Did 13 Reasons Spark A Spike In Suicides?

We do not know if the airing of "13 Reasons Why" caused an increase in suicide or not, and that in and of itself is astonishing. In the world of very advanced techniques for collecting and monitoring data, and in a world that we are led to believe is on the edge of the next epidemic, you would think the suicide rate could be estimated on the fly, with minor corrections later. Climate scientists are able to assimilate tens of thousands of data readings taken multiple times a day around the world into estimates of global surface temperatures. There is a daily ongoing estimate that I assume uses only part of the data, and at the end of every month, the data are crunched and the estimate spilled out, and only rarely is there a correction needed.

Anyway, we don't have that information but there are two pieces of information we do have. One is from an older study.

There is evidence to suggest that some of the variation in suicide rates is accounted for by some of the variation in internet search rate. (This is not a causal statement, but a statistical statement.) From the abstract of the study:

... a set of suicide-related search terms, the trends of which either temporally coincided or preceded trends of suicide data, were associated with suicide death. These search factors varied among different suicide samples. Searches for "major depression" and "divorce" accounted for, at most, 30.2% of the variance in suicide data. When considering only leading suicide trends, searches for "divorce" and the pro-suicide term "complete guide of suicide," accounted for 22.7% of variance in suicide data.

A recent piece by Madhumita Murgia in the Washington Post reported the connection between that older work and a current study showing that Internet search activity in relation to suicide spiked at the time that the Netflix series "13 Reasons" (based on this book) was released.

The 13-episode series, which was released all at once, chronicles 13 tapes that Hannah sends to those she blames for her actions. The series has captured the imagination of kids across the country. In April, it set a record for the most-tweeted-about show in 2017, when it was mentioned more than 11 million times within three weeks of its March 31 launch.

The jump is documented in a study published in JAMA by John Ayers, and others, called "Internet Searches for Suicide Following the Release of 13 Reasons Why.: The study results:

All suicide queries were cumulatively 19% (95% CI, 14%-24%) higher for the 19 days following the release of 13 Reasons Why, reflecting 900 000 to 1.5 million more searches than expected (Figure). For 12 of the 19 days studied, suicide queries were significantly greater than expected, ranging from 15% (95% CI, 3%-32%) higher on April 15, 2017, to 44% (95% CI, 28%-65%) higher on April 18, 2017.

Seventeen of the top 20 related queries were higher than expected, with most rising queries focused on suicidal ideation. For instance, “how to commit suicide” (26%; 95% CI, 12%-42%), “commit suicide” (18%; 95% CI, 11%-26%), and “how to kill yourself” (9%; 95% CI, 4%-14%) were all significantly higher. Queries for suicide hotlines were also elevated, including “suicide hotline number” (21%; 95% CI, 1%-44%) and “suicide hotline” (12%; 95% CI, 5%-19%). Last, public awareness indicative searches, such as “suicide prevention” (23%; 95% CI, 6%-40%) or “teen suicide” (34%; 95% CI, 17%-52%), were elevated.

...

Additional surveillance will clarify our findings, including estimating changes in suicide attempts or calls to national suicide hotlines. Nonetheless, our analyses suggest 13 Reasons Why, in its present form, has both increased suicide awareness while unintentionally increasing suicidal ideation.

So, yes, "13 Reasons" may have had the effect in spiking suicide rates for a short term, but until we know we should not make too much of it. But generally I would like to see mortality and morbidity data more frequently updated.