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Katherine Langford as Hannah Baker

This post contains spoilers about 13 Reasons Why

The finale of 13 Reasons Why begins with a warning: “The following episode contains scenes that some viewers may find disturbing and/or may not be suitable for younger audiences, including graphic depictions of violence and suicide. Viewer discretion is advised.”

About halfway through the episode, it becomes clear why this warning is necessary. Hannah (Katherine Langford) goes into her bathroom, runs a bath, cuts her wrists with a razor blade, and bleeds to death before being found by her devastated parents.

“They felt for a TV series, if you’re going to watch it, you want to show it as horrific as it actually is,” Jay Asher, who wrote the 2007 novel on which the Netflix adaptation is based, tells EW about the scene. “So the way she does it, you can’t watch it and feel like it’s glamorized in any way. It looks and is painful, and then when she’s found by her parents, it absolutely destroys them.”

Screenwriter and show creator Brian Yorkey echoed that sentiment in Beyond the Reasons, a half-hour special also available on Netflix that features interviews with the cast and crew along with mental health professionals about the series’ approach to topics like suicide, sexual assault, and bullying. “We worked very hard not to be gratuitous, but we did want it to be painful to watch because we wanted it to be very clear that there is nothing, in any way, worthwhile about suicide,” Yorkey said.

But depicting a suicide — no matter how graphic — creates its own set of potential dangers. Studies have found that exposure to portrayals of suicide can negatively influence those already experiencing suicide risk factors (including depression and substance abuse). In its Recommendations for Reporting on Suicide, the American Foundation for Suicide Prevention notes, “Risk of additional suicides increases when the story explicitly describes the suicide method, uses dramatic/graphic headlines or images, and repeated/extensive coverage sensationalizes or glamorizes a death.”

How should television shows balance that fact while also shedding light on a rarely talked-about yet common issue?

“You could depict a character that is struggling, is dealing with mental health concerns as well as life concerns, whether those are bullying or other kinds of stressors, and you could show them even becoming suicidal, having thoughts of suicide, and then working through their fears about, ‘Is it okay to speak up?'” says Dr. Christine Moutier, the American Foundation of Suicide Prevention’s chief medical officer. “Who is safe for me to talk to? Can I still accept that I’m the same vibrant person if I have to get treatment for this?”

“And if they start coming to terms with [the fact] that mental health is a type of health, period,” she continues, “those are the ways that probably has a prevention effect on the audience and on the community, whereas showing the person going straight down the path, taking their life — again, any graphic portrayal any of that is a big red zone for danger for contagion.”

While 13 Reasons Why does depict Hannah’s death by suicide, it also shows where she could have asked for help or where others could have stepped in with guidance and support. In one of her final scenes, Hannah meets with a guidance counselor and tells him that she feels “empty” inside. “I don’t feel anything,” she says. “I don’t care anymore.” Her counselor misses the sign that she’s in a desperate place, but later, after she has died, he and some of the people Hannah left behind have learned to ask more questions, to listen a little harder, to be kinder. 13 Reasons Why also shows people reaching out in the midst of their struggles; at the end of the season, Jessica (Alisha Boe) tearfully opens up to her father about her sexual assault.

“We believe strongly that the issue of suicide is really important to raise the volume on,” says Moutier, who hasn’t seen the Netflix series. “So it’s not that portrayals are all bad — it’s the way that it’s done and that it needs to be with a prevention message and a message of hope, something that can inspire others to work through life’s struggles whether they’re way upstream from actually being in a crisis or even when it’s at the moment of suicidal crisis.”

In 13 Reasons Why, Hannah does die, and the show is filled with numerous other dark, upsetting story lines. But it also aims to show that help is out there.

“Reach out,” Langford says in Beyond the Reasons. “Even if you feel like Hannah in that you can’t talk to your parents or you don’t want to tell anyone at school because you’re embarrassed, call a hotline. Talk to someone anonymously. Just talk to someone. Because the moment you start talking about, it gets easier. Just know that there’s life beyond what you’re feeling at the moment. I promise it will get better. There’s an entire future full of incredible things waiting for you. And if you go, you don’t get to see it.”

If you or someone you know is contemplating suicide, call the National Suicide Prevention Lifeline at 800-273-8255. Find more information about suicide here.

Katherine Langford as Hannah Baker
13 Reasons Why

Based on the 2007 novel by Jay Asher, the Netflix drama follows a teen named Clay who attempts to figure out what led his classmate and crush Hannah to take her own life.

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