Internet searches related to suicide increased in the immediate aftermath of the premiere of the Netflix series “13 Reasons Why,” which explores how bullying contributes to a high school girl’s suicide.
A team of researchers led by behavioral scientist John Ayers of San Diego State University published its findings as a research letter Monday in the Journal of the American Medical Association.
“For some viewers, the series glamorizes the victim and the suicide act in a way that promotes suicide, while other viewers hope the series raises suicide awareness,” the researchers wrote in their opening discussion, while noting widespread interest in the series and its implications has generated more than 600,000 news reports.
“To advance the debate, we examined how internet searches for suicide changed, both in volume and content, after the series’ release,” the researchers wrote.
Based on the 2007 young adult novel of the same name by Jay Asher, the series follows the aftermath of the suicide of a girl who sent 13 cassette tapes to classmates she holds responsible for driving her to kill herself.
“I understood that we were going into something that is difficult, but these kids today are so exposed to things that I would never even have comprehended when I was 8,” executive producer Selena Gomez told a radio morning show last month.
To assess and analyze online searches, the researchers used Google Trends to identify the top 25 queries that included suicide and five terms related to suicide.
They examined a period of 19 days from the debut of the show and compared it to trends from January to March, before the show was available online. All 13 one-hour episodes were available at once on Netflix to subscribers on March 31.
During that time, researchers found a 19 percent increase in Google queries related to suicide, which reflected 900,000 to 1.5 million more searches than what would have been expected.
Nationally, suicide rates have increased from 12.3 per 100,000 people in 2011 to 13.3 per 100,000 in 2015, according to the Centers for Disease Control and Prevention.
Suicide accounted for more than 44,000 deaths in 2015 and is the second-leading cause of death for people ages 10 through 34 after unintentional injury.
In the research letter, the scientists said that searches for suicide hotlines were higher but were fewer than “suicide ideation,” which included search terms like “how to commit suicide” (up 26 percent), “commit suicide” (up 18 percent) and “how to kill yourself” (up 9 percent).
Other queries like “suicide hotline number” increased to 21 percent, “suicide prevention” by 23 percent and “teen suicide” by 34 percent.
The researchers said they couldn’t confirm that suicide rates increased as a direct result during this period of increased queries, but they referred to other research that shows a correlation between search trends and actual suicides, and media coverage of suicides and increased suicide attempts.
A 2011 study in Taiwan found an association between internet search trends and actual suicides, and a 2003 study examined how the media coverage of people killing themselves can influence “copycat” suicides.
The researchers suggest, based on recommendations by the World Health Organization’s media guidelines for preventing suicide, that the show remove scenes showing suicide — the series finale shows the main character’s suicide over a three-minute scene — and add disclaimers to the episodes with the number for a suicide hotline.
Netflix has added disclaimers before the episodes amid public outcry, warning viewers of its graphic nature, that the content may be unsuitable for certain age groups and listing a link to the show’s website for information on suicide prevention.