MEDPAGE TODAY–Researchers see a link between upswing in suicide info searches and Netflix show.
Internet searches linked to suicide spiked following the airing of Netflix’s controversial teen drama “13 Reasons Why,” which tells the story of a high school student who kills herself.
Using what they called a “quasi-experimental” approach, researchers compared actual Internet search volumes for 20 queries which included the word “suicide” after the 13-episode television show was released March 31, with an estimate of the number of such searches that would have been expected if the show had not aired (from daily trends from Jan. 15-March 30, 2017).
Searches increased for terms associated with suicidal ideation, including “teen suicide,” “how to commit suicide,” and “suicidal thoughts,” as well as for seeking help terms including “suicide hotline,” and “suicide hotline number,” reported John W. Ayers, PhD, of San Diego State University, and colleagues July 31 in a JAMA Internal Medicine research letter.
In particular, the analysis showed a 19% cumulative increase in queries for the suicide terms included (95% CI 14%-24%) during the 19 days following series’ online release, “reflecting 900,000 to 1.5 million more searches than expected,” the researchers wrote.
“Our analyses suggest ’13 Reasons Why,’ in its present form, has both increased suicide awareness while unintentionally increasing suicidal ideation,” they concluded.
The show has been praised as an honest depiction of issues commonly faced by teenagers, including bullying and sexual assault. But it has also been strongly criticized by some mental health practitioners who say it romanticizes teen suicide.
Netflix has announced that it will air a second season of the show.
“The debate about the potential impacts of ’13 Reasons Why’ on suicide has been tremendous,” Ayers told MedPage Today in an email exchange. “However, the debate isn’t ‘he said, she said’.”
Ayers noted that mental health professionals have expressed strong concerns about the show because it ignores the World Health Organization’s validated media guidelines for preventing suicide.
“The show’s staff instead continue to prefer their gut instincts. It’s unsurprising then that we find the show has increased suicidal thoughts, thoughts that are known to be linked to suicide attempts.”
Using the search engine monitor Google Trends, Ayers and colleagues obtained daily search trends for 20 queries including the word “suicide” before and after the 13-episodes of the show were released.
Specifically, the researchers focused on searches originating from the United States between March 31 of this year, when the show’s 13 episodes were released, and April 18. The mid-April cutoff date was chosen because it preceded the widely publicized suicide death of former New England Patriots player Aaron Hernandez.
“Seventeen of the top 20 related queries were higher than expected, with most rising queries focused on suicidal ideation,” they wrote. “For instance, ‘how to commit suicide’ (26%, 95% CI 12%-42%), ‘commit suicide’ (18%, 95% CI 11%-26%), and ‘how to kill yourself’ (9%, 95% CI 4%-14%) were all significantly higher,” the researchers wrote.
Queries for “suicide hotline number” increased by 21% (95% CI 1%-44%), while queries for other phrases associated with help-seeking and public awareness also increased, including “suicide hotline” (12%, 95% CI 5%-19%), “suicide prevention” (23%, 95% CI 6%-40%), and “teen suicide” (34%, 95% CI 17%-52%).
“It is unclear whether any query preceded an actual suicide attempt,” the researchers wrote. “However, suicide search trends are correlated with actual suicides, media coverage of suicides concur with increased suicide attempts, and searches for precise suicide methods increased after the series’ release.”
Ayers told MedPage Today that while teen suicide should not be considered off-limits by Hollywood, filmmakers should work within the WHO guidelines to “offer a message those contemplating suicide need to hear.”
“This is where ’13 Reasons Why’ misses the mark,” he said.
Primary Source: JAMA Internal Medicine – Ayers JW, et al. “Internet searches for suicide following the release of 13 reasons why” JAMA Intern Med 2017; DOI: 10.1001/jamainternmed.2017.3333.