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"13 Reasons Why" and the Difficult Subject of Teen Suicide

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Credit: Netflix

While depictions of teen suicide in popular media aren’t anything new, the realities of being a modern-day teenager are constantly shifting. The term ‘cyberbullying’ didn’t even exist two decades ago. Social media and the ‘always connected’ mindset mean you can’t just leave certain problems behind the moment you step off the bus anymore.

To add to these difficulties: The speed at which the landscape is shifting means the normal avenues of recourse for adolescents who need help — parents, teachers, guidance counselors, therapists, and in some cases the police — may have trouble keeping up. The consequences can be tragic.

It’s a subject the writers and producers of “13 Reasons Why,” a Netflix show based on a Jay Asher book by the same name, hoped to confront. In it, high school junior Hannah Baker takes her own life, but only after recording a series of audio tapes accusing numerous classmates and guiding figures of being partially responsible for her decision.

The show has received significant attention, not all of it positive, for the graphic way it portrays suicide, sexual assault, and bullying. For Steve Berkowitz, MD, director of the Penn Center for Youth and Family Trauma Response and Recovery, the show fails to adequately handle the subject of teenage suicide in a number of ways — some all too common.

“One of the dilemmas — and this happens all the time when we’re talking about these very complex emotional and psychological issues — is the series doesn’t really get into that complexity,” Berkowitz said. “It has a story to tell. But things just aren’t that simple.”

The framework of that story is built around the tapes Hannah made before killing herself, which Berkowitz acknowledged serve the dual purpose of tapping into the appeal of general adolescent angst and ostensibly providing something so many friends and loved ones are desperate for in the case of a suicide: explanations.

Still, if the show is going to broach such immensely complicated subject matter, Berkowitz noted it has a duty to explore it further and portray it with the proper complexity — especially given the propensity for those exposed to suicide to be more likely to attempt or die by suicide themselves.

“We know about the contagion effect,” Berkowitz said. “We know that when there’s a suicide in a high school, for example, there’s an increased risk of other people suiciding or making attempts. That’s why the lack of complexity in explaining this girl’s reaction and her suicide is problematic.”

Part of the reason it's important to tread carefully: According to the Center for Disease Control and Prevention’s National Center for Health Statistics, suicide rates have been climbing since 1999 — from 10.5 per 100,000 to 13 per 100,000, adjusted for age — after two decades of being in decline. The suicide rate for females aged 10 to 14 years climbed from 0.5 to 1.5 per 100,000, while the rate for females aged 15 to 24 climbed from 3.0 to 4.6 per 100,000. For males in the same age groups, the increases were from 1.9 to 2.6 per 100,000 and 16.8 to 18.2 per 100,000, respectively.

While the depiction of suicide in “13 Reasons Why” is unflinching and graphic — Hannah slits her wrists on screen — Berkowitz believes the show’s responsibilities shouldn’t stop there. Essentially: The depiction of the act itself was handled properly, but the revenge fantasy-esque framework that composes the story handles the complexities and nuances of suicide poorly by promoting the idea that dying by suicide is a way to accomplish certain goals.

“The vast majority of people who watch this show will not have any suicidal tendencies, or increased suicidal tendencies, or any of that,” Berkowitz said. “But there are vulnerable kids and individuals out there who will — and that’s where I think the danger really is.”

Understanding, then, that there are so many aspects of the issue to be grasped if one is going to tackle the subject of suicide in a responsible manner and avoid glorifying it, the question naturally follows: Is it even possible to handle something like suicide in an entertainment medium without, in some way, doing just that?

Berkowitz acknowledged the difficulty inherent to depicting suicide in a properly intricate and accurate way, but also noted that depicting suicide in and of itself is not an act of glorification. In the case of “13 Reasons Why,” the glorification of Hannah’s suicide comes through in the show’s very premise: the idea of revenge, of shifting the burden of responsibility, of getting multiple people involved. Lacking in the show’s handling of the subject, Berkowitz noted, was the oft-undiscussed fact that suicide is a very aggressive act.

“Not only do you kill yourself, you’re killing everybody else,” he said.

Something else Berkowitz noted was lacking: The impact of Hannah’s suicide on her parents. While numerous scenes throughout the show do depict them struggling with the loss of their child, the effect was not as enormous as it maybe should have been. Families are destroyed when a child is killed. The divorce rate triples, Berkowitz said, and that only increases if the child has ended his or her own life.

His reservations with regard to the way the show handled its subject matter notwithstanding, Berkowitz did note that the conversations surrounding the show can be beneficial — not just for families, but for professionals in healthcare and school systems. The trick is getting it started.

“In response to this, there is a responsibility — unfortunately that primarily falls on schools — to address this head-on,” he said. “The conversation can be useful, but it has to happen. It has to be formalized. This is the kind of book and show that people should be discussing with their parents or friends, in a real way, to try and unpack all of the things that were missing.”

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