Teenage girl suicides ‘jumped 20%’ in 3 months after Nextflix’s 13 Reasons Why

Suicides among adolescent girls soared by more than 20% in the three months after popular Netflix show 13 Reasons Why aired, it is claimed.

They also rose by over 12% in boys, research suggests, in the aftermath of series which was slammed for its graphic depiction of a 17 year-old's suicide.

And Dr Thomas Niederkrotenthaler, author of the research, blamed "contagion by media" – and claimed the story could have been behind "more than 100 deaths" across the US.

But the show's creators deny the allegations and argue it has actually helped people with anxiety and depression.

They say the show is sensitive and extensive research was carried out during production.

The study's team used nationwide data before and after its release in 2017 to estimate suicides among three different age groups.

Dr Niederkrotenthaler said: "Specifically, excess suicides of approximately 15% occurred in the first month after the show's release in the main target group – 10 to 19 year-old individuals.

"Significant associations were present for all of the three months in which the show was discussed on social media.

"Our findings appear to point to the need of engagement by public health and suicide experts to engage with members of the entertainment industry to prevent further harmful suicide portrayals."

The phenomenon was only identified in those aged 10 to 19. There was no increase in suicides of 20 to 29 year olds or those 30 and above.

Dr Niederkrotenthaler, of the Medical University of Vienna, added: "With regard to the specificity of these associations, young people were the clear target demographic of 13 Reasons Why, which portrayed issues such as bullying at schools and life problems in adolescence.

"Increases in suicide were seen only in this age group with no associations observed for individuals aged 20 to 29 years and 30 years or older, and this finding is potentially consistent with contagion by media."

He claimed there were potentially greater proportional increases in suicides among females.

He argued this pattern fits with previous studies indicating contagion by media is more likely to occur among individuals of the same sex and age as fictional characters who die by suicide.

The show tells the story of Hannah Baker who leaves behind a series of 13 tapes directed at those she blames for her decision to take her life.

The first season's final episode showed her slitting her wrists in a bathtub.

It caused a backlash among parents and health professionals, prompting Netflix in 2017 to put up additional viewer warnings and direct viewers to support groups.

The show released on 31 March 2017 was one of the most watched that year – generating more than 11 million Tweets within three weeks of its launch alone.

It also sparked immediate criticism from mental health and suicide prevention organisations for not following recommendations on responsible media portrayal of suicide.

Statistical models suggested there were 37 extra suicides among adolescent females in the three months following the screening of Hannah's death – a 21.7% rise.

There were also 66 (12.4%) more involving their male peers. The proportional increase was higher in girls as suicide is more common in boys.

And Dr Niederkrotenthaler said: "In particular, concerns were raised the graphic depiction of Hannah cutting her wrists in the bathtub, and the implication seeking help for suicidal thoughts is futile, might trigger imitation acts and additional suicides."

He said the increase in suicides involved hanging – instead of cutting.

Research conducted immediately after the release of 13 Reasons Why indicated web searches for suicide methods and queries on how to kill oneself increased immediately.

Dr Niederkrotenthaler said: "Hannah's controversial suicide scene was discussed on social media, and the discussions highlighted the method was difficult to carry out."

He said caution must be taken in interpreting the findings published in JAMA Psychiatry as it cannot be proven the victims watched the show.

But he added: "However, the suicide increase in youth only and the signal of a potentially larger increase in young females all appear to be consistent with a contagion by media and seem to reinforce the need for collaboration toward improving fictional portrayals of suicide."

Earlier this year a US study found suicides by young Americans rose by nearly a third in the month following the debut of 13 Reasons Why.

The team at Nationwide Children's Hospital in Ohio claimed the increase was driven primarily by young boys.

They said the rate of suicide in April 2017 was 28.9% higher among US youth ages 10 to 17 than would be expected based on suicide counts and trends observed in previous years.

The third season is currently in production.

Brian Yorkey, who created the show and series advisor and psychiatrist Rebecca Hedrick, said: "At every step, including for every script of the series, the writers and producers worked with psychiatrists, experts in sexual assault as well as bullying, school counsellors and teachers to ensure that even the most challenging scenes were grounded in reality

"And just as with the book, we've heard from people all around the world that the series gave them the courage to talk about issues they'd struggled to discuss before, including with their own families.

"The show's positive impact has been observed in numerous independent pieces of research. In one study, the vast majority of respondents who'd admitted to bullying before watching season one said that they had changed their behaviour afterward.

"Another study showed that viewing 13 Reasons Why gave college students a better understanding of suicide but did not increase suicidal thoughts or behaviour."

Citing the government data, they added: "There was no increase in suicide rates for adolescent girls that spring – and for boys the increase started before the show even launched.

"The highest recorded month for girls was November 2016, well before anyone had ever watched  13 Reasons Why."

A Netflix spokesman said: "Experts agree that there’s no single reason people take their own lives – and that rates for teenagers have tragically been increasing for years. These two studies raise important issues but directly conflict with each other, even though they’re based on the same US government data. And they don’t explain the increases for girls in November 2016 and boys in March 2017 – before the show had launched. 13 Reasons Why tackles the uncomfortable reality of life for many young people today and we’ve heard from them, as well as medical experts, that it gave many viewers the courage to speak up and get help."

For confidential support in the UK: call the Samaritans on 116123 or visit a local Samaritans branch, see www.samaritans.org for details

For confidential support in the US: call the National Suicide Prevention Line on 1-800-273-8255.

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