Since the show's debut in 2017, mental-health experts have expressed alarm about the Netflix series 13 Reasons Why, in which a teenage suicide victim posthumously describes how she came to her decision. A study later that year found that Google searches for suicide—including searches for specific methods—had spiked after the series' release.
New research among youth at high risk for suicidal behavior will only add to these experts' concerns. Among a sample of 87 such children and teens, half had watched at least one episode of the show—and half of those who did reported that it had heightened the risk that they would take their own lives.
"Few believe this type of media exposure will take kids who are not depressed and make them suicidal," said lead author Dr. Victor Hong, medical director of psychiatric emergency services at the University of Michigan. "The concern is about how this may negatively impact youth who are already teetering on the edge."
The study, in the journal Psychiatric Services, featured responses from 87 young people between the ages of 10 and 17, plus a parent or guardian of each. All of the kids had been transported to the University of Michigan's psychiatric emergency division at some point because of "a suicide-related concern."
The youths filled out a series of surveys measuring the severity of their depressive symptoms, the seriousness and intensity of their thoughts of suicide, and their exposure to 13 Reasons Why. Subjects familiar with the series indicated how many episodes they had watched, how strongly they had reacted to the show, and the extent to which they identified with the central character.
Their parents completed a separate questionnaire, measuring their own awareness of the series, and whether they knew their child was watching it.
Of the 43 suicidal youths (71 percent of whom were female), half had watched at least one episode of the show, and 40 percent had seen the entire 13-episode series. Strikingly, 84 percent reported that they had watched it alone.
While 80 percent of viewers reported talking about the series with friends, only 34 percent said they had done so with a parent.
"The idea that watching it would prompt conversation between youths and parents was not supported by these results," the researchers write.
In what may be the most troubling statistic, 51 percent of those who had seen at least one episode of the show "indicated that they believed watching the series increased their own risk of suicide to some degree." Not surprisingly, those who expressed that view tended to identify more strongly with the central character, Hannah.
"The main character is easy to identify with," Hong noted. "She’s a teen girl who has suffered from sexual assault, bullying, and anxiety—which, unfortunately, impact too many of our youth today."
The researchers conclude that the combination of such relatable characters and emotionally charged storytelling may heighten suicidal thoughts among those who are already contemplating taking their own lives. At least, that's what the kids themselves report.
Television is, of course, just one of many factors that influence suicidal behavior. But given that the rate of suicide attempts among American teens is increasing dramatically, all potential contributors need to be examined.