Did Netflix’s 13 Reasons Why really increase suicide rates?

https://www.newscientist.com/article/2201621-did-netflixs-13-reasons-why-really-increase-suicide-rates/

13 Reasons Why

The Netflix show deals with the suicide of a young woman

Netflix

In the Netflix show 13 Reasons Why, 17-year-old Hannah kills herself in a scene that shows her suicide. Following the show’s release, researchers raised concerns about the possibility that it could lead to suicide contagion, in which explicit depictions of self-harm can lead people to copy the method.

Now, a study of suicide rates among children in the US between the ages of 10 and 17 has found a 28.9 per cent rise in April 2017, the month after the show was released. On the face of it, that statistic follows the pattern of suicide contagion, which is strongest in the first few weeks after publicised suicide stories. But it may not be that simple.

Jeffrey Bridge at Nationwide Children’s Hospital in Ohio and his colleagues analysed data from the US Centers for Disease Control and Prevention on suicides in the US between 2013 and 2017. They found a spike in April 2017 as compared with the surrounding months, and an overall increase in the following 8 months as compared with the previous years. The rise was statistically significant in boys under 18, but not in girls or adults.

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“It doesn’t make sense that boys would be the ones that would show this effect,” says Daniel Romer at the University of Pennsylvania, given that the show is about a young woman. “It’s not clear that that would trigger a contagion phenomenon for suicides in men.”

Girls are more likely to attempt suicide than to kill themselves, says John Draper, director of the National Suicide Prevention Lifeline in New York, so if the show had an effect on girls, it would not be apparent in the data the team looked at. Bridge and his team didn’t respond to requests for comment.

Another as-yet unpublished study by Steven Stack at Wayne State University in Michigan and his colleagues gauged attention to the show on Twitter and analysed US suicide rates in April and May 2017, the months with the most tweets.

For boys aged 10 to 19, they found an increase in suicide rate of 12.4 per cent, while in girls they saw a jump of 21.7 per cent compared with previous months. This is more in line with the time period in which suicide contagion takes place, and reflects the gender split expected for a show with a female lead character, says Stack.

Romer also studied the show’s impact, surveying 729 people aged 18 to 29 before the second season aired to assess their vulnerability to risk of self-harm, and followed up with them a month after the show was released. He found that people who stopped watching partway through the season exhibited higher suicide risk and less optimism than those who watched the final episode.

But he also found that those who finished the series reported lower levels of suicide ideation and self-harm than people who didn’t watch the show. That may be because it portrayed the protagonist’s friend coping with life’s challenges, says Romer.

Complicating this analysis is a general increase in suicide rates, of nearly 10 per cent, among 15 to 24 year olds during 2017. Seasonal effects may also be at play – studies have shown that suicide rates peak in the spring, though the reasons for this also aren’t clear.

It doesn’t have to be this way. Draper says that for every person who dies by suicide, there are another 280 who think seriously about it but don’t kill themselves. The ratio we see on screen doesn’t reflect that reality. “We need to flip the script,” he says. “There’s evidence that shows that if you show people coping through those moments, it is associated with a reduction in suicide rates.”

Journal reference: Journal of the American Academy of Child and Adolescent Psychiatry, DOI: 10.1016/j.jaac.2019.04.020

Journal reference: Social Science & Medicine, DOI: 10.1016/j.socscimed.2019.04.007

Need a listening ear?  UK Samaritans: 116123; US National Suicide Prevention Lifeline: 1 800 273 8255; hotlines in other countries.

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