Article

The Representation of Suicide in Television Drama

Author
  • Andrew Pacitti (Dublin City University)

Abstract

This article critiques contemporary television drama as a platform for encouraging and expanding discussion around mental health issues, specifically suicide. Drawing upon the tensions between ‘media contagion’ and the ‘Papageno’ effect (two contrasting perspectives on the influence mass media may exert on its audiences), the article delivers a comparative analysis of the representation of suicide in two contemporary US series - 13 Reasons Why and The Walking Dead. The original version of this article was submitted as an essay for the CM3001 ‘Television Drama’ module (2020-21).

Keywords: Media representation, mental health, contagion effect, Papageno effect, television drama

Published on
05 Apr 2022
Peer Reviewed

According to the World Health Organisation, it has been estimated that around 800,000 people die by suicide across the world each year. It has been debated among critics that its portrayal in media can lead to imitation by some, influencing these numbers (Posselt, McIntyre and Procter, 2020). The following passages will detail how suicide is represented in chosen television dramas and whether it opens dialogue or causes harm by using this sensitive topic as nothing more than mere entertainment. The series central to this discussion will be 13 Reasons Why with AMCs The Walking Dead used to compare. Particular reference will be made to how both series portrayed the process of taking one's life and the reaction they received from critics.

Representation in television needs to be viewed precisely like that, a representation. The audience's view of a drama is only a version of reality that a showrunner wants the viewer to see. As Stewart and Kowaltzke (2008, pp. 35-36) say, "a media representation is a depiction, a likeness or a constructed image... however, depending on the audience, different interpretations are to some extent possible". This comment is relevant when the sensitive issue that is suicide is taken and broadcast to the world; studios need to be aware of the social impact on the audience watching the show. Researchers have explored the effects of the portrayal of issues of a sensitive nature. One of these is the "contagion effect", which considers that the portrayal of an issue such as suicide can lead to imitation. The other is the "Papageno effect", which sees the depiction of such an issue as raising awareness. Organisations such as the World Health Organisation have made recommendations to the media for best practice on reporting sensitive topics, including suicide. One recommendation stated was to avoid any "reference to the method and or means" (World Health Organisation, 2017, cited in Posselt, McIntyre and Procter, 2020, p.29). This recommendation and its disregard will be discussed later concerning 13 Reasons Why in particular.

It is recognised that sharing high profile issues through television series can have greater reach and influence than if they came from a public health body. Storylines can be created that entertain and educate and help with prevention (Henderson, 2018). Pirkis et al. (2005, cited in Henderson, 2018) argued that television series have more influence than news programmes in moulding the public perception of mental health. This influence and the potential impact should not be taken lightly but used to better a viewer's awareness of important issues. As Henderson (2018) highlights, there is no step-by-step guide in portraying mental health stories, but they require consultation with professionals and those affected by the issues. Scalvini (2020, pp. 1569) says that a project may be approached with the intention "to create a controversy, provoke emotional reactions," which is what 13 Reasons Why did. Scalvini also observes that these shows can "at the same time raise awareness about taboo subjects", which is something else the show achieved.

In 13 Reasons Why, the viewer is presented with a series based on the sole premise of suicide. From the beginning, the audience knows the character Hannah Baker has already taken her life. This is a show presenting what led her to that ultimate decision. Unlike the series The Walking Dead, which will be discussed, this is not exactly a show about how characters fight for survival, as the viewer contemplates who will be the next character to lose their life. The audience knows harm has already fallen upon the protagonist. Hannah has been a victim of sexual violence at the hands of a fellow student and suffered alienation from her peers. She ultimately takes her own life and leaves behind thirteen tape cassettes, which form the series' narrative structure, documenting the people and situations that led to this decisive moment. The release of the series on Netflix quickly became one of the highest viewed shows on the platform. With these high viewer ratings came a significant discussion about the portrayal of explicit content and subjects that include suicide on television (O'Brien et al., 2017, cited in Scalvini, 2020). The finale of the first season culminated with the moment Hannah took her life. The audience sees her sitting in a bathtub, fully clothed, where she proceeds to cut through the skin of her wrists' with a razor blade. The viewer sees blood pour from Hannah's self-inflicted wounds as the blood diffuses in the water-filled bathtub with bloody water tipping over its side. Hannah slowly loses consciousness and is later found by her mother covered in blood ("Tape 7, Side A," 2017, 36:38). This show happens to be adapted from a novel by the same name, and with most adaptations, liberties are taken. One such change was the method of suicide that Hannah uses. In the novel, Hannah overdoses on sleeping pills, but it is vastly different in the series. It must be questioned why they felt it was necessary to change this to such a graphic method and show it on the screen (Scalvini, 2020). As previously mentioned, it is recommended shows when portraying controversial issues such as suicide do not show the method.

One criticism the show received included the representation of Hannah seeking help within her school. A stigma exists in seeking help for mental health issues, with people embarrassed or believing they will not get the help they need. Hannah approached her guidance counsellor Mr Porter, telling him in tears, "I need everything to stop, people, life" ("Tape 7, Side A," 2017, 24:32). His response to this revelation is less than helpful as he lets her walk out without providing assistance or resources. This depiction highlights real problems and the failures in educational systems in helping those in its care. At one point, Porter says, "but if she wanted to end her life, we weren't going to stop her" ("Tape 7, Side A," 2017, 39:39). This attitude is not something a person who is in a vulnerable state needs to hear. It could lead to the interpretation that if someone is considering ending their lives, it is already too late for them to seek help. Misinterpretation is an aspect that needs consideration and addressing when dealing with sensitive matters. As Grunau (2017, cited in Carmichael and Whitley, 2018) says, "don't be like the guidance counsellor in the Netflix series" "be there for them". This show could have decided to show a way to offer help to those seeking it, but all it did was perpetuate precisely what not to do, which is only part of the education needed to assist those struggling.

Suicide is a subject that affects another character within 13 Reasons Why. Alex Standall, a student at the same school as Hannah, shoots himself in the head in an attempted suicide but ultimately fails. This attempted suicide was something they did not show in detail; whether it was considered it would be too gratuitous to show multiple deaths in one series is unknown, but ultimately it would prove more tasteful. Krebs (2020) believes this to be a character better portrayed as showing real-world warning signs of being a suicide risk. He drops out of his school band, representing a loss of passion once held. He engages in the use of alcohol frequently to numb the guilt he feels over Hannah's death. This behaviour can be linked to what was mentioned as a portrayal of the contagion effect. He also displays aggression not previously associated with his personality. Having a character depicted as Alex can be considered more educational in identifying people's changes. Krebs (2020, p.197) believes that 13 Reasons Why "offers audiences a call to learn more about suicide while also engaging in knowledge production surrounding prevention efforts themselves". The audience's active learning would be a positive outcome from using such a sensitive topic as the basis of a series instead of only attempting to provide entertainment.

In The Walking Dead, the audience is presented with a show which is ultimately about surviving at any cost. The series takes place in a post-apocalyptic world that has become overrun by zombies. The first season revolves around a group of survivors who work together to survive the harsh environment they find themselves in. Death is the running theme of the show. It is seen in every episode, whether it be killing a zombie or one of the survivors. The audience expects death as they watch a programme called The Walking Dead, so the viewer is prepared for it. The series shares themes similar to 13 Reasons Why concerning trauma, death and suicide. Within this series, the world order has collapsed. Law and order have all but disappeared, and it is now the survival of the fittest. If a person is out in the open, they are presented with danger at every turn. With this in mind, Hagman (2017) posed a question: if a person were stuck in this world, would they be able to carry on or even want to? It is a question multiple characters face throughout the show. In the season one finale of The Walking Dead, the thought process in taking one's own life is addressed. The episode ("TS-19," 2010) sees the audience introduced to Dr Edwin Jenner's character. He is the last surviving doctor at the Centre for Disease Control building, where the survivors find themselves. Jenner was trying to find a cure with his colleagues, but they ultimately failed. When queried as to where the other scientists are, he replies, "they opted out. There was a rash of suicides" ("TS-19," 2010, 08:47) the sense of unknowing and no end in sight to the end of this disease led to them deciding the end for themselves. In a world where people have lost all control, taking one's own life is the only control one can find. This scene reflects the power and influence a person's mental health has in reacting to traumatic situations. Edwin reveals to the group that the generators powering the building are running low on fuel; when that happens, the building will self-destruct to destroy any infectious disease being stored at the time. Edwin proceeds to let the building seal itself with all those present inside it. He believes taking one's own life is the better option, "you know what's out there. A short, brutal life and an agonising death" ("TS-19," 2010, 32:36). Edwin has gone as far as he can with the resources he had; he has reached his limit and has eventually conceded. The group ultimately gets him to release them, but one member stays behind, with Edwin agreeing it is better to decide to take one's own life than barely surviving on the outside. He is last seen holding hands with the woman who chose to remain in the building rather than face back into the unknown. This moment is not the last time the theme of suicide is presented, as it reoccurs across multiple episodes in various seasons. In the season six episode "Now", a character takes her life, similarly to Hannah from 13 Reasons Why, by cutting her wrists; however, the contrast in portrayal is significant. In The Walking Dead, the audience only sees the aftermath of the character's wrists once she has cut them. It is a scene that is in no way heavily dramatized. This intense visualisation was something that was criticised in the showing of 13 Reasons Why.

Both shows and their characters share themes of shame and escape. Hannah feels shame in the sexual assault she experienced, and as she feels nobody is there to support her, she takes her own life at home. Edwin feels shame in failing to create a cure and wants to escape this and the world; he knows he does not have the resolve to survive, so he decides to remain in the building as it explodes. Scalvini (2020) mentions that producers will often include controversial scenes in shows if they believe it is required to invoke a strong response from the viewer. However, in 13 Reasons Why, some critics saw it as going beyond achieving a strong reaction. The graphic scene could be interpreted as a guide in taking one's life instead of seeking help. Viewers who have had difficulty with their mental health could be more susceptible to the graphic content shown and, in turn, may be more inclined to replicate it (Arendt et al., 2019; da Rosa et al., 2019, cited in Scalvini, 2020). It is, as Scalvini says, an ethical issue where producers need to find a balance between art and showing the realities associated with life. They may be under no obligation, but television shows can still discuss sensitive issues without being graphic. Why someone chooses to harm themselves is another vital aspect. As Knopf (2017, cited in Saclvini, 2020, p.1571) says, when you represent suicide as an act of revenge, which is a driving force behind 13 Reasons Why you risk portraying it as a "means of accomplishing meaningful ends". The audience is being shown the aftermath of suicide, giving a perception; this is how to get noticed. Ideally, it would be best if viewers could see that people can take notice and offer help before it becomes too late.

It has not been a common theme for shows to receive vast amounts of backlash when portraying graphic nature scenes such as suicide. This criticism could come down to how viewers process specific genres of shows. The Walking Dead is a lot easier to distinguish from reality, unlike 13 Reasons Why. Its audience could be seen as being desensitised to death, with its frequency throughout the series. The viewer can distance themselves from the show's premises and see it as a fictitious piece of work. The viewer is not worried about the undead walking around. These reasons could play a part in why it received practically no viewer backlash on the subject matter consisting of rape, suicide and more; the only time the audience may feel aggrieved is when a favourite character is killed off.

In 13 Reasons Why, another aspect of the storyline criticised was its failure to address mental health adequately. They used suicide as a revenge method against those who wronged Hannah. They portray her almost in a vindictive manner instead of treating her as someone with a health issue. The show fails to use the term depression and address the symptoms associated with it. The writing does not contribute to it as a factor in why she took her life. Due to mounting criticism and backlash from certain corners of the media after the release of 13 Reasons Why, the show succumbed to pressure. Netflix released a statement saying they would be removing Hannah's controversial scene in the bathtub. Showrunner Brian Yorkey and writer Nic Sheff said that they intended to show the ugly side of suicide and its reality to discourage it (Goldberg, 2019). They did not want it to be an easy watch, and in the end, they made it unwatchable. Swathi Krishna of Morehouse School of Medicine disagrees with this assessment. She said the scene with Hannah "doesn't portray the suicide scene as painful … they make it look almost peaceful. That's so disturbing to me" (Lawler, 2017). This comment is valid so far, as the pain of taking a blade to one's wrists would be excruciating, yet Hannah only winces with the pain. Another concern with some Netflix shows, such as 13 Reasons Why, is that they release all the episodes in one sitting. The viewer may not have a slow build-up to heavy subjects such as self-harm when binge-watching a series. This increased viewing without a break between episodes can significantly impact the viewer as they become fully immersed in the world they are watching.

Though the presentation may not have been what many critics believed necessary, it did open up for discussion the topic of suicide and mental health with many encouraging open and critical dialogue. The series has been included in more than 600,000 news reports, ranging from raising awareness of suicide to glamorising it. One study by Wartella et al. (2018, cited in Ferguson, 2021) found that in a survey of over 5000 youth across the world, watching 13 Reasons Why had a positive influence in opening discussion between parents and children around mental health. However, this study could be scrutinised as Netflix themselves funded it, even though they may not have influenced its findings. Chesin et al. (2020) found that those who watched the show showed less stigma to suicide and increased knowledge of it than those who did not watch the show. The show highlights that it is impossible to know what is going on in everyone's head and the importance of checking in on others and seeing how they are. As Hannah says, "I think I've made myself very clear, but no one's coming forward to stop me… some of you cared, none of you cared enough" ("Tape 7, Side A," 2017, 33:24). These words from Hannah are powerful. It is not always typical for a television drama to create a sense of reflection and have the viewer asking how aware are they of the true feelings of the people around them. However, with the positives also came negative aspects. After the release of 13 Reasons Why, internet searches relating to suicide increased with users searches include "how to commit suicide" and "teen suicide". It is unclear if any of these searches were before someone ultimately took their life. It has been found in the past that typically "suicide search trends are correlated with actual suicide attempts" and "searches for precise suicide methods increased after the series' released" (Ayers et al., 2017, pp.1527-1528).

While both shows depict the act of suicide, they are presented in vastly different ways. The Walking Dead is a show that is at its centre an entertainment series set in a post-apocalyptic world and should only be seen as that. It is not focussing on it as an integral part of its story, but rather a side effect of the story the characters live. Then there is the series 13 Reasons Why, which is trying to be more than just a show to be consumed for entertainment. It reflects the real world and is about suicide and the elements that play a part in its process. Therefore, it has a moral obligation to be factual, educate and discourage. Critics had different views on this and the romanticising of suicide. Whether a viewer agrees with this or not, which comes down to an individual’s interpretation, it was seen to increase conversation about the topic among a younger audience which is positive. However, the graphic scenes could be argued as unnecessary for any show going forward. In the end, the positives and negatives in the portrayal of suicide in media need to be weighed. Is it better to have dialogue around mental health opened up more or is it better to shield viewers from such complex issues?

References including episodes cited

Ayers, J.W. et al. (2017) 'Internet Searches for Suicide Following the Release of 13 Reasons Why', JAMA Internal Medicine, 177(10), pp. 1527–1529. DOI: http://doi.org/10.1001/jamainternmed.2017.3333.

Chesin, M. et al. (2020) 'Knowledge of Suicide Risk Factors, But Not Suicide Ideation Severity, Is Greater Among College Students Who Viewed 13 Reasons Why', Journal of American college health: J of ACH, 68(6), pp. 644–649. DOI: http://doi.org/10.1080/07448481.2019.1586713.

Ferguson, C.J. (2021) 'One Less Reason Why: Viewing of Suicide-Themed Fictional Media is Associated with Lower Depressive Symptoms in Youth', Mass Communication and Society, 24(1), pp. 85–105. DOI: http://doi.org/10.1080/15205436.2020.1756335.

Goldberg, L. (2019) 'Netflix Alters Graphic "13 Reasons Why" Suicide Scene After Controversy', The Hollywood Reporter, 15 July. Available at: https://www.hollywoodreporter.com/tv/tv-news/netflix-alters-graphic-13-reasons-why-suicide-scene-controversy-1224489/.

Hagman, G. (2017) 'Surviving the zombie apocalypse: Trauma and transformation in AMC’s The Walking Dead', Psychoanalytic Inquiry, 37(1), pp. 46–56. DOI: http://doi.org/10.1080/07351690.2017.1250589.

Henderson, L. (2018) 'Popular television and public mental health: creating media entertainment from mental distress', Critical Public Health, 28(1), pp. 106–117. DOI: http://doi.org/10.1080/09581596.2017.1309007.

Lawler, K. (2017) 'Is "13 Reasons Why" more controversial than other depictions of suicide?', USA TODAY, 5 May. Available at: Available at: https://www.usatoday.com/story/life/tv/2017/05/05/13-reasons-why-netflix-suicide-depiction-backlash-explained/101210380/.

Posselt, M., McIntyre, H. and Procter, N. (2021) 'The impact of screen media portrayals of suicide on viewers: A rapid review of the evidence', Health & Social Care in the Community, 29(1), pp. 28–41. DOI: http://doi.org/10.1111/hsc.13112.

Scalvini, M. (2020) '13 Reasons Why : can a TV show about suicide be "dangerous"? What are the moral obligations of a producer?', Media, Culture & Society, 42(7–8), pp. 1564–1574. DOI: http://doi.org/10.1177/0163443720932502.

Stewart, C. and Kowaltzke, A. (2008) Media: new ways and meanings. 3rd ed. Milton, Qld: John Wiley & Sons Australia.

"Tape 7, Side A" (2017) 13 Reasons Why, season 1, episode 13. Directed by Kyle Patrick. Written by Brian Yorkey. Netflix, March 31.

"TS-19" (2010) The Walking Dead, season 1, episode 6. Directed by Guy Ferland. Written by Adam Fierro and Frank Darabont. AMC, December 5.