After I finished binge-watching(not advised by the way) the Netflix series, “13 Reasons Why,”  I exhaled deeply and immediately thought-possibility and prevention.  To state the obvious, this is a work of fiction:a highly dramatized and graphic storyline of teen suicide.   Is it possible for one teenager to experience all that in high school?  To choose suicide when she had loving parents and a couple of caring friends she could have asked for help?  And to blame her choice, as if she had no other options, on the people who hurt her?  I hope not.

In my opinion, the series skillfully pulls together the complexities and challenges of adolescence: family life, achievement, independence and responsibility, mistakes and failure, peer pressure and relationships, bullying, cyber bullying, sexuality, drugs and alcohol, sexual consent, trauma and violence.  OMG!

Most teens navigate this period in life adequately and go on to be productive, mentally well adults.  That’s the norm.  Suicide is not an option for them.

But for a few, often struggling with a mental health condition and unable to cope with adversity, suicide is a possibility.  So we should do all we can to recognize this and prevent it.  As caregivers we must equip teens with appropriate options and reasons to live.

Know The Facts

  • According to the CDC, suicide is the third leading cause of death among persons aged 10-14 and
  • The second leading cause of death among persons aged 15-34
  • In 2015,  among US students in grades 9-12
    • 17.7%  Seriously considered attempting suicide
    • 14.6%  Made a plan about how they would attempt suicide
    • 8.6%  Attempted suicide
  • 4 out of 5 teens who attempt suicide give clear warning signs

Now, sit down and watch this series.  I’ll let you decide if your teen should watch it(probably already have).  It’s rated TV-MA.  And yes, teens are engaging in these activities  and dealing with these hardships whether you know it or not.  Trust me, I’m their doctor!

After watching, you should do these 3 things:

Talk To Your Teen(No!  This does not create the idea!)

Ask questions.  Have you thought about harming yourself?  Do you feel sad, hopeless, or depressed?  Are you experiencing conflict with your friends, bullying or any forms of assault?

Be supportive, nonjudgmental and understanding

Reassure that you can handle whatever is said

Instruct to ask for help

Explain why suicide should not be an option

Have this conversation often

Monitor for Warning Signs(Pay attention and listen!)

Feelings of  hopelessness, helplessness, sadness

Actions that are risky

Changes in Behavior

Threats or thoughts of harming self

Situations of sudden trauma or loss

Get a mental check up

Your teen should have a yearly, well exam(check up) which includes physical, social, and psychological evaluation.

As a pediatrician, I encourage teens to speak freely and honestly about their lives.  I assure them that our conversation is private and won’t be shared with anyone without their permission unless someone is in danger.

I review various risk assessments to identify any red flags in areas of: Home, Education, Eating, Activities, Drugs, Safety, Sex and Suicide(HEEADSSS).

I ask teens if they are feeling sad, anxious, or depressed.  I ask if they have considered suicide.  These questions have unearthed stories of trauma, abuse, depression, substance use, risky sexual behaviors, suicidal thoughts and attempts.  And sometimes, parents are not aware.

Surprisingly, most teens welcome a conversation with their parents and me as the facilitator.  My goal is for parent and teen to leave equipped to handle whatever has come to light. This often includes a plan to receive mental health services in the form of counseling and/or evaluation by a psychiatrist.

So I appreciate “13 Reasons Why” and media like it for placing this serious topic right in our faces.  I’m glad that it is trending with teens and hope the same happens with parents and other caregivers so that we realize the possibility of teen suicide and take steps to prevent it.  Please, spread the word about suicide awareness and verify that even your school is educated in suicide assessment and prevention.  Talk to your teen and if there are any warning signs, take action-don’t leave them alone and call for help!

The information expressed in this article is for educational purposes only and not intended to replace personal, medical attention.  For any concerns, see your child’s medical provider. 

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The National Suicide Prevention Lifeline: 1-800-273-TALK(8255)

Society for the Prevention of Teen Suicide

American Foundation for Suicide Prevention