Suicide increase after '13 Reasons Why' demands media follow prevention best practices

Joshua A. Gordon, Shelli Avenevoli and Jane Pearson
Updated

Responsible and realistic portrayals of suicide, mental illnesses and related issues in the media have the potential to promote awareness and help-seeking behaviors, reduce stigma and misperceptions, spread information about effective treatments, and provide hope. But media depictions about suicide can also do grave harm, often through a contagion-like process in which depictions of suicide increase the risk of subsequent suicidal behavior in exposed, at-risk individuals. Media portrayals of suicide can have a particularly powerful influence on adolescents, who are high media consumers and whose brains are still developing the capacity to regulate emotion and impulsive action.

In a recent study published in the Journal of the American Academy of Child and Adolescent Psychiatry, researchers funded by the National Institute of Mental Health (NIMH) found disturbing evidence of the potential harms of entertainment media depictions of suicide. These researchers examined suicide rates in United States before and after March 2017, the release date of the popular Netflix series "13 Reasons Why" (13RW). This show tells the story of a teenage girl who died by suicide, leaving a series of 13 audio tapes detailing her reasons for ending her life. The researchers found a nearly 30 percent increase in suicide rates in U.S. adolescent males (10-17 years of age) in the month following the release of the series.

The number of deaths by suicide recorded in April 2017 was greater than the number seen in any single month during the five-year period examined by the researchers. When researchers analyzed the data by sex, they found the increase in the suicide rate was primarily driven by significant increases in suicide in young males. Suicide rates for females increased after the show’s release, the increase was not statistically significant.

While studies of this kind cannot prove that the release of "13 Reasons Why" caused the increase — they demonstrate only an association, not causation — the findings highlight the importance of considering the public health impact of portrayals of suicide in entertainment.

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How can we safeguard vulnerable youth against harmful messaging in entertainment? One crucial way to do this is by promoting safe messaging surrounding suicide — that is, responsible media reporting of suicide, accurate portrayals of suicide and mental illnesses in the entertainment industry, and providing ways to get help in online content related to suicide.

This safe messaging goal is addressed in the National Strategy for Suicide Prevention, a framework for suicide prevention developed by the National Action Alliance for Suicide Prevention, which consists of more than 250 partners, including NIMH, other federal agencies, and private organizations. The Action Alliance worked collaboratively with suicide prevention experts and representatives of the entertainment industry to develop the first National Recommendations for Depicting Suicide in entertainment, which encourage best practices that minimize potential harms and promote awareness and help-seeking behaviors. Building on these best practices, further research can help all of us understand how the contagion-like process might occur through entertainment media, and expand our approaches to prevent suicide. It will be important to understand how prevention strategies that bolster problem solving skills, enhance communication, and promote connection with trusted adults also protect youth from potentially noxious media exposure.

These and other efforts of the Action Alliance reflect the high priority placed by the NIMH and our partners on suicide prevention. Such partnerships play a key role in translating the scientific evidence base developed by NIMH-funded research into public health practices that could save the lives of the most vulnerable among us. The entertainment industry now can use the National Recommendations to promote messages of hope and recovery. The recent Journal of the American Academy of Child and Adolescent Psychiatry report underscores the impact of messaging in entertainment on our children and the importance of harnessing that impact for good. Together, we can make a difference.

To reach the National Suicide Prevention Lifeline, call 800-273-TALK (8255). You can also text a crisis counselor by messaging the Crisis Text Line at 741741.

Dr. Joshua Gordon is director of the National Institute of Mental Health. Dr. Shelli Avenevoli is NIMH deputy director. Dr. Jane Pearson is chair of the NIMH Suicide Research Consortium and program chief of the Adult Preventive Intervention Program. Follow Dr. Gordon on Twitter: @NIMHDirector

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This article originally appeared on USA TODAY: Suicide increase after '13 Reasons Why' demands media follow prevention best practices