Media & Mental Health: Brief Reflection and Question for the Future

Hannah muttered softly, “Some of you cared… none of you cared enough,” into her tape-recorder. These would be among the last words she said to her friends before taking her own life. Hannah’s fictional story was depicted on the popular Netflix series, 13 Reasons Why, which became the “Most Tweeted About Show” of 2017 (Wagmeister, 2017).  While it was intended to crusade against mental health stigmatization, the outcomes are hotly debated. Hannah’s story is relevant; suicide rates among teenage girls are at their highest in the last 40 years (Newman, 2017).  Similarly, suicide is currently the second leading cause of death among people 15 to 29 years of age (World Health Organization, 2017). However, the best intentions do not guarantee positive consequences.

After the airing of 13 Reasons Why, a media frenzy ensued. Over 600,000 articles were written debating the merits and downfalls of the series (Ayers, Althouse, Leas, Dredze, & Allem, 2017). Bloggers and popular culture webpages praised the show for highlighting suicide and “not shying away” from a taboo topic. Others actively opposed this, fearing Hannah’s list of reasons which led to her death glamorizes suicide as a viable option for those struggling with depression (Hale, 2017). Unfortunately, the literature points toward an undesirable result; following the show’s release, all suicide related inquiries were 19% higher than usual, reflecting around 1.5 million more searches than expected. The majority of the 20 most popular searches had a focus on suicidal ideations. These searches included phrases like “how to commit suicide” and “how to kill yourself” (Ayers et al., 2017). These expressions are mentioned in the DSM-V criteria for Major Depressive Disorder, specifying “recurrent thoughts of death” and “recurrent suicidal ideation” as symptoms (American Psychiatric Association, 2013).

It is unclear if any searches resulted in a suicide attempt; nevertheless, the surge in suicide related searches warrants discussion. Literature has recognized suicidal media documentation may lead to copycat behavior among vulnerable populations, such as youth (Niederkrotenthaler et al., 2012).  Due to evidence from celebrity suicide publicity, the World Health Organization released explicit guidelines for suicide prevention among media professionals. The list includes items such as, “avoid explicit description of the method used in a completed or attempted suicide,” “avoid language which sensationalizes or normalizes suicide, or presents it as a solution to problems,” and “take the opportunity to educate the public,” among others (World Health Organization, 2008). Despite guidelines, producers of 13 Reasons Why actively disclosed Hannah’s death, including vivid scenes using razor blades to slit her wrists. Rather than focusing on emphasizing access to resources and normalizing self-care, Hannah provides an explicit account of why she chose to die, as if any amount of logic could justify suicide. Instead of providing resources to those struggling after each episode, the show captivates the viewer with a heightened sense of drama to see who Hannah will blame next and when she will ultimately pass away. These triggers led the National Association of School Psychologists to recommend vulnerable youth do not watch the show at all (Conolly et al., 2017).

13 Reasons Why is only one of many popular shows with mental illness integral to the plot. Others include, The Good Doctor, To The Bone, Breaking Bad, and Shameless. As media continues attempting to authenticate the human experience through depictions of depression, alcoholism, autism, and other illnesses a question remains: what responsibility, if any, does media and popular culture have in preventing negative health outcomes? As the recent literature has shown in regard to 13 Reasons Why, the portrayal of mental illness has the power to produce potentially harmful consequences. Greater research is needed to assess to what extent fictional characters and romanticized narratives may affect viewers, as well as how to apply existing recommendations to producers and other media professionals.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, D.C: American Psychiatric Association.

Ayers, J., Althouse, B., Leas, E., Dredze, M., & Allem, J.-P. (2017). Internet Searches for Suicide Following the Release of 13 Reasons Why. JAMA Internal Medicine, 27(3), 12–13. https://doi.org/10.18637/jss.v027.i03

Conolly, C., Cowan, K., Faustino, P., Fernandez, B., Brock, S., Reeves, M., & Lieberman, R. (2017). “13 Reasons Why” Netflix Series: Considerations for Educators. Retrieved September 19, 2017, from https://www.nasponline.org/resources-and-publications/resources/school-safety-and-crisis/preventing-youth-suicide/13-reasons-why-netflix-series-considerations-for-educators

Hale, M. (2017). Review: “13 Reasons Why” She Killed Herself, Drawn Out on Netflix. Retrieved September 19, 2017, from https://www.nytimes.com/2017/03/30/arts/television/netflix-13-reasons-why-tv-review.html

Newman, K. (2017). Suicide Rates for Teenage Girls at All-Time High. Retrieved September 19, 2017, from https://www.usnews.com/news/national-news/articles/2017-08-04/suicide-rates-for-teenage-girls-hit-all-time-high-in-40-years

Niederkrotenthaler, T., Fu, K., Yip, P., Fong, D., Stack, S., Cheng, Q., & Pirkis, J. (2012). Changes in suicide rates following media reports on celebrity suicide: a meta-analysis. Journal of Epidemiology and Community Health, 66(11), 1071–1078. https://doi.org/10.1136/jech-2011

Wagmeister, E. (2017). Netflix’s “13 Reasons Why” Is Most Tweeted About Show of 2017 (EXCLUSIVE).

World Health Organization. (2008). Preventing suicide : a resource for media professionals. Department of Mental Health and Substance Abuse, 7, 1. https://doi.org/10.1186/1744-859X-7-1

World Health Organization. (2017). World Health Organization: Suicide. Retrieved September 18, 2017, from http://www.who.int/mediacentre/factsheets/fs398/en/