The streaming service’s show caught viewer attention nationwide after its debut in March. The show follows the story of high school student Hannah Baker, who commits suicide and leaves behind 13 cassette tape recordings for her peers, who she said contributed to her decision to end her life.

Based on a 2007 novel with the same title, the graphic depictions in the 13-episode show – rated TV-MA for mature audiences only – raised concerns among mental health experts, educators, parents and youth. Efforts against the show include that of Oxford High School students in Michigan, who started their “13 reasons why not” project, discussing their uplifting stories about getting help during tough times every day throughout May.

Three episodes feature explicit material, such as rape and suicide, and have “viewer discretion advised” warnings. In a statement earlier this month, Netflix said that they added more warnings before the first episode, following critic response. Original messages before the graphic episodes also reemphasized its content.

After becoming the “most tweeted show of 2017,” according to Variety, “13 Reasons Why” was renewed for a second season, to debut in 2018.

Howard County schools spokesman John White said the school system released a letter to parents and the community on May 1 in response to reports of students discussing the show with their peers and teachers. The letter was written by staff and student services employees, with input from counseling support and school psychology staff and nursing staff.

“While people may have differing opinions on the appropriateness of children and adolescents watching the series, we can use this as an opportunity to reinforce positive mental health practices,” the letter states. “It is critical that we consider safe messaging when we talk to all youth and adolescents about suicide, whether it is about this series or a situation that involves them more closely.”

A memo was also sent to principals throughout the school system, said Frank Eastham, executive director of school improvement and administration. The memo states that “13 Reasons Why” is not approved for viewing in Howard County schools.

Eastham said parents are encouraged to talk with their children about whether they’ve heard of or seen the show as well as provide an outlet for open discussion regarding suicide, rape, bullying or other concerns.

“When anything hits national news, such as this particular Netflix series, we want to make sure principals are equipped with the message and resources they need to speak intelligently about the issue,” Eastham said. The memo and letter included links to more information on mental health and contacts for mental health experts.

Prince George’s County schools followed suit on May 10 when Adrian Talley, executive director for student services, sent a letter to parents, which provided additional resources from the National Association of School Psychologists and the American School Counselor Association. Talley said teachers discuss suicide with eighth-grade students during the health education class and continue discussions in the high school health issues course.

Courses review causes and warning signs of suicide as well as ways to help someone suffering from a mental health illness or contemplating suicide. The material aligns with the Maryland State Health Education Curriculum.

“Our school psychologists, nurses and professional school counselors are trained to recognize risk behaviors in our youth and take seriously all reports of suicide attempts and suicidal thoughts,” Talley said.

Similar courses in Anne Arundel County public schools address suicide, and the school system posts a parents’ guide to school health on its website and includes information on how to talk to kids about suicide.

Critics respond

In Howard County, Kami Wagner, the school system’s instructional facilitator for school counseling, said she hasn’t watched the show, but heard about it from colleagues who are watching the series. The more she heard about its content, she said, the more she wanted to inform everyone about proper responses and available resources for those who need help.

Suicide, rape and bullying are part of the school system’s ninth-grade health curriculum, which White said uses educational resources based on fact rather than fiction.

Parents need to be part of the conversation, Wagner said.

“For young kids to be watching it, not that they shouldn’t watch it, parents need to be involved,” she said. “Our goal is not to have students watching this by themselves. If they are going to make the choice to watch it, we want parents to be actively engaged in the conversation.”

White and Wagner agreed that they’ve heard students talk about how the show is related to their own experience, specifically regarding its depiction of peer conflict in school. Technology and social media are contributing factors to this issue, Wagner said, with the negative effects also depicted in “13 Reasons Why.”

As a parent, White, who’s currently watching the show, said he’s talked about the series with his daughter, a high school senior who also watched the series. Despite some critics’ response saying the show “glorifies suicide,” White said it’s “less of an idea that you’re glorifying and more of the need to communicate and have conversations about the topic.”

“This is a very well done program from the movie and cinematic viewpoint,” White said.

Because certain aspects are relatable, he said, they raise awareness of the negative consequences that may follow and how to help people who need it.

However, Howard County Mental Health Authority Executive Director Madeline Morey said the show might trigger a contagion effect or copycat behavior among vulnerable youth, despite the intention of the show’s creators and producers to shed light on the issues. Individuals involved in the series creation and development discussed their intentions in a 30-minute Netflix documentary, “13 Reasons Why: Beyond the Reasons,” which accompanies the series.

In this case, the contagion effect refers to children who are vulnerable or might already have a preexisting mental health condition, Morey said. If they watch something like “13 Reasons Why,” they may be more likely to repeat certain actions as a solution to a stressful situation.

Morey said she believed those behind the show unintentionally “promoted some of the behaviors” as viable options in their depictions of suicide or bullying.

“From what I could tell, the intent of it was to introduce the subject that may be difficult for people to talk about,” Morey said. “It certainly is hard for parents or anyone to talk about some of these difficult subjects, like violence, self-harm or suicide. I think that what the producers of the show or the show itself may not take into account is that the adolescent brain is really wired for risk taking.”

It’s important to know how to properly broach the subject, she said.

The county’s mental health authority recently completed its needs assessment report and FY18-22 strategic plan, which is based on input from focus groups conducted with 111 participants, including mental health recipients and providers, family members and school personnel.

In the behavioral health system, according to a focus group within the strategic plan, a top area in need of improvement was suicide intervention in children and youth up to age 17, and reducing the stigma among adults, ages 18 to 59. Another behavioral health need identified among children and youth was discussing and understanding self-worth. Focus groups in the same category revealed parental involvement and family support as strengths, with improvements suggested in school-based mental health in the behavioral health system.

“It’s important to seek advice from a qualified professional,” Morey said. “Even as a parent, you may not be equipped to deal with some of these sensitive subjects. If a child is expressing, or you have concerns about, any behaviors, go to a professional and make sure you have attempted to address what you’re seeing or witnessing.”

White said counseling is available in all Howard schools every day, in addition to a crisis teams, if needed.

“It’s difficult to talk about this happening to any child, especially for a parent thinking about it happening to their child,” White said. “This isn’t the first time any school has had to talk about suicide. It has just been elevated by this production. We have to be aware that if children want to watch it, they’re going to find a way these days. We have to be prepared on how to engage them on their level.”

http://www.baltimoresun.com/news/maryland/howard/elkridge/ph-ho-cf-thirteen-reasons-why-0518-20170517-story.html

For more information or to find help, contact Grassroots Crisis Intervention Center at 410-531-6677; Howard County Mental Health Authority at 410-313-6300; or the National Suicide Prevention Hotline at 1-800-273-TALK (8255).