An alarming nationwide study released earlier this week revealed approximately 195 more youth suicide deaths than expected were associated with the television series “13 Reasons Why” in the nine months immediately following the series’ release.
The study, led by Nationwide Children’s Hospital with collaborators, demonstrated that following the series’ release on March 31, 2017, the following month had the highest suicide rate during the five-year study period among 10- to 17-year-olds. However, there was no significant association between the series’ release and suicide among individuals 18 and older.
“Youth may be particularly susceptible to suicide contagion, which can be fostered by stories that sensationalize or promote simplistic explanations of suicidal behavior, glorify or romanticize the decedent, present suicide as a means of accomplishing a goal, or offer potential prescriptions of how to die by suicide,” said co-author Jeff Bridge, director of the Center for Suicide Prevention and Research at Nationwide Children’s Hospital and professor of Pediatrics, Psychiatry and Behavioral Health at the Ohio State University College of Medicine. “Portrayals of suicide in entertainment media should avoid graphic detail of the suicide — which the series did not — and adhere to best practice guidelines to reduce risk of subsequent suicide.”
The study authors used interrupted time series and forecasting models to analyze monthly rates of suicide between Jan. 1, 2013 and Dec. 31, 2017 — the time period before and after the release of “13 Reasons Why.” The researchers examined immediate effects and subsequent trends and adjusted for potential effects of seasonality and underlying trends on suicide rates. Data was obtained for cases in which suicide was listed as the underlying cause of death, according to the Web-based Injury Statistics Query and Reporting System of the Centers for Disease Control and Prevention.
Following the “13 Reasons Why” release, national experts raised concerns about the series and a month later, Netflix strengthened the graphic content advisories and added a warning about the whole series that appeared before the initial episode. A website with resources and referral information was also made available.
“It is possible to portray suicide in a way that cultivates hope by increasing awareness of available supports for those who struggle with suicidal thoughts or behaviors,” said John Ackerman, a co-author on the study and a suicide prevention coordinator who has written a blog for parents about “13 Reasons Why.” ‘’However, this study demonstrates parents should be cautious about exposing youth to this series. With a third season of the series expected to air soon, continued surveillance is needed to monitor potential consequences on suicide rates in association with viewing the series.”
The show is popular, no doubt. That should make it easier for us all to talk about. Going forward, we must be mindful that suicide may be on kids’ minds again as the show’s third season launches later this year.
In Vermont, the Youth Risk Behavior Survey done for 2017 polled more than 20,500 high school students from 69 schools around Vermont. (They also poll middle school students.) The report found that when it comes to students’ mental health, there are serious concerns lurking.
“Both the high school and middle school surveys asked students about suicidality,” the report stated. “The high school survey asked students about feeling sad or hopeless, intentional self-harming behaviors and plans for dying by suicide and actual suicide attempts. . The middle school survey focused on suicidality by asking students about suicidal thoughts, plans and attempts.”
The statistics are troubling. In 2017, overall, 16 percent of surveyed students, or nearly 3,300, reported hurting themselves without wanting to die. They did so through cutting or burning themselves on purpose. From 2009 to 2015, self-harming behaviors significantly increased. Since 2015, however, fewer students reported harming themselves on purpose, the results found. That trend is encouraging, overall.
Among Vermont middle-schoolers, 19 percent of those surveyed said they had felt hopeless or sad; 18 percent said they had thought seriously about killing themselves; 12 percent said they had made a plan; and 6 percent of those surveyed said they had made an attempt at suicide.
“Youth development requires multiple sources of positive influence and protective factors, these include environmental characteristics, or conditions, or behaviors that can reduce the effects of stressful life events, increase the ability to avoid risk behaviors, and promote social and emotional competence,” the report’s authors wrote.
The struggle for teenagers is real, and social media and popular shows give those struggles a new — more prominent — face. We need to talk to our kids and help them through rough patches. We need to listen and support our youth; and, yes, we must talk to them about what they are watching and processing. We need to know why.
This editorial originally appeared in the Rutland Herald on April 30.
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