Citation

O'Brien KHM, Knight JR, Harris SK. JAMA Intern. Med. 2017; 177(10): 1418-1419.

Affiliation

Harvard Medical School, Boston, Massachusetts.

Copyright

(Copyright © 2017, American Medical Association)

DOI

10.1001/jamainternmed.2017.3388

PMID

28759674

Abstract

The national suicide rate has risen steadily in recent decades, making suicide now the second leading cause of death among young people, accounting for more than 1 in 6 deaths. Adolescent reports of suicide ideation and attempts are on the rise. According to national high school Youth Risk Behavior Survey,2 the percentage of high school respondents who reported that they seriously considered attempting suicide during the 12 months preceding the survey rose from 13.8% in 2009 to 17.7% in 2015; during this same interval, the percentage of high school students making a plan for how they would attempt suicide increased (10.9% to 14.6%), as did the percentage who actually attempted suicide (6.3% to 8.6%).

Ayers and colleagues found that suicide-related internet searches increased following the release of the series 13 Reasons Why on Netflix, with increases in specific query terms suggesting that the series had both a positive effect of elevated suicide awareness as well as a deleterious effect of increased suicide ideation. We cannot ascertain whether the searches on “how to kill yourself” were made out of idle curiosity or by suicidal individuals contemplating an attempt. While it is likely that far more were due to the former, the producers of the series should have taken steps to mitigate the latter, as encouraged by suicide prevention specialists. For instance, greater attention to safe messaging guidelines for suicide prevention (http://www.suicidepreventionmessaging.org) could have protected against some unintended effects. Specifically, as Ayers and colleagues3 point out, the series would have benefitted from emphasizing seeking help and providing information on finding help by listing concrete steps before and after each episode, such as calling the National Suicide Prevention Lifeline (1-800-273-TALK). In addition, the choice to graphically depict the suicide death of the star of the series was a controversial decision, as evidence suggests that pictures or detailed descriptions of how or where a person died by suicide can be a factor in vulnerable individuals imitating the attempt...

Language: en