A recent study found a correlation between the premiere of Netflix's 13 Reasons Why in March 2017 and a spike in teen suicides the following month.

The researchers at the Nationwide Children's Hospital emphasized that they've identified correlation but could not confirm causation. Still, their findings seem to confirm the public's long-held fears about the popular TV show, which is based on Jay Asher's 2007 young adult novel of the same name. However, just last week, a Social Science & Medicine published a separate study of the show's second season that documented positive effects on teenage viewers, specifically in terms of declined suicidal ideation, greater optimism about the future, and increased interest in helping a suicidal person. Altogether, there's no definite confirmation that 13 Reasons Why is responsible for higher rates of suicide among teens. However, it is possible that the show—despite raising suicide awareness—colored public perception of the topic in problematic ways.



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The show, recently renewed for its third season, has been the target of criticism since its debut, with Psychology Today publishing "'13 Reasons Why': The Good, the Bad, and the Ugly" in May 2017 to address widespread criticism that the show glorified suicide and could possibly encourage teenagers to end their lives. "While 13 Reasons Why is a story about a young teen's suicide," Dr. Deborah Serani wrote, "it does little to teach about mental illness. And this is truly bad." At the time, suicide was already the second leading cause of death in adolescents aged 15 to 24.



The recent study from Nationwide Children's Hospital found no difference in suicide rates among girls ages 10 to 17 following the show's premiere; however, they did observe an abnormal rise among boys of the same age group in April 2017, which can't be explained by normal trends. Matthew K. Nock, a psychologist at Harvard, noted, "They nicely controlled for this by looking across years and showing a discontinuity for this particular year only."

Jeffrey A. Bridge, director of the Center for Suicide Prevention and lead author of the study, said, "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."

When asked about Bridge's findings, a Netflix spokesperson told The New York Times, "We've just seen this study and are looking into the research, which conflicts with last week's study from the University of Pennsylvania." Social scientists conducted a survey of young adults between the ages of 18 and 29 to observe both the "helpful and harmful effects of watching season 2 of 13 Reasons Why." In conflict with Bridge's study, they found that "viewers who stopped watching the second season exhibited greater suicide risk and less optimism about the future than those who continued to the end. However, unexpectedly, current students who watched the entire second season reported declines in suicide ideation and self-harm relative to those who did not watch the show at all." They added, "Moreover, those who watched the entire second season were also more likely to express interest in helping a suicidal person, especially compared to those who stopped watching."

Of course, the two studies differed in focus, with Bridge examining only the first season of the show and UPenn scientists evaluating viewers' responses to the second season; and the latter focused on an older age range of students. But while neither study resolutely confirms that any suicide was the direct result of watching the show, Netflix and the series' producers have always been aware of the show's sensitive material. "This is a critically important topic and we have worked hard to ensure that we handle this sensitive issue responsibly," the spokesperson added.

In fact, Netflix consulted with the JED Foundation, a teen suicide prevention group, regarding the series' treatment of suicide. Dr. Victor Schwartz, the chief medical officer at JED, acknowledged the spike in suicide rates: "This is the first report I've seen like this, and of course it was our greatest fear that this might be a possibility."



Teen Vogue

Still, the only concrete measurement we can make about 13 Reasons Why's social impact is that it remains a widely popular show, with Variety calling its first season the "most tweeted show of 2017." Similarly, season two averaged 6.08 million viewers within the first three days of its release. With that level of influence comes a responsibility to handle its sensitive subject matter carefully.



Lisa Horowitz, Bridge's co-author and a staff scientist at the National Institute of Mental Health, said, "The results of this study should raise awareness that young people are particularly vulnerable to the media...All disciplines, including the media, need to take good care to be constructive and thoughtful about topics that intersect with public health crises." With those concerns in mind, Dr. Serani criticized, "13 Reasons Why glamorizes suicide, with decorated lockers, pep rallies, students taking selfies by Hannah's locker, mysterious packages, audio-taped travel hunts, and even flashback scenes that keep Hannah 'alive' in the series."

Ultimately, studies can observe a spike in the number of suicides in April 2017, but it's impossible to measure how many suicides were prevented, how many parents and teenagers became more comfortable discussing suicidal ideation, or how many teens may have sought help because of the show's promotion of suicide awareness.

Meg Hanson is a Brooklyn-based writer, teacher, and jaywalker. Find Meg at her website and on Twitter @megsoyung.



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