health

Media-trician Moment: ‘Thirteen Reasons Why’


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On March 31 2017, Netflix released a drama web television series based on Jay Asher’s 2007 novel ‘Thirteen Reasons Why’. The web series, starring Katherine Langford and Dylan Minnette, explores the final, tumultuous weeks of a high school student, Hannah Baker, through a series of tapes she leaves behind after she has suicided. Hannah leaves detailed instructions for select individuals on where and when they should listen to the tapes. The individuals Hannah has selected are people she feels have been implicated in her psychological downturn including several peers and one teacher.

‘Thirteen Reasons Why’ became a hot and controversial series seemingly overnight. Some audiences praised the show for its coverage of sensitive subject matter such as sexual assault, bullying, suicide, and the use of social media in transmitting intimate photographs. Some health organizations condemned the show’s graphic portrayal of sexual assault and suicide and expressed concerned that these images would  be triggering for struggling adolescents and young adults.

I originally heard about the series from one of my colleagues who felt a strong, personal connection to Hannah’s narrative. Initially, I was extremely hesitant to watch the show. What I understood from my colleague’s description, was that the protagonist was utilizing the tapes as a form of retribution against those she felt victimized by. Throughout the series, each of the individuals identified by Hannah, slowly begins to realize their misdoings and expresses remorse for their actions. I was skeptical – how would this message be interpreted by different age groups, specifically those with developing insight? Initially, I felt that the message of the series was problematic and over-simplified the psychological and emotional impact of suicide; however, after hearing more and more media buzz, I decided to give the show a go. One post-call day, I suited up in my favourite track pants, grabbed some snacks, made a cup of tea, and settled onto my couch. The following are my thoughts on the series as a psychiatrist-in-training and person with lived experience with mental illness:

Suicide: I still feel that the series may romanticize suicide in the way that it portrays the reactions of characters implicated in Hannah’s psychological downfall. I’m cautious as to how the responses of these characters may be perceived and understood by individuals who are struggling with their own feelings of hopelessness, trauma, and self-harm. Suicide is not a conflict resolution tool and should never be conceptualized as such. Undoubtedly, a completed suicide is a high impact event. The person who has suicided has no further opportunities to engage in conflict resolution and/or to receive emotional and psychological support. Furthermore, the individuals who loved and cared for the person who has suicided are irrevocably changed by their passing; however, no one can truly anticipate or expect that their suicide will elicit a particular emotional response in their “wrongdoers”. The only people who can reasonably be expected to suffer from such an event are the individual who has suicided and their loved ones.

Normalization of Mental Illness: I commend the series for the amount of discussion it has generated around suicide, trauma, and mental illness. In Canada, we have made some progress in reducing stigma and recognizing mental illness as a legitimate health problem; however, there is still a long way to go. As a psychiatry resident, I get jibbed by other physicians on a fairly regular basis that I don’t want to practice “real medicine”. I think it is really important to recognize the platform the show has created to explore different facets of mental health, specifically within adolescents who may be less willing to discuss emotional struggles. Regardless of whether you agree with how the series has addressed suicide and/or trauma, ‘Thirteen Reasons Why’ has become so ubiquitous in popular culture that everyone (okay maybe not everyone, but a lot of us) are talking about it. Talking leads to exchanging ideas which leads to increased understanding which leads to change in societal perception leads to…I think you see where I’m going with this.

Support Systems: Hannah does make a few efforts to reach out for help; unfortunately, she does not find solace or support from any of the individuals she contacted. In fact, her feelings of abandonment and isolation are reinforced by these interactions. As the viewer, I felt hopeless and helpless watching Hannah’s missed opportunities for therapeutic intervention. I recognize that these “near misses” were juxtaposed with Clay’s identification of an isolated peer and his eventual decision to check in. That being said, I feel that this positive interpersonal interaction paled in comparison to Hannah’s missed interventions. I wonder if younger audiences were able to appreciate these subtle nuances. I feel that the ending may have felt different if a more resounding intervention was modelled to demonstrate that help is available and that it can be useful, especially in crisis situations.

Consent: I think the show is incredibly strong in its exploration of sexual assault and consent. Undoubtedly, the sexual trauma depicted in the show is difficult and disturbing; however, some really powerful modelling behaviours are demonstrated. The differences between Bryce’s and Clay’s verbal and physical behaviours towards Hannah and they ways in which they did (or didn’t) ask for consent are profoundly stark. I am glad that the show demonstrated positive consensual behaviours through Clay otherwise the sexual violence in other scenes would have felt gratuitous.

Final thoughts: Do I think ‘Thirteen Reasons Why’ is appropriate for all audiences? Absolutely not. It is undoubtedly chock full of mature themes. Regardless of their age and maturity level, young people would benefit from some guidance and support with some of the triggering themes presented. Do I think that the series should be banned from schools? Not necessarily.  ‘Thirteen Reasons Why’ has significant potential to be a powerful discussion and learning tool. I feel that the series can provide a platform for teachers, parents, healthcare professionals, and adolescents to engage in safe and therapeutics discussions around mental health, mental illness, and suicide. I look forward to exploring the upcoming season and hope that the show continues to address such sensitive topics in a mindful and compassionate fashion.

What did you think of ‘Thirteen Reasons Why’? Did you have any reservations about the show? Do you think any viewing restrictions should be placed on the show? Why or why not? Will you watch the upcoming season? I look forward to hearing your thoughts.

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