Citation

Felton C. Sociol. Sci. 2023; 10: 930-963.

Copyright

(Copyright © 2023, Society for Sociological Science)

DOI

10.15195/V10.A33

PMID

unavailable

Abstract

I present evidence that the release of Netflix's 13 Reasons Why--a fictional series about the aftermath of a teenage girl's suicide--caused a temporary spike in emergency room (ER) visits for self-harm among teenage girls in the United States. I conduct an interrupted time series analysis using monthly counts of ER visits obtained from a large, nationally representative survey. I estimate that the show caused an increase of 1,297 self-harm visits (95 percent CI: 634 to 1,965) the month it was released, a 14 percent (6.5 percent, 23 percent) spike relative to the predicted counterfactual. The effect persisted for two months, and ER visits for intentional cutting--the method of suicide portrayed in the series--were unusually high following the show's release. The findings indicate that fictional portrayals of suicide can influence real-life self-harm behavior, providing support for contagion-based explanations of suicide.

METHODologically, the study showcases how to make credible causal claims when effect estimates are likely biased. © 2023 The Author(s). This open-access article has been published under a Creative Commons Attribution License, which allows unrestricted use, distribution and reproduction, in any form, as long as the original author and source have been credited.

Language: en

Keywords

suicide; self-harm; imitation; contagion; causal inference; interrupted time series