The Case Against "13 Reasons Why"

Trigger Warning: This piece discusses mental illness, suicide, and rape.

Last year, we shared a piece about some common concerns about the Netflix original series 13 Reasons Why based on the novel of the same name by Jay Asher. Since then, the show has had a second emotional season, and despite it being less successful than the show’s first, Netflix has announced that the show will continue with a third season set to premiere in 2019.

The show has received criticism since its debut in March 2017 for its depiction of serious  topics such as rape and suicide. Numerous mental health experts and those who personally experience mental health problems have been vocal about their concerns that the show may be harmful to those viewing it. One of the strongest concerns lies in the graphic depictions of rape and suicide. In response to the criticism, Netflix added trigger warnings to the beginning of each episode, but many don’t think that’s enough.

Those against the show believe that 13 Reasons Why glorifies suicide and could be dangerous for vulnerable youth, while those who support the show claim that it is an important tool in promoting conversations about these topics in order to help prevent suicide. There is support for both sides of the argument. According to a research letter in JAMA Internal Medicine, in the 19 days following the release of 13 Reasons Why, suicide-related internet searches increased by a considerable 19%. Searches focused on suicidal ideation, such as searches for suicide methods, increased by 26%. However, these statistics were matched by a 26% increase in searches for suicide prevention and a 21% increase in searches for suicide hotlines.

As is all too common with media, the controversy surrounding 13 Reasons Why had all but faded to the background of the internet as the show’s popularity declined. Then, last week, the show returned to headlines following the publication of a University of Michigan study on the impact of the show on at-risk youth. The study, published in Psychiatric Services on November 20th, 2018, found that 13 Reasons Why did cause increased suicidal ideation in youths already at risk of suicide.

Michigan Medicine researchers surveyed 87 at-risk youths and their parents. Those eligible for the study were youths between 10 and 17 years old who presented to a psychiatric emergency department (ED) with a suicide-related concern. Both youths and parents were given questionnaires to determine their exposure to and effects from 13 Reasons Why. In order to prevent advertising the show, kids who didn’t have access to streaming sites or hadn’t been exposed to the show were asked no further questions. Those who were asked further questions were inquired as to how much of the show they watched, who they discussed the show with, their emotional response to the show, and how much they identified with the lead characters, among other things.

Only half of the sample had viewed at least one episode of 13 Reasons Why, and most of the youths (84%) watched it alone. The youths also reported that they were much more likely to discuss the show with peers than with a parent. 51% of the youths surveyed reported that viewing the show increased their suicide risk. Those who identified more strongly with the lead character, Hannah, were more likely to report a negative effect from viewing. This connection increased in youths with more symptoms of depression. There was no connection determined between identifying with the lead male character, Clay, and an increase in symptoms.

“Our study doesn’t confirm that the show is increasing suicide risk, but it confirms that we should definitely be concerned about its impact on impressionable and vulnerable youth,” says lead author Victor Hong, M.D., medical director of psychiatric emergency services at Michigan Medicine. “Few believe this type of media exposure will take kids who are not depressed and make them suicidal. The concern is about how this may negatively impact youth who are already teetering on the edge.”

However, the study does have a few problems. The kids in the sample were mostly female, mostly Caucasian, and were all recruited from a single psychiatric ED. The sample size was also fairly small. Because the study only relates to youths already at-risk, it provides no information on kids who don’t already have symptoms of depression and suicidal thoughts, and thus lacks many potential comparisons between the two. The study also neglected to take into consideration the sexual assault aspect of the show, as well as information on any history of sexual assault of those surveyed and how that information could affect the results.

The idea for the study was based on an increase in the discussion of 13 Reasons Why by teens being treated for suicidal symptoms across multiple children’s hospitals. The authors share that, although further research is needed before anything is certain, they believe that youths at risk of suicide are vulnerable to the effects of the show’s themes. In the meantime, it’s important for parents to be open and honest with their kids and to not shy away from such difficult topics. The researchers recommend tailored prevention programming for vulnerable youths, education and training for parents regarding youth suicide, and peer-focused interventions. Since youths are statistically more likely to talk to their peers, it’s also important for friends and other loved ones to watch out for each other.

If you or someone you know is experiencing symptoms of depression or suicidal thoughts, please reach out to the National Suicide Prevention Hotline, or one of the many resources available here on campus.