At Least 13 Reasons Why Not


The media has tremendous power in delivering messages to the public about mental illness. This year, the media got it wrong.

According to the CDC, suicide is the second leading cause of death for young people ages 10 to 24. Youth suffering from suicidal ideation should be encouraged to seek out help rather than suffer alone or consider suicide as a solution.

The media has tremendous power in delivering messages to the public about mental illness.

This year, the media got it wrong.

13 Reasons Why is a popular Netflix series about a fictional teenage girl who shares her high school experience of sexual assault, bullying, and suicide, narrating 13 reasons why others are responsible for her death. This compelling drama has been watched by youth globally, often in rapid succession without time to process its graphic content. Its emotional material may increase the risk of self-harm or suicidality among teens who are especially vulnerable. According to a JAMA publication, after the series’ release, internet searches about suicide and ways to die were significantly higher than expected.

There are clear recommendations to combat copycat or contagion suicides, but unfortunately this series does not cast a positive light on reaching out for help from mental health and school providers. There is a message of unrealistic problem-solving by suicide. In addition, the show suggests that others are to blame or are at fault for the death of the protagonist and revenge is glamorized after her death.

Causes of suicide are never simple; rather, the majority of those who die by suicide are suffering from a serious mental illness and likely have multiple genetic, social, interpersonal, and/or environmental vulnerabilities. With such a broad-base audience, there could have been a real opportunity to highlight the effectiveness of mental health treatment and to educate viewers that even the most difficult problems have solutions, particularly when working with a recovery-oriented metal health team along with supportive community and family members.

Desiree Shapiro, MD, is Assistant Clinical Professor of Child and Adolescent Psychiatry at the University California, San Diego (UCSD). She helps patients and families in psychiatric crises on an inpatient unit, in the emergency room, and in a crisis stabilization unit at Rady Children's Hospital. She is also a member of the Psychiatric Times advisory board.

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