“13 Reasons Why” – An Opportunity to Talk with Young People about Mental Illness

Before I begin, I must admit that I have not watched this series, and have never read the novel, although I plan on dedicating time this summer to do both.

Nonetheless, I have thought a lot lately about the controversy surrounding the new Netflix series “13 Reasons Why” and the momentum it has built around the topics of mental illness, suicide, bullying, sexual assault and parenting. At first, I found myself most focused upon, and sharing, the concerns of others within the mental health community, whom I believe have correctly pointed out the series’ potentially unsafe portrayal of several mental health themes and topics, including suicide and help-seeking. If you are unfamiliar with these arguments, there have been many articles written this past week, which highlight and discuss these points of concern.

The Executive Director of Suicide Awareness Voices of Education, a non-profit organization dedicated to the prevention of suicide, was quoted last week as expressing concerns about the potential for the series to lead to an increase in suicides and negatively impact youth who are struggling with mental illnesses or a history of trauma and abuse. I can definitely understand if this idea strikes fear and concern in the minds of parents. After all, the health and safety of our children are often unspoken standards for most. As a parent of younger children, who seem more interested in watching videos of kids opening toys on YouTube (yes, this apparently is a thing) than the series 13 Reasons Why, I have experienced the perceived privilege of not having to ‘worry too much’ about their being exposed to the series, and thus, any resulting and potentially negative fallout. However, as I thought more about this over the past weekend, I began to see a potential flip side to this coin. Perhaps this series offers parents an opportunity to talk with their children about important and serious topics. Topics that have historically been stigmatized, and as a result, are often neglected. That is, the many topics surrounding mental illness and wellness.

As a parent, I can absolutely empathize with wanting to shelter and protect one’s child or children, to prevent them from being exposed to ‘too much, too soon’. It can certainly be argued that there are definitive, empirically supported, and healthy limits when it comes to concepts, topics and content that are appropriate for children; developmentally, emotionally, neurobiologically, morally and so on. However, think about the possibility, for a moment, that there may potentially be greater costs for remaining silent about this series and the discussions it has created, when it comes to our children. Or, even further, for reprimanding our children for watching the series or threatening them, without an explanation, to try to dissuade them from doing so, e.g. “you better not dare watch that series”. What message(s) may we be unintentionally communicating. By remaining silent, might we be contributing to the very stigma that silences those struggling with mental illnesses or those caring for family members who are struggling with mental illnesses?

To be sure, I do believe that this novel and series are not for everyone, and taking into consideration a potential viewer’s age and past/present life struggles are very important considerations when deciding whether viewing the series or reading the novel would be appropriate. However, I also believe that talking about, normalizing and educating children, adolescents and young adults about mental illness is never inappropriate, and here are some reasons why:

1. Talking about suicide does NOT increase the risk of suicide. Research has shown that asking others about suicide not only does not lead to an increase in the risk of suicide, but it may lead to a reduction in suicidal thoughts, as well as an increase in help-seeking. It may be difficult to have those ‘hard’ conversations in life, especially with our children, as we may want to avoid making them/ourselves feel uncomfortable, or we may hope and believe that if they don’t talk about it, they won’t think about it, and therefore ‘it’ won’t happen to them. Talking about difficult topics can create and cultivate a culture of openness within your family that paves the way for future, meaningful and important conversations.
2. Talking about mental illness helps to reduce stigma. Stigma, both social and perceived/self-stigma, are major barriers to mental health and wellness, as well as the acceptance and empowerment of people struggling with mental “Stigma is shame,
   Shame causes silence
   and Silence hurts us all”illness. Research has indicated that stigma contributes to a reduction in the prioritization of public resources for mental healthcare and reduced help-seeking. The more we talk about and educate one another about mental illness, the more we contribute to reducing stigma and limiting its impact. Additionally, research has suggested that having connections and contact with people who have struggled with mental illness is associated with lower stigma. Consider sharing your struggles with mental illness and stories of help-seeking, with your children, as it may prevent them from feeling alone. As the mental health advocacy group Active Minds points out, “Stigma is shame, shame causes silence and silence hurts us all”. 
3. Suicide is the 2nd leading cause of death among adolescents and young adults. In 2014, the Center for Disease Control (CDC) reported that suicide is the second leading cause of death for young people between the ages of 10-24, behind accidents. Further, boys (81%) are more likely to die by suicide than girls (19%). This is a key point, as the process of gender role socialization, as well as culturally driven gender role expectations and standards, may lead parents to have fewer conversations about mental illness and treatment with their male children, when compared to their female children.
4. Adolescents and young adults are less likely to seek help for mental illness. Research has indicated that there are several barriers that prevent adolescents and young adults from seeking mental healthcare and treatment. Stigma, as mentioned before, plays a major role. Researchers have noted that feelings of embarrassment and a fear about ‘what others may think’ are significant barriers to help-seeking among adolescents. Additional barriers include: an inability to trust the healthcare provider, a lack of education about the symptoms of mental illness, a lack of accessibility to mental healthcare, a preference for self-reliance, a lack of knowledge about mental health services, and fears and/or stress related to help-seeking. Given these barriers, if you find yourself reading this and thinking, “Okay, I want to talk with my children about mental illness and wellness, but I don’t think they will want to talk with me”, chances are that you are not alone. Consider starting the conversation with your children by first talking about any potential ‘fears and concerns‘ they may have when it comes to speaking with you about mental illness and their mental health.
5. Myths, misunderstandings and misinformation contribute to negative attitudes and stereotypes. Victim and family blaming, diagnostic labeling, and inaccurate media (news and entertainment) representations of mental illness all contribute to stigma. Misinformation and the resulting negative attitudes about mental illness causes people to remain silent and suffer. After all, who would want to talk about their experiences of depression if they were afraid they would be looked down upon or discriminated against. Increasing mental health literacy through education, and combating stigma through awareness efforts does have an impact on these negative attitudes and stereotypes, which are prevalent in our communities. Research has demonstrated that the more education and correct information a person has about mental illness, the less likely they are to stigmatize mental illness, compared to those who are misinformed. Mental health education, awareness and promotion of the respectful and dignified treatment of people with mental illnesses can take place in the home. As parents, we have an opportunity…an opportunity to support our children’s health and wellness, and help redefine how society views mental illness…and “13 Reasons Why” may have provided the spark.