A statement on the Netflix Series ‘13 Reasons Why’

Dr Alys Cole-King and Dr Stanley Kutcher
May 08 2017

Dr. Stan Kutcher, Sun Life Financial Chair in Adolescent Mental Health and the Director World Health Organization Collaborating Centre in Mental Health Policy and Training at Dalhousie University and IWK Health Centre in Canada. He is a renowned expert in adolescent mental health and leader in mental health research, advocacy, training, and policy and has been involved in mental health work in over 20 countries.

Dr Alys Cole-King is Clinical Director, Connecting with People

This blog is in response to the growing media and social media coverage of the Netflix Series ‘13 Reasons Why’. We are keen to ensure that adults are alert to the situation whilst not being unduly anxious. Many international mental health and suicide prevention experts have already published guidance, position statements and blogs on the programme (see below for links).   One theme that is consistently found in these documents is a significant concern that 13 Reason’s Why inaccurately portrays youth suicide and contains many of the elements that research has identified as impacting on increased rates of suicide through the contagion and copycat phenomena that irresponsible media portrayal of suicide can have on vulnerable young people.

We are also dismayed by  ‘13 Reasons Why’ as it either ignores or breaks national and international media guideline on suicide safety and responsible media portrayal of suicide, is overly sensationalist and ignores all the expert advice provided before the show was made. It glamorises suicide, suggests that suicide is a plausible solution to life problems, presents suicide as a means of gaining peer respect and does not accurately portray the common factors that underlie suicide in young people.  Thus it contains the very components that research has identified as contributing to suicide contagion and increasing rates of suicide in young people, particularly those who may be most vulnerable.  However the programme is here and has probably already been ‘binge watched’ by hundreds of thousands of teenagers around the world.

Our aim now, is for damage limitation and for all viewers, especially vulnerable young people to know that suicide is preventable with early identification, intervention, hope and removal of access to means. Young people need to know that others will listen when they share their distress, that it's never to late to seek help, and there is always hope. 

The majority of young people who end their lives by suicide are not in touch with mental health services around the time of their death, even though many are suffering from problems that would benefit from receipt of mental health care or support. However, most are in contact with someone who could provide an opportunity to support them and who can help them access the care that they need.  For those young people at risk of suicide, connecting with an empathic, confident and competent person could be their tipping point back to safety, when they start to receive and accept help to deal with their problems and find a way forward.

Remember suicide is tragic but rare event and we must keep this in perspective. Young people need to know that thousands of people become distressed and have thoughts of suicide but with the right support they can get through tough times. People need to know what they can do to help themselves and others. Dr Cole-King, Clinical Director, Connecting with People states that “We wish we could reach every young person who is thinking that life isn’t worth living and help them to see that their feelings are a sign that they need to change something in their life, not to end their life”. 

Encouraging help-seeking behaviour, rapid access to effective treatments, hopefulness, identifying reasons for living, and removal of access to means can contribute to suicide prevention. It is essential that health care providers be available to give the help and support needed.

Dr Cole-King  said “It’s key that every young person considering suicide needs to know they can be supported through tough times. If they are considering suicide, they should have a Safety Plan with details of what they can do to help themselves and who they can contact for support when they need it. Information about how to make a Safety Plan can be found in the ‘Feeling Overwhelmed and Helping You Stay Safe’ resource. This is an online resource for anyone struggling with suicidal thoughts, designed  to offer hope, compassion and practical ideas on how to find their way forward http://www.connectingwithpeople.org/StayingSafe

Since the program is now widely available and the media attention to it may be having the impact of fuelling viewing rates, it is necessary to share what can be done by those who are concerned. Here are some tips for parents, guardians, teachers, youth workers and concerned adults to help address this issue and how to have a conversation with young people about the series.   

  • Keep calm and do not panic - remember the majority of young people may not be unduly affected
  • Have a conversation with the young person watching the series and to discuss their feelings and thoughts and open up a channel of communication in case they do become affected or concerned, so that they know they can talk to you
  • Let them know they can ask you any question now or in the future if an issue crops up
  • Reinforce the reality that ‘13 Reasons Why’ is a made up story and not based on a real person and that the majority of people who experience bullying, the serious injury or death of a friend, a sexual assault or any other life adversity do not think about suicide nor do they take their lives 
  • Reinforce the message that people think about suicide when they are in a huge amount of emotional pain and they don’t know what else to do - but that actually there are so many things that they could do – if only they knew who to contact for support or what to do
  • The most important thing to do is to speak to someone - and that they can speak to you any time now or in the future
  • Suicide is not a solution to problems and that help is available. This is particularly important for adolescents who are isolated, struggling, or vulnerable to suggestive images and storylines.
  • Thousands of young people experience thoughts of suicide every day, but they find ways to cope with these intense feelings. Like them, your child or the young person you care about, can get the help they need to deal with their feelings

Advice if the young person is actively distressed or talking about suicide:

  • Reassure them that you are taking them seriously and that you will be there for them

  • Reassure them that there is help and they will not feel like this forever

  • Avoid statements that they could perceived as minimising their distress such as “surely it’s not that bad” or “Come on now... you need to get over this.”
  • Provide support and supervision as required
  • Never agree to keep suicidal thoughts a secret and always support them to seek support or seek assistance on their behalf
  • Do not leave the person alone until you think it is safe to do so:
    • You have concrete evidence and reassurance and you are convinced that their distress or intent to self-harm or attempt to take their life has passed 
    • Once they have received additional support or an assessment from a suitably qualified person.  Take them to a health care provider who has the skills needed to help.  In a crisis this may be your closest A and E Department
    • See http://www.connectingwithpeople.org/StayingSafe for specific advice and guidance on who to approach if you are worried about a young person in distress

Self-help resources

Connecting with People have produced a series of leaflets on behalf of the Royal College of Psychiatrists, providing information for both individuals experiencing suicidal thoughts and those who are concerned. These are available through the Royal College of Psychiatrists or the Connecting with People website: http://Connectingwithpeople.org/ucancope

For guidelines on best practice in talking about suicide in the media or social media

Articles outlining concerns about ‘13 Reasons Why’

With thanks to Professor Siobhan O’Neil for reviewing the draft and for her helpful suggestions.

Senior Business Leaders Share Personal Mental Health Experiences and Publicly Challenge Workplace Mental Health Stigma

Claire Metters
December 08 2016

Marketing & Programmes Manager, Connecting with People

For the first time EVER senior business leaders have publicly shared their personal mental health experiences, in an effort to eradicate workplace mental health stigma. The ‘This is my Story’ event took place in London on 7th December 2016 and was organised by Minds@Work, a movement co-founded by Geoff McDonald, former Global VP of Human Resources at Unilever, Executive Director at Open Minds Health and passionate campaigner for breaking mental health stigma within the corporate world.

Research reveals that a staggering 71% of the people would worry about disclosing a mental health problem to their employer, fearful of receiving a negative response. A valid concern given that 1 in 5 people have lost a job at some point in their life following mental health disclosure or inappropriate disclosure on their behalf. 

The implications of non-disclosure of mental health conditions has wide implications for both the employee and employer. Employee’s who feel unable to openly discuss their mental health are highly likely to experience increased professional anxiety, with no line management support, and risk finding themselves in a downward spiral leading to further mental health problems that could otherwise be avoided. For employers, the associated costs in terms of increased absenteeism, presenteeism, staff replacement and reduced productivity are significant; particularly as one in four people experience a mental health problem at any given time. The total cost of staff mental health problems to UK employers is estimated to be around £26 billion each year, the equivalent to £1,035 for every employee across the UK.

Employer’s that lead by example and purposefully create a culture that openly discusses mental health, can and will remove the stigma sting. Stigma relies upon ignorance, prejudice and discrimination for its survival. Introducing a framework that educates, supports and challenges attitudes and behaviour provides confidence to employee’s struggling that disclosure won’t result in negative consequences. 

The ‘This is my Story’ event has gained media attention from BBC Online, BBC Business Daily, BBC Worldwide and The Telegraph, coverage that will no doubt help Minds@Work achieve their aim to normalise workplace mental health discussions and “create mentally and emotionally healthy and human workplaces where individuals can flourish and organisations prosper

THE Award Validates the Importance in Addressing Student Mental Health

Claire Metters
December 02 2016

Marketing & Programmes Manager, Connecting with People

The esteemed Times Higher Education Awards are widely accepted to be the oscars of the higher education sector, celebrating innovative and inspirational projects, initiatives or endeavours that demonstrate best practice. Entries are numerous and competition is fierce. Winning an award is an prestigious accolade and this year’s winners were announced during an evening ceremony every bit oscar-inspired, with smart dress code and celebrity host Richard E Grant no doubt inspiring plenty of Withnail and I quotes! Comedy aside, this year’s event has proven to be incredibly significant for mental health awareness and suicide prevention efforts, after the University of Wolverhampton claimed the Outstanding Student Support Award for a pioneering self-harm and suicide prevention programme. 

The university’s ‘3 Minutes to Save a Life’ programme was born from a collaboration with Connecting with People, industry experts providing wellbeing, self-harm and suicide prevention training from a safe-guarding and ‘whole-community’ perspective. It equips all staff members (regardless of their employed role) with the skills, knowledge and confidence to gauge students’ distress and respond appropriately, as well as encouraging them to consider their own mental health needs and previously been considered best practice by student organisations NUS and AMOSHEE.

Nearly 450 staff members from academics to security staff have successfully attended sessions in Emotional Resilience, Suicide and Self-harm Awareness since training dissemination began and as ‘3 Minutes to Save a Life’ is a rolling programme, it offers a sustainable, cost-effective, safe and consistent approach to providing a supportive environment to both students and staff. The judges considered the University of Wolverhampton entry to be a clear winner. The ‘Train the Trainer’ model of delivery was regarded as an effective approach to rolling out training throughout, with the judges stating that “It’s an easy thing to say that all staff should be equipped to support their students in this way, but it’s not an easy thing to implement.

The disparity between the traditional stereotype of students (lazy days in the pub, attending occasional lectures and generally being quite work-shy) and today’s reality has never been wider. Social, economic and political changes have had enormous implications for students in higher education, with a number of professional bodies raising concerns and providing recommendations for increased student mental health support. Universities are wonderful places that nurture talent, aid development and provide opportunities to students that otherwise wouldn't be available, however, honest discussions regarding the numerous concerning statistics of student mental health and the implications for service provision are undoubtedly required. 

Winning the Outstanding Student Support Award with a mental health initiative has real potential to provide further validation of the importance in addressing student mental health, hopefully encouraging other HE providers to follow suit. Congratulations University of Wolverhampton, your pioneering approach may very well help other students UK wide in the future.

 

References available upon request.

Student Mental Health - Time for an Honest Discussion

Claire Metters
June 23 2016

Marketing & Programmes Manager, Connecting with People

The THELMAs (Times Higher Education Leadership and Management Awards) celebrate the successes of those who work ‘behind the scenes’ in higher education institutions. They’re a little like the BAFTAs for universities. They may not quite have reached OSCAR status (The ‘THE Awards’ takes this acclaim), however like the BAFTAs, they’re considered highly reputable and prestigious, with celebrity hosts (this years choice is Jimmy Carr) and outfits every bit as good!

Each year a charity is chosen to partner the THELMA awards, with 2016 shining a huge spotlight upon The Nightline Association, who provide the tools and support enabling student volunteers to run vital listening services within their university throughout the night. There are 39 Nightlines in the UK, all with fully-trained volunteers answering calls, emails, instant messages and texts from fellow students, and all offering a supportive, non-judgmental and anonymous outlet to those who are struggling. Trust fund donations from family members affected by suicide have enabled Nightline to collaborate with Connecting with People, industry experts providing wellbeing, self harm and suicide prevention training from a safeguarding perspective. These generous donations have allowed volunteers to receive an appropriate level of training and now armed with the knowledge, tools and confidence that could very well save a life.

There has never been more disparity between the myth and reality of todays higher education students. Long gone has the existence of the stereotype - spending lazy days in the pub, attending the occasional lecture and generally being quite work-shy (perceptions no doubt reinforced by the likes of TV programmes ‘Fresh Meat’ and ‘Skins’). Todays students are more likely to be experiencing difficulties in financial support, managing full time courses whilst working part time, with increasing awareness of the economic difficulties they face following graduation. That’s not to say that the student experience is all negative. Universities are wonderful places that nurture talent, aid development and provide opportunities that otherwise wouldn't be available. Honest discussions regarding the pressures students face today and the implications upon mental health and service provision are beneficial for all and needn’t be regarded negatively. If anything, they offer universities a unique opportunity to further improve the overall, student experience. Given that mental health social responsibility is increasingly becoming a focus for staff development within the corporate world (The Duke and Duchess of Cambridge and Prince Harry have even launched their own ‘Heads Together’ campaign), universities are best placed to prepare students for the pressures of working life, reinforcing their status as true community leaders.

Historically, little attention has focused upon researching the mental health experience of UK students. However the last ten years has seen a significant increase in statistics and research, with concerns raised regarding high numbers of students choosing not to disclose mental health concerns and assessment methods used by universities in allocating mental health provision funding.

Youthsight’s ‘Psychological Distress in the UK Student Population: Prevalence, Timing and Accessing Support’ Report’ (on behalf of the Nightline Association) revealed that:

  • 75% had personally experienced psychological distress whilst at university, with 1 in 3 students experiencing this at night, when specialist university welfare services are closed.
  • 65% had experienced high levels of stress
  • 43% had experienced anxiety, loneliness and feelings of not being able to cope

Time to Change, an anti-stigma programme run by charities’ Mind and Rethink Mental Illness revealed that:

  • 66% (559) considered themselves as having a mental health disability, however only 0.3 per cent of students declared a mental health disability on their application form
  • 93% (781) believed they have felt unusually stressed out while at university 
  • 76% (593) stated stress from personal problems, in addition to university work as main cause

The NUS survey of 1,093 students in further and universities in 2015 on behalf of the All Party Parliamentary Group (APPG) on students, revealed:

  • 75% of students reported having had a mental health problem over the last year 
  • 1/3 reported experiences of suicidal thoughts, with this figure increasing to 55% to those who did not identify as heterosexual.

A number of reputable student and professional bodies have offered recommendations for institutional change; however student mental health remains a ‘hidden problem’ for many universities, thus making the service offered by Nightline all the more a vital. 

Rising fees, academic pressures and concerns about future employability all impact on student mental wellbeing, with the exam period being particularly stressful for many students. It is important that they can share those feelings and have somebody to talk to, even during the night.” Victoria Sinclair, Charity Manger.

I’m sure most would agree that troubles and concerns can feel ultra magnified at night and it’s good to know that Nightline is there for students who are struggling. Nightline services truly deserve to be the centre of attention at this years THELMAs. Shame there isn’t an award for the most outstanding charity supporting student populations….

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