The Netflix series 13 Reasons Why was launched in Australia to considerable media coverage in April 2017. The second series followed in May, 2018 and a third series is currently in development. The show revolves around the fictional character 17-year-old Hannah Baker who takes her own life and leaves behind audio recordings for 13 people who she says, in some way, played a role in her reasons for killing herself. Each tape recounts painful events in which one or more of the 13 individuals were involved. The final episode of series one showed the graphic depiction of the suicide of the main character of Hannah and the episodes leading up to the finale highlighted many challenges faced by young people. The series was set in contemporary times in the United States, based on a novel written by a male writer more than 10 years ago. In various ways, it tackled the teenager’s struggles of knowing who they are, wanting to fit in but struggling to know how, trying to find ways to voice concerns and views and the risk of not being heard, even when trying to tell people how they are feeling.
“The challenge is in finding ways to ensure that new media provides support for vulnerable young people, rather than helping or encouraging self-destructive behaviours”
For a long time, there has been a silencing about suicide and we’ve only just started to talk about it publicly, with some caution, in Australia in the last few years. The release of 13 Reasons Why was met with what could be described as moral panic, with calls initially to ban it, an impossible task of course given the nature of technology where the series once released became easily accessible. Some of the concerns related to the lack of safeguards in providing resources such as warnings and phone helplines, but also because of concerns about the impact of explicitly showing the act of suicidal behaviour. It has been known for some time that the reporting and portrayal of suicidal behaviour in the media can affect those exposed to such stimuli (Skehan, Maple, Fisher, & Sharrock, 2013). The impact of the media on suicidal behaviour is not new, first recognised in the late 18th century following the publication of Goethe’s The Sorrows of Young Werther. In this text the hero shot himself after falling in love with a woman who was out of his reach. Following a spate of suicides across Europe after its release the novel was implicated. Many of those who died were dressed in a similar fashion to Werther, adopted his method, or were found with a copy of the book. The book was consequently banned in several European countries (World Health Organization, 2008).
Guiding the media
As a result of these concerns, guidelines for media reporting of suicide have been developed. An important issue is the potential effect of new and emerging media. As younger people are more vulnerable to media influences and with the growth of pro-social websites, social media, and chat rooms (which can encourage suicide pacts) the potential impact on youth suicide is considerable. The challenge is in finding ways to ensure that new media provides support for vulnerable young people rather than helping or encouraging self-destructive behaviours. Recent guidelines were developed, using a Delphi Consensus Method, to help young people communicate safely online about suicide (Robinson, Hill, Thorn, Teh, Battersby, & Reavley, 2018). Mindframe also promotes evidence-based approaches to the media portrayal of suicide (www.mindframe-media.info).
Series in the spotlight
Mental health agencies in Australia initially scrambled upon the release of the first series of 13 Reasons Why to generate information to support families, schools and young people. Calls to ban the series were quickly replaced with efforts instead to provide support. Within two weeks of the release a range of resources were made available for parents and schools. As the year progressed, with the support of organisations such as Mindframe, the need for support resources to be available was acknowledged by Netflix and were made available for the release of series two (www.13reasonswhytoolkit.org). Netflix also commissioned research which revealed that many young people found the series to be a realistic representation of their lives (Lauricella, Cingel, & Wartella, 2018). The results underscored the potential importance of media exposure and adolescent-life portrayals in the lives of young people. It also illustrated how tough topic-driven media can influence conversations with supportive adults like parents, teachers, and counsellors, as well as information seeking, attitudes, and behaviour among adolescents and young adult viewers. Overwhelmingly, the findings suggested that the series led to an interest in increasing conversations about what goes on in the lives of adolescents away from the watchful gaze of adults; empowering both young people and the adults who care for them to find a bridge that allowed them to use the content of the series to better understand the world of contemporary adolescence and most importantly to work together on what can be done to improve the lives of young people (Lauricella, Cingel & Wartella, 2018).
A look at the evidence
Research into adolescent suicide has tended to focus on family origins of the behaviour and on psychiatric disorders, however, it is important to note that the absence of evidence for other risk factors should not be interpreted as evidence of absence. Some of the primary factors specific to young people include restricted educational achievement, family history of suicidal behaviour, parental separation, divorce, or death, and social contagion. Poor family relationships seem to contribute to suicidal behaviour, perhaps by compounding genetic variability (Hawton, Saunders & O’Connor, 2012).
The importance of discussions and support for young people is exemplified by the sobering statistics released by the Australian Bureau of Statistics in relation to deaths by suicide in 2017. Suicide remained the leading cause of death of children 5–17 years of age, with 98 deaths occurring in this age group. This represented a 10.1 per cent increase in deaths from 2016. The age-specific rate of suicide in this age group was 2.4 per 100,000 in 2017, with the male rate of 2.9 substantially higher than the female rate of 1.9. Nearly 80 per cent of the child suicides were aged between 15 and 17 (78.8%), leading to an age specific death rate of 8.4 compared to a rate of 0.7 for 5-14 year olds. When all child suicide deaths are combined for years 2013 to 2017, the Northern Territory reported the highest jurisdictional rate of child deaths due to suicide, with 13.9 deaths per 100,000 persons. All other states and territories reported rates ranging from 1.7 to 3.6 deaths per 100,000 (Victoria and Tasmania, respectively) (Australian Bureau of Statistics, 2018).
Further, recent research was undertaken by KidsHelpline in 2015 of 472 young people who completed an online survey about preventing suicide in children and young people. The survey was designed to give young people a voice in suicide prevention and a number of crucial issues were raised, including:
- Parents were identified by the respondents as the people they most sought help from, however, 44 per cent of the respondents reported that their parents were not helpful when they sought help in relation to mental health problems. Young people reported that sometimes parents didn’t believe them when they disclosed thoughts of suicide and made light of their concerns. Young people reported wanting their parents to listen without judging, take them seriously, show that they care and help them access professional support.
- Non-mental health professionals, such as teachers and GPs, were identified as extremely useful sources of support, however, young people described many unhelpful experiences with education and medical professionals, suggesting a need for more awareness and understanding of mental health and suicide amongst these groups. School staff were reported to be helpful more often than not, but more than a quarter of young people found them ‘not at all helpful’.
- Close friends were an important source of emotional support for many young people. Good friends were described as listening without judging, showing that they care, and helping the young person to feel valued and wanted. The broader peer group was often less understanding, both in their general attitude to suicide and their response to an individual. A small number of responses described malicious behaviour by peers, but many unhelpful experiences suggested that peers simply lack understanding of suicidality, are uncomfortable with the situation and don’t know how to respond appropriately (Batchelor, 2017).
Being responsive
Despite the many concerns raised initially by the release of 13 Reasons Why it appears nevertheless to be helping us to gain a deeper understanding about the life experiences and needs of young people. Viewing the series can provide adults with increased awareness about the day to day experience young people face at school and home and how important these experiences are. The series also highlights how help-seeking by young people at significant risk of suicide can be subtle. The research related to the series also identified how young people can have a range of responses to viewing drama about suicide, and adults (both parents and professionals) may be concerned or fearful about youth suicide and seeking support. It is clear that social media may be a double-edged sword, bringing both challenges and opportunities for young people and adults caring for them when it comes to complex and sensitive issues such as suicide.
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