Tag: Media

New study: 13 Reasons Why did not cause an increase in suicides, and may have done some good

I’ve written repeatedly about Netflix’s 13 Reasons Why, and usually in a pretty damning light. Like others (who are far more informed and educated than I am), I’ve expressed my real concern that the show has unintentionally glamorized suicide, and there has been evidence to suggest that it actually led to an increase in suicides.

However, a new study shows that this may not be the case, and, in fact, that 13 Reasons Why may have done some good.

First, a review. 13 Reasons Why tells the story of Hannah Baker, a teenage girl who dies by suicide and leaves behind tapes for people to listen to, explaining why she died and their role in her demise. The show was criticized by many for glamorizing suicide and presenting it as a possible choice, and Netflix eventually removed the three-minute, highly graphic scene in which Hannah dies.

Of course, that removal came after being viewed millions of times, and at least one report directly tied the show to a rise in suicides.

However, a new study came to the opposite conclusion:

But a recent reanalysis of the data by Dan Romer, research director of the Annenberg Public Policy Center at the University of Pennsylvania, found no evidence of an increase in suicides for boys, and (like the original study) an insignificant increase for girls. Romer adjusted the data to factor in trends like an overall increase in adolescent suicides since 2007.

That’s important. But it’s not as important as this finding:

But when Romer conducted a study on 13 Reasons Why’s effects on self-harm, published last April, he found that teens who watched the entire second season of the show were less likely to purposely injure themselves or seriously consider suicide, even when compared with those who did not watch the show. He said that this could be because of the Papageno effect, which occurs when stories that portray people overcoming their suicidal crisis end up reducing suicide rates. The effect is named for a character in Mozart’s opera The Magic Flute who considered suicide until his friends showed him a different way to solve his problems.

The second season of 13 Reasons Why features a character who is depressed and considers suicide – but survives. This is important, and it feeds in with a larger theme in the mental health universe: We have to share stories of hope, of survival, and of seeking help successfully.

Part of the reason that so many (myself included) thought 13 Reasons Why was so damning, as portrayed, is because it features a character dying by suicide in a graphic manner. This can create copycat scenarios. However, the good news is that the Papageno Effect is real and has been repeatedly backed up by science. This is great news: If you can show someone finding hope, you can inspire others to do the same.

I appreciated this alternative perspective of 13 Reasons Why, and I appreciated the hope that it could potentially inspire in others. It also reinvigorates what I have said for ages: Share your story. It’s why I’m so passionate about sharing mine.

You can save a life.

Netflix removes controversial suicide scene from 13 Reasons Why

13 Reasons Why is a Netflix series based on the popular book by Jay Asher. The book deals with the aftermath of the suicide of Hannah Baker, who then sends tapes to people involved in her life, detailing the reasons behind her suicide.

The show was then turned into a hit Netflix series, which generated a ton of controversy for a variety of reasons, chief among them being the graphic depiction of Baker’s suicide, which features Baker, in the bathtub, slitting her wrists, crying in pain and ultimately bleeding to death.

I’d written about the show before, and mainly in terrible terms: It’s premier had been tied to a rise in suicide among 10-17 year olds, and the graphic depictions of Baker’s suicide seemed to violate every best practice of reporting on suicide.

Netflix – in response to the controversy – has changed the season finale of Season One, which featured this scene: It has now been been completely removed. In a statement, Netflix said:

“We’ve heard from many young people that 13 Reasons Why encouraged them to start conversations about difficult issues like depression and suicide and get help — often for the first time. As we prepare to launch season three later this summer, we’ve been mindful about the ongoing debate around the show. So on the advice of medical experts, including Dr. Christine Moutier, chief medical officer at the American Foundation for Suicide Prevention, we’ve decided with creator Brian Yorkey and the producers to edit the scene in which Hannah takes her own life from season one.”

As the Hollywood Reporter noted, a variety of anti-suicide groups praised the removal in a joint statement.

The damn shot should never have aired. In prior statements, show creator Brian Yorkey had said that they didn’t want to make suicide look peaceful and thus glamorize it. I get that. And – if you assume that they were operating with the best of intentions – I get that they were trying to make it seem realistic and less abstract.

But, as Vox notes, that’s exactly the problem:

The theory is that for people who struggle with suicidal ideation, anything that can make suicide feel more familiar to them and cause them to keep thinking about it can be dangerous. That’s part of what leads to suicide contagion, the phenomenon in which media coverage of a death by suicide can lead more people to die by suicide.

As I argued in my entry earlier in the week, we have to be very, very careful with how we discuss suicide, lest we inadvertently plant the idea in someone’s head that suicide is somehow acceptable or “freeing.” While the type of discussion which occurred here is different than the blog entry I was writing about, the concept is the same: Be careful in how you discuss suicide, particularly given the way it could impact the most vulnerable of people.

I’m glad Netflix did this. But the show has generated controversy because their is evidence to suggest that it is correlated with more people dying by suicide. That’s a major problem, and they need to do better.

Suicide is never “gotta set myself free” – a letter to Epic Rap Battles and a discussion on how we talk about suicide

Sunday entry instead of a Monday one, but it’s an important and timely one.

If you are a nerd like me, and you’ve spent any time on YouTube, chances are you have come across Epic Rap Battles of History. They are a YouTube channel which hosts rap battles between historical or celebrity figures. They lampoon everyone, and they are so, so clever and funny. I’ve always loved them and get excited when they publish a new video.

Early this morning, they premiered their latest battle between George Carlin and Richard Pryor. The battle, as usual, was hilarious. This one featured guest appearances be Joan Rivers and Robin Williams. Williams appears last, and it’s his last line which causes the problem:

Again, that last verse:

“I love the prince
but you’ll never have a friend like me
Thanks folks that’s my time
Gotta set myself free”

And Williams disappears into the top of the screen.

That last line is clearly a reference to William’s suicide in August 2014. And that line is a huge problem. Suicide should never, ever be discussed as a freeing option, one which somehow frees people from the bonds of pain and life. Suicide is not an option. Discussing it as a positive thing frames it in a positive way, and that encourages others to look at suicide as if it should be considered.

Some of you may remember that this isn’t the first time that William’s suicide was displayed this exact way, using the same language (which is a reference to both the suicide itself and Genie’s desire to be free in Aladdin). After William’s suicide, The Academy of Motion Picture Arts and Sciences put out this tweet:

The tweet was criticized by suicide prevention activists. It made suicide appear celebratory, a victory over depression and pain, and a viable option for anyone who hurts. This can never, ever be the case.

From the article:

  • Christine Moutier, chief medical officer at the American Foundation for Suicide Prevention: “If it doesn’t cross the line, it comes very, very close to it. Suicide should never be presented as an option. That’s a formula for potential contagion.”
  • Ged Flynn, chief executive of the charity Papyrus: I am particularly concerned that use of the ‘Genie, you’re free’ tweet could be seen as validation for vulnerable young people that suicide is an option.”
  • Jane Powell, director of the support group Calm, “We all want Robin to be in a happier place but it’s not a good message for people feeling suicidal, because we want them to stay with us and not go find some starry night escape with genies,” she said.

This is needed largely because suicide contagions are real: After William’s suicide, suicides increased by 10%. And, as the study I linked to notes, media coverage of suicide can be critical to how the coverage of suicide influences suicidiality in others. There are media recommendations for how to cover suicide (I actually tweeted it yesterday, before this video, in reference to an ongoing situation in my home region which thankfully ended well).

One of the key recommendations is not to glamorize suicide or present it as an option. The media has failed that before: Epic Rap Battles failed it here. Do I think they did this on purpose? No, absolutely not. I think it’s an honest mistake. But I hope it’s one they correct.

Again, here are the facts:

  • In 2017, over 47,000 Americans took their own life. These are the highest rates of suicide since World War 2.
  • Suicide is the 10th leading cause of death in the United States, and the 2nd leading cause of death for 10-24 year-olds.
  • Suicide rates have increased 33% since 1999.

We have an epidemic, or, in the words of Congersswoman Susan Wild (D-PA), a national emergency. National emergencies require being addressed on all fronts. One of those is cultural and communication. No one with a platform over over fourteen million subscribers should make such a casual reference to suicide and describe it as “gotta set myself free.” I’m hoping this was unintentional. And I hope that ERB will consider changing the video.

And to everyone else: Please watch how you discuss suicide. Please take it seriously. And please use person-first language which ensures that we let people know they are loved and cared for, and that we never, ever, ever want them to “set themselves free.”

The language of suicide, and why it matters

As you may have noticed, whenever I discuss suicide on this blog, I’m always very careful on how I phrase it, although researching this blog entry has made me realize that I’ve been messing this up to. There are words and phrases you should and should not use when describing suicide – here’s a quick overview about some best practices.

Why “committed suicide” is bad

This one is more obvious and stigma oriented. Simply put, “committed” is used to describe a crime. Someone committed a murder. They committed a robbery.

Committed, in this context, is usually associated with a moral judgement, and that’s not a way that any of us want to describe suicide. Suicide and mental illness shouldn’t be associated with a moral failing. Doing so can make people who suffer feel weak or ashamed, and that can serve to increase the stigma that surrounds both mental illness. The language we use should encourage others to seek help, not drive them into a closet of fear and shame.

Why “completed suicide” is also bad

This is the phrase I’d always used – I viewed it as preferable – but this is a really good point:

Think of the sense of accomplishment you feel when you complete a big project. Then think of the disappointment you feel when you don’t.

Completion is good, and suicide isn’t.

To complete something conveys success; to leave something incomplete conveys failure.

Indeed, we do associate completion with success, and no one’s suicide should be viewed as a success. So, there must be something else.

The alternatives

I think the AP is on track when it comes to these alternatives. The phrases used here are preferable, in that they are accurate and avoid the moral connotations that comes with “completed” and “committed.”

Language matters. Words matter. We know that the way we describe an action can unintentionally pass judgement over the action and can increase or decrease the stigma that comes with it. All of us have an obligation to be careful in the way we talk, and I’m going to be better at this from now on.

And one more thing: In our society, there’s been a backlash against being “politically correct” when it comes to how we describe things. My experience has been that this backlash is more orientated around being a decent and non-racist person, but that’s besides the point.

The way we discuss suicide has nothing to do with political correctness. It has everything to do with creating an environment that makes people feel safe, that supports (rather than harms) their mental health, and that can increase the odds of someone seeking help instead of ending their life.

Any thoughts you want to add? Any other language recommendations? I’d love to hear them – please let us know your thoughts in the comments!

4 Video Games that portray mental illness

As I’ve discussed before, I’m a video game nerd.  Hardcore.  And, as someone who is a bit obsessed with eradicating stigma that is related to mental illness, I remain fascinated by public portrayal of depression, anxiety and addiction.

Video games, I believe, are art.  I define art as the ability to make a profound emotional impact on a person.  As such, the portrayal of mental illness in video games – and indeed, humanity – continue to fascinate me, and make me think.  The good news is this: Video games can often describe the human condition in a more thoughtful and complete than many movies and television shows.  That line of thinking inspired this blog entry: How does video games portray mental illness?  How accurate is that portrayal?

Oh, and spoilers below.

Life is Strange: Before the Storm

LifeIsStrange

This one is the prequel to Life is Strange, one of my favorite games, made by Square Enix.  It is a walking simulator  in which you follow Chloe, the main character, as she battles her way through high school and falls in love with Rachel, the previously unseen character who plays a pivotal role in Life is Strange.  

I firmly believe that Chloe is suffering through some major depression symptoms.  Her father has died a few years before and her mother is dating a man who she openly despises and fights with; both of these experiences can lead to depression.  She drinks and does drugs often enough to have a regular dealer to whom she owes money. Her best friend is gone, and not communicating with her at all.  She comes across as angsty, but it’s more than that.  Her quotes, thoughts and actions are often self-destructive and reflect a young woman in pain.

To me, this is more than just a teen being a teen.  She’s miserable, she fights with her mom and her mom’s boyfriend, her family has financial issues, and she is clearly discovering her sexuality.  These are all symptoms that lead my to believe that Chloe is suffering from depression.

What makes the game more relatable is the game’s treatment of Chloe.  In the start of episode one, she is petulant and miserable – not the greatest portrayal.  However, as the game evolves, she becomes a more sympathetic character, and a multi-layered one at that.  You see her hopes, dreams and ability to connect with others.  And, by hearing her thoughts, you can hear all of the truly heartbreaking things she is thinking and saying to herself, about herself.

You intrinsically want Chloe to be better, to have healthier thought patterns and make better decisions.  And, in that sense, I hope that the game can give people a better idea of what it is like to live a life under duress, as Chloe clearly does.

A Night In The Woods

NightInTheWoods

Disclosure: I’m only part way through this one

A Night In The Woods is a platformer. You play as Mae, who has just dropped out of college and returned home.  I’m not very far along this one, but where I’ve gotten to, strange things are happening in her hometown after she reunites with her friends.

The college drop-out part is interesting.  Again, I’m not far in, but thus far, Mae has refused to talk about what happened to her in college, aside from saying that college “didn’t work out” or some variation of that phrase.  She reconnects with old friends, who all have their own battles:

Mae, the protagonist, experiences depression and anxiety, which sometimes create dissociative states during which she becomes completely disconnected from reality. It is implied, though never directly stated, that Gregg has bipolar disorder. His poor impulse control gets him into bad situations, and at times these factors impact his feelings of self worth. Bea and Angus both struggle with the consequences of abusive pasts and their relationships with their families.

As has been noted by Kotaku, the game’s creator’s have both discussed their own battles with mental illness:

The game’s creators have spoken candidly in the past about their own mental health struggles. Scott Benson, who animated and illustrated the game, has type two bipolar disorder. Programmer Alec Holowka runs the Everybody’s Fucked Up podcast, which aims to break through stigma around mental illnesses by interviewing people who have experienced them. (Bethany Hockenberry, the writer of the game, was unable to meet with Kotaku for an interview.)

This game is different than the standard platformer in a few ways, but chief among them is that it allows users to make dialogue choices that affect the game.  This puts you in the driver seat and gives you the perspective of Mae, thus ensuring that you get a first-hand look at what it is like to live a life with depression.

As I said, I’m only a little way into this one, but I’m very curious to learn more.

Please Knock On My Door

Disclosure: I haven’t played this one.

PleaseKnock

This is the portion of the blog entry where the games start getting a touch more obvious.  In Please Knock On My Door:

Please Knock on My Door is a simple game about a person living with depression. The protagonist, a blocky, inky-black character, lives a fairly standard life: Wake up, go to work, come home, repeat. The days are punctuated with mundane tasks like making a sandwich or showering, but each one carries extra weight as it drains — or bolsters — the main character’s mental fortitude.

The game’s art style is simple and stripped down, forcing players to experience the emotions of the game, not be overwhelmed by its graphics, and the focus on simple decisions and how draining they can be gives players the experience of depression, and the added knowledge that each decision made can weigh on a normal human being.  In that sense, it seems to concentrate on giving players the sense of just what a burden living with depression can be.

Depression Quest

Depression Quest

Disclosure: I haven’t played this one either.

Gee, I wonder what this game is about?  From the website:

Depression Quest is an interactive fiction game where you play as someone living with depression. You are given a series of everyday life events and have to attempt to manage your illness, relationships, job, and possible treatment. This game aims to show other sufferers of depression that they are not alone in their feelings, and to illustrate to people who may not understand the illness the depths of what it can do to people.

The game was designed by Zoe Quinn, who faced a slew of death threats for her efforts.  Charming.

As for the game itself: You live the life of someone with depression, making what are relatively mundane decisions about living life.  That being said, in the game, happier decisions are often grayed out, forcing the player to experience life as through someone with depression.  The game is told through a series of text decisions.  In that sense, again, it tries to get the user to experience depression from a first-person perspective.

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These are just four, and there are certainly many more.  Any other games you’d like to share?  Let us know in the comments below!