If you listen to the actors, producers, and consultants involved in Netflix's newest hit, the intense high school drama 13 Reasons Why, it's clear none of them meant harm.
In a behind-the-scenes episode that follows the series finale, they use words like "truth," "honest," and "tribute." They talk about helping people, raising awareness, and taking seriously the responsibility of portraying sexual assault and suicide.
They see the Selena Gomez-produced series as a kind of noble crusade, and they're right about the vital importance of shedding light on adolescent emotional trauma. But experts say they got something terribly wrong in their graphic depiction of the main character's suicide. Convinced that only a drawn out, gory scene could deter young viewers from contemplating or attempting suicide, the show's creators immortalized a dangerous representation of self-harm that may do more damage than good.
— Crisis Text Line (@CrisisTextLine) April 3, 2017
The controversy is a painful reminder that even the best intentions can fail us when dealing with a subject like suicide. It also raises a larger question about what happens next. This scene, which experts say may actually prompt viewers to consider or attempt suicide, can be accessed by countless adolescents and teens for as long as the series lives on Netflix. In response, mental health organizations have issued warnings about the show, and the suicide-prevention groups SAVE and The Jed Foundation published a list of tips for viewing and discussing the series.
The fallout means that Hollywood and its creatives need to rethink how they present suicide, and why. The debate also begs us to elevate the voices of people who have survived a suicide attempt or loss and can provide a variety of sensitive narratives about what those experiences are like. Instead of treating suicide first as a plot device that packs a devastating emotional punch, we could focus on accounts where people survive and ultimately lead happy lives, or where family members learn how to navigate grief and guilt.
These kinds of complexities have been on filmmaker Lisa Klein's mind for years. Her brother and father died by suicide, events that shaped her forthcoming documentary The S Word. When she began cutting the early footage for her film, she included attempt survivors talking about the method they used. But then a mental health advocate and attempt survivor asked Klein, "What are you going to get out of that?"
"I sat down and looked at the footage and thought about it," says Klein, "and realized [it would bring] absolutely nothing except distress."
Klein deleted those scenes from her trailer, and has worked closely with a number of suicide prevention experts on ensuring that the film omits any triggering material.
There's a good reason for that approach. Research shows that suicide can have what's known as a "contagion effect." Both news reports and dramatizations of suicide have been linked to a temporary spike in suicides, and public health officials recommend against providing detailed descriptions of the suicide and the method used.
Those recommendations, however, aren't universally followed by media outlets. It doesn't always seem feasible to leave out the cause of death in big news stories, such as the recent suicide deaths of former Patriots football player Aaron Hernandez and Cleveland homicide suspect Steve Stephens. Yet, it's possible to find a balance between trying to inform the public and publishing gratuitous portrayals of suicide.
The producers of 13 Reasons Why perhaps weren't familiar with this research, or maybe thought their artistic license trumped it. The book from which the series was adapted didn't originally end with the main character dying of suicide. But the novel's author, Jay Asher, said his editors wanted a death instead.
The actress Kate Walsh, who discovers her fictional daughter after she's died by suicide, hinted at the profound disconnect between art and reality in her comments about the scene.
"We wanted to make that moment, particularly, as realistic as it could be without ever having experienced that," she says in the behind-the-scenes episode. "That's the moment, the pinnacle of the series where you talk about wanting to do honor to the people who've actually had to go through this in their lives. Like you want to pay tribute to them and make it real and authentic."
Klein watched the series with her 15-year-old daughter. They both turned away during the scene.
"It was very important for them to really make the viewer uncomfortable," she says. "My own opinion is that I find it irresponsible that they showed the suicide."
One alternative, she says, would have been to show just the horror on the mother's face upon discovering her daughter. "When you're talking about loss ... that's the power," she says. "You've lost somebody you love. How they did it and all of that is so irrelevant."
The show's creators also seemed to think that viewers needed to experience pain in order to reject suicide as an acceptable option, but they may have underestimated their audience. Suicide is the second-leading cause of death among teenagers in the United States.
Julie Cerel, a clinical psychologist and president-elect of the American Association of Suicidology, says there's nationally representative data showing that more than half of Americans know someone who has died by suicide. Many of the young people watching the series probably have encountered or heard about the suicide of a loved one, and don't need to relive it to understand its tragedy.
Cerel is critical of the idea that artistic impulses should override high-stakes public health concerns, pointing to widespread agreement that it's harmful to glamorize smoking in films made for young viewers.
"I don't care if it's more artful — we're influencing kids," she says. "This [show] is aimed at kids and young adults, and the last thing I want them to do is glorify the idea that suicide will [end] all of their problems."
— Dese'Rae L. Stage (@deseraestage) April 13, 2017
Though 13 Reasons Why sought the feedback of mental health professionals, one of those experts seemed to support the depiction. Perhaps others were overruled. Whatever happened, Cerel says that while psychologists and psychiatrists may treat suicidal patients, not all of them have studied suicidal behavior closely or have received specialized training. Surprisingly, that isn't a common feature of graduate programs in the field.
Klein is worried that only the behind-the-scenes episode prompts viewers to reach out for help by pointing them to a website with crisis information. She believes each installment should begin and end with that message. Better yet, she says, Netflix could update the series with cast member-led conversations about its themes, and include practical information about how to reach out for help and how to talk to people about suicidal feelings.
"There's got to be support around it," she says. "The genie is out of the bottle. Now it really is about containing it."
If the creators, cast, and consultants who brought 13 Reasons Why to Netflix are truly dedicated to preventing suicide, they'll work hard to minimize the series' damage, and shine a light on voices and experiences that go far beyond the vision of suicide in their show.
If you want to talk to someone or are experiencing suicidal thoughts, text the Crisis Text Line at 741-741 or call the National Suicide Prevention Lifeline at 1-800-273-8255. Here is a list of international resources.