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The finding was reported in a research letter published Monday in JAMA Internal Medicine by researchers from multiple institutions. They found that searches using the terms “how to commit suicide,” “commit suicide,” and “how to kill yourself” were all significantly higher following the series’ release.
“13 Reasons Why” explores the suicide of a fictional teenage girl, and the final episode of the series includes a three-minute, graphic scene of her death. The series has generated widespread interest, as well as debate about its public health implications.
The researchers compared Internet searches using some 20 terms related to “suicide” in the 19 days following the premier of “13 Reasons Why” (March 31, 2017, through April 18, 2017) with expected search volumes assuming the series had never been released. Statistical modeling, using daily trends from January 15, 2017, to March 30, 2017, was used to forecast expected volumes.
All suicide queries were cumulatively 19% higher for the 19 days following the release of “13 Reasons Why,” reflecting 900,000 to 1.5 million more searches than expected. For 12 of the 19 days studied, suicide queries were significantly greater than expected, ranging from 15% higher on April 15 to 44% higher on April 18. Searches using the terms “how to commit suicide” were 26% higher during this period.
Notably, searches for suicide hotlines were also elevated, including “suicide hotline number” (21%) and “suicide hotline” (12%), as were searches using the terms “suicide prevention” (23%) and “teen suicide” (34%).
“It is unclear whether any query preceded an actual suicide attempt,” John W. Ayers, Ph.D., M.A., of San Diego State University and colleagues wrote. “However, suicide search trends are correlated with actual suicides. … The deleterious effects of shows such as 13 Reasons Why could possibly be curtailed by following the World Health Organization’s (WHO) media guidelines for preventing suicide, such as removing scenes showing suicide, or addressed by including suicide hotline numbers in each episode. These strategies could be retrofitted to the released episodes, included in the planned second season, or applied to other programs.”
“I think the points in the research letter about not glamorizing suicide are on point,” said immediate past APA President Maria A. Oquendo, M.D., Ph.D. (pictured above), an internationally recognized expert on suicide. “This is especially important for adolescents who are impressionable. Anything that makes anyone dying by suicide appear heroic, larger than life, or unusually sympathetic is a disservice.”
Oquendo echoed the researchers in calling for adherence to WHO guidelines regarding publicity about suicide, especially highlighting the relationship of mental illness to suicide, and the fact that mental illness is treatable. “It is very important for parents to be talking to their kids if they are watching this show or others like it, emphasizing the relationship of suicide with mental illness, and that suicide is not a solution, but getting treatment is,” she told Psychiatric News.
For related information, see the APA blog post “13 Mental Health Questions about ‘13 Reasons Why’” and the Psychiatric News article “Experts Respond to Facebook's Updated Suicide Prevention Tools.”
(Image: courtesy Maria A. Oquendo, M.D., Ph.D.)