Dear Netflix,

13 Reasons Why is a captivating series and it is brave of the producers and writers to take on multiple challenging topics. The movie is based on the fictional portrayal of a teenage girl who commits suicide after being harassed and sexually assaulted. As physical and mental healthcare providers who work with adolescents, we acknowledge and value the ability of media portrayals like 13 Reasons Why to bring numbers and statistics to life; media can engage viewers to process difficult and controversial subjects by experiencing them alongside a character they relate to and with whose struggles they can empathize. By raising difficult topics, 13 Reasons Why may help adolescents talk more openly about suicide and sexual assault, an important outcome. However we feel strongly that the show may also increase risks to vulnerable youth, which need to be addressed.

There is evidence from communities that adolescents who know of, or see details of, a suicide may be motivated to be a “copycat” and make a suicide attempt themselves. From watching the show, a teen with suicidal thoughts may have unrealistic expectations that they can seek revenge on others through suicide. An adolescent who suffered sexual assault may be re-traumatized by watching the graphic scene in 13 Reasons Why. Lastly, an adolescent may assume that if they talk to a counselor about suicidal thoughts or sexual assault, they will not be able to get the help they need. In fact, many school professionals receive specific training in addressing these issues and if there is a school official who does not respond appropriately, a teen could reach out to a local or national crisis hotline number where a professional is always available.

The follow-up episode, 13 Reasons Why: Beyond the Reasons is excellent at addressing some of the concerns we raise above. In order to ensure its important content is seen by viewers, we recommend that that it be promoted and even become Episode 14, instead of separating it from the series. Additionally, although several episodes advise viewer discretion, we highly recommend that at the beginning and end of each show, crisis hotline numbers be listed such as those found at: http://13reasonswhy.info/. These resources should not be hard for viewers to find. We are requesting that these additional changes be made to help vulnerable adolescents cope with the distress that may arise due to the show’s content.

The Society for Adolescent Health and Medicine is a multidisciplinary international organization committed to improving the physical and psychosocial health and well-being of all adolescents through advocacy, clinical care, health promotion, health service delivery, professional development and research. Adolescent and young adults who may be affected by the show and need to locate an adolescent health provider for additional support and resources can find a provider directory on our website (http://www.adolescenthealth.org/AboutSAHM/Directory.aspx).


Tamera Coyne-Beasley, MD, MPH, FAAP, FSAHM

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