by Elizabeth Ortiz-Schwartz, M.D, Adolescent TLP Service Chief, Silver Hill Hospital
The popular yet controversial new season of the Netflix show “13 Reasons Why” was released on May 18 prompting parents and mental health clinicians to ask themselves once again whether this is the best forum for addressing teen suicide and other controversial themes.
Season one aired last year with the premise of an adolescent who committed suicide and who left behind a series of videos addressed to the individuals who had wronged her in some way by being hurtful or indifferent and contributed to her suicide.
The show created a stir amongst concerned parents and mental health professionals due to the idea that it romanticized suicide. The person who committed suicide in the show could see the reaction her death had on others after her death. This can be problematic as it may give young people contemplating suicide the idea that they could somehow have revenge or help others understand their pain when that is never the case.
Additionally adults, even those in the mental health field were not portrayed as helpful.
Across our area and possible across the country, many teens had strong reactions to watching the show by increases in outreach to school mental health professionals and crisis teams.
Although the authors intention, to destigmatize talking about mental health might be a noble goal but one with perils, particularly with sensitive individuals who can easily identify with these themes and might not have the ability to differentiate between their own thoughts and feelings and the longer term consequences of their actions. A long studied phenomenon is that teen suicide can be subject to contagion, meaning that there is occasionally a copycat phenomenon in sensitive individuals. It may be hard to predict if shows such as these may be more problematic than helpful in addressing teen’s mental health needs.
Being available on Netflix lends itself to watching privately or teens binge watching alone in their rooms. Parents were often unaware of their teens viewing habits and might not have been helpful in their ability to process these very difficult themes.
The new season will address topics of suicide and school violence, which can be very anxiety provoking.
Since shows like this and others are likely to continue and expand in number, it is important for parents to learn how to talk to their teens about them.
Some tips for parents.
- Ask in a non-judgmental way what the child or teen knows about the show. If they have not seen it, they might have learned about it from friends or social media.
- If the child or teen has seen the show ask them to discuss with you what did they learn and how did they feel. Ask open ended questions, “What did you think of Hannah?”
- If they state they have felt uncomfortable, anxious or have experienced negative emotions related to this. Ask them if they have ever felt that way themselves.
- If they don’t, ask them if they would still like to talk about it with a knowledgeable trusting adult.
- If they have ever felt that way, find out if they are feeling safe in the moment. If they do, increasing supervision and seeking help from a qualified mental health professional.
- If your child has experienced suicidal or self-injury avoid the show altogether.
- If your teen wants to watch the show, try to prescreen it and suggest watching it together.
- Maintain the lines of communication open. Create a safe zone to discuss their concerns.
- Talk to your child about bullying and kindness. Teach them how to solve conflicts peacefully.
- Teach your child to relax and have positive emotional outlets.
- If you see your child experience significant sustained changes in mood, appetite, energy, school avoidance, isolation or anxiety speak to his/her pediatrician and/or mental health professional. Only 20% of children in need of mental health supports across the US actually receive it.
Below are some resources to help talk about the difficult subjects the show brings up:
https://www.sprc.org/resources-programs/know-signs
https://suicidepreventionlifeline.org/how-we-can-all-prevent-suicide/
Silver Hill Hospital is an 87 year old, not-for-profit psychiatric hospital with acute crisis stabilization and longer-term Transitional Living Programs. It admits 3,000 adolescents and adults annually for psychiatric disorders that include addiction, pain with co-occurring addiction, depression, bipolar disorder, eating disorders, schizophrenia and Silver Hill also specializes co-occurring diagnosis and treatment.