“13 Reasons Why” suicide depiction raises concerns

The Netflix original series “13 Reasons Why,” based on the popular young adult book by Jay Asher with the same name, has been the subject of heated online discussion over its entertainment value vs. potential detrimental effects on viewers, since the show’s debut on March 31.

The show centers around high school student Hannah Baker, who makes tapes listing characters and what they did to influence her suicide. One character listens to the story unfold as the 13 episodes progress.

Some critics praised the show for realistically and boldly addressing mental health and suicide in the compelling series.

Some University of La Verne therapists and psychology students, however, claimed the drama romanticizes suicide, and the show’s graphic nature may “trigger” vulnerable viewers.

Viewer discretion essential

“This show is an issue across the board,” said Elleni Koulos, University of La Verne’s Counseling and Psychological Services Director.

CAPS staff member and psychology graduate student Tatiana Kassar, who has also watched the show, said she understands its entertainment value. She said her main concern as a mental health professional is the show’s impact on young adult and teenage viewers.

“The target audience does not have a fully developed prefrontal cortex,” she said. “They don’t have executive function yet.”

The prefrontal cortex controls personality expression, decision making, complex cognitive behavior and social behavior. Executive function includes reasoning, problem solving and control of inhibitions, according to the University of Rochester Medical Center.

“We are 100 percent concerned about copy-cats,” Koulos said. “A lot of high schoolers have that ‘I’ll show you’ mentality, and now they not only have a how-to guide, but this unrealistic idea that this is how the aftermath of suicide will happen.”

The prefrontal cortex is not fully developed until approximately 25 years old, according to the University of Rochester Medical Center.

“High school was not that long ago for college students, so developmentally college students are in similar stages,” Kassar added.

“Any vulnerable college student could react to the show the same way as a junior high or high school student.”

Another concern the therapists raised was how accessible the graphic content is to children or those impressionable due to mental illness.

“All Netflix does to combat that is when you’re watching it will ask who’s watching,” said CAPS staff member and psychology graduate student Katherine Courtney. “All a kid has to do is click the adult’s profile and they have access to adult Netflix.”

On Netflix, ratings are only available in the show or movie’s overview, which a viewer must intentionally click to read.

According to the Netflix overview, “13 Reasons Why” is rated TV-MA, for mature adult audiences.

Trigger Warnings

The show does provide some trigger warnings, including a screen before the first episode reading: “This fictional series covers several difficult issues including depression and suicide. If you or anyone you know needs help finding support and crisis resources in your area, go to 13reasonswhy.info for more information.”

“There should be a much more explicit warning before you even get into the show about what exactly you might see or feel, because a screen is not going to stop people from pressing play once they are into it,” Kassar said.

The other warnings come before episodes that include sexual assaults and Hannah’s suicide.

“It’s after someone has been hooked on this show and may already be triggered,” Kassar said. “It should be at the beginning of every single episode.”

Courtney said that the show can also be upsetting to someone who has lost a loved one to suicide.

“The show does not consider what the effect might be on them in processing their own grief,” Courtney said.

Specifically, CAPS said, parents who watched the show may identify with Hannah’s parents and have a reaction.

“I often think about all the parents who have lost children to suicide and how triggering this show is for them,” Koulos said. “Reliving the blame all over again.”

The reaction of Hannah’s parent is a huge plotline in the show, Kassar said.

“We watch their experience and the scene where they come in, find her body, and that whole process,” Kassar said. “It’s hugely triggering for the family and parents of those who died by suicide.”

Graphic content is explicit

Another concern raised by the ULV therapists and the online community is the show’s use of graphic content, including two sexual assaults as well as Hannah’s suicide.

“I think that you can still talk about these issues without showing the graphic content,” Koulos said.

Kassar added that she felt sick watching the completed suicide scene.

“I think that there’s no need for anyone to ever see that,” Kassar said. “The camera doesn’t cut away, you just completely watch her bleed out. No one can unsee that.”

The CAPS staff said the technical accuracy of the act is troubling.

“In some ways, it’s a how-to guide,” Kassar said, adding that the sexual assault is also gratuitous in its explicitness.

The show includes two plot-lines surrounding the sexual assault of the main character Hannah and supporting character Jessica. The characters react to the assault differently: Hannah spirals into depression and later attributes the assault to her suicide, and Jessica represses the memory and self-medicates with alcohol.

The scenes are shot from a third-person perspective, but also the point of view of the attacker and the victim.

“It could be very triggering for someone who has been raped to see it in that graphic way,” Courtney said.

Staff at CAPS agreed that another accurate part of the show is its portrayal of depression.

“It definitely shows the darkness that someone who is suicidal goes through,” Kassar said. “It doesn’t really glamorize depression, which is good.”

She said the show demonstrates the roller-coaster those with depression experience.

“I think the show explains how a person that presented with really no symptoms at the beginning can go from that point and experience all these kinds of stressors in her life where she does end up killing herself,” Kassar said.

Difficult communication

Another aspect of the show, the CAPS staff criticized is the way the main character Hannah does not reach out for help until the day she decided to complete suicide, when she passively attempts to make her high school counselor, distracted by his ringing cell phone, recognize she needs help. She takes the tape recorder with her to the meeting and even speaks to her future audience as she fruitlessly waits for her counselor to run after her.

“She needed to talk about it,” Kassar said. “A missing piece of the show is that we saw all the things that happened and what went wrong, but we didn’t see much of her reaching out for help. It was, at the end, her last attempt.”

This too may be typical teenage behavior: wanting others to know something is wrong without having to tell them, the CAPS staff said. “A lot of teens don’t reach out,” Koulos said. “It takes a friend or a family member to convince them they need help and to talk.”

Kassar said that it was realistic that even Hannah’s parents, who were involved in her life by often checking in on her, and her counselor, who may have many students and not properly trained, could miss the clear signs of a suicidal person.

In the tapes, Hannah mentions that she wished they had asked her what was wrong one more time.

“There are scenes that show the audience what could have been done differently, but that’s not the case,” Kassar said. “She needed to reach out. You can’t be passive with your own mental health. It’s okay to talk about it, it’s okay not to be okay.”

Romanticizing suicide

The show follows Clay, Hannah’s friend, as he tries to come to terms with her death and reacts to the tapes. He often acts out against those listed in her tapes, even before reaching his own.

“This show casts all blame on those in the tapes, but the reason she killed herself is because she killed herself,” Kassar said. “That was a choice. Suicide is a choice.”

Kassar said the title of the show is indicative of blame.

“When someone in their lives kills themselves a lot of people sit with the ‘Did I cause that?’ feeling,” Kassar said. “To say “13 Reasons Why” implies causation.”

The title itself is where CAPS thinks the controversy that the show romanticizes suicide comes from.

“I think I would say it romanticizes suicide because of the 13 reasons component,” Kassar said. “It’s a very accurate representation of suicide itself, but it’s also very fictional because who, realistically, is going to make 13 tapes?”

CAPS staff explained the making of tapes, although not impossible, is not what a suicidal person would do.

“It’s an inaccurate representation of the mindset of someone who is actively going to kill themselves,” Kassar said. “To think that ‘I am absolutely going to do it, but first let me sit down and record these tapes and make a map and essentially avenge my death,’ is not realistic.”

The tapes can be interpreted as Hannah’s final act of vengeance.

“I do think the cognitive ability of some high schoolers is that (suicide) is a way to get back at people,” Koulos said.

CAPS staff stressed that suicide should not be interpreted that way.

“If you kill yourself, that’s it,” Kassar said. “You have no idea what’s going to happen and all of that information may never come out, so the show does romanticize the aftermath of suicide.”

According to Kassar, viewers get the feeling that Hannah, since she is narrating the tapes and therefore part of the show, is watching over the characters from death.

“The narration makes us think she’s watching and she’s not, or at least we don’t really know if she could, so that is very romanticized and fictional,” Kassar said.

Suicidal people are focused on the act, a reason there may not be a note with suicide attempts.

“This is a character who really detailed all the people who hurt her and it’s not always like that – a clear picture of why someone chose to end their life,” Courtney said. “Often times there isn’t a note or explanation, and even if you have those reasons, it doesn’t take away the pain of losing someone.”

Not for the vulnerable

The CAPS counselors do not recommend the show to anyone, especially those suffering from depression, suicidal thoughts or mental illness.

Kassar said that she would not recommend the show to patients or friends, but if someone told her they were going to watch it, she would give them a severe trigger warning.

“The show made it seem like suicide is the only solution, but it’s not, so in that way the show was very narrow and not as inclusive as it could be,” Kassar said. “If we could learn anything as a campus is that there are resources and people you can reach out to instead of trying to deal on your own.”

Courtney agreed that the show, although bringing to light sensitive subjects, should not be seen as realistic or a good step toward awareness.

“Overall, I don’t think the show is necessary. It’s not representative of someone who is actively suicidal. You cannot avenge your own death, and you can spread awareness without this triggering content,” Courtney said.

Koulos said that despite CAPS’ negative review of the show, they are using it as a platform.

“I think the problem with the show overall is that you can spread awareness in other ways, like educating people,” Koulos said. “It doesn’t have to be that explicit and graphic. The good thing that came out of this is that we can use this to start a conversation about mental health and give people 13 reasons why not,” Koulos said.

Kassar said that bullying, sexual assault, depression and other issues Hannah had could be dealt with by seeking professional help.

“So many people have gone through these issues and not committed suicide, and I wish it showed more of that,” Kassar said. “We may have all kinds of experiences, positive and negative, but how are you going to use that to make yourself better or others better? Suicide is not the only solution.”

CAPS helps over 300 students annually. The program has over 3,000 appointments a year and does both individual and group appointments.

“If Hannah were at ULV, I’d tell her to come to CAPS,” Koulos said.

To make an appointment, students can call CAPS at 909-448-4178 or visit the CAPS office at 2215 E St in La Verne, located at the corner of Second Street and E Street. Concerns about the mental health or safety of an individual can be submitted through a Behavior and Wellness Referral Report via the CAPS webpage at sites.laverne.edu/caps.

CAPS recommends contacting the National Suicide Prevention Lifeline at 1-800-273-8255 or the Rape Abuse and Incest National Network at 1-800-656-4673 for 24-hour and weekend emergencies.

This story was originally published by The Campus Times.

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