Hannah Baker

Mark Sinyor, Tribune News Service

Two years after the series “13 Reasons Why” debuted, Netflix has finally edited out a graphic and highly controversial suicide scene. The network deserves some credit for deleting the on-camera suicide of a teenage girl, Hannah Baker, who remains a central character of the show even in death. But her suicide never should have been shown in the first place.

US and international guidelines for safe and responsible portrayals of suicide in the media recommend that graphic depictions of suicide be avoided.

The first season of “13 Reasons” revolves around 13 audiotapes left behind by the protagonist that detail events leading to her death. Soon after it was released in 2017, mental health experts, suicide-prevention organisations and alarmed educators quickly complained that the show would lead more teens to take their own lives. They were right to worry.

A study my colleagues and I recently published in the journal JAMA Psychiatry showed that suicides increased in the US among those from age 10 to 19 in the three months following the show’s release, when interest in “13 Reasons” was at its highest. The sudden increase occurred only among youths, and it was particularly pronounced among young women. (Hannah is portrayed by Katherine Langford, a young actress with whom viewers are meant to identify).

Of course, we can’t prove the series is responsible for the 94 additional suicides that occurred from April to June 2017. But we weren’t the only researchers to make this connection. Another study, published in April in an adolescent psychiatry journal, found that suicide rates spiked among boys between ages 10 and 17 in the month after the show was first released.

The deleted suicide scene represents less than three minutes of the 12-hour run time of the show’s first season. Those hours are essentially a lengthy tutorial for young viewers on how suicide could be a predictable or even expected consequence of common stressful life events. The show presents suicide as a way to get revenge and sends a message that seeking help is pointless.

Removing one shocking scene won’t change that message. The idea that suicide is preventable and mainly arises from treatable mental illness is also conspicuously absent. You shouldn’t need to be a medical doctor or a psychologist to see the problem here: There is no rational reason to imagine that editing out one recklessly inappropriate scene will somehow mitigate the potential for youths to copy the behavior they see in “13 Reasons.”

In an announcement on Twitter, Netflix said it deleted the scene “on the advice of medical experts,” including Dr. Christine Moutier, the chief medical officer of the American Foundation for Suicide Prevention. In a separate statement, show creator Brian Yorkey said the decision to portray suicide “in such graphic detail” was meant to show the horror of the act and to “make sure no one would ever wish to emulate it.”

It’s likely no coincidence that both statements mention that the third season of the show will launch soon, presumably driving renewed interest in the series. And more viewers means more opportunities for harm. Whether it would have been better to bury the series with the scene intact instead of having more young people see an ever-so-slightly improved version of “13 Reasons” is an open question. Regardless, society should demand that entertainment providers like Netflix do the most they can to ensure their content will do no harm. Instead, after what was reportedly months of internal discussion, three minutes were cut from the show.

That is not enough. Even if it happens off-screen, Hannah’s suicide is presented as a natural and unavoidable result of her situation. It drives the plot of the first two seasons, and the continued airing of the series poses ongoing, serious danger to at-risk youths. Our research findings about “13 Reasons” highlight the need for better collaboration between mental health professionals and those who present fictional portrayals of suicide on TV or in any other medium. Netflix and other content providers have the potential to do good in the world when handling sensitive mental health issues — if they adhere to safe and responsible practices.  Mark Sinyor is a psychiatrist at Sunnybrook Health Sciences Centre in Toronto.