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"13 Reasons Why" and Teen Suicide

Did the popular show really spark an increase in youth suicides?

On March 31, 2017 Netflix released its controversial series 13 Reasons Why. If you haven’t seen the show, it details the suicide of a teenage girl who, in audiotapes, describes the reasons for her suicide, typically blaming the actions of others. The show was a critical and commercial success, but also a lightning rod for moral criticism. Advocates for suicide prevention and other groups were concerned that viewing the show might trigger some youth into committing suicide.

Concerns about media and suicide are nothing new. Such concerns are often referred to as the Werther Effect, named after the 18th-century novel that features the suicide death of a young man. At that time, people worried that reading the novel led to imitative deaths, though social science back then being what it was, the evidence was largely anecdotal and apocryphal.

A more recent parallel to 13 Reasons Why might be the 1980s concerns that both Dungeons and Dragons and heavy metal music could cause suicide in players and listeners. Heavy metal acts such as Ozzy Osbourne and Judas Priest were sued (unsuccessfully) for allegedly causing several young men to commit suicide. Today, nobody seriously thinks any of these things cause suicide, but people then were quite earnest in their concerns.

Fast forward to 2017 and the release of 13 Reasons Why. The show’s release sparked a wave of concern and condemnation from suicide prevention activists, educators and clinicians worried the show might prompt “vulnerable” youth into committing suicide. Perhaps most prominent of these was the National Association of School Psychologists (NASP), who warned that “Its powerful storytelling may lead impressionable viewers to romanticize the choices made by the characters and/or develop revenge fantasies,” and that “Research shows that exposure to another person’s suicide, or to graphic or sensationalized accounts of death, can be one of the many risk factors that youth struggling with mental health conditions cite as a reason they contemplate or attempt suicide.”

Except that, at least in the case of fictional media, research shows no such thing. Indeed, NASP didn’t actually cite any research when making that claim. In fact, past research on suicide-themed media generally do not show that fictional media is associated with viewer suicide.

There is a whole line of sociological research on moral panics, going back to when Moral Panic Theory was first proposed back in 1972. Most people are familiar with some famous moral panics… the Satanic Ritual Abuse Panic, or fears of Dungeons and Dragons, video games or rock music. Historically, the Salem Witch Trials and McCarthyism also fit. More recently we’ve seen panics over the Momo Challenge (also related to suicide), scary clowns stalking schools, and the “knockout game” wherein youth would supposedly try to knock out random strangers for “points.”

Moral panics about media aren’t reliant on data, of course. They’re about feeling. Some media just feel bad from a moral perspective, so they need to be eliminated. Sometimes moral panics may distract people from other issues, such as the focus of many Republicans on violent video games after mass shootings, despite now clear evidence that violent games do not play a role in societal violence.

In that sense it’s not surprising that so many concerned citizens jumped on the bandwagon of demonizing 13 Reasons Why without evidence. It’s just what people do. They’ve been doing it for all of recorded history. Plato’s dialogues record examples of ancient Athenians griping about the delinquency effects of Greek plays (which, fast forward 2,500 years, we have to force youth to read in humanities classes).

The thing about moral panics is that they begin with a conclusion, such as "13 Reasons Why causes suicide." Then, society demands evidence for this foregone conclusion, and that puts pressure on scientists to comply. There is something I call the scientific pile-on effect. This occurs when scientists get wound up with something that is trendy and naughty and begin to try to link it to every bad outcome they can think of. Given the poor quality of so much social science research, it’s easy to get a lot of false-positive results. This can create a kind of reverse snake oil effect where instead of a quack medicine curing everything, flawed science links something to numerous bad outcomes. Pornography, for decades the target of numerous moral panics related to everything from sexual assault to impotence, is a classic example of this.

In the months after 13 Reasons Why’s release, a few studies came out that were mainly anecdotal, essentially suggesting that suicidal teens coming into ERs mentioned 13 Reasons Why. But anecdotes aren’t science and, frankly, these small studies just weren’t very good. One study appeared to show positive effects for 13 Reasons Why, with viewing the show associated with increased positive conversations among youth and parents related to suicide and mental health. However, though conducted by well-respected psychological researchers, the study had been funded by Netflix, a fairly obvious conflict of interest.

The real bombshell came with two studies that examined CDC data on youth suicides. In April 2019, one study came out that claimed to link 13 Reasons Why to an increase in youth suicide. The press release boldly stated, “The findings of this study add to a growing body of information suggesting that youth may be particularly sensitive to the way suicide is portrayed in popular entertainment and in the media.” Only a look at the study’s results revealed them to be a mess. Suicides were already increasing before the show came out, so it wasn’t clear if the show was just coincidental with a preexisting trend. Suicides increased only for boys, not girls (the opposite of what we’d expect for a show with a young female lead), but only for some months (only three of nine) and not others. Suicides actually decreased for girls in one of the months after the show. There were no effects for young adults, either male or female. Overall, it appeared the authors had cherry-picked from mixed results to fit a scary story that was, itself, largely fiction.

About a month later, a second study looking at the same data was released. Compared to the first, it appeared to show clearer correlations between 13 Reasons Why and youth suicide. But this also raised a red flag. How had two groups looked at the exact same data and ended up with very different-looking results?

Remember, these studies focused not on individuals, but rather on societal data. That’s not necessarily bad, societal data can be useful, but it is correlational. In these studies, in fact, we don’t know that any of the suicide victims actually watched the show. Around the same time one study did come out that surveyed youth and families. This study was more cautious in its claims. Overall, the authors concluded, watching the show had only minimal impacts on viewers. For those who watched the entire series, suicide risk actually decreased, though it increased slightly for those who watched the show only partly. However, this nuanced data was largely ignored in favor of the scarier press releases.

The problem is that suicide has been increasing year-to-year for most age categories, not just youth (middle-aged adults, in fact, have a much higher suicide rate), and tends to show peaks in the late spring, coincidentally right around the time 13 Reasons Why was released. The two studies using the CDC data hadn’t properly controlled for these seasonal variations. So, sure enough, in January 2020 a third study looking at the exact same CDC data concluded that, when seasonal patterns were properly controlled, 13 Reasons Why was not linked to an increase youth suicide.

More recently, I published a research study of youth and their parents. In this study, watching the show 13 Reasons Why was associated with reduced depression and suicidal ideation in youth. And, it should be noted, I have no funding from Netflix or any other media company. At this point, I think we can safely say that, overall, the show is not associated with any danger to youth. Granted, every kid is different and it’s always possible the show might help some kids and hurt others in idiosyncratic ways that are difficult for social science to measure. But, on balance, the influence of the show appears to be more positive than negative.

Compared to many long-lasting panics, the arc for the re-evaluation of 13 Reasons Why was relatively swift—just three years from extreme statements of harm to their repudiation. But it offers us a warning as we move forward. Statements made from emotion or moral outrage often do not reflect reality. And, following a wave of fear, the initial science can be quite flawed. It often takes time to really understand the impact of fictional media. In the future, we need to remain calm—at present, evidence suggests fictional media across realms has little to no impact on viewers’ attitudes or behaviors. We need to remember that the next time we see something that offends us.

Teaser image: MTV International [licensed under the Creative Commons Attribution 3.0 Unported license]

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