Mental health Research Youth mental health

Behind the research: How fictional portrayals of suicide can influence vulnerable people


A new study published in JAMA Psychiatry has found that the Netflix series 13 Reasons Why led to an increase in death by suicide in children and youth in the three months after the show’s launch.

Dr. Mark Sinyor is a psychiatrist at Sunnybrook Health Sciences Centre and author of the study which included experts from Austria, Canada, Australia and the United States.

Dr. Sinyor shares deeper insight into the study.

What did your study find?

Our study found that deaths by suicide in 10-19 year olds in the U.S. increased by 13 per cent (94 more deaths) in the three months after the release of the Netflix series “13 Reasons Why.”

This was a predictable outcome given past scientific research showing that when news media publicizes harmful information about suicide it can influence vulnerable readers or viewers and result in higher suicide rates. We also know, however, that when messages of hope or information to seek help are shared, people are more likely to be influenced positively and reach out for help.

We hope this study highlights the impact and influence that the entertainment industry can have on the public and suggest that stronger collaboration is needed between the entertainment industry and suicide prevention experts to help prevent this kind of impact from happening again.

» Learn more about recommendations for media reporting on the topic of suicide

Watch a clip of Dr. Sinyor:

How can fictional portrayals of suicide influence people who are vulnerable?

Suicide is complicated and involves multiple factors.

Research studies have shown that the media can have an influence on the public. For example, if a negative message that suicide is inevitable is published or presented, some people who are already considering suicide may take that seriously and assume it is true.

However, research also shows the opposite – that if positive messages about hope are shared or if crisis-line information is shared, many people will act on those messages and seek help.

We do know that suicide almost always arises from a treatable mental illness. People need to know that there is help and that suicide can be prevented.

» Read personal stories of hope, strength and resilience

It is vital that we educate our youth as well as adults that if you begin to think life is not worth living or about ending your life that this is a signal that you aren’t well and that by reaching out to mental healthcare, you can recover.

It is important to note that caution must be taken in interpreting the data. While studies like this one cannot definitively prove cause-and-effect, the observed increase in death by suicide in the youth age group and in particular young women are consistent with what would be expected if there was a contagion effect by media.

We hope this study reinforces the importance of close collaboration between the entertainment industry and suicide prevention experts to ensure that any future fictional portrayals of suicide are safe.

Aren’t TV shows a way to keep up the conversation about suicide and mental health and reduce stigma?

They can be, but it depends on the content.  Education is a good thing as long as we are not presenting myths as truth. TV shows can help as long as they emphasize what is scientifically accurate: for example, that suicide is preventable. There is no reason whatsoever that anyone, let alone any young person, has to die by suicide.  People thinking about suicide need to know that help is out there and that they can overcome those thoughts if they reach out for help.

If you need help in an emergency, please call 911 or visit your local emergency department. If you’re feeling like you’re in crisis or need somebody to talk to, please know that help is also available 24/7 through community resources:

Phone: toll-free at 1-833-456-4566
Text: 45645 (4 p.m. – 12 a.m. EST)

About the author


Jennifer Palisoc

Jennifer Palisoc is a Communications Advisor at Sunnybrook.

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