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Mental health community prepares for season 2 of ’13 Reasons Why’
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Last year’s release of “13 Reasons Why,” a Netflix show that depicts the suicide of a teenaged girl and the reasons she believed to be responsible for her death, triggered an unprecedented debate among audiences, parents and mental health professionals over the portrayal of suicide in the media and its impact on adolescents and young adults.
Despite concerns, the new season of “13 Reasons Why” will be available May 18, 2018.
“It really is our professional responsibility, as mental health providers, to have a pulse on what youth are being exposed to in the media. Solely being aware that this season has been released is an important first step,” Sansea L. Jacobson, MD, assistant professor, department of psychiatry, University of Pittsburgh School of Medicine, and program director, Child and Adolescent Psychiatry Fellowship and Triple Board Program, Western Psychiatric Institute & Clinic of UPMC, told Healio Psychiatry.
Data from a recent Northwestern study showed that 18% of teenaged viewers admitted their parents did not know they were watching the first season and adolescents are more likely to watch the show alone, Jacobson said. Encouraging teens to watch the show with a trusted adult and reminding them of available support is important, she said.
“Professionals also need to know that the content of the show is likely to expose youth to themes of suicide, bullying, substance abuse, and possibly a school shooting,” she continued. “It is especially important to act now, as we know from research that serious clinical outcomes, such as suicide mimicry, are most likely to occur within the first 2 weeks, in individuals who identify with the characters, and who have pre-existing vulnerabilities. We also know that risk further heightens when there is an absence of mental health information.”
“13 Reasons Why” response
In the year since the first season aired, the show has acquired a large following on social media as well as huge media attention for its depictions of bullying, depression, trauma and suicide, according to an American Psychiatric Association blog post.
Last year, the Suicide Awareness Voices of Education (SAVE) and JED Foundation created a tip sheet of talking points to help parents discuss the series with their teenagers after the first season, which brought up the concern that a viewer who had suicidal ideation may believe that talking to a mental health professional about their issues was not the best option because the counselor in the show is portrayed as incompetent when addressing the main character’s own suicidal thoughts.
Although television and other platforms can be useful tools to help reduce stigma that surrounds psychiatric issues, media portrayals that do not show options for treatment or misrepresent mental illness can negatively affect viewers suffering from these problems and impact the psychiatrists who treat them, according to the APA blog. This is especially true for teenagers, who are particularly impressionable and often copy behaviors depicted in television and online.
Helping clinicians, parents prepare
To prepare for the new season, a coalition of mental health experts, led by SAVE, collaborated to provide clinicians with a toolkit available at www.13ReasonsWhyToolkit.org. The site has resources and language specifically geared toward five different audiences: youth, parents, educators, media, and clinicians, according to Jacobson.
“The ‘Guidance for Clinicians’ section of the toolkit was created by two dozen psychiatric experts from across the world and provides clinical perspectives on topics pertinent to the series: suicide contagion, peer victimization, consent as a core principle of sexual education, threat detection in schools, and the opioid epidemic as it pertains to adolescents. Clinicians will also find practical guidance on what professionals can do in response to season 2 in terms of supporting patients and families, talking to the media, and educating our communities,” Jacobson said.
Recently, SAVE, in collaboration with other mental health awareness organizations, also released a statement with recommendations for parents, educators and professionals, including:
- make thoughtful decisions about whether vulnerable and at-risk youth should watch “13 Reasons Why;”
- try to watch with them and talk with teens on their thoughts and feelings about the content;
- emphasize that the show is fiction; and
- learn what resources are available at the local level.
“We hope that by spreading the word, mental health professionals and clinicians will feel more knowledgeable and equipped to engage their patients in important conversations, gently correct misconceptions, and promote help-seeking behaviors in our communities,” Jacobson told Healio Psychiatry.
To help mental health professionals prepare for the response that is sure to follow the release of the new season, Healio Psychaitry has compiled a list of articles that relate to suicidality in young people. – by Savannah Demko
Media may inaccurately portray, dramatize suicide
Though the association between fictional depictions of suicide and imitative self-harm is not new, recent trends in media content and viewer habits, specifically seen with the television phenomenon “13 Reasons Why,” has misrepresented and possibly sensationalized suicide to adolescents, according to a presentation at the American Psychiatric Association Annual Meeting. Read more.
Number of youth suicide-related hospital visits on the rise
Findings published in Pediatrics showed the annual percentage of hospital visits for suicide ideation and suicide attempts nearly doubled from 2008 to 2015 among U.S. children and teenagers. Read more.
Cyberbullying increases risk for self-harm, suicidal behavior
Youth who are victims and, to a lesser extent, perpetrators of cyberbullying are at higher risk for both self-harm and suicidal behaviors than those with no cyberbullying involvement, study findings showed. Read more.
Risk for depression, suicide drops when transgender youth use chosen names
Study findings published in the Journal of Adolescent Health showed that young transgender persons who used their chosen name at work, school and home instead of the name given to them at birth reported fewer depressive symptoms and less suicidal thoughts and behaviors. Read more.
Prior self-harm in teens, young adults increases risk of suicide nearly 27 times
Teenagers and young adults who participated in the Medicaid program were at 26.7 times higher risk of suicide following nonfatal self-harm, with an increased risk observed specifically in American Indians, Alaskan natives and those who used violent methods for self-harm, according to findings published in Pediatrics. Read more.
Sexual minority adolescents more likely to consider, plan, attempt suicide
Sexual minority adolescents were significantly more likely to report that they considered, planned or attempted suicide compared with heterosexual teenagers in the United States, according to 2015 national survey data published in JAMA. Read more.
Rates of suicide, nonfatal self-harm differ by sex, age among teens
Results of a retrospective study in England showed that ratios of fatal to nonfatal self-harm rates differed between boys and girls, with higher incidence of suicide in boys and higher incidence of self-harm in girls, and between younger and older adolescents, according to recent findings. Read more.
Self-injury rates increase among girls, not boys in US
ED visits for self-inflicted injury significantly increased among female youths in the U.S. after 2008, yet remained stable among males, according to recent analysis of CDC data. Read more.
Study links screen time to increased depression, suicide rates
Recent findings that matched national survey data by year suggested more new media screen time may be associated with increases in depression and suicide rates among adolescents. Read more.
References:
APA. 13 Mental Health Questions about “13 Reasons Why.” https://www.psychiatry.org/news-room/apa-blogs/apa-blog/2017/04/13-mental-health-questions-about-13-reasons-why. Accessed on May 17,2018.
Suicide Awareness Voices of Education. “Statement from Experts on the Upcoming Release of ‘13 Reasons Why,’ Season 2.” https://docs.wixstatic.com/ugd/a0415f_5fe0939a4d1b4192a23702f8d3a4a53f.pdf. Accessed on May 17, 2018.
SAVE. 13 Reasons Why Talking Points. http://www.jedfoundation.org/wp-content/uploads/2017/03/13RW-Talking-Points-JED-SAVE-Netflix.pdf. Accessed on May 17, 2018.
For more information:
National Suicide Prevention Hotline,1-800-273-TALK (8255) or chat at suicidepreventionlifeline.org (USA)
Disclosures: Jacobson reports no relevant financial disclosures.