A significant number of at-risk teenagers say the Netflix show "13 Reasons Why" puts them at greater risk for suicide, according to a study published in the journal Psychiatric Services.
The show, marketed to teenagers, revolves around the suicide of a 17-year-old girl and its impact on her friends and community. The story goes into graphic detail about the reasons behind her suicide, and also addresses sexual assault and substance abuse.
There's a body of evidence supporting that interest in suicide rose among teenagers following the show's release. Netflix itself commissioned a study on the issue and ultimately added a content warning before each episode.
The new study, conducted by professors at the University of Michigan, surveyed a group of young people - mostly people between the ages of 13 and 17, and mostly female - and asked them about the show. Everyone in the sample had also gone to a psychiatric emergency department "with suicide-related concerns" in the year since the series premiered.
49% of the sample surveyed said they watched at least one episode. Of those people, 51% said it increased their risk of suicide. The effect was especially strong among "high-risk" youth, according to the study.
"Youths with more depressive symptoms and suicidal ideation were more likely to identify with the lead characters and report negative affect while viewing," the study said.
Victor Hong, the study's lead author and the medical director of psychiatric emergency services at Michigan Medicine, said that parents, teachers, and health providers were concerned about the effect of the show - especially on teenagers already at risk for suicide.
"Our study doesn't confirm that the show is increasing suicide risk, but it confirms that we should definitely be concerned about its impact on impressionable and vulnerable youth," he said. "Few believe this type of media exposure will take kids who are not depressed and make them suicidal. The concern is about how this may negatively impact youth who are already teetering on the edge."