How 13 Reasons Why sparked years of suicide-contagion research

When 13 Reasons Why debuted on Netflix on March 31, 2017, it was initially met with mostly rave reviews from critics and viewers alike. Viewers appreciated the show’s frank and sensitive handling of such complex topics as suicide, bullying, rape, and depression. Within weeks, however, mental health professionals began voicing strong objections to the YA-targeted show’s treatment of suicide in particular—these professionals believed the depiction could trigger suicidal thoughts or actions in vulnerable teens.

It’s well known that high-profile suicides can sometimes influence copycats, but the issue is less clear when it comes to fictional stories. Throughout the last four years, multiple, often contradictory studies on that very topic have since appeared. Some of the studies show negative impacts, while others show beneficial effects in young people who watched 13 Reasons Why.

The series aired its fourth and final season last year, but 13 Reasons Why continues to inspire research on the potential impact (positive or negative) of fictional stories on teen mental health. A new study available today from researchers affiliated with UCLA’s Center for Scholars and Storytellers focuses specifically on the show’s third season, and it shows that series like 13 Reasons Why can have a positive impact on teen mental health as long as the issues are depicted accurately and with empathy.

The report also recommends that appropriate supplementary resources be provided to viewers—which is a major challenge, since most viewers don’t engage with such resources even when they are available. But whether it’s a streaming series or accompanying readings, the researchers at UCLA’s Center for Scholars and Storytellers strongly believe that the media tweens and teens consume plays a crucial role in their development, as it does with any other young demographic.

“I went into the film business because I believe content can change the world,” said Yalda Uhls, a former film executive who went on to earn a PhD in child development and now leads this three-year-old research center. “We’re working to harness the power of entertainment media for tweens, teens, and young adults, and to support social and emotional learning. There’s a long history of doing this for preschool audiences, like Sesame Street and PBS Kids. I felt there was a gap there. The tween and teen years are just as important a developmental period as early childhood.”

(Spoilers for 13 Reasons Why below.)

The Netflix series at the center of all this is based on the 2007 YA novel Thirteen Reasons Why by Jay Asher, in which a high school student named Clay struggles in the aftermath of his friend Hannah’s suicide. (Asher was moved to write the book after a close relative attempted suicide.) Hannah has left behind seven double-sided cassettes, identifying 13 people she blames for driving her to such a desperate act. It’s her way of confronting her tormenters from beyond the grave.

There is the boy who humiliates her after their first date; the girl who spreads rumors about Hannah to hide her own same-sex inclinations; a student who betrays her trust; the bullying jock, Bryce, who rapes Hannah; and the high school guidance counselor who turns a blind eye to Bryce’s chronic bullying and rape-y behavior, just to name a few. (Hannah was not Bryce’s only victim.) The tapes are mailed out to each person on the list in succession. Hannah’s story is told in flashbacks, with present-day events narrated from Clay’s point of view.

Asher’s novel remained on The New York Times bestseller list for more than three years despite mixed critical reviews, and it ultimately garnered a number of awards. But the story also generated a fair amount of controversy because of its frank depictions of bullying, sexual assault, and suicide. From 2010 through 2019, it was the third most-banned book in the US. The release of the Netflix series only brought renewed attention.

Apart from a few small deviations, the streaming series hews pretty closely to Asher’s novel. There is one key difference, however. In the novel, Hannah kills herself by swallowing a handful of pills. By contrast, the TV series originally included an intense, graphic scene where Hannah slits her wrists in the bathtub. Full disclosure: I was a fan of the first season, and I found that scene to be beautifully rendered and emotionally powerful, albeit extremely difficult to watch. (The two are not mutually exclusive.) So I was frankly surprised when the backlash began. In retrospect, I shouldn’t have been.

The backlash begins

By standard Hollywood metrics, 13 Reasons Why was a success. The response, and viewership, was sufficiently strong to spawn three subsequent seasons (which were far less well received). Katherine Langford, who played Hannah, was nominated for a Golden Globe. The series even won a Mental Health America Media Award in 2018 “for elevating the dialogue across the country between parents, students, and mental health advocates on the epidemic of teen suicide, depression, and bullying.”

Among those who were not fans was Washington Post television critic Hank Stuever, who compared the show to one of ABC’s old afterschool specials. He also objected to the basic storyline. “[It] strikes me as remarkably, even dangerously naive in its understanding of suicide,” he wrote. As the weeks wore on, voices like Stuever’s began to dominate the conversation.

The backlash centered on the risk of suicide contagion (or copycat suicides) among teens. Suicide contagion is a phenomenon in which exposure to suicide within a family, among friends, or through the media may be associated with an increase in suicidal behavior. Many expressed concerns that the show glamorized suicide, and these critics thought the bathtub scene in particular violated current journalistic guidelines for responsible reporting on suicide.

In April 2017, the National Association of School Psychologists released a statement warning about the potential adverse effects of the series, and the organization also sent a letter to school mental health professionals—the first time it has undertaken such an action. The Society of Clinical Child and Adolescent Psychology (SCCAP) released a similar statement and also criticized the depiction of ineffectual mental health professionals—notably, high school guidance counselor Kevin Porter (Derek Porter), who fails Hannah when she seeks his help after her rape by Bryce.

“From a public health perspective, the producers of 13 Reasons Why (S1) disregarded established science and the evidence that the approach they were set on taking—depicting suicide in a raw and graphic way—would set a blueprint for a vulnerable subgroup, especially those who identified with the main character,” said John Ackerman, a psychologist specializing in suicide prevention at Nationwide Children’s Hospital in Columbus, Ohio.

Ackerman is quick to emphasize that he is not anti-Netflix. “I am not someone who overstates media effects,” he told Ars. “Media, gaming, and social media can be part of the solution if done well. However, the science was strong enough at the time to know there was strong potential for harm. There was virtually unanimous condemnation of this series by the suicide prevention and mental health community. Why? Because they knew what the producers did not—all attention to a problem is not created equal, and modeling suicide as a solution to distress and bullying is dangerous.”