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Starting the Conversation is Just the Beginning

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This summer, people have been discussing mental health with each other thanks to several shows, movies, and even a musical, that follow characters’ struggles with mental health disorders. While most mental health professionals are glad these shows are prompting conversations, many worry that the messages audiences take away will be more hurtful than helpful.

The 13-episode show “13 Reasons Why,” about a high school student who leaves cassette tapes for her peers after she dies by suicide, has been lauded by some for its realistic portrayal of teen issues, including sexual assault and bullying, and for bringing up the conversation of youth suicide.

The show has also been criticized, though, for its graphic and drawn-out depictions of suicide and rape, for suggesting a teen’s suicide can be blamed on her classmates, and for not discussing depression. Perhaps most troubling, in the series, the teen who dies by suicide reaches out to an adult for help and is brushed off, teaching young viewers the opposite of what prevention experts want them to know – that if they have or their friends have suicidal thoughts, they should seek help immediately. Screening for Mental Health’s Signs of Suicide (SOS) Prevention Programs teach the acronym ACT – Acknowledge that you see the warning signs, show that you Care, and Tell a trusted adult.

Many in the mental health community worried that the detailed depiction of suicide in “13 Reasons Why” could influence those who may be vulnerable to suicidal ideation. A recent study published in JAMA Internal Medicine shows that in the 19 days after the show premiered on Netflix, there were roughly one million more internet searches regarding suicide.

The recent Broadway hit “Dear Evan Hansen” also shows the aftermath of a teen’s suicide, through the lens of the student’s classmate who had also had depression and suicidal thoughts. The main character Evan Hansen fabricates evidence that he had a friendship with Connor, another teen from his school who died by suicide, gaining attention from Connor’s grieving family and sister, whom Evan has feelings for.

Many fans have written about how the production portrays depression and anxiety in teens in an emotionally authentic way and gives examples of other people understanding and being willing to help those struggling, even after they’ve made poor decisions. It sends the message that even when you mess up, people can forgive you, and things will get better. Unlike “13 Reasons Why,” when Evan reaches out for help, there are people who are supportive and understanding to help him.

The play didn’t escape criticism, though. Some viewers were concerned that the anxiety and depression are more plot devices to blame the character’s bad actions on, and that certain messages – like that Evan can suddenly stop taking his prescribed medication for anxiety and start to feel better – might be harmful for viewers.

Similarly, Netflix’s movie “To the Bone” has received both praise and criticism for its portrayal of eating disorders. Lily Collins’ character, Ellen, who later decides to go by Eli, has gone through a number of treatments to help her recover from anorexia, but none have worked. Her stepmother signs her into an in-patient facility that is meant to be more cutting edge, in hopes this will finally help her recover. The movie has been praised for its realistic approach to the disease, but others worry that many scenes could be triggering.

“To the Bone” shows the seriousness of eating disorders, how important it is for someone to want to get better before they can start to recover, and how difficult it can be to get to that place. But for a movie about treatment and recovery, very little screen time focuses on what the therapy looks like, or addresses the psychology behind the disorder.

In contrast, the new movie “Feed,” written by “Pretty Little Liars” star Troian Bellisario, depicts anorexia by focusing more on the main character Olivia’s need to control her situation after a severe trauma. This shows a side of anorexia that isn’t often shown in the media – that it’s about much more than the desire to be thinner. The tone of the movie is more of a psychological thriller in order to get the audience to feel how scary it can be to live with this disorder.

Depicting mental health disorders in a way that deals with the psychology of the illness, rather than creating a how-to guide for engaging in those behaviors, is a more responsible way of starting the conversation about mental illness. It’s important to show the experiences of people dealing with mental illness realistically without encouraging viewers to copy these behaviors.

When deciding whether or not a show or movie is going to be helpful or appropriate for you, or your children, it’s important to take into consideration what you might gain from watching it compared to what you risk . If you do decide to let your kids watch these shows or movies, it's a good idea to watch it with them and have a conversation about what you saw. If watching these shows has you feeling not like yourself, take an anonymous online screening to give you some insight on whether these topics may be triggering for you.


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