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'13 Reasons' sparks criticism '13 Reasons' sparks criticism of teen suicide depiction A teen suicide portrayed in the new Netflix series '13 Reasons Why' has triggered criticism from some mental health advocates, who say it romanticizes suicide and has prompted many schools nationwide to send warning letters to parents and guardians

Winston-Salem Journal - 4/29/2017

NEW YORK - It's a scene as painful to watch as it is graphic: A 17-year-old girl climbs into a bathtub with a razor. We see her slice into her skin, we see the blood pour out, hear her cry and struggle to breathe. Then she is still.

The suicide of the heroine in Netflix's new popular series "13 Reasons Why" shouldn't come as a shock, since it's depicted in the final episode of a series built around the character's death. But knowing that it is coming doesn't make it any easier.

That stomach-turning scene has triggered criticism that it romanticizes suicide and prompted many schools across the country to send warning letters to parents and guardians. The show's creators are unapologetic, saying their frank depiction needs to be "unflinching and raw."

"Many people are accusing the show of glamorizing suicide and I feel strongly - and I think everyone who made the show - feel very strongly that we did the exact opposite," said writer Brian Yorkey, who won a Tony Award and a Pulitzer Prize for the musical "Next to Normal," which grappled with mental illness. "What we did was portray suicide and we portrayed it as very ugly and very damaging."

The 13-episode drama, co-produced by actress and singer Selena Gomez, is based on Jay Asher's young-adult 2007 bestseller about a high school student who kills herself and leaves behind 13 audiotapes detailing the events that led to her death, including sexual assault, substance abuse and bullying.

Per usual, Netflix released all 13 hours of the series at once - on March 31 - leaving suicide prevention specialists worried teens might binge the entire series without a chance to fully absorb the issues and ask questions. They also say they wish the show would consistently flash the National Suicide Prevention hotline.

"Graphic details about suicide we know historically are not recommended," said Phyllis Alongi, the clinical director of The Society for the Prevention of Teen Suicide . "I understand what the producers are saying but it could really be unsafe and I think we need to be a little more responsible."

Netflix and the show creators point out that several mental health professionals were consulted and they offer a 30-minute show called "Beyond the Reasons" that delves deeper into the tougher topics portrayed, as well as a site with links to resources.

The show is rated TV-MA, which means it may be unsuitable for children younger than 17, and three episodes that contain explicit material have "viewer discretion advised" warnings.

But some mental health professionals are going further, with the National Association of School Psychologists declaring, "We do not recommend that vulnerable youth, especially those who have any degree of suicidal ideation, watch this series."

Critics of the show argue that depression and mental illness - keys to understanding suicide - are rarely mentioned and the fact that its heroine, Hannah, gets to tell her story after her death sends a potentially dangerous message. They're also upset that the school guidance counselor depicted on the show seems to blame the victim.

The Jed Foundation and Suicide Awareness Voices of Education joined forces to create 13 talking points for young adults and guardians to discuss while watching the series, including warnings that the way the counselor is portrayed is "not typical" and that "leaving messages from beyond the grave is a dramatization produced in Hollywood."

School systems across the country are alerting parents, making them aware that their teens may be streaming the series, urging them to watch it with them, and providing information to help them talk about it.

In the upstate New York community of Grand Island, school administrators warned that the series "sensationalizes suicide." Indiana's largest school district warned in an email that the series "does not accurately model what we would want or hope individuals do if they are struggling or in crisis."

In Maryland, principals in the Montgomery County public school system noticed teens talking about the series and wanted to make sure parents had resources to handle tough questions. A warning letter and links to resources eventually went out to all 35,000 middle schoolers.

According to the Centers for Disease Control and Prevention, suicide was the second leading cause of death for children and young adults ages 10 to 24 in 2014.

Dr. Helen Hsu, a clinical psychologist in Fremont, California, whose work involves suicide prevention in schools, helped shape some of the "13 Reasons Why" scripts. She said not showing Hannah's suicide would be almost "coy and avoidant" and that medical studies aren't definitive about the risks of suicide contagion. Plus, there are already graphic how-to guides online.