Shortly after its 2017 release, the Netflix series 13 Reasons Why rang the alarm bells of many mental health experts and advocates, who believed that the series glorified teen suicide and presented it as a foregone conclusion for anyone who experienced trauma. Now, research from the Journal of the American Academy of Child and Adolescent Psychiatry has found that there was, in fact, a spike of suicide deaths shortly after the show premiered, during the month of April 2017.
According to the study, the overall suicide rate among young people between the ages of 10 and 17 increased in April 2017, which was actually the highest suicide rate for that age group over the past five years. Interestingly, although the suicide rate spiked for boys in that age group, it did not increase for young girls between the ages of 10 and 17, even though the majority of the show’s audience is young women (approximately 65% of its viewership, or more than 1.7 million viewers). But the increase in suicide rates in April 2017 was found exclusively among the 10-17-year-old demographic, and approximately 75% of the show’s demographic is young people.
“Suicide is a problem worldwide, and it’s so hard to knock these rates down,” Lisa M. Horowitz, a co-author of the paper and a staff scientist in the National Institute of Mental Health’s Intramural Research Program, told the New York Times. “The last thing we need is something that increases them.”
This is not the first time 13 Reasons Why (which is now in production for its third season) has been linked to increasing suicide rates among young people. Shortly after the show’s release, an analysis of Google search terms found that searches for “how to commit suicide” increased 26 percent following the show’s release (though it’s worth noting that the timeframe of the study was very limited, and Google data is not exactly the most reliable data source).
Adapted from a popular young-adult book, 13 Reasons Why tells the story of Hannah (played on the show by Katherine Langford), a teenage girl who sends a group of seemingly unconnected people 13 tapes explaining her “reasons” for taking her own life, and their connection to her. While the show was explosively popular from the outset, many mental health experts criticized the fact that the show portrayed the decision to take one’s life as someone else’s “fault,” rather than something an individual person decides on their own. Many mental health professionals also expressed concern that the show glamorized teen suicide, with many school counseling organizations issuing warnings to parents and teenagers before watching the show.
The show was also accused of portraying suicide as a cause-and-effect phenomenon, an inevitable result of being subject to bullying or (in the case of the show) sexual assault. “A lot of people experience horrible things and don’t think about suicide, or do think about suicide and go on to survive and recover,” Dr. April Foreman, a psychologist and a board member at the American Association of Suicidology, tells Rolling Stone. “The idea that we’re creating a narrative among our children that if these bad things happen to you, you might think of killing yourself, is horrible.”
Netflix took the criticism seriously, setting up a website offering mental health resources to viewers as well as issuing a disclaimer before each episode. In the wake of the most recent research surrounding the show, however, the company has appeared to double down on its defense of 13 Reasons Why,: in a statement to the New York Times, while Netflix acknowledged that suicide prevention “is a critically important topic and we have worked hard to ensure that we handle this sensitive issue responsibly,” the company also made sure to note that the results of the most recent study conflicted with research from the University of Pennsylvania, which found that teenagers who watched the second season in full were less likely to experience suicidal ideation and self-harm.
Nonetheless, the most recently released study appears to endorse the idea that 13 Reasons Why could potentially play a role in encouraging suicide contagion, or the “Werther effect,” an oft-cited yet poorly understood phenomenon in which increased media coverage of suicide leads to more at-risk people taking their own lives. Some studies have supported this idea, including a recently released study suggesting that emergency room presentations and visits to suicide prevention hotlines spiked following the media frenzy over the suicide death of actor Robin Williams in 2014. There is also research to indicate the opposite, i.e., that increased coverage of positive stories from survivors who have recovered from suicidal ideation can help to prevent suicides, a phenomenon called the Pappageno effect.
At the end of the day, Foreman says that we simply don’t know enough about the complex motivations behind suicide to make any “firm scientific conclusions” about what causes it. Despite the shortcomings of 13 Reasons Why and the many legitimate criticisms mental health professionals have of the show, the fact that this specific JAACAP study indicated correlation rather than causation means it would be unwise to claim that the show has caused an increase in suicide rates. “Anyone at risk of suicide should be mindful of what they’re watching and mindful of their health, but its hard for me to say 13 Reasons Why caused suicides,” she says. “It’s much more likely there are complex things going on in society. We just don’t understand suicide well enough.”
If you or someone you know is struggling with suicidal thoughts, call the National Suicide Prevention Lifeline at 800-273-TALK (8255). You can also reach out to the Crisis Text Line, a free, 24/7 confidential text messaging service that provides support to people in crisis when they text 741741.