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13 Reasons Why Season 2: A Clinical Perspective on the Series’ Impact and Consequences

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by Elizabeth Weinberg, MD, and Katie Lewis, PhD

Austen Riggs Center’s Drs. Elizabeth Weinberg and Katie Lewis offer a clinical perspective on the impact and consequences of 13 Reasons Why Season 2. In 2017, Netflix released the first season of a series targeted towards young adults, 13 Reasons Why. Despite concerns regarding the explicit depiction of the suicide of the main character, Hannah Baker, Netflix recently released the second season of this series and a third season is also being planned. Last year, we addressed the risks of showing explicit, graphic acts of suicide, and concerns regarding how the producers of this show chose to frame this act in our blog post, “A Clinical Perspective on the Graphic Depiction of Suicide.” The chief narrative device in 13 Reasons Why is 13 audio cassettes that Hannah uses to explain the way the people she trusted each contributed to her suicide. We were concerned that the series misrepresented the subject of suicide by romanticizing and valorizing her act; by suggesting that she had no other choice; by displaying authority figures who were incompetent, ineffective or dishonest; by seeming to blame other characters in the show for her attempt; and in general failing to follow common-sense guidelines issued by the World Health Organization regarding the depiction of suicide in the media. We were concerned that such explicit depiction of suicide could foster suicide contagion, and that the producers of the series were not making enough of an effort to warn parents, children, and vulnerable viewers about the disturbing content of the series, which involves graphic rape and self-injury. 

Several events following the release of the first season supported these concerns. While there has been little systematic research regarding the effects of this particular series, researchers Ayers, Althouse, Leas, et al. (2017) published a study in the Journal of the American Medical Association using Google to investigate changes in searches using the term “suicide” following the release of the series. They found that searches regarding suicide were 19% higher for the 19 days following the release of the first season of 13 Reasons Why, with 900 000 to 1.5 million more searches than otherwise expected. Of these, frequent searches involved terms that were particularly concerning, such as “commit suicide” or “how to kill yourself.” On a more positive note, there was also an increase in searches for suicide crisis services, suggesting an increase in interest in seeking help. 

In response to these concerns, Netflix commissioned a study carried out at Northwestern University on the effects of the series. The findings of this study were considerably more positive. In summary, the study found that teens were able to understand the content of the series effectively, found that it accurately reflected the circumstances of their lives, and that the series helped open up conversations about difficult matters such as sexuality and mental illness with parents. However, concerns about the study were also raised: the study did not specifically examine the reactions to the show of teens with prior histories of trauma, current suicidal ideation or self-destructive impulses, or other high-risk youth–the population of viewers that experts expressed specific concern for, due to the show’s potentially triggering content. Dr. Regina Miranda speaks to this concern in an article on Vox

Netflix also responded to concerns by adding warnings before each episode of the new season, and provided links to a related website, which includes information about suicide prevention hotlines and other suicide and mental health resources. It also includes a conversation between actors and experts, 13 Reasons Why: Beyond the Reasons, which provides an opportunity to give viewers additional information and some context regarding issues prominent in the series, such as sexual assault, mass shootings, and bullying. 

Nevertheless, despite these efforts, we stand by our original recommendations in our “Clinical Perspective on Suicide Contagion” blog, and we cannot recommend either season to viewers, particularly not to parents, adolescents, or children. While the focus of the second season is much less on suicide, and much more on other problems such as sexual assault, drug addiction, gun violence, and bullying, the choice made by the show’s creators to maintain Hannah Baker’s ghost as a character undermines the understanding that suicide is a final act. The focus on other characters’ efforts to render her justice implies that Hanna’s suicide is more meaningful and heroic than her actions while alive. The overall chaotic depiction of violent and disturbing content significantly interferes with any positive educational or artistic mission the series might have served. 

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