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TV's obsession with suicide can do real harm

Simply prompting conversations about suicide is no longer enough to forgive problematic portrayals that can do real harm to those at risk.

Suicide has never been a truly taboo subject on television. The first episode of “ER,” back in 1994, ended with nurse Hathaway being brought in on a gurney after a suicide attempt; and Tony’s son AJ tried to drown himself in the family’s pool in a 2007 episode of “The Sopranos.”

But television is currently experiencing a cluster of shows that don’t simply deal with the subject but delve deeper into it. There’s “The Leftovers,” in which the protagonist has tried to kill himself twice and his ex-wife considered intentionally drowning herself while scuba diving. Comedian Chris Gethard’s HBO comedy special “Career Suicide” is nearly entirely devoted to discussing, in a way that both busts your gut and tears at your heart, his lifelong struggle with suicidal thoughts. In perhaps the most relevant example, Netflix’s “13 Reasons Why” depicted its narrator’s suicide in graphic detail.

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These shows are sparking conversations, not just in the mental health community but also in schools and within families, about suicide. That’s particularly true of “13 Reasons Why,” with its teenage target audience. But simply prompting conversations about suicide is no longer enough to forgive problematic portrayals that can do real harm to those at risk.

“We are talking about it more often. But we certainly aren’t talking about it better,” said Dese’Rae L. Stage, a suicide attempt survivor, who created the project Live Through This, which tells the stories of other survivors in their own words. “I sometimes think our obsession with suicide, not just in our art but in our lives, comes from our fear of death.”

The surge of shows that explore suicide in depth comes as more Americans are affected, in some way, by suicide. Just under 43,000 people in the U.S. took their own lives in 2014, and more than 1 million are estimated to have tried, according to the most recent data from the Centers for Disease Control and Prevention. That’s an increase of 24 percent since America’s suicide rate started steadily climbing in 1999, reversing the previous decades’ downward trend.

Despite the increase, however, the subject of suicide inspires such deep discomfort in the general populace that survivors or those who’ve lost loved ones are quickly taught to keep their thoughts to themselves.

Stage, too, has noticed an uptick in suicidal themes in popular culture. “I would be willing to say we’re obsessed with suicide,” she said, citing not just scripted TV series and movies but books and musicals, like Dear Evan Hansen, which tells the story of a suicidal teen boy who becomes enmeshed in another family’s tragedy when their son takes his own life.

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While new players show up each year, not all of them have the intended positive effect on the mental health community. Though their popularity can lead to increased awareness and important conversations about suicide prevention, the shows can also reinforce problematic stereotypes about victims and the people around them. In fact, Stage can hardly name a TV show that hasn’t botched suicide portrayal in some way.

“We are talking about it more often. But we certainly aren’t talking about it better.”

In “13 Reasons Why,” for example, a teen girl turns her suicide into a posthumous scavenger hunt to place blame on her classmates, whose crimes range from being a bad friend to rape. “She essentially blackmails people into listening to her suicide note,” Stage said with some disbelief. “Yeah, I guess we’re assholes when we’re suicidal, but you can’t reduce everything to those last moments of life.”

Marie Dyak, president and CEO of the Entertainment Industry Council, as well as other critics, took issue not only with such a graphic and prescriptive portrayal of suicide in “13 Reasons Why” but also that the show reinforced the idea — not uncommon among suicidal teens — of using suicide as revenge.

“There’s a seductive kind of thinking there, an inspiration, almost, that seems to be the takeaway,” Dyak “And that’s really disturbing to me.” Her organization works with mental health groups like the National Action Alliance for Suicide Prevention to educate the entertainment industry on helpful, instead of harmful, depictions of suicide.

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For Lisa Horowitz, a staff scientist and pediatric psychologist at the National Institute of Mental Health, the show did further damage by portraying all the adults as useless. “Every adult failed Hannah [the protagonist] in the show,” she said. “That just fosters this sense of isolation along that typical teenage perspective that adults are useless.”

And so what’s to be done, particularly in situations when a show has already aired the objectionable storyline? Industry experts widely point to education as the first step in creating an authentic depiction of suicide.

“I don’t doubt the writer’s intentions — they were clearly good and pure. But you have to educate yourself,” Stage said of “13 Reasons Why.” “You have to create a character who’s three-dimensional if you’re going to portray this kind of trauma.”

While the instinct can be to criticize problematic suicidal characters, Dyak focuses on positive reinforcement. Crucial to this strategy is steering showrunners into thinking of their shows as dialogues, rather than monologues. Constructing a world and characters that go beyond just their final act is crucial to sending the audience a message with a positive effect.

“It’s not just about what the speaker is saying, but what the listener is hearing,” Dyak added. “Suicide portrayals are similar to mental health conditions. We don’t want to say a person is bipolar — that’s just one piece of it. They are so much more than a diagnosis. They’re a full person.”

To start, a set of standardized guidelines, like the ones journalists are encouraged to abide by when covering suicide for the news, might help the creative industry portray suicidal characters more responsibly.

There’s hope now among suicide attempt survivors and mental health advocates that better depictions will make it easier to discuss their pain with family and friends and even health care providers. The shows are showing, rather than telling; characters in many of these series aren’t just giving stereotypical answers to the question “Why did you do it?” Instead, the viewer follows them down these dark paths.

That leads to richer storytelling but also greater empathy from the audience. A viewer might not have felt the urge to end their life, but when they see the mental anguish of a veteran, or the slow unraveling of a man suffering from hallucinations, they may just be better equipped to help someone in need.

Suicide is preventable, and if you are feeling suicidal, you must get help. Please reach out to the National Suicide Prevention Lifeline at 800-273-8255, Trans Lifeline at 877-565-8860 (U.S.) or 877-330-6366 (Canada), or The Trevor Project at 866-488-7386. You can also reach Crisis Text Line by texting HOME to 741741. If you live outside the U.S., you can click here to find crisis centers around the world.