To The Bone and 13 Reasons Why – does Netflix have a problem with mental health?

Two controversial dramas have opened up a flood of issues surrounding the depiction of mental health on TV – Ben Allen examines the issues


This week, Netflix’s new film To The Bone arrives amid a whirlwind of vitriolic tweets, think pieces and conflicted reviews.


The trailer for the film – which centres around a 20-year-old girl (Lily Collins) who is at the make-or-break stage in a battle with anorexia – caused controversy when it dropped on 20th June.

Some critics called it an irresponsible portrayal of eating disorders, as it framed unsettling images of Collins’ weight loss – the actress, an eating disorder survivor, lost a significant amount for the film – against an uplifting soft-rock soundtrack, making it seem like a feel-good indie drama that trivialises anorexia.

It was the second controversy surrounding the portrayal of mental health issues on screen in recent months: In April, Netflix teen drama 13 Reasons Why was criticised for ‘glamourising’ suicide.

Based on a YA novel of the same name, 13 Reasons tells the story of a teenage girl who commits suicide, leaving behind a series of tapes detailing the events, and people, that drove her to take her own life. The final episode shows, in graphic detail, 16-year-old Hannah Baker as she climbs into a bath and cuts both of her wrists with razor blades stolen from her parents store. 

If the above sounds unsettling, it should. In fact, it’s kind of the point. 13 Reasons Why sought to open up a dialogue about complicated mental health issues amongst young people.

In the end, though, it missed the mark.

Good intentions aside, the series neglected to bring up mental health once throughout its 13-episode run. Hannah’s journey to suicide is painted as a step-by-step decline through a series of unfortunate events, and there is no significant insight into her mindset. Depictions of sexual assault and self-harm are clearly in place to drive points home, but end up feeling like unnecessary added trauma for the viewer.

Analysing To The Bone is less straightforward. The film is quite a different animal to its trailer. It’s raw and harrowing, presenting a story of one very specific kind of anorexia – an experience shared by its director and star – in a manner that is sure to move, unsettle and educate an audience who might not otherwise have considered the reality of eating disorders.

However, like its predecessor, its approach to sensitive issues has already run into problems. The trailer alone breaches a number of guidelines for media portrayal of eating disorders laid out by UK-based eating anorexia charity Beat, who advise against imagery of particularly gaunt young women and discussion of numbers, whether relating to calories or weight lost or gained.

In the two-minute clip, which has now been watched over 4 million times, Collins’ character is shown rattling off the calorie count of a plate of food. A number of people have reported on Twitter that the trailer was “triggering” – when something people see or hear causes them to remember a previous traumatic experience.

Both To The Bone and 13 Reasons Why have, in different ways, come unstuck by the same problem: how do you discuss mental health illnesses frankly on screen, when by their very depiction you risk glorifying the issues you’re seeking to confront?

Eating disorders are a relatively untouched subject in mainstream media, and these problems are going to keep occurring as filmmakers figure out how to depict them without causing harm to survivors in the process.

Some of the reviews urge viewers to boycott the film. But given that the moral panic in the wake of 13 Reasons Why had zero negative impact on the show’s popularity (it likely added to it), there should be other ways of reacting to this kind of controversy.

Netflix wields an unprecedented cultural clout: 13 Reasons Why is the most tweeted about show in 2017 so far, with over 13 million tweets in its first month.

For the most part, Netflix has established this influence while promoting diversity in its shows and telling stories that traditional broadcasters might have eschewed. To discourage adventurous decisions in TV, even when they’re not working out, would feel like a step in the wrong direction.

So what is the solution? Netflix created additional warnings for 13 Reasons Why after pressure from parents, schools and mental health professionals; To The Bone too includes a brief message (below) warning viewers that they may find the content upsetting. Is it enough?

Perhaps the answer is to urge the streaming giant to find better ways to safeguard its content from vulnerable viewers, and to ensure its shows come with adequate warnings and information in advance of their release.


There are no easy answers here, but the fact remains that Netflix has a direct connection with younger audiences that traditional broadcasters can only dream of. However the conversation surrounding mental illness is framed, whether online or on TV, filmmakers and distributors must know exactly who they’re talking to.