If you haven’t heard of the Netflix television series “13 Reasons Why,” just ask the nearest teenager. They most likely will tell you it’s an immensely popular show among their young-adult peers, depicting the anguish and eventual suicide of a teenage girl as experienced by a friend listening to the series of audio-cassette journal entries she left behind.
The implications of the show have been heavily debated. Some praised it for its frank content, while others claimed it depicted an idealized idea of suicide that viewers might emulate.
A new study published in JAMA Internal Medicine and led by San Diego State University Graduate School of Public Health associate research professor John W. Ayers delved into Americans’ internet search history in the days after the series aired. He found that queries about suicide and how to commit suicide spiked in the show’s wake.
For the study, Ayers and colleagues turned to data from Google Trends, a public archive of aggregated internet searches. The team focused on searches originating from the United States between March 31, 2017, the series’ release date, and April 18.
They collected all search phrases containing the word “suicide,” except for those accompanied by the word “squad,” as those were most likely for the unrelated movie “Suicide Squad,” released around the same time.
The team then compared the search frequency of phrases containing the word “suicide” over that time frame with a hypothetical scenario in which the “13 Reasons Why” had never been released, based on forecasts using historical search trends.
“This strategy allows us to isolate any effect ‘13 Reasons Why’ had on how the public engaged with and thought of suicide,” said study co-author Benjamin Althouse, a research scientist at the Institute for Disease Modeling in Bellevue, Washington.
All suicide-related queries were 19 percent higher than expected following the show. Some of that bump came from a higher-than-expected number of searches for phrases like “suicide hotline” (up 12 percent) or “suicide prevention” (up 23 percent). But an alarming percentage of the spike also came from phrases like “how to commit suicide” (up 26 percent), “commit suicide” (up 18 percent) and “how to kill yourself” (up 9 percent).
“In relative terms, it’s hard to appreciate the magnitude of the release of ’13 Reasons Why,’” added study co-author Mark Dredze, professor of computer science at Johns Hopkins University in Baltimore, Maryland. “In fact, there were between 900,000 and 1.5 million more suicide-related searches than expected during the 19 days following the series’ release.”
A public health challenge
It’s not clear whether any of those searches led directly to suicides, Ayers said, but previous research has found that increases in internet searches for suicide methods are correlated with actual suicides.
“While it’s heartening that the series’ release concurred with increased awareness of suicide and suicide prevention, our results back up the worst fears of the show’s critics: The show may have inspired many to act on their suicidal thoughts by seeking out information on how to commit suicide,” Ayers said.
The team notes that some of the harm potentially related to the series’ release could have been avoided by following existing media standards.
“The World Health Organization has developed guidelines for media makers to prevent this very problem,” said co-author and SDSU alumnus Jon-Patrick Allem, now a research scientist at the University of Southern California in Los Angeles.
“It is critical that media makers follow these guidelines. For instance, these guidelines discourage content that dwells on the suicide or suicide act. ‘13 Reasons Why’ dedicated 13 hours to a suicide victim, even showing the suicide in gruesome detail.”