May 16th, 2017


Netflix describes their popular and controversial show, “13 Reasons Why”:

After a teenage girl’s perplexing suicide, a classmate receives a series of tapes that unravel the mystery of her tragic choice.


Lorraine Ali’s description only hints at the reasons why the series is rated MA-17 (may be unsuitable for children under the age of 17):

“Mean Girls.” “Freaks and Greeks.” “Heathers.”

Perhaps you’ve heard: High school is treacherous place.

Students are ruthless to one another. Hormones are bad-behavior accelerants. And adults? Utterly clueless.

Now throw in social media-shaming, sexism and suicide, and you have the basic building blocks for the addictive mystery that is “13 Reasons Why.”


Emma Dibdin explains the controversy for Seventeen:

Netflix has added new warnings to 13 Reasons Why, following ongoing criticisms of the show’s graphic depiction of suicide and sexual assaults. While many have praised the show for opening up an honest dialogue about these issues in teenagers, some experts have cautioned that its emphasis on its heroine’s suicide could be damaging, and schools are warning parents against letting their children watch the show.


Sansea L. Jacobson, M.D., a child and adolescent psychiatrist at Pittsburgh’s STAR Center, recently binged-watched the first season:

From an artistic perspective, undeniably the characters and narrative of “13 Reasons Why” are compelling and it is understandable that teens are drawn to it. Furthermore, the sensitive topics raised (i.e., bullying, sexual assault, substance use, suicide) are important and should not be ignored.


But Dr. Jacobson thinks the show “romanticizes suicide, which places youthful viewers at risk for suicide contagion.” She offers 12 more reasons why parents should be concerned with allowing their children to watch, including two which center on the key role of mental illness:

It focuses on blaming others, as opposed to recognizing that greater than 90 percent of individuals who complete suicide actually struggled with mental illness.

It downplays the cognitive distortions of depression, and instead repeatedly suggests that suicide was the protagonist’s rational “choice” in order to escape the emotional pain caused by others or perhaps, more provocatively, to take revenge on those who wronged her.


Graphic imagery, including “self-injury and the suicide itself,” “prolonged rape scenes (yes, more than one, and from multiple perspectives),” and “gratuitously violent” fights and beatings can be distressing to young viewers, especially to those who themselves suffer bullying in their real lives. It is Dr. Jacobson’s final point of criticism that leads to her extremely important piece of advice for parents:

This series had real potential to make a difference, destigmatize mental illness, promote mental health care and inform the public about the signs and symptoms of adolescent depression. But it fell short. That does not mean that we as a community need to fall short, too. There is no one right way to talk to teens. It is most important that adults simply (and intentionally) make time and space for the conversation to happen. Be open and honest. Follow their lead. Listen. Really listen. Non-judgmentally. Then repeat what they say to let them know they are heard and help them clarify fact from fiction. What we do know is that asking about suicide does not increase the risk of suicide. It is silence that is dangerous.


It is unlikely that older children and teenagers will be watching “13 Reasons Why” in the presence of their parents, who are the ones most responsible for their children’s physical and emotional well-being. Violence. Sexual assault. Substance abuse. Mental illness. Suicide. All of these sensitive topics must be addressed by responsible parents not only in the presence of their teenagers, but also with their undivided attention.

Silence is dangerous. Parents — initiate these conversations and have them early and often.


Previous discussions on the topics of teen depression and suicide have appeared on The PediaBlog here and here.


(Google Images)


One Response to “13 Reasons Why” Not

  1. The admonition is as true today as it was in 1966 when Simon and Garfunkel tried to awaken the nation from its dogmatic slumber of the 50’s by releasing “Sounds of Silence.” Here are the most haunting of the verses:
    “Fools” said I
    “You do not know, silence like a cancer grows
    Hear my words that I might teach you
    Take my arms that I might reach you”
    But my words like silent raindrops fell
    And echoed
    In the wells of silence

    And the people bowed and prayed
    To the neon god they made
    And the sign flashed out its warning
    In the words that it was forming
    And the signs said
    “The words of the prophets are written on
    the subway walls
    And tenement halls”
    And whisper’d in the sounds of silence

    And then the music just drops off—as into an abyss.


    Ned Ketyer, M.D.

    Ned Ketyer, M.D.

    Dr. Ketyer has special interests in developmental pediatrics and preventative medicine, specifically how nutrition and the environment affect health. He earned his bachelor’s degree from the University of Vermont and his medical degree from Northwestern University Medical School. He completed his residency at Children’s Hospital of Pittsburgh.

    As one of the founding physicians of Pediatric Alliance, PC, Dr. Ketyer served as its president from 1997-2004. He has been practicing general pediatrics at Pediatric Alliance since 1990. Dr. Ketyer and his wife have three boys and live in Pittsburgh's South Hills. 

  • Note: The information included in these posts is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice.

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