The Netflix series, 13 Reasons Why, has caused a furor.  In the show, a high school student who has died by suicide has left 13 tapes, one for each person she believes have contributed in some way to her eventual decision. Each episode relates to an individual tape. The penultimate episode depicts the suicide in a gruesome manner. Some say the series is an accurate and sensitive portrayal of the inner angst of an individual that will help enlighten us as to the motivations behind suicidal behaviour and suicide itself.  Such an openness can only be good and may be helpful to others in similar predicaments. Critics, though, have worried that it may glamorise suicide or normalise it as a legitimate option when dealing with interpersonal predicaments—leading to more suicides. 

It is well known that suicide can be a contagious phenomenon. “Copycat” suicides are seen in local clusters from time to time. Any possible causes of such contagion should be taken seriously, but the science shows that the role that fiction can play in inspiring suicide is at best unclear. 13 Reasons Why is not the first work of fiction to be embroiled in this type of controversy.  Shakespeare’s Romeo and Juliet has been accused of glamorising suicide.  Johann Wolfgang von Goethe’s novel, The Sorrows of Young Werther, released in 1774, describes the pain and heartache experienced by Werther because of his affection for Charlotte, who eventually married Albert, Werther’s friend.  Unable to cope, Werther decides that one of them must die and ends up shooting himself with Albert’s pistol.  It was widely believed that von Goethe’s work led to a wave of young men deciding to end their lives all over Europe, many of whom were dressed in the same clothing as von Goethe’s description of Werther and using similar pistols.  Some even had the copies of the novel beside their bodies with the page opened to the page of the suicide scene.  The suicide researcher, David Phillips, coined the term, “The Werther Effect,” to refer to the phenomenon of copycat suicides.  The result of Phillips’ research from the 1970’s was the recommendation that stories about suicide not be placed on the front page of newspapers.

In Vienna of the 1980’s, a spate of subway suicides was combatted by the city’s main newspapers’ decision to substantially curtail the publicity surrounding these deaths.  After a certain date, these suicides were no longer mentioned. This coincided with a progressive fall in the number of subway suicides illustrating the power for good of the media.

Counteracting the Werther Effect, though, is the Papageno Effect, taking its name from the character, Papageno in Mozart’s Opera The Magic Flute. Papageno tries to hang himself after he’s convinced that he will never win over his love, Papagena. He is persuaded, though, by 3 child-spirits not to end his life.

Research has shown that excessive media coverage of suicides of celebrity figures actually has led to an increase in suicide attempts and ideation.  Women in their 30’s were more at risk of suicide after Marilyn Monroe’s death in 1962.  Suicide experts King-wa Fu and Paul Yip examined the impacts of the deaths of 3 Asian celebrities on suicide using a time series analysis comparing the deaths in the weeks before and after the suicide.  They found a substantial rise in the number of suicides in the first, second and third weeks after the death of each celebrity in Hong Kong, South Korea and Taiwan compared to a reference period. This was even more the case with people of the same gender as the celebrities.

However, the research evidence in relation to fictional portrayals of suicide in TV and film is more complicated. Pirkis and colleagues reviewed the literature regarding film and television drama portrayals of suicide. The group was unable to offer conclusive answers to questions surrounding the impact of fictional suicides on actual suicidal outcomes in the general population.

Studies attempting to assess the effect of broadcasting an episode of the British soap, Eastenders, on March 2nd, 1986 have been conducted.  This episode featured an attempted overdose by a female character in her 30’s.  The studies attempted to assess the attendance at emergency departments in the UK before and after the episode.  Some of the studies provided evidence for a copycat effect, but some did not.  Mixed findings were reported in others.  Therefore, it just cannot be concluded whether fictional portrayals of suicidal behaviour on film and television increase its incidence in the population. While it is certainly true that over-the-top media representations of suicide of celebrity-type figures will have a copycat effect, it does appear that the public at large are able to distinguish fact from fiction. 

Nevertheless, we should be aware of the Werther and Papageno Effects.  It is difficult to see how the fictional portrayal of suicide in an explicit manner could have a positive effect in any way unless, of course, the downsides of suicide in terms of its effect on relatives and friends are also strongly portrayed. From a deterrent perspective, the gruesome nature of the suicide itself may be a positive feature, and the same could be said of the adverse effects on the survivors. However, the message that suicide can have simple, or a simple set, of causes, or that suicide represents some type of solution, is unfortunate. There is never one reason why, or even thirteen.