Destigmatizing suicide to save lives

Credit: Alison Yin/EdSource

For the first time in my career as a child and adolescent psychiatrist, I binge-watched a television show for work.

The Netflix series “13 Reasons Why” tells the story of a high school student who commits suicide, and the 13 tapes she leaves behind to explain her motivation. Since its release in March, the show has received a wide range of kudos and criticisms—kudos for raising awareness about teen suicide and criticisms, rightly, for glamorizing suicide. Glorifying what is essentially a crisis is regrettable because of the possibility of copycat suicides, but it’s also inevitable, given that it is one way for the series to engage viewers into discussing the series and spreading the word about it.

As a psychiatrist who works with teens I think the series is making a positive contribution toward destigmatizing a topic over which we can no longer afford to keep silent.

In my practice, I often assess depressed youth, many of whom are suicidal. Some of these young people see me following hospitalization from a suicide attempt, while others have been pondering suicide for months, even years.  It’s not a surprise, then, that parents and patients ask for my thoughts on the show.

My answer is a simple one. Thousands, if not millions, of children and young adults suffer every day with suicidal thoughts.  In the previous 12 months, 17 percent of students – two girls for every boy – seriously considered suicide. If this television series brings these truths out of the shadows and opens lines of honest communication between young people and those who care about them, I’m all for it.

Children and their parents often have significantly different reactions to suicide. When I ask teens about their suicidal thoughts, I often get a look of guilty relief. They have been holding in and living with these thoughts for so long that they are visibly surprised and relieved to learn that it is OK to talk about them.

Parents have a different reaction. A question of whether their child has been suicidal can lead to tears, anger, and defensiveness. I have even had parents shut down the conversation because the idea of losing their child is unbearable to them. Bringing the topic to light, even within a context of avoiding suicide, makes people uncomfortable.

Both responses are natural, human reactions to a painful and stigmatized subject. But as a society, we ought to seize the opportunity “13 Reasons Why” provides to talk about suicide. We can start by admitting it: suicide happens. And we can acknowledge, too, that it happens a lot. According to the American Academy of Pediatrics, “thousands of teens commit suicide each year in the United States. Suicide is the third leading cause of death for 15-to-24-year-olds.”

We cannot bear to not talk about suicide. As a society, we need to be more comfortable discussing suicide with children. Parents, children, and mental health providers should freely ask questions and discuss the topic with neither judgment nor shame. Perhaps even more important is adults’ ability to hear teens’ responses about where suicidal thoughts originate, and what drives them. Mental health providers can assist with the difficult task of assessing for safety, risk factors, protective factors, and developing a safety plan – all while ensuring confidentiality.

Suicide impacts each of us. The sooner we work together to erase its stigma, the sooner we can save young lives.

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Dr. Takesha Cooper is an assistant clinical professor of psychiatry at the UC Riverside School of Medicine and a child and adolescent psychiatrist at the Riverside County Department of Mental Health’s Lake Elsinore Family Mental Health Services.

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