Medical Examiner

We Don’t Need Science to Know 13 Reasons Why Had Problems

It’s hard to draw conclusions from the swell of research on the show’s influence over suicide rates. We don’t need to.

Alisha Boe and Katherine Langford sit in chairs against a wall in 13 Reasons Why
Alisha Boe and Katherine Langford in 13 Reasons Why.
Netflix

In April, a study was published that suggested Netflix’s 13 Reasons Why, a show that is centered around the main character’s suicide, might be linked to a “ significant increase in monthly suicide rates” among teen boys that occurred following the release of the show. A study published just this week in JAMA Psychiatry found, like the April study, that the show was linked to an increase in teen suicide—though the authors of this study think the show potentially had a greater impact on girls, not boys. These studies have been covered with concern but caution: the research is not definitive.

Also this week, the show’s creator and executive producer Brian Yorkey took to the Hollywood Reporter to defend himself. Along with Rebecca Hedrick, a psychiatrist who served as an adviser to the show, he offers the same critique of the April study that others, including the original study authors, have: Correlation is not the same as causation. It’s not clear that fictional stories can function as a suicide contagion, Yorkey writes, and he’s right (the authors of the JAMA study said the same—“caution must be taken in interpreting these findings.”) Netflix having the blood of teens on its hands would be an extraordinary claim, for which extraordinary evidence should be required. But Yorkey and Hedrick make a different extraordinary claim: They think 13 Reasons Why is actually having a positive impact. That’s not right, either.

Their argument is that the show is starting an important conversation around mental health, a thesis that has been a central tenet of the program’s press strategy for years. In 2017, following the show’s premiere, producer-slash-celebrity Selena Gomez responded to the resulting backlash by saying the same thing: She hopes the show’s unflinching approach opens a “door for people to actually accept what’s happening and actually go and change it, talk about it.” (Incidentally, encouraging “conversation” around mental health resulting from the show is conveniently similar to encouraging conversation around, and viewership of, the show itself.)

Yorkey and Hendrick note that there are “numerous independent pieces of research” that support their theory that the show is having a positive influence. Unfortunately, it’s difficult to evaluate this body of work because they describe it only briefly and do not link to any actual papers. But one might be a study published recently in Social Science and Medicine, which found that folks who watched the second season of the show all the way through reported less suicidal ideation than before. The findings weren’t straightforward though: Viewers who stopped partway through “exhibited greater suicide risk and less optimism about the future,” the authors write (and either way, we’re still stuck in a correlation-isn’t-causation place).

Another example of Yorkey and Hendrick’s data might be an online survey out of Northwestern’s Center for Media and Human Development that was commissioned by Netflix itself. The resulting report, perhaps unsurprisingly, paints a rosy picture, suggested that the show resonated with parents and kids, provided relevant information, and, yep, “supported conversation.”

I have to wonder who would voluntarily admit in an online survey that they watched the show and were, as a result, more likely to bully someone. But even given the questionable methods of the survey, the data found in the middle of the report tell a more negative story: One-third of teens and young adult viewers surveyed in the U.S. found a rape scene in the show too graphic, didn’t agree that watching the show was beneficial, and didn’t find that the suicide to be depicted in a way that “was appropriate for me personally.” These figures, which represent a rather large swath of viewers, tended to be higher among folks with social anxiety. The researchers did not go much further than that. What about the kids grappling with depression and suicidal ideation—the people who stand to be the most harmed by the program? They didn’t ask.

I don’t think it’s impossible that there are some upsides to the show for some people. The PSA that aired at the start of the second season was well-received, though that was arguably a response to backlash—meaning that if the show is doing helpful things, it’s precisely because of pressure from viewers who found it lacking. But it’s too simplistic to argue that flinging any depiction of suicide into the world counts as starting a positive conversation. Instead, we need to acknowledge that the show offers a mess off “complex trade-offs,” as the authors of a JAMA Psychiatry editorial that ran alongside the most recent paper explain. Trying to precisely calculate what those trade-offs are, and whether they present a net positive or a net negative, will be extremely hard. For one thing, it’s nearly impossible to prove any direct relationships between suicide rate and watching 13 Reasons Why because it’s nearly impossible to place blame squarely anywhere after a suicide.

But we don’t need hard research proving that the show had a negative impact on enough people’s lives to understand that it could have, especially for more vulnerable teens. Instead of waiting for evidence proving that Netflix did a net good or net bad job with this one, we should consider what mental health professional after mental health professional has noted: There are issues with the plot that spread iffy ideas about suicide and mental health. Specifically, that the show depicts the act as a revenge fantasy and suicide as a means to exercise some control over your social circle. We don’t need to show that the program led to a spike in suicides to be concerned about the ramifications. We can just call it what it is: a piece of entertainment that’s constructed around a dangerous message.