Suicide Rates Spike Nationally Among Youth After "13 Reasons Why" Release

A new research study reports the Netflix series "13 Reasons Why" was associated with a significant increase in monthly suicide rates among U.S. youth aged 10 to 17 years.

The research team, led by Nationwide Children's Hospital with collaborators from Carnegie Mellon University, The National Institute of Mental Health, The Ohio State University College of Medicine and West Virginia University, demonstrated that the number of deaths by suicide among 10- to 17-year-olds during April 2017, the month following the show's release, was greater than any other month in the prior five-year period examined by the researchers.

"13 Reasons Why" tells the story of a young girl who kills herself and leaves behind a series of 13 tapes detailing the reasons why she chose to end her life.

"Youth may be particularly susceptible to suicide contagion, which can be fostered by stories that sensationalize or promote simplistic explanations of suicidal behavior, glorify or romanticize the decedent, present suicide as a means of accomplishing a goal or offer potential prescriptions of how-to die by suicide," said Jeff Bridge, director of the Center for Suicide Prevention and Research (CSPR) at Nationwide Children's and professor of pediatrics, psychiatry and behavioral health at The Ohio State University College of Medicine, and first author of the publication. "Portrayals of suicide in entertainment media should avoid graphic detail of the suicide — which the series did not — and adhere to best practice guidelines to reduce risk of subsequent suicide."

The study authors used interrupted time series and forecasting models to analyze monthly rates of suicide between Jan. 1, 2013 and Dec. 31, 2017 — the time period before and after the release of "13 Reasons Why."

"We adjusted for potential effects of seasonality and underlying trends on suicide rates and estimated that the series' release was associated with approximately 195 additional suicide deaths in 2017 for 10- to 17-year-olds," said Joel Greenhouse, professor of statistics in CMU's Dietrich College of Humanities and Social Sciences, the second author on the study. "Interestingly, there was no significant association between the series' release and suicide in individuals 18 and older."

Dr. John Ackerman, a co-author on the study and suicide prevention coordinator of the CSPR, has written a blog for parents about "13 Reasons Why."

"It is possible to portray suicide in a way that cultivates hope by increasing awareness of available supports for those who struggle with suicidal thoughts or behaviors," Ackerman said. "However, this study demonstrates parents should be cautious about exposing youth to this series. With a third season of the series expected to air soon, continued surveillance is needed to monitor potential consequences on suicide rates in association with viewing the series."

The study, "Association Between the Release of Netflix's 13 Reasons Why and Suicide Rates in the United States: An Interrupted Times Series Analysis," was published in the Journal of the American Academy of Child & Adolescent Psychiatry. The National Institute of Mental Health provided funding for the study.