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Increase in deaths by suicide in young women after Netflix series '13 Reasons Why'

May 29, 2019


Researchers say stronger collaboration needed between entertainment industry and suicide prevention experts

A new study shows that suicides spiked in youth, particularly young women, after the release of the Netflix series 13 Reasons Why which portrays the suicide of a teenage girl. The study findings are published in JAMA Psychiatry.

A time-series analysis found a 13 per cent increase in suicides among 10-19 year olds in the United States three months after the show’s release, or 94 more suicides than expected. The researchers hypothesized that the increase would be most pronounced in young women since the main character who dies by suicide in the series is a teen girl in high school. The study found a 22 per cent increase in suicides among young women in the same age group during that time.

“If youth, some of whom are at risk, are exposed to this kind of content which we know to be misleading and dangerous, they may identify with what the character is going through and mistakenly think that suicide is the only option,” says Dr. Mark Sinyor co-author of the study, psychiatrist at Sunnybrook Health Sciences Centre and assistant professor at the University of Toronto. “But there is no reason that has to happen. The series 13 Reasons Why failed to show that suicide almost always arises from a treatable mental illness. People need to know that there is help and that suicide can be prevented.”

Researchers from Austria, Canada, the United States, and Australia analyzed suicide data and social media analytics from the show’s launch in April to June 2017, when interest in the series was the strongest.

“While caution must be taken in interpreting any association, the direction and magnitude of effect observed here are all consistent with what would be expected if 13 Reasons Why was producing a contagion effect,” says Dr. Thomas Niederkrotenthaler, the study’s lead author and suicide research group lead at the Medical University of Vienna.

Suicide contagion can occur when harmful information about suicide is prominent in media and entertainment domains. But experts say that more scientifically accurate portrayals emphasizing hope and resilience can lead to contagion of positive coping strategies and can help save lives.

“It is vital that the entertainment industry takes this issue seriously. Research has shown that when the media shares stories of people finding ways to cope with suicidal crises, and provides information about how to get help, people will also copy that behaviour,” says Dr. Sinyor.

With mounting evidence pointing to a rising trend in youth suicides following 13 Reasons Why researchers say there is a need for improved collaboration between the entertainment industry and suicide prevention experts regarding the portrayals of suicide.

“These findings raise concern and reinforce that strong collaborations could result in on-screen portrayals that potentially act as a force for good in suicide prevention,” says Dr. Niederkrotenthaler.

“The tragedy is that this outcome was predictable,” says Dr. Sinyor. “Hopefully this will be a wake-up call to the entertainment industry that we desperately need them to help disseminate accurate and healthy messages about mental health and to stop sending potentially harmful ones. No one wants to see more children die and there is absolutely no reason they need to. We already have the information we need to make sure that messages we send our youth are safe.”

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About Sunnybrook

Sunnybrook Health Sciences Centre is inventing the future of health care for the 1.3 million patients the hospital cares for each year through the dedication of its more than 10,000 staff and volunteers. An internationally recognized leader in research and education and a full affiliation with the University of Toronto distinguishes Sunnybrook as one of Canada’s premier academic health sciences centres. Sunnybrook specializes in caring for high-risk pregnancies, critically-ill newborns and adults, offering specialized rehabilitation and treating and preventing cancer, cardiovascular disease, neurological and psychiatric disorders, orthopaedic and arthritic conditions and traumatic injuries. The Hospital also has a unique and national leading program for the care of Canada’s war veterans.

About University of Toronto Faculty of Medicine

World-class talent, interdisciplinary excellence, and collaboration with peers and partners have helped the University of Toronto Faculty of Medicine continually solve the world’s most pressing medical challenges since 1843. We are Canada’s largest Faculty of Medicine, with more than 8,000 faculty members and 7,600 students enrolled in undergraduate medicine, postgraduate medicine, radiation sciences, and professional and doctoral graduate programs. We partner with nine fully affiliated hospitals and 20 community-affiliated hospitals and health facilities. This partnerships fuels a thriving research enterprise — one of the largest in North America — that includes one-fifth of all health and biomedical Canada Research Chairs and has attracted $864 million in research funding (2017-18). In 2018, the National Taiwan University Ranking placed U of T Medicine first in Canada and third in the world in clinical medicine.

About Medical University of Vienna

Medical University of Vienna (MedUni Vienna) is one of the most traditional medical education and research facilities in Europe. With almost 8,000 students, it is currently the largest medical training centre in the German-speaking countries With 5,500 employees, 26 departments and three clinical institutes, 12 medical theory centres and numerous highly specialized laboratories, it is also one of Europe’s leading research establishments in the biomedical sector.