Editor's note: This post contains spoilers for the Netflix series "13 Reasons Why."
Full disclosure: It’s my job to save Hannah Baker’s life.
Not the character Hannah, of course — but students like her. If you watched Netflix’s powerful new series "13 Reasons Why," then you know the main character kills herself after a spate of traumatic events, including bullying and rape. I work in a school-based health center caring for "high-risk" students who are struggling with depression, suicidal thoughts, poor decision-making and/or impulsive behavior. My own mother died by suicide when I was 4.
Because this series is particularly popular with teenagers, I watched it with much trepidation. I know how difficult it is to portray a delicate topic like suicide. In writing my memoir about my mother’s suicide, I wrestled against idealizing her and telling a story that both educates and engages the reader.
In "13 Reasons Why," the adults, unfortunately, are clueless and ineffectual.
I worry that "13 Reasons Why" discourages students at risk for suicide from seeking help, and inadvertently glamorizes suicide for vulnerable teenagers. That’s why this is a critical cultural moment to speak with young people about suicide.
Throughout the series, Hannah was in so much pain and yet was incredibly private about her isolation. Her solution was to escape what she perceived as intolerable pain, leaving us with the sense that this was an inevitable tragedy. Viewers can see that her parents and Clay, a friend, adored her. But she couldn't. She was in a place where she magnified those who were cruel to her and allowed their views to define her self-worth.
Remembering that this is fiction, we can see this as an opportunity to talk to teenagers who are confronted with some of the same stresses as Hannah. We can encourage them to seek help.
In "13 Reasons Why," the adults, unfortunately, are clueless and ineffectual. When adults at school talk with Hannah, they are distracted and ineffective; they allow Hannah to be devastated by her treatment at the hands of other students, and they don't hold the other kids accountable. After Hannah dies, Clay's parents suggest that he take a medication (I assume an antidepressant) but cannot talk to him about his distress. So we're left thinking this fictional world has a "Lord of the Flies" mentality where cruelty and shaming are accepted. If teenagers don't feel safe, and don't know that there is a responsive adult nearby, they are less likely to ask for help.
Guidelines by the American Foundation for Suicide Prevention say that news stories with sensational headlines or images, repeated coverage and death glamorization increase the likelihood of suicide in vulnerable individuals. So whenever suicide hits the news — both with the show, and with the news of former Patriots player Aaron Hernandez's suicide — I encourage talking about the stigma of mental illness and the silence that often surrounds suicide. Below is my cheat sheet for parents to talk about suicide, using "13 Reasons Why" as a springboard:
Know the signs
A completed suicide is often referred to as the “tip of the iceberg” — and if you peel back the layers, there are often inward signs of misery including increased isolation, prior suicide attempts, academic failure, sense of being a burden, agitation and difficulty sleeping. One of the risk factors for teenage suicide is “interpersonal loss" — or the loss of a close relationship with another person. One crucial study on teen suicide revealed that most teens who die by suicide had a mental illness. It’s important to educate students on the symptoms of mental illness, and to let them know their condition is treatable.
Encourage talking about suicide
Many suicides occur with little planning during a short-term acute crisis, although research by psychologist Thomas Joiner suggests that most people who die by suicide have thought about it for a long time even when it appears to be an impulsive act. This leads to two clear intervention points: arming students with a suicide prevention lifeline, and encouraging teenagers who are worried about the safety of a friend to let an adult know. Countless times over the years that I've practiced in a school-based health center, a life has been saved because a teenager was brave enough to tell an administrator that they had suicidal thoughts.
Whenever suicide hits the news ... I encourage talking about the stigma of mental illness and the silence that often surrounds suicide.
Limit access to guns
While Hannah kills herself by slicing her wrists, that method is only effective five percent of the time. Adolescents are twice as likely to kill themselves when there is a gun in the house. Parents should reduce easy access to guns and keep small quantities of alcohol at home to avoid the toxic combination of alcohol, guns, and suicidal ideation.
Sensitive topics like suicide, depression and sex are often hard to broach with young people — but the key is to look for opportunities to listen and show interest in having those difficult conversations. I’ve often heard parents and invested adults like teachers say they’re afraid to ask if a young person is suicidal, as if it might plant the idea. But questioning is essential. The QPR Institute offers three steps — Question, Persuade, Refer — as a scaffolding for life-saving efforts.
Know the resources
Losing someone to suicide is brutal and we all want to take the necessary steps to prevent this loss. We can make a difference by communicating to teenagers that suicide is not inevitable and encouraging them to share their despair so that they can get appropriate support. There are people out there ready to help — the American Foundation for Suicide Prevention, Samaritans and National Suicide Prevention Lifeline (1-800-273-8255) to name a few — you just have to have the courage to ask.