Editor's Note: (Mark Henick (@markhenick) is a mental health advocate, speaker, and media commentator. He lives in Toronto, Canada. The opinions expressed in this commentary are solely those of the author. If you are feeling suicidal, or know someone who is, please reach out for help. Crisis lines in your community can be found here. For further resources, you can consult the American Foundation for Suicide Prevention or the National Suicide Prevention Lifeline. )
(CNN) Albert Camus once wrote, "Good intentions may do as much harm as malevolence if they lack understanding."
I can think of at least 13 reasons why these wise words remain true today.
The latest Netflix hit, "13 Reasons Why," is based on the novel of the same name by Jay Asher and deals with fictional teenager Hannah Baker's death by suicide. Before her death, she records a series of 13 tapes, blaming various people and enumerating the reasons for her death. The overarching narrative is a noble, if simplistic one: be nice to people, because you never know what they might be dealing with.
Or, more troublingly: Be nice to people, or they might make you regret it.
After revealing in the show's behind-the-scenes special that she wanted to adapt "13 Reasons Why" to help people, pop superstar and series executive producer Selena Gomez, who has been candid about her own mental health struggles, has faced considerable backlash.
Many -- myself included -- object to the series' depiction of suicide because it lacks understanding about how to show it on screen safely. And that narrative choice, while an artistic one, is also a potentially devastating setback in the effort to combat a problem which by any conservative estimate is a global health crisis. Nic Sheff, who wrote the series' 6th episode, had a personal connection with the content. Informed by that experience, he recently wrote an article for Vanity Fair defending the series and its choice to depict Hannah's suicide on-screen.
"From the very beginning, I agreed that we should depict the suicide with as much detail and accuracy as possible. I even argued for it -- relating the story of my own suicide attempt to the other writers," he wrote. "In AA, they call it playing the tape: encouraging alcoholics to really think through in detail the exact sequence of events that will occur after relapse. It's the same thing with suicide."
I get Sheff's point, and understand why he feels that way. However, one of the things that people recovering from a mental health problem or illness learn in their recovery is that your feelings are not always facts. The biggest problem with Sheff's defense is that, while it feels right, it's scientifically, demonstrably, incorrect and dangerous.
Numerous credible evidence-based organizations with a firm grasp of the suicide prevention world discourage graphic depictions or discussions of suicide, because, according to the American Foundation for Suicide Prevention and others, risk of additional suicides increases when a story explicitly describes the suicide method, uses dramatic or graphic headlines or images, and when repeated coverage of that story sensationalizes or glamorizes a death.
According to a variety of expert sources, harmful portrayals of suicide may include some of the following features, many of which "13 Reasons Why" uses in its portrayals of Hannah and her community:
None of the criticism of "13 Reasons Why" means that we shouldn't talk about suicide; we should. In fact, it's critical that we do. But we need to do it right. We know that contact-based education -- when people share their personal stories of struggle and recovery -- is by far the most effective way of breaking down stigma surrounding suicide, which is the primary reason people don't speak up or get help.
I know, I've done it a few times. My TEDx talk about some of my own suicide attempts is among the top 40 most watched TEDx talks in the world. In it, I share some details about my own journey, and have since also reconnected via YouTube with the passing stranger who intervened and helped to pull me to safety during a suicide attempt when I was a teenager.
Triggers are not necessarily to be avoided at all costs, but if you're going to pull off a band-aid, you had better be ready to stop the bleeding and help the person to heal. To the credit of Netflix, they do link to resources from the JED Foundation. They've also added warnings to some episodes, and have rated the series TV-MA. Not doing so would have been a grave mistake, both morally and legally.
Discussion and media portrayals of suicide, even disturbingly inaccurate ones like those shown in "13 Reasons Why," don't "give people the idea" to kill themselves, but may still contribute to a suicide contagion or, somewhat crudely, "copycat suicides." That's because these portrayals provide a cognitive pathway, a roadmap of sorts, that tricks the minds of those at risk for suicide into believing the lies that their mental illnesses tell them. That is, at some level, they're probably already thinking of it, but rather than releasing those feelings in a controlled burn, the unhelpful content on the screen just adds fuel to a forest fire.
The critiques of "13 Reasons Why" are also about more than artistic license; the show has interjected itself into a dire real-world situation. Suicide is one of the leading causes of death around the world. More than 40,000 people die by suicide across the United States each year, and more than 800,000 around the world. In fact, according to the World Health Organization, more people die by suicide globally than from both murder and war combined.
People are dying, and they don't have to be. They don't have to be because the real underlying risk factors for suicide -- generally mental health problems and illnesses like depression -- are completely and effectively treatable. The problem is that people aren't getting access to the help they need, and those who do are far too often getting it too late.
This is a scandal. If people were dying from any other preventable illness at the rates we're losing good, creative, beautiful, intelligent, average everyday people to suicide, there would be (and often are) massive social actions to prevent it. Washington would be bolstering mental health resources for fear of losing an election, rather than gutting existing legislation that attempts to provide, albeit feebly, protections and resources.
In her own defense of the series, Gomez described it in a recent discussion with the Associated Press as "a beautifully tragic, complicated yet suspenseful story." Netflix itself initially responded to the criticism by pointing out that "entertainment has always been the ultimate connector." Suicide is never beautiful, Selena. It is not entertainment, Netflix. However, it is always tragic.
I don't doubt that Netflix, Sheff, Gomez, or nearly anyone else motivated by their own personal experience and interpretation of suicide intended to do harm by creating "13 Reasons Why." In fact, seemingly in response to overwhelming criticism from mental health professionals and advocates alike, Netflix has bended to some calls for additional warnings and resource information. However, they may find it a challenge to put this particular genie back in the bottle.
Should you choose to watch it, please do so with great caution. If you do watch, know your triggers, know your self-care tools, and know who to talk to if you need help.
Also, please consider avoiding making the recommendation that "everyone watch" a show like this, as we do with so many others.
You never know what someone else is going through.
If you are feeling suicidal, or know someone who is, please reach out for help. Crisis lines in your community can be found here. For further resources, you can consult the American Foundation for Suicide Prevention or the National Suicide Prevention Lifeline.