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“13 Reasons Why”

Posted 8/14/2017 by UHBlog

If a teenager or child you know is experiencing feelings of hopelessness, lethargy or extreme sadness, don’t ignore it. We can help.

13 Reasons Why

“13 Reasons Why,” the Netflix miniseries, has brought an expanded awareness to the issues of teenage suicide and depression.

In 2015, suicide was the third leading cause of death in Americans ages 10 to 14, and the second leading cause of death in Americans ages 15 to 24, according to the Centers for Disease Control and Prevention. That year, more than 400 Americans under the age of 14 took their own lives.

Based on a 2007 novel, “13 Reasons Why” is a fictional drama about Hannah, a high school student who leaves behind audio tapes to expose classmates whose behaviors led to her suicide.

While child and adolescent psychiatrist John Hertzer, MD, commends the show for helping to spur discussion about emotional and mental health issues that teens may experience, he's less enthusiastic about some of the messages it sends.

“Hannah’s parents are generally supportive, yet they are portrayed as minimally impactful,” Dr. Hertzer says. “Likewise, the school counselors are portrayed as having a diminished role. In reality, supportive parents who address these issues with their children can have a significant impact, and school counselors can be very influential in helping students who may not have approached anybody to that point about how their mood is changing or their feelings of depression.”

The bottom line, Dr. Hertzer says, is that parents and other adults should be proactive when they see signs of depression or emotional problems in teens and children.

“The inaccurate portrayals are unfortunate because we don’t want anything to interfere with the ability or the willingness of people to take steps to help others who are going through depression,” he says. “It is always better to bring these things out in the open for discussion. One of the things that concerns some parents is whether asking their kids about having suicidal thoughts will in and of itself prompt them to feel suicidal. The answer to that is clearly ‘no.’ If a parent suspects that his or her child or teen is depressed by observing him or her as being more withdrawn, less interested in activities, showing changes in sleep or appetite, or because of concerns raised by teachers or peers, then it is entirely appropriate to ask about suicidal thoughts. It’s important to be alert – observe and listen to what’s happening in your child’s life.”

Another misperception in “13 Reasons Why,” Dr. Hertzer says, is the vengeful nature of Hannah’s audio tapes.

“In reality, clinical depression and suicidal thoughts come from despair and helplessness, not focusing on getting back at others for perceived wrongdoing,” he says. “Suicidal people don’t want to go on living because they feel that they can’t.”

Dr. Hertzer believes the miniseries, which is scheduled to return for a second season on Netflix, is helpful in prompting discussion about emotional challenges that teens encounter.

“I think it is an overall positive because it opens additional conversations between parents and kids, kids and kids, teachers and kids, and mental health professionals and kids,” he says. “The show brings up sensitive topics besides suicide, such as bullying and sexual assault, and demonstrates the risks associated with sending compromising photos of yourself on your phone. If conversations following the release of the series further de-stigmatize mental health, that, in and of itself, is constructive.”

Suicides in the United States, points out Dr. Hertzer, outnumber homicides twofold. Each year, more than 40,000 Americans take their own life, about 4,000 of whom are children or teenagers.

“Suicide rates in the 10- to 14-year-old age group have notably increased,” he says. “That may be due to the consequences of being impulsive, leading to a potentially dangerous outcome.”

Viewing “13 Reasons Why” may prompt questions and concerns among teens. That’s why Dr. Hertzer believes it can be helpful for parents to watch with their children.

“There are some good opportunities for talking points along the way,” he says. “Because it is streamed on Netflix, you can pause it along the way to have a discussion.”

It’s important for teens to be aware that there are effective treatments for depression, too. According to Dr. Hertzer, University Hospitals partners with LifeAct, which offers a suicide prevention educational program to Northeast Ohio middle schools and high schools.

John Hertzer, MD, is a child and adolescent psychiatrist and is division chief of psychiatry at University Hospitals Rainbow Babies & Children’s Hospital, and division chief of child and adolescent psychiatry at University Hospitals Cleveland Medical Center. You can request an appointment with Dr. Hertzer or any other doctor online.

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