I HAD A DIFFICULT time watching the Netflix series 13 Reasons Why. The series is based on the 2007 novel Thirteen Reasons Why by author Jay Asher. It revolves around high school student Clay Jensen and the aftermath of the suicide of fellow high school student Hannah Baker. Before her death, she leaves behind a box of cassette tapes in which she details the reasons why she chose to end her life as well as the people she believes are responsible for her death. The show explores and depicts a wide range of social issues affecting today’s youth, including suicide, sexual assault, bullying, and rape. Hannah’s narrative in the series puts these critical issues in plain view, aptly presented by Katherine Langford as Hannah. According to Nielsen, 13 Reasons Why drew an audience of 6 million viewers in the U.S. in the first three days.1
For immediate HELP if you are in a crisis call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), which is available 24 hours a day, 7 days a week. The content of all calls is kept confidential.
The Daily Item newspaper in my hometown published an article online on May 7, 2017, shortly after the mini-series debuted. The writer interviewed local educators regarding 13 Reasons Why, specifically focusing on whether Hannah Baker justified her suicide by blaming others, and whether the final scene was an unnecessarily graphic depiction of the act. The series prompted mental health professionals to voice concerns directly to Netflix and the series producers. The controversial scene in the episode “Tape 7, Side A” showed Hannah contemplating her life in front of a mirror before getting into the bathtub, where she takes a razor and makes deep cuts along the length of her forearms. The camera stays on Hannah as her breathing slows down and the tub fills with blood. I remember the scene being disturbingly “peaceful.” Hannah’s mother walks in and finds her daughter dead. In July 2019, Netflix edited out the suicide scene in the first season’s final episode.2
With the release of the first season of the series, Netflix also released 13 Reasons Why: Beyond the Reasons, an aftershow documentary television film. The 29-minute documentary featured the cast and crew of the series and mental health professionals discussing their experiences working on the series and dealing with different issues including bullying, depression, and sexual assault.
Schools are crucial for keeping kids safe and connecting them to resources for handling mental and physical health concerns. U.S. Surgeon General Vivek H. Murthy, M.D., M.B.A., issued a rare public health advisory on December 6, 2021, calling on the nation to respond to the growing mental health crisis impacting young people that has worsened with the COVID-19 pandemic as a result of prolonged isolation. Murthy advised in his report that recent national surveys of young people showed alarming increases in the prevalence of certain mental health challenges. In 2019, one in three high school students reported persistent feelings of sadness or hopelessness, an overall increase of 40% from 2009 to 2019. Suicide rates among youth aged 10 to 24 years increased by 57% between 2007 and 2018, and there were more than 6,600 deaths by suicide in 2020 in this age group.3
The COVID-19 pandemic dramatically changed the world of our youth, including how they attended school, interacted with friends, and received health care. They missed graduation ceremonies, sports competitions, playdates, and time with relatives. More than 140,000 children in the U.S. lost a parent or grandparent caregiver to COVID-19.4 Recent research covering 80,000 youth globally found that depressive and anxiety symptoms doubled during the pandemic, with 25% of youth experiencing depressive symptoms and 20% experiencing anxiety symptoms.5 Moreover, pandemic-related measures reduced in-person interactions among children, friends, social support, and professionals such as teachers, school counselors, pediatricians, and child welfare workers. This made it harder to recognize signs of child abuse, mental health concerns, and other challenges.
Jennifer Ellers and Emma Benoit write, “Even more concerning than the number of youths struggling with depression is the figure (60%) of teenagers who received no mental health treatment for depression—not counseling or medication.”6 Sadly, in the U.S. today suicide is the third-highest cause of death between the ages of 15 and 24.7 Between 2019 and 2020, there was a 30.7% increase in emergency room visits for mental health reasons for children ages 12-17. Suicide is a serious public health problem among all age groups. But, when a young life is extinguished it exacts a tremendous toll on entire communities as people recognize the significance of the loss. Boys are 4 times more likely to die from suicide than girls. Girls are more likely to attempt suicide than boys. Guns are used in more than half of youth suicides.8
Current statistics suggest that 1 in 5 high school students report being bullied on school property. More than 1 in 6 high school students reported being bullied electronically. Many youths are emboldened by a lack of face-to-face confrontation when leveling attacks via social media or texting. The potential fallout from cyberbullying is far greater than traditional bullying. Social media does not allow for conversation: an actual give-and-take discussion about feelings and concerns. Caroline Miller writes, “In several studies, teenage and young adult users who spend the most time on Instagram, Facebook, and other platforms were shown to have a substantially (from 13 to 66 percent) higher rate of reported depression than those who spent the least time.”9 These platforms promised increased connectivity at the outset, but this has been far from the truth. Sherry Turkle, Ph.D., believes social media is causing a “…flight from conversation—at least conversation that is open-ended and spontaneous, conversation in which we allow ourselves to be fully present and vulnerable,.” Turkle says social media has led to “…an assault on empathy.”10
Teen suicide risk factors include mental illness (including depression), conduct disorders, poor self-image, and substance abuse; family stress/dysfunction; environmental risks, including the presence of a firearm in the home; and, situational crises (e.g., traumatic death of a loved one, physical or sexual abuse, family violence). Most suicidal teens act in ways that can signify ongoing crises. They might make statements like, “I wished I’d fall asleep and never wake up,” or “I’m going to kill myself.” It is not unusual to see online postings containing vague threats or suggesting a plan. Sometimes, the depressed teen will give away prize possessions or cancel major activities. He or she may become preoccupied with death. There can be changes in appearance such as choice of clothing or personal care. It is critical to realize that teens who feel suicidal are not likely to directly ask for help.
Effective suicide prevention among youth must be incorporated into school and after-school activities. Of paramount importance is maintaining a positive school climate, including student behavioral expectations. Teachers and counselors must promote care and trust in student/adult relationships. This is the responsibility of the entire school staff. Obviously, parents are at the crux of modeling behavior and play a vital role in helping children develop a positive sense of worth. If a school notifies a parent of their child’s risk for suicide, it becomes the responsibility of the parent to seek mental health assistance and follow through with all professional or pastoral recommendations. Take all threats seriously, and maintain regular communication between the school and the counseling service. Above all, it is crucial to validate the feelings of anyone who is struggling to cope with his or her emotions.
Steven Barto, B.S. Psy., M.A. Theology
References
1 https://variety.com/2018/digital/news/13-reasons-why-season-2-ratings-premiere-nielsen-1202825235/
2 “Netflix Deletes Graphic Suicide Scene from First Season of 13 Reasons Why,” CBS News, archived from the original on July 17, 2019, retrieved Feb. 23, 2023, https://www.cbsnews.com/news/13-reasons-why-suicide-scene-hannah-baker-season-finale-death-katherine-langford-season-1-episode-13/
3 Linda M. Richmond, “Surgeon General Calls for Action to Address Youth Mental Health Crisis,” Psychiatryonline.org, Jan. 27, 2022, accessed Feb. 23, 2023, https://psychnews.psychiatryonline.org/doi/10.1176/appi.pn.2022.2.11
4 Hillis, Blenkinsop, Villaveces, et al., 2021, “Covid-19-Associated Orphanhood and Caregiver Death in the United States. Pediatrics,” DOI: 10.1542/peds.2021-053760
5 Racine, McArthur, Cooke, et al., 2021, “Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19: A Meta-analysis,” JAMA Pediatrics, 175(11), 1142–1150, https://doi.org/10.1001/jamapediatrics.2021.2482
6 Jennifer Cisney Ellers and Emma Benoit, “The Dark Side: Teen Depression and Suicide,” Christian Counseling Today, Vol. 26, No. 2, (n.d.), 29.
7 “Suicide Statistics and Facts,” SAVE, Oct. 12, 2022, accessed Feb. 20, 2023, https://save.org/about-suicide/suicide-statistics
8 “Teen Suicide,” Johns Hopkins Medicine, (n.d.), accessed Feb. 24, 2023, https://www.hopkinsmedicine.org/health/conditions-and-diseases/teen-suicide
9 Caroline Miller, “Does Social Media Cause Depression?” Child Mind Institute, Apr. 14, 2022, accessed Feb. 23, 2023, https://childmind.org/article/is-social-media-use-causing%20-depression/
10 Sherry Turkle, Ph.D., Reclaiming Conversation: The Power of Talk in a Digital Age (New York, NY: Penguin Books, 2015), 4.
The Accidental Apologist 