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'13 Reasons Why' sparks controversy

McPherson Sentinel - 5/25/2017

May 25--A nation-wide conversation on teenage suicide started with the death of one fictional teen.

Groups of parents and mental health professionals are gathering across the nation to discuss one of the most tweeted-about shows on Netflix, "13 Reasons Why." McPherson joined the fray with a public meeting held at McPherson High School on Tuesday.

Their qualm with the show revolves around its depiction of suicide, which is the second-leading cause of death for people ages 15 to 24, reports the Centers for Disease Control and Prevention. Mental health professionals warn that glamorizing the act can contribute to the copycat factor among teens.

"These kids already feel isolated, suicidal, and there's also a concern with suicide contagion. We call it copy-catting, and that happens when there's more details given about it," said Nicole Stevenson, a licensed specialist clinical social worker with Prairie View in McPherson. "You see her slitting her arms and you have to look away. I can't imaging watching this as a teen and trying to make sense of it."

On the other hand, some see the show as an entry point with which to talk about teen suicide with the young people around them.

"The students I've talked to ask why we don't openly talk about this more frequently. We need to have conversations not only in the school, but with parents so they're aware of what our teens is going through," said Kim Krase, McPherson High School counselor. "I think it's giving us a tool to start those conversations and show parents how to have those tough conversations and what they might look like."

Vulnerable populations

The show is based on a 2007 novel of the same name by Jay Asher, which is less graphic than the show. In the Netflix version, high school sophomore Hannah Baker, played by Katherine Langford, dies by suicide after making 13 recordings about how people in her life influenced her decision. The tapes are distributed among her peers, and the viewer of the show follows one particular boy's reception of the tapes as he listens.

"This show looks at the life of a teenage girl who experiences bullying, substance abuse, self-harm, depression, rape and suicide. It's a graphic show and goes into extreme detail about why these things happen to her, so it's brought up a lot of public attention," said Anoria Carlson, a licensed specialist clinical social worker with Prairie View in McPherson. "We're talking about this because the show is meant to be a cautionary tale; unfortunately, a lot of people worry that teens will just copy after it. We're trying to educate adults on healthy ways to notice these behaviors in their teens and get them the appropriate help."

The series is produced by Selena Gomez, who reportedly wanted to produce the show to start a conversation on the all-too-common occurrences of bullying, rape and suicide among teens.

Parents watching the show agree with cautionary aspects, but still worry for how their children might respond to its themes.

"It shows that even the slightest thing you say or do can hurt someone because you don't know what they're dealing with, but I had mixed feelings on it," said Dawn Zaharis of McPherson. "I think it was a good show, and it's real life that does happen and that kids deal with stuff on their own, but I don't want my 14-year-old to see this as an example."

Some young people watching the show agree with the intention of being a cautionary tale.

"I think that the purpose was to show people an in-depth look at why people commit suicide," said Alyvia Johnson, who will be a freshman at Abilene High School next year. "When it happens, people assume that it was on a whim or they didn't think through it, so the show really shows that she had reasons why and that people should be nicer to others. In Abilene, we've seen kids commit suicide in the past two years, and when that happened, my parents talked about it and ways to get help. When the show came out, they talked to me about it again because they wanted to make sure that if I felt like I wanted to do something to myself, that I could talk to them or someone else."

Though the second leading cause of death for young people, behind accidental death, completed suicide among children and adolescents is relatively rare in the U.S.: 425 people ages 10 to 14, and 5,079 people ages 15 to 24, died by that means in 2014, the latest year for which the CDC has final data.

Suicidal thinking affects a larger group. According to the CDC's latest Youth Risk Behavior Surveillance Report, published in June 2016, 17.7 percent of students age 10 to 24 had seriously considered attempting suicide during the year before the survey. Girls and young women outnumbered males in having these thoughts two-to-one. About 15 percent of students reported being bullied online, and 20.2 percent had been bullied on school property, which are both themes explored in the show.

This doesn't sound meaningful; however, according to Carlson, in a school of 500 students, 85 would have seriously considered suicide, 68 would have a plan, 40 kids would have attempted and 13 would have made an attempt that resulted in medical attention. This is a school approximately the same size as McPherson High School.

"The show has a huge following but the population we're concerned about are the kids already struggling with depression, abuse, and self-harm," Stevenson said. "I encourage you that if your teen wants to watch it, you watch it with them. Even if they're not in the vulnerable population, it's still a heavy show to watch and they know kids who are. They're the ones seeking help for their friends, so we as adults need to come into that conversation and help them help their friends."

Unanswered questions

Yes, the show is creating open conversations, partly because "13 Reasons Why" leaves some questions unanswered.

Some view "13 Reasons Why" as a cautionary tale, while others find that the show doesn't caution enough.

"It's opened some conversations between parents and kids and guiding that, but some of us are more concerned that it's not teaching kids what other options they can reach to for help," Krase said.

The purpose of these conversations is prevention. "13 Reasons Why" depicts the downward spiral that many health professions want to avoid altogether.

As a health professional and parent, Brooke Kanitz of McPherson hopes that conversations prevent damage that can't be reversed in the emergency room.

"But I am always an advocate for raising awareness on anything like that. That's going to potentially save lives and have people making good choices," Kanitz said. "You can have compassion, and love on them and pray for them, but there's not whole lot of change I can make as a provider. Our hands are tied, which is very sad."

Action

In 2016, Kansas passed the Jason Flatt Act, which requires youth suicide prevention training be given to all school district personnel. This paints a very different picture from the uncaring school counselor depicted in "13 Reasons Why."

"As counselors, we want to bring awareness to parents about what's in this show and bridge that gap between parents and their kids," Krase said. "These kiddos have been through all this, maybe haven't talked to a parent or counselor, and now they're watching this show. We want to fill the gaps left by the show so they know there are resources available."

Mental health professionals hope good will comes from the conversations had between youth and the adults in their lives.

"A lot of adults have the feeling that if they talk about suicide with their kid, they're planting the seed for it to happen," Carlson said. "Parents don't know how their kids feel on these topics because it's not an open discussion. Suicide and death are very taboo in our society, so parents and adults don't feel comfortable discussing it."

To aid these discussions, Prairie View has a list of questions parents can ask their children to start these conversations. Some revolve around the child's feeling about the show like, "What do you think of Hannah's choice to commit suicide?", while others voice the parent's concern and ask how they can be available listeners -- "What ways can I support you in telling me if things aren't going OK for you?"

Carlson listed several warning signs of students who might be considering suicide, which include being withdrawn, unusual neglect in appearance, giving verbal hints, not tolerating praise and awards, suddenly cheerful after period of depression or that they've come to peace with a plan, a decline in schoolwork, putting affairs in order, a drug or alcohol abuse problem, or self-injury.

"If you have any relationship with that person, don't assume someone else will talk to them. Just listen, you don't need to have the right words," Carlson said. "Accept their feelings. What they're feeling doesn't feel that great -- you may not agree with it -- but just accept it and listen to them. They matter."

If you feel that someone is struggling with thoughts of suicide or self-harm, please take one or more of the following steps:

* Call 911

* Call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text "START" to 741741

* Visit The American Foundation for Suicide Prevention for free resources: https://afsp.org/

* Contact your physician, nearest hospital, and/or mental health organization. The Prairie View 24/7 hotline is 1-800-362-0180 and Client Centered Counseling can be reached at 6260-241-2300.

A guide for parents

Here's a guide to questions to ask your kids and get the conversation going. "13 Reasons Why" raises concerns about several sensitive topics, so the best option is open communication with teens about the topics.

Remember to phrase questions without an easy yes or no answer to get discussion about the issues.

If your kids won't talk to you, see if there is another trusted adult they'd prefer to talk with.

Be intentional about spending one-on-one time with them -- this leads to better communication.

* What was it like for you to watch the show?

* What parts of the show can you relate to?

* What do you think of Hannah's choice to commit suicide? Do you think other students were to blame?

* In what ways have you been bullied?

* Has anyone ever said or done anything to you like what is in the show?

* In what ways does bullying happen at your school? Do you feel the administration knows about this? What would it be like if you reported it?

* If you got to a party or place and needed to get out of a situation, what would you do?

* Can you define sexual consent? What does it mean for consent to be given?

* What ways can I support you in telling me if things aren't going ok for you?

* What plan could we have if you are feeling unsafe?

* Have you ever had thoughts about harming yourself? Can you help me understand what they are like for you?

* What would you like me to do if you need to talk to me about something?

* How would you like us to spend time together as a family?

* What things as school bring you joy? What is hard at school?

* If you could change one thing at your school, what would it be?

* Who do you feel you can talk to at school if you feel isolated, bullied or depressed?

* How would you respond to a friend that comes to you feeling depressed? What ways can I help you if this happens?

* If the youth said they have been depressed, bullied or sexually targeted, ask them what they want you to do to help.

* Normalize that as teenagers, there is often an emotional roller coaster that one goes on which could lead to days when you wish you were dead or feel really down. How can you communicate to me on those days that you are feeling that way and what can I do to help you?

* What questions do you have for me?

* If you have been sexually assaulted or targeted with sexual bullying, an adult can report without all the details. You don't have to remember everything. Any counselor that you see will have to make a report to keep you safe. Counselors should be asking more questions than what is shown in "13 Reasons Why" to assess safety if you think of harming yourself with cutting or suicide. Help is available and affirm to your child that you will help them get the help they need.

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(c)2017 McPherson Sentinel, Kan.

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