Netflix’s popular new series, 13 Reasons Why, deals with the difficult issues of bullying, rape, depression and suicide in the context of a high school peer group. The show follows Clay Jensen, who discovers a set of double-sided cassette tapes recorded by his classmate Hannah Baker that detail why she decided to commit suicide. From a mental health standpoint, it’s important to address the show’s relevance as an opportunity to talk about critical issues facing adolescents and young adults. In Canada, youth are one of the populations at highest risk for suicide, and suicide is responsible for 24% of deaths of those between 15-24. Mental health education and awareness is a crucial first step toward combating this troubling statistic.
As mental health professionals, the following are key messages we’d like to highlight about teens, depression and suicide:
Many adolescents struggle with bullying and peer pressures every day.
Hannah’s story is one that is all too real for children and adolescents in today’s society. In a 2007 survey of 13 – 15 year olds, over 70 percent reported having been bullied. This pressure is increased when you throw social media into the mix. One in every five Canadian teens witnesses or is the target of cyber-bullying. Over half of bullied children do not report the incident(s) to a teacher or their parents.
Depression is increasingly prevalent in young people and is a major risk factor for suicide.
Hannah’s words and behavior throughout the series demonstrate depressive symptoms and isolation. According to the Canadian Mental Health Association, mental health disorders are on the rise for youth, yet only 1 in 5 children who need mental health services will access them. We also know that the most common leading event to suicide, in approximately 90% of cases, is mental illness.
It’s imperative that we all know the risk factors and warning signs for suicide.
Risk factors are characteristics that make it more likely that an individual will consider, attempt, or commit suicide, and they include prior attempts, substance use, mood disorders and access to lethal means (i.e. pills, weapons, other means of self-harm).
Warning signs demonstrate an immediate risk of suicide, and include the following:
-Discussing wanting to die or the idea of killing oneself
-Searching for methods (e.g. obtaining a weapon, making a plan, etc.)
-Referring to a sense of hopelessness or lack of a reason to be alive
-Talking about “feeling trapped” or wanting to “end pain”
-Expressing thoughts of being a burden to others
-Increased use of alcohol or drugs
-Increased anxiety and agitation, and extreme mood swings
-Increased impulsive and reckless behavior
-Discussing the need for revenge
Fostering protective factors is a key component in decreasing the risk of suicide.
Protective factors are characteristics that make it less likely that individuals will consider, attempt, or commit suicide. They include accessible and effective mental health care; connectedness to family, friends, school and community; problem-solving and coping skills; and healthy relationships with caregiver(s). As we see many of these protective factors disintegrate throughout Hannah’s tapes, the show suggests how imperative it is for those experiencing depression to have the support, connectedness, and healthy coping strategies they need to get better.
We all need to be educated about the resources available to help young people cope when they are dealing with difficult feelings and situations.
Hannah’s struggles highlight how her feelings of hopelessness and her isolation from sources of support ultimately led her to the perception that suicide was her only option. The show’s producer, Selena Gomez, emphasized in an interview that one of the messages the show tries to get across is just the opposite – that suicide is not an option. Young people at risk need to know that they have healthy options for coping, and this support needs to be readily accessible to them.
Below are a few telephone numbers and websites to reach out to if you or someone you know is experiencing suicidal thoughts:
National Suicide Prevention Line:
Toronto Distress Centre:
Kids Help Phone:
And of course, if there is an immediate risk of suicide, call 911 or go to your local hospital emergency room right away.
If you or someone you know is struggling with depression and/or suicidal thoughts, please reach out to a mental health professional for help, or call us at (416) 515-2649 to be connected to one of our caring and highly-qualified clinicians at The Clinic on Dupont.
Liane Kurz is a registered Psychotherapist specializing in the treatment of children and adolescents.