If you know a child in middle school or high school, it’s almost certain they have heard of the Netflix series “13 Reasons Why.”
There’s also a really good chance that teenager is watching the popular 13-episode drama about a high school girl who kills herself.
The show has been criticized by a number of suicide prevention groups that say it glamourizes teen suicide.
However, those involved in the series and those who support it say the series is bringing issues such as bullying and social media shame to light, as well as initiating conversations on the topic of life and death.
Dr. Christine Moutier, a suicide prevention expert interviewed by Healthline, did express some concerns about teens identifying with the series and its main character.
However, she agreed that “13 Reasons Why” provides a forum to discuss suicide with teens.
“We all have a role to play. In a way this is an opportunity,” said Moutier, the chief medical officer for the American Foundation for Suicide Prevention (AFSP).
The big questions are: What’s the best way to approach a teen? And what should you do when you talk to them?
What the show is about
The main character in “13 Reasons Why” is 17-year-old Hannah Baker.
She has just moved to a Northern California town and is new to her high school.
The series opens with students mourning the suicide of Hannah.
Shortly afterward, one of Hannah’s classmates, Clay Jensen, receives a box of audio cassette tapes.
As the series unfolds, it’s revealed Hannah recorded the tapes shortly before her death. There are 13 segments, each one blaming one of her classmates, Clay included, for pushing her toward suicide.
Each of the 13 classmates gets the tapes at different times and tries to keep the contents secret. Clay wants to make them public, much to the chagrin of those who have already listened to the tapes.
The show frequently bounces from present day to past, so Hannah is shown in most of the scenes.
One of the flashbacks is a graphic scene where Hannah cuts her wrists to kill herself.
Hannah is a strong-willed personality, but during her months at her new school she has trouble making friends, is bullied by a number of classmates, and is embarrassed several times on social media.
Praise and criticism
The show’s creators have defended the series for truthfully and forcefully depicting teen suicide and its aftereffects.
They have created a 29-minute documentary, “13 Reasons Why: Beyond the Reasons,” in which the cast members and others discuss the messages they hope “13 Reasons Why” will get across.
"We wanted to do it in a way where it was honest, and we wanted to make something that can hopefully help people because suicide should never, ever be an option," actress Selena Gomez, who co-produced the series, says in the documentary.
Co-producer Brian Yorkey said the show’s creators worked hard to make sure the series wasn’t gratuitous. They also wanted to drive home a point.
“We did want it to be painful to watch because we wanted it to be very clear that there is nothing, in any way, worthwhile about suicide,” Yorkey says in the documentary.
Actor Brandon Flynn, who plays Justin in the series, told the Hollywood Reporter the show does not glorify teen suicide. In fact, he said, he and other cast members have heard from fans who said the series saved their lives.
The show’s supporters do get some backing from some mental health experts.
Child psychologist Janet Taylor told ABC News that the show addresses important issues.
“We have to break the silence, talk to our parents, talk to counselors,” she said. “If you have a family history of mental illness, be aware of it, talk to your children. If your child makes a threat about wanting to hurt themselves, take it seriously.”
A “13 Reasons Why” Facebook page has also been created where people watching the show trade comments about the episodes.
The attention, however, does worry experts in the suicide prevention field.
They note that suicide is the second leading cause of death for people ages 15 to 34 in the United States.
Dan Reidenberg, PhD, the executive director of Suicide Awareness Voices of Education (SAVE), told ABC News the series could do “more harm than good.”
“There is a great concern that I have ... that young people are going to over-identify with Hannah in the series, and we actually may see more suicides as a result of this television series,” he said.
Reidenberg added the series doesn’t present any viable alternatives to suicide or discuss issues such as depression or mental illness.
“The way things are portrayed in the media does have an effect on the way suicides can happen,” he said. “This is particularly true for young people that are very vulnerable and at risk of suicide.”
The series has prompted SAVE and The Jed Foundation to create a webpage called “13 Reasons Why Talking Points.”
Among other things, the site tells teens there are “healthy ways to cope” with the issues highlighted in the Netflix series but “acting on suicidal thoughts is not one of them.”
It adds that “suicide is never a heroic or romantic act” and “suicide is never the fault of survivors of suicide loss.”
“When you die,” the talking points state, “you do not get to make a movie or talk to people anymore.”
It urges teens who have watched the series and “feel like they need support” to reach out to a family member, a friend, a counselor, or a therapist.
Talking to teens
Moutier shares some of the concerns of those who have criticized the Netflix show.
She told Healthline she worries the series is so “engaging” that it might send the wrong message to some young viewers.
“The status of suicide can get elevated in situations like this,” she said.
However, Moutier said the show’s popularity does present an opportunity for parents and other family members, as well as teachers, counselors, and family friends to talk to teens about suicide.
She recommends starting with an “open-ended conversation” with the teen.
Ask them first how they’re doing and what’s on their mind.
From there, Moutier says to listen for clues in what the teen is saying. They’re unlikely to say outright that they are contemplating suicide, but they might tell you life is difficult, or they are under an incredible amount of stress.
“Follow the cues the young person is giving you,” Moutier said.
She adds that adults should not “overreact” to anything the teen says. Rather, follow up with them in a nonjudgmental way.
“Teens need to have adults who can handle it,” she said.
If you do pick up signals that concern you, assume you are the only one the teen is talking to about these issues.
They may be hiding these emotions from others.
“Kids are good at showing only the parts they want you to see,” Moutier said.
She added if the teen seems to be harboring any kind of suicidal thoughts, you should alert that child’s parents.
The teen may not have talked to their parents, or the parents may be too close to the situation to see the warning signs.
You can also suggest the teen talk to a mental health professional.
Overall, listen and don’t ignore even what may appear to be minor issues.
“You have to raise the sensitivity on your radar,” Moutier said.
The issue isn’t likely to go away soon.
“13 Reasons Why” is a show teens are talking about, and now Netflix is reportedly in discussions to produce a second season.