Release of “13 Reasons Why” Associated with Increase in Youth Suicide Rates

Previous discussion: <a href="https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=19788773" rel="nofollow">https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=19788773</a>.

Same reason that when they show the shooter&#x27;s face all over the media and they give them tons and tons of attention, it typically spawns more copycats who are just lonely&#x2F;sad&#x2F;broken teens looking for the same attention.<p>In the show, this teen&#x27;s suicide was portrayed to have had an impact on many students&#x2F;families&#x2F;teachers etc for a very long time after the incident. It almost glorified the suicide and the methods of leaving tapes behind.<p>Real suicide is not so glorious and does not leave a much of an impact as you would think, other than on the immediate family.<p>For example, when my mother committed suicide, my sister, grandparents and myself were impacted severely for a bit, but outside of our family circle it didn&#x27;t have as much of an impact.<p>When I was in high school, we had a student commit suicide, which we ended up having 1 school meeting regarding it, but after about a week it had been forgotten by most and swept under the rug as everyone moved on to the next thing.<p>I guess I am biased based on my two experiences with suicide, however glorifying it in any way will only lead to more incidents.

The full text is on Sci-hub: <a href="https:&#x2F;&#x2F;sci-hub.tw&#x2F;10.1016&#x2F;j.jaac.2019.04.020" rel="nofollow">https:&#x2F;&#x2F;sci-hub.tw&#x2F;10.1016&#x2F;j.jaac.2019.04.020</a><p>I&#x27;m extremely skeptical. I don&#x27;t know how many ways they carved up the data before they found a segment of the population with increased suicide rates at the right time. Also, the show is about a girl who kills herself, but the female rate of suicide didn&#x27;t increase enough to be considered statistically significant. Lastly, the spike in suicides starts in March, which is a month before the show was released. Their claim only makes sense if you think that watching the trailer is enough to trigger suicides.

This is just bogus p-hacking and perverse causality analysis.<p>Look at their graph of monthly data.<p><a href="https:&#x2F;&#x2F;i.imgur.com&#x2F;mc8PJW8.png" rel="nofollow">https:&#x2F;&#x2F;i.imgur.com&#x2F;mc8PJW8.png</a><p>You can&#x27;t draw any conclusion from that but that it is an overall increasing trend with cyclic tendencies by season.<p>March prior to the release in the end of March was already all time high rate of suicides.<p>&quot;Table 1. Association Between the Release of 13 Reasons Why and Suicide in the United States, by Age Group&quot;<p>I mean ... it&#x27;s just stupid. The series&#x27; premiere date is also a arbitrary point in time.<p>I don&#x27;t refute that the series might have increased the suicide rate, but I have no idea how to verify that or put a estimate on it. The authors surely don&#x27;t know either.

Obviously horrific but a major failing of the study is that it doesn&#x27;t state what percentage of the teens who committed suicide actually watched or were even aware of Netflix&#x27;s &quot;13 Reasons Why&quot;. The conclusions are drawn from very indirect evidence.

&quot;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. While suicide rates for females increased after the show’s release, the increase was not statistically significant.&quot;<p>I have watched the series. I wonder why males saw a significant increase in suicides if the show revolved around a female suicide. And, yes, I understand they didn&#x27;t find direct causation.<p>There explanation at the end was refreshing.<p>&quot;While compelling, this research had several limitations. For example, the study used a quasi-experimental design, meaning that the researchers cannot make a causal link between the release of “13 Reasons Why” and the observed changes in suicide rates. The researchers cannot, therefore, rule out the possibility that unmeasured events or factors influenced suicide rates during this period.&quot;

Paper: <a href="https:&#x2F;&#x2F;webcache.googleusercontent.com&#x2F;search?q=cache:gUa9-SNEkTgJ:https:&#x2F;&#x2F;www.jaacap.org&#x2F;article&#x2F;S0890-8567(19)30288-6&#x2F;pdf+" rel="nofollow">https:&#x2F;&#x2F;webcache.googleusercontent.com&#x2F;search?q=cache:gUa9-S...</a><p>The Werther Effect was well known, from inception, filming and publishing, the concerns seem to have been brushed aside. I really can&#x27;t see how the studio, netflix and the producers can reject the blame for the induced suicides.<p>The show distinctly glorifies suicide, playing on the emotional issues and need for acknowledgment of teenagers.<p>Responsibility does not vanish if the effects are indirect or abstract.<p>&quot;We produced the show true to the book.&quot; is no defense at all and there is a higher moral standard if you sell a product to children still.

I&#x27;m curious if there&#x27;s an unusual dip after the spike. In other words, it might have accelerated some suicides, versus adding to the overall rate over a longer time period.

Potentially OT. Why do people write<p>&gt;&quot;While suicide rates for females increased after the show’s release, the increase was not statistically significant.&quot;<p>instead of<p>&gt;&quot;Suicide rates for females did not increase significantly after the show&#x27;s release.&quot;<p>?<p>I have seen this quite often and it always seems a bit misleading to me.<p>Edit: I should have written the 2nd version as &quot;No statistically significant increase in [...] was found&quot;. My point is not about the difference between &quot;significance&quot; and &quot;statistical significance&quot; but about mentioning an effect, while also saying the effect is not statistically significant. If it&#x27;s not statistically significant, why mention it?

These suicide studies are ridiculous. A 30% increase works out to something like twenty additional suicides in a population of around forty million. Trying to blame that on a television show seems far fetched.

You should be _extremely_ skeptical of this finding.<p>1. It&#x27;s an observational, retrospective study.<p>2. The control analysis is dubious, and its unclear if the control analysis was selected in advance.<p>2. It&#x27;s an astonishingly high effect size.<p>3. They do numerous sub-group analyses without any indication that such analyses were pre-registered, and apparently without doing any multiple-comparisons corrections (e.g. bonferroni).<p>3. From the article: &quot;The observed suicide rate for March 2017 — the month prior to the release of “13 Reasons Why” — was also higher than forecast. The researchers note that the show was highly promoted during the month of March, exposing audiences to the show’s premise and content through trailers. The researchers did not find any significant trends in suicide rates in people 18- to 64 years of age.&quot;<p>We&#x27;re being asked to believe not only that the show itself can have this huge effect, but that the trailer can too. But only among males in a certain age group.<p>This stinks.

It&#x27;s a show that (at least from the title, and a quick summary of the plot) agrees with the common, awful idea that what people do to you can <i>make</i> you kill yourself, and that killing yourself will somehow punish the people who made you do it. You would expect it to increase teen suicides as much as you would expect a slickly produced show about a suicide bombing in a shopping mall causing an unjust government to fall and the bomber to be remembered forever as a hero to increase suicide bombings.

&gt; NIH-supported study highlights the importance of responsible portrayal of suicide by the media<p>I&#x27;m not going to say that media doesn&#x27;t play a part, but this is mostly a symptom of an inadequate mental health system and a disfunctional society that provides no sense of community&#x2F;cohesion. Many of us are painfully alone and directionless. We come from broken homes and experience neglect and abuse in childhood.<p>Pointing the blame at a TV show just feels insulting.

&gt;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.<p>&quot;13 Reasons Why&quot; was a show about the suicide of a young girl and was primarily aimed at a young female audience. If the studies numbers were primarily driven by an increase in suicides among young males, the causation implied seems rather dubious.

Interesting to ponder, but hard to draw any conclusions. There are too many confounding factors, including other prominent suicides covered in the media.<p>LA Times article criticising the study[1]:<p>&gt; While no variations in the suicide rate were found for people ages 18-64, the rate among people ages 10 to 17 increased by 28.9% in April 2017, the month after the series debuted, the study said. It was also up significantly in June and December of that year, and was higher than expected in March 2017, when the show was heavily promoted. The April 2017 rate was the highest in the five-year period that was studied.<p>&gt; Outside events include things such as the much-covered suicides of Soundgarden’s Chris Cornell in May 2017 and Chester Bennington of Linkin Park in July of that year, and the death of musician Tom Petty by accidental overdose that October, Moutier says. Also, former NFL star Aaron Hernandez died by suicide in April 2017. […]<p>&gt; Here’s how a 28.9% increase can also be described as a “weak association,” according to Moutier: The overall suicide rate of boys 10-17 is actually very low, she says, around 0.6 per 100,000 people. Therefore, any change could be seen as significant change.<p>Guest column from the executive producer of the show[2]:<p>&gt; However, the research failed to substantiate the author&#x27;s own hypothesis: that when the show launched on March 31, 2017, young females would be most affected, because it&#x27;s a girl whose suicide is depicted onscreen. In fact, there was no increase in suicide rates for adolescent girls that spring — and for boys the increase started before the show even launched. As you can see from the chart below, which is based on the same government data, suicide counts for adolescent girls over the last decade have been much more stable than for boys, which have risen consistently. The highest recorded month for girls was November 2016, well before anyone had ever watched 13 Reasons Why.<p>[1]: <a href="https:&#x2F;&#x2F;www.latimes.com&#x2F;entertainment&#x2F;tv&#x2F;la-et-st-13-reasons-why-suicide-study-netflix-20190501-story.html" rel="nofollow">https:&#x2F;&#x2F;www.latimes.com&#x2F;entertainment&#x2F;tv&#x2F;la-et-st-13-reasons...</a><p>[2]: <a href="https:&#x2F;&#x2F;www.hollywoodreporter.com&#x2F;live-feed&#x2F;13-reasons-why-creator-refutes-studies-linking-netflix-hit-suicide-increase-guest-column-1213858" rel="nofollow">https:&#x2F;&#x2F;www.hollywoodreporter.com&#x2F;live-feed&#x2F;13-reasons-why-c...</a>

Depression is a tough topic. Speaking from experience here, it&#x27;s healthy to talk about your feelings, etc. But if you look at the communities like # depression on tumblr&#x2F;reddit etc, I bet it will make healthy people feel a bit depressed.<p>In kinda a cyclic issue, the problem is that depressed people need to sorrounded them selves with happy people to talk to, consume more positive media,etc.<p>Otherwise you end up feeding your own depression, producing and consuming more depressive content and comments with others.<p>To anyone facing depression : Please talk to a therapist, and consider avoiding needlessly negative communities&#x2F;media. Sorrounding yourself with depressing things won&#x27;t help.

Throwaway and vagueness for hopefully obvious reasons.<p>I was loosely involved in the production of this show. I didn&#x27;t find out about it until after our contribution was finished.<p>If I had known what content we were working on I would voiced my concern. I&#x27;m deeply ashamed I had anything to do with this and if I had known, I wish I could have verbalized my objection and voiced concern over being affiliated with the reckless disregard the production staff has for a leading cause of death among people in America that has taken the lives of friends and family.

A pet peeve of mine is the noble suicide trope used often in film and tv. Armageddon, Aliens, Endgame, 7 Pounds, its everywhere. I haven&#x27;t seen any research but I imagine it could normalize suicide in the minds of the impressionable young.<p>I get that&#x27;s its an effective (though artistically blunt) plot device but I would prefer that it be used less.

The movies we watch can affect our decisions and choices we make in our life. And the affect is different for different people.<p>In the same way that those sponsored scenes already did to smoking and drinking trends. Bad driving styles, attraction to martial art etc.

Here&#x27;s the study itself, although it&#x27;s not open access, so you&#x27;ll need to be somewhere that can get you access to it.<p><a href="https:&#x2F;&#x2F;www.jaacap.org&#x2F;article&#x2F;S0890-8567(19)30288-6&#x2F;fulltext" rel="nofollow">https:&#x2F;&#x2F;www.jaacap.org&#x2F;article&#x2F;S0890-8567(19)30288-6&#x2F;fulltex...</a>

the title of the paper is at the bottom of the nih page. plugging that into google produces this page:<p><a href="https:&#x2F;&#x2F;www.jaacap.org&#x2F;article&#x2F;S0890-8567(19)30288-6&#x2F;pdf" rel="nofollow">https:&#x2F;&#x2F;www.jaacap.org&#x2F;article&#x2F;S0890-8567(19)30288-6&#x2F;pdf</a><p>which combined with sci-hub, gets you full text.

Yeah no cap they kinda glorified suicide. I don&#x27;t mean like the gritty details, but like the concept. The show romanticizes suicide as a way to get back at the people who harmed you, solve your problems, and make a huge impact on all the people around you, for better or worse.

This is not suprising and not the first time something like this happend.<p>There is even a term for that &quot;Werther Effekt&quot;<p><a href="https:&#x2F;&#x2F;en.wikipedia.org&#x2F;wiki&#x2F;Copycat_suicide" rel="nofollow">https:&#x2F;&#x2F;en.wikipedia.org&#x2F;wiki&#x2F;Copycat_suicide</a>

This news marks the end of my Netflix subscription. This news should have everyone at the company questioning why they are contributing to service that claimed the lives of nearly two hundred children.

So I suppose that we should ban series about suicide... Also the more people that drive, also increases the number of people who die on the road, thus it follows that we ban driving.

I seem to remember suicide being considered cool in the grunge era of the 90s, especially after Kurt Cobain took his life. I wonder if there’s data on that.

But how many people realized they were depressed, or someone around them had suicidal tendencies, and got help as a result of this program?

This must be brutal for the producers &amp; actors. I&#x27;d be crushed.

Where can I find the full text of the study?

Funny how one tv series would have induced many suicides, while currently family situation and society have nothing to do with it? Please...

Is there a link to the study?

But how many of those students watched the series? Or was it less direct? Maybe the show’s popularity led to a higher number of suicide discussions, insults, references etc?