Can “13 Reasons Why” Really Trigger Suicides?

I don’t really want to read one more thing about 13 Reasons Why, let alone add to the mix. But I think it’s necessary. Many articles and essays I read about the show are based on emotion, without acknowledging the very well-researched phenomenon of suicide contagion. The more that people understand the facts about this phenomenon, the better. Here goes.

Suicide contagion is real, with four decades of research to back up its existence. It is a tricky issue. On the one hand, researchers know that asking people if they are thinking of suicide does not trigger suicidal impulses. On the other hand, we also know that news articles, TV shows, and movies about suicide can lead to an increase in suicides. Contagion doesn’t happen all the time, but it happens often enough to cause tremendous concern.

The contagion effect is also called the Werther effect, so named for the novel The Sorrows of the Young Werther. Written by Goethe in 1774, the novel’s central character, a young man, dies by suicide. Following the book’s publication, waves of suicide reportedly occurred among young men in Europe, where the book was published, and authorities in Italy and Copenhagen banned the book entirely.

Some people also refer to suicide contagion as the copycat effect. Researchers have found evidence of copycat suicides after the deaths of celebrities such as Marilyn Monroe. Especially relevant in the case of 13 Reasons Why, researchers also uncovered suicide contagion after a 6-episode TV series ran in the 1980s.

The 1980s series showed the suicide of a 19-year-old man, who intentionally got hit by a train. In the 70 days following the series, railway suicides increased, according to this study. Tellingly, the contagion effect was strongest among those who were the same age and gender as the character who died by suicide. Among 15- to 19-year-old males, the rate of railway suicides went up 175%.

It’s not that someone who’s healthy and happy would watch a TV show or, say, a Netflix series and suddenly become suicidal. It’s that someone who already has suicidal tendencies, depression, and other vulnerabilities could watch a show about suicide and then be moved to act on those thoughts. These things certainly are not a show’s fault directly, but the producers have a responsibility to keep in mind the research on suicide contagion and take protective measures accordingly, such as providing hotline numbers or other information to help vulnerable people.

The Failures of “13 Reasons Why”

The producers of 13 Reasons Why ignored the enormous responsibility they had to help deter vulnerable people from acting on suicidal thoughts in response to the series. Whether or not you think that the show is constructive in some ways or that it should never have been made, there indisputably are things the producers could have done to head off copycat suicides.

Photo by Krisztina Konczos, via Wikimedia Commons

After Kurt Cobain died by suicide in 1994, many suicide prevention advocates feared that his death would inspire copycat suicides among vulnerable youth in the Seattle area. To help prevent this from happening, suicide prevention advocates, crisis centers, and others did a massive outreach to the local media. This led to newspapers and television stations providing numbers to crisis hotlines with each story about Cobain’s death.

Researchers looked at suicide rates in the months following Cobain’s death. It turns out that the suicide rate did not increase in Seattle and nearby. But guess what did increase substantially? Calls to the local crisis hotline. The awareness campaign had worked.

In the same way, the producers of 13 Reasons Why had the opportunity – and obligation, I believe – to help prevent tragedies.

Potential Remedies

So, what could the show’s producers have done instead? First, the producers could have looked to the guidelines for media portrayals of suicide.

One thing these guidelines call for is not providing graphic information about suicide methods. The graphic scene of Hannah’s suicide has inspired passionate debate. Some say it triggers and traumatizes vulnerable youth, while others say its brutality can steer people away from suicide. For example, this is from one of the show’s writers, Brian Yorkey: “Many people are accusing the show of glamorizing suicide and I feel strongly — and I think everyone who made the show — feel very strongly that we did the exact opposite. What we did was portray suicide and we portrayed it as very ugly and very damaging.”

I choose not to see the scene, so I will say only that I think there are other ways to portray suicide as “very ugly and very damaging” without exposing vulnerable people to traumatic images. The American Psychiatric Association acknowledges in the DSM-5, the diagnostic “bible” in the mental health field in the U.S., that watching a movie with traumatic material can lead to PTSD when the person is required to watch it for their job. (See, also, this article.) In this case, nobody was required to watch the suicide scene, but once you see something, you cannot un-see it.

Poster by Dese’Rae Lynn Stage

Another media guideline calls for providing information about how to get help whenever portraying suicide in television, newspapers, or shows. This is where the 13 Reasons Why folks failed terribly.

How hard would it be for the show’s producers to provide numbers at the end of each episode for the National Suicide Prevention Hotline (1.800.273.8255), the Crisis Text Line (text 741741), and other resources such as To Write Love on Her Arms, a group that is popular with young people?

How hard would it be to have someone say at the end of each episode that, generally speaking, suicide is preventable and mental illness is treatable? This same person or voice-over could also give information about ways to recover from the traumas of sexual assault and bullying.

How hard would it be for the show’s producers to sponsor a social media campaign on Facebook, with Selena Gomez at the forefront, detailing all the reasons why – and there are far more than 13 – Hannah’s suicide need not have happened?

There is a 30-minute show, Beyond The Reasons, where Selena Gomez and others discuss suicide, bullying, sexual assault, and mental illness, and they provide resources for getting help. That is a good contribution, but it requires viewers to wait too long to receive the information. Again, why not flash the numbers to the hotline and text line?

To their credit, the show’s creators hired mental health experts to provide guidance for the show. At first, I thought those experts failed either at providing truly expert advice based on decades of research, or at persuading the show’s producers to do the right thing.

Then I read this article, in which one of the “experts” states the research about suicide risk isn’t definitive. Little to no research in the social sciences is 100% definitive, but the evidence is definitely overwhelming that contagion can occur. In particular, the study of the 1980s series I mentioned above provides compelling evidence that a TV series can trigger suicides. To say that the study was not definitive is a cop-out.

What Are the Consequences?

Now I keep hearing of suicides that supposedly are linked to 13 Reasons Why. An 8-year-old girl and, separately, a male teenager who killed themselves after binge-watching the show. A teen boy in Denver who killed himself after making tapes for those who he blamed for hurting him. Whether these stories are true or apocryphal, I cannot know. Time will tell.

And if the suicides did occur, we can’t know for sure that the show bears true responsibility. Even before 13 Reasons Why came out, about 7 children and adolescents a day were dying by suicide in the U.S. Perhaps the suicides that occurred after the show’s release were part of that same, as-yet unstoppable pattern. In time, to figure out if the show truly triggered suicides, researchers will look at suicide rates before and after the show and compare them with suicide rates at the same time periods in previous years.

Even without those empirical findings, it’s clear that the show’s producers ignored readily available evidence that their show could create contagion among vulnerable young people.

They ignored well-researched guidelines for how to most safely portray suicide.

And they ignored basic compassion and decency, both of which call for taking steps to help prevent suicide contagion, especially when it is easily in one’s power to do so.

*

If you want to talk with someone by phone, email, text, or online chat about your suicidal thoughts, please click here for resources or go directly to SpeakingOfSuicide.com/resources/#immediatehelp

For guidelines on how to talk with your child about 13 Reasons Why, see this article: A Parent’s Guide to Watching 13 Reasons Why.

 

© Copyright 2017 Stacey Freedenthal, PhD, LCSW, All Rights Reserved. Written for www.speakingofsuicide.com.

Photo purchased from Fotolia.com

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  1. Theresa Bird says:

    Thank you for this article. I hope everyone reads it. Especially those who are in despair and considering suicide. I felt very sad after I watched the series, which was recommended to me as a great show. I really appreciate your thoughts on how the show should have given the suicide prevention line after every episode. I think that would have made a great statement to those watching who are in despair, and have considered suicide to relieve the pain they are going through. I had never heard of the contagion effect, and I really see how watching the show could lead to that, as any show watched can leave a vulnerable brain to take the next step. Again, thank you.

  2. Maree Dee says:

    What a very informative post on this series. Thank you for your work in this area.

  3. Carol Mielke says:

    I can’t watch this show as I think it sounds too triggering. But I appreciate their trigger warnings. Maybe one day in the future, but not ready yet.

    • Stacey Freedenthal, PhD, LCSW says:

      Carol,

      I know many people who feel the same way. It’s good you are taking care of yourself!

    • Louise says:

      Wouldn’t it be wonderful if a campaign could be started to contrast with 13 Reasons Why, people were instead encouraged to list 13 Reasons Why I Celebrate Life? Obviously the most important reasons would be family members who folks really cared for, then friends, how they share their love with others on the job and in the community and also natural wonders. There are so very many reasons for everyone to celebrate life. Each person just has to find them. I know it is not always easy, but suicide is never the answer. I know. I tried it a couple of times and it only brings greater pain to those who love you and makes it harder to find joy in your own life. I know I am alive today to encourage others to open their eyes and see the joys around them!

    • Stacey Freedenthal, PhD, LCSW says:

      There is such a campaign! It’s called 13 reasons why not. Students at a school school in Michigan (I think) started it, though I don’t know if it’s caught on nationally.

    • Louise says:

      Instead of 13 Reasons Why, Let’s all interested in stopping suicide, start a movement where people are encouraged to get shirts with the words:
      13 Reasons Why I Believe in and Celebrate Life!
      The T-shirts could then list the first names of the important family members and friends who love them and simple phrases of things around them the individuals enjoy celebrating, such as smiling at a homeless man, hearing birds sing in the morning, seeing a rainbow in the sky.

      Let’s all join together and Celebrate Life!

  4. Paul says:

    Contagion deaths do show how many blame themselves for the evil of others in the world. They see themselves as worthless and the world would be better without them. This goes along with what I see in the GREEN movement to make a smaller impact on the planet. There are other things that are world wide projects that are about control that ultimately make people feel that they are the problem and need to be removed from the world. The end result is that they eventually commit suicide as they feel that they are doing the right thing for the planet. I say all of this because it is the direction that I know many that are going (not myself though) as I see the harm. I see myself as better than the many, and those that consider their life as important as some species of slug etc as not mentally healthy. There will probably be far many suicides in the future as so many do not see themselves as those that have dominion over things in this world, but see themselves as a parasite that needs to be removed. Why are so many forced to see that they are not worthy, and I see this as part of a major thing that goes along with our society in this country and others, where people are nothing but existing to feed the beast so to speak and seen as little more than a number. There has yet to be a public place that I do not see many that fit the profile of seeing themselves as worthless. Such as the woman who started the semicolon usage, who is another that committed suicide as part of this problem that affects both men and women but more women have the psychological problems. I see womens problems as they are told by advertizing that they are fat, ugly, smell bad, and have to buy their products for men to even just like them. This is very unhealthy and needs to be changed if we are going to be better people. I say that television is the most dangerous drug that is for the most part unregulated. Then the drugs that really have the ability to help people are highly regulated and expensive. We could fix healthcare in this country, first of all do whatever it takes to make necessary visits and medications affordable without the need for insurance, and have insurance cover things that will never be affordable such as reconstructive sugery, heart surgery and other such things that few can afford without coverage.

  5. Puck says:

    I have to wonder though where the minds of people who make policies for medications are. I had never given a serious thought of when it would be best for me to die till it became much harder to get pain medications. If I have to live in so much pain that I can hardly move my chest to breath let alone move there really is little choice but to die. However if I am going to die because of this it would only be right to take a number of those that think that people are supposed to suffer in agonizing pain as well. This is a sick world and there are times that death is better than life. My hope is that there are those that will take up my thoughts and act to make the world a better place where death is not the best choice for many.

  6. Tore Nielsen says:

    Thanks for writing about this.

    I suffer from suicidal ideation myself, and the series has not affected me negatively. I think it is a good series, and I appreciate how it shows that suicide isn’t always arrived at via a great tragedy. It is the long crawling days, that robs you of any ambition beyond seeing the end of them.

  7. Toni Fiero says:

    This is by far the best thing I have read so far on this important topic. Thank you.

  8. Louise Morrison says:

    Instead of 13 Reasons Why to commit suicide, I want to help all to realize there are 7 billion reasons out there to Celebrate Life, Love, Family, and help others to do the same.

    Years ago, I did not recognize my bad habits and could not celebrate the family I had right around me. I was not humble within my marriage. I did not listen to and learn from my husband and his family. I failed to recognize the support he was giving me and our children. I did not realize that charity should always begin at home. I did not realize that family should always come first, because I was not raised this way. I understand also my mom, herself, was not raised this way. I was not able to talk openly with my spouse about what I needed to change within myself to allow our love to fully blossom over to our children. Our marriage ended and our children went back and forth between us, until when our children were with their father, I made a violent attempt to end my life. But I can still walk, talk, write about my experiences, and most importantly hug my children, listen to them, ask questions about how they are doing, how they are feeling and tell them I love them. Our children now live with their father and I see them at church and school events. I am living in a secure assisted living facility. Due to the support of one wise woman, I have been able to reflect back on my life. I now understand my missteps in the past were due to the fact that I was the youngest child in a family where both my natural parents were married 3 times, multiple moves from the time I was ten to thirty, being from an academic family, and then an accidental very serious head injury when I was in my late teens. I am alive today to help guide others, most importantly my children, to choose wiser courses of actions as they navigate life. Every human being matters. Ending one’s life is NEVER the right choice. Divorce is rarely the right option, but even when the family separates, each person really DOES matter and has the opportunity to move forward to help others.
    We are all human. We all make mistakes. But we have the opportunity to look back on our past, learn from our mistakes and move forward in a more positive direction and help others to do the same. I know the mistakes I made. I know the pain I caused, but I know the reasons why I made them and want to help others move toward the rainbows and sunshine in life.

    • Natalia says:

      Louise, that is a great message. It’s good to read a positive post from someone who is an example of 1 reason why not (to suicide)

    • Louise Morrison says:

      With this follow-up to my posting on May 1, I wish to encourage all readers to talk openly within their families about how compulsive habits of any family member can be destructive to the entire family. I know this, because I did not realize how my own eating and exercise habits were hurting our family 10 years ago. I did not know how to talk openly with my husband and thought my depression was a problem with him. I now understand that depression is best remedied by open honest communication within an entire family. If the husband and wife need to leave their children in the care of responsible extended family members or other caregivers to have such open honest dialogue then that is in the long term best interest of everyone. By everyone, I mean not just the family, but every life each family members interact with. Healthy, happy families help our entire society. I say all this, because I know when our family split it hurt many, many people in our school and church community. I am very ashamed of my inability to truly celebrate family so many years ago. However, I know without any doubt that I am alive today to encourage others, most importantly my beloved children to celebrate life. And life is best celebrated by positive interactions one has with other people most importantly one’s own family. I challenge everyone to list every day 13 ways they celebrated life!

  9. Anastasia says:

    This is exactly how I feel and have been saying from the moment I found out about the show. We lost my son to suicide when he was 16. My daughter was 12 when she found him. She’s 15 now and was doing well these last 2 years. After binging the series, which I didn’t know about at the time, she resorted to cutting, her depression increased, and she had suicidal ideation. All things she had after losing my son. I commend the show for what it was trying too do, but the missed the boat. They had such a huge platform to not only address bullying and suicide, but mental health.

    • Stacey Freedenthal, PhD, LCSW says:

      Anastasia,

      I’m so very sorry to hear this, both about your son’s suicide and the show’s effect on your daughter. The Resources Page provides information and resources for people who have lost a loved one to suicide; perhaps something there can be of us to you.

      Thanks for sharing your family’s experience. I’m afraid there are others out there, too, for whom watching the show was destabilizing and dangerous.

  10. Natalia says:

    Thanks. I can say for certain that you are right, it is contagious. My husband committed suicide 6 months ago. I found him, not soon enough. I am broken. Since that day, the thought to take my own life has not left me, not even for a second. I even know how to do it now – that knowledge can’t be undone. Life for me now is a continuous battle not to do it. Someone said to me recently “once someone gets it in their mind to do it, its just a matter of time”, well I have come to realise that this is true. Because life is tough, we come across unbearable hurdles and we just get through them because there is no other choice. But once we see suicide, it becomes our new solution to every hurdle and feels so right when we are in the depths of despair.

    • Stacey Freedenthal, PhD, LCSW says:

      Natalia,

      I’m so sorry about the suicide of your husband and about your own suicidal thoughts and urges.

      Are you getting help? I recommend doing so as soon as you can, if not. You can reach out to people via phone, text, email or online chat; please see the Resources Page for information. However, given the depth of your despair and suicidal urges, I hope you will also consider seeking professional help.

      I hope your belief that “once someone gets it in their mind to do it, it’s just a matter of time” does not lead you to think that your own suicide is inevitable. Nobody’s suicide is inevitable, as I say in another article. Consider that even among people who attempt suicide and survive, the vast majority do not go on to die by suicide.

      I certainly understand how suicide can seem like a solution, an escape from your pain. I truly hope you will consider other ways to cope with your pain that do not require you to die. I’m sending you my best wishes for hope and healing in your future!

    • Natalia says:

      Thanks Stacey, you’re very caring and kind.. Yes the Police arranged therapy for me and I’m heavily medicated which helps somewhat but nothing cures the pain. When I reached out to my mum and told her I wasn’t coping and that I didn’t want to be alive, she said “oh don’t we all”. People say to speak up which is so hard and when you finally build the courage to say something, they don’t hear it anyway. I’ve not been suicidal before but maybe that’s because I never thought of it as a ‘real’ option before. One thing for sure is this world is a cruel place with unbearable suffering when you’re in a suicidal state. I couldn’t understand how or why my husband left me like that until I found myself suicidal also. Sometimes I believe I need to feel this way to help me understand why he did what he did. I’m just saying this so anyone on this forum, who is in grieving over losing someone to suicide, I can tell you from my own personal suffering that they leave us because they are in unbearable emotional pain that is not sustainable, it’s not because they don’t love us 🙁

      If I had even one person who loved me, it would be SO enough to fight the battle. So I say to everyone who is reading this, if you have just one person who loves you, that one person will want to help you if only you have the courage to ask, you are SO lucky to have their love, cherish it. Love is everything.

    • Margit says:

      I’m sorry for Your loss Natalia! I totally understand where You are coming from! We lost Our precious Son, Jason at the young age of 20 on February 15th 2016. I blame myself even though I know He would have tried and tried again. He tried a little bit over 2 weeks prior his passing and He thought He will get the help He so desperately needed, but no medical doctors took Him seriously and they kept sending Him home. We lived 8 hours away from Him and He wouldn’t want to come home. After His attempt We stayed with Him for 10 days and it looked like He was doing much better. Now We know He was trying really really hard to fight His battle and wanted to do it on His own after seeing no doctors will help Him. He hid it from Us as well as He sent Us home and said He is too busy with work and school…I blame myself for not staying with Him! And the suicide thoughts are on my mind all the time! I try to fight it because statistics shows there is a high chance that it will be repeated in the close Family. We have two other children and I’m afraid if I follow my Jason then who knows what happens after?! Our Family is broken as it is and I’m trying hard to stay around! But I know “how to do it”.

    • Natalia says:

      Hi Margit. I know exactly what you mean. It’s the “knowing how to do it” that’s so dangerous. Because even if I ever lightly contemplated it before, by the time I started thinking about how to do it, my rational mind would kick in and I would focus on alternative rational solutions. But now, with the immense confusion and pain I’m going through, together with knowing how to do it, then it makes me only a few minutes away from achieving the result. That knowledge for a person in grieving is like giving a gun to someone suicidal. It takes every fibre of my being to fight the urge.

      I’m so sorry for the loss of your son. I know it’s easier to say from an outside perspective but as someone who truly knows all the pain that suicude causes, I can tell you it’s not your fault Mama. Do you know why? Because there was nothing you said or did that had intention to cause this. You didn’t know, it’s not your fault Margit. I know it’s easier said than done though, my self blame is through the roof despite being told it’s not my fault.

      When suicude isn’t an option in our own minds, we don’t take it seriously. I made the same mistakes as you but much worse, I had an argument with my husband right before, harsh words were said… they are our last words together. I had no idea he was suicidal, there were zero signs, he didn’t have depression. It’s very hard.

      Just remember that you have 2 other children who love you and they will be your saving grace AND through all the extensive research I’ve done on the afterlife, I am 100% sure that you will see your son again, but just not yet. Stay strong, you will get through this xoxox

    • Natalia says:

      Hi Margit, I just want to say one more thing… because I know how dangerous the “knowing how to do it” is…. especially during grief attacks. Maybe you should be honest with your husband and just let him know how you feel, that way he can watch over you and keep you safe from making an impulsive decision.

      For me, I have no family at all and my husband and I didn’t get to have children. So I tell myself this rule: I’m not allowed to make a decision during a grief attack, I have to wait 48hrs after I make the decision. And 100% of the time, I decide against it 24hours later and most of the time I’ve forgotten about it completely. That tells me it’s an irrational, impulsive decision. This is my way of “unloading the gun” and this rule is what keeps me safe/alive.

      I wish you strength!

    • Paul says:

      Natalia sorry to hear about loss of your husband. Sorry to also say that there is no way to make the pain completely go alway from the loss. However there are things that you can learn about such as what pushed him to it that can put why he did it into perspective. When things make sense quite often it is easier to go on with your life and move forward. I have lost family members from suicide, complications of cancer, and other such things. One of my uncles used a shotgun to end his pain from prostate cancer, and this is because he could no longer stand the pain. I lost my grandmother she starved herself to death as she could not stand the pain from dialysis due to failing kidneys and other problems due to old age. Seems the meanest ones live the longest, but they can easily bring others down when they go such as my wife’s mom she died from complications of untreated breast cancer, but lived most probably longer with the cancer than trying to fight it. We all lose people that we love, but quite often suicide is harder to deal with because unlike cancer it is a very sudden death and quite often we blame our selves for it. However it is not our fault, and there is a good chance that even if we were there 24/7 we could not have stopped it such as a friend of mine that comitted suicide with cynide. He acted normal to everyone up to the point that he did it. He had major medical problems that could not be fixed that he did not want to live with. Key thing now is your life is about you now, do what you can to live each day like it might be your last, and if you can do that life will be much easier.

  11. Linda Snyder says:

    Well done. Thank you. – Linda Snyder

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