Suicides among US children aged 10 to 17 jumped to a 19-year high in the month following the release of a popular TV series that depicted a girl ending her life, researchers said.
The study published on Monday could not prove that the Netflix show 13 Reasons Why was the cause, but there were 195 more youth suicides than would have been expected in the nine months following the show’s March 2017 release, given historical and seasonal suicide trends, the study estimated.
In April 2017 alone, 190 US tweens and teens took their own lives. Their April 2017 suicide rate was .57 per 100,000 people, nearly 30 percent higher than in the preceding five years included in the study.
An additional analysis found that the April rate was higher than in the previous 19 years, said lead author Jeff Bridge, a suicide researcher at Nationwide Children’s Hospital in Columbus, Ohio.
“The creators of the series intentionally portrayed the suicide of the main character. It was a very graphic depiction of the suicide death,” which can trigger suicidal behavior, Bridge said.
Bridge acknowledged the study’s limitations, including not knowing whether anyone who died by suicide had watched the show.
The researchers were also unable to account for other factors that might have influenced suicides.
The researchers analyzed data from the US Centers for Disease Control and Prevention on deaths of Americans aged 10 to 64 from January 2013 through December 2017. Their results were published in the Journal of the American Academy of Child and Adolescent Psychiatry.
The researchers found no change in suicide rates in those 18 and older after the show was released.
The results are plausible and add to evidence that compelling media depictions of suicide can negatively influence young people, said sociologist Anna Mueller of the University of Chicago, who was not involved in the research.
Lisa Horowitz, a coauthor and researcher at the US National Institute of Mental Health, said that suicide is the second leading cause of death for US teens and called it “a major public health crisis.”
Netflix included warning messages with some of the episodes and created a Web site with crisis hotlines and other resources. In the second season, the show’s actors offered advice to viewers on where to seek help.
The series’ third season is to run later this year.
A Netflix spokesman said that the new study conflicts with University of Pennsylvania research published last week that found fewer suicidal thoughts among young adults who watched the entire second season than among nonviewers.
Horowitz said that the new results highlight how important it is for parents and other adults to connect with young people.
“Start a conversation, ask how are they coping with the ups and downs of life, and don’t be afraid to ask about suicide,” she said.
It is a myth that just asking might be a trigger, she added.
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