seems off, seek help immediately.

If you or someone you know is having thoughts of suicide, contact the National Suicide Prevention Lifeline: 800-273-TALK (8255).

Get support from Linden Oaks Behavioral Health. Contact the Linden Oaks 24-hour Help Line at 630-305-5027.