May 13, 2019&mdash;Few TV series have sparked more debate than Netflix's 13 Reasons Why. It is a vivid fictional portrayal of a teenage girl who was bullied and sexually assaulted. She kills herself and leaves behind 13 tapes detailing why she ended her life. 
Suicide is a leading cause of death for people 10 to 24 years old in the U.S. It claims some 4,600 lives every year. The show's critics worry that it glamorizes suicide and could trigger even more deaths in vulnerable young people. 
Now two new studies&mdash;released just days apart&mdash;shed light on the series' impact among different age groups. 
Suicide rates spike
One study revealed a troubling jump in suicides after the series premiered in April 2017. 
It looked at whether suicide rates after the release were greater than what would be expected based on those from the past five years.
And it found that suicide rates for 10- to 17-year olds were far higher in the months of April, June and December of 2017 than were typical. This increase translated into nearly 200 additional deaths. 
Suicide rates also climbed in the month before the show's release, when it was heavily advertised. 
That study appears in the <a target="_blank" href="https://www.jaacap.org/">Journal of the American Academy of Child and Adolescent Psychiatry</a>. 
Some viewers were helped
For the other study, researchers surveyed 729 people 18 to 29 years old before and after the show's second season aired in May 2018. More than half of them were students. 
The researchers found that viewers who stopped watching the show partway through its second season showed a higher risk of suicide and less optimism about the future than those who saw the entire season or didn't watch it at all. 
Surprisingly, for students who finished the season, the risk of suicide went down&mdash;not up. Compared to students who didn't watch the series at all:
<ul>
 <li>They were less likely to report recent self-harm. </li>
 <li>They had fewer thoughts of suicide. </li>
</ul>
What may explain these results? 
The second season may have conveyed life-affirming messages better than the first, the researchers speculated. So those who made it all the way through season 2 may have absorbed those messages. 
This study appears in the journal <a target="_blank" href="https://www.journals.elsevier.com/social-science-and-medicine">Social Science and Medicine</a>. 
Adding it all up 
Both studies contribute to a growing body of evidence that young people may be especially sensitive to how suicide is portrayed in entertainment media. And they highlight the need to depict suicide with great care and to emphasize that help is available for depression and suicidal thoughts. 
If you know someone who may be thinking of suicide, <a href="[BASEDOMAIN]/healthinfo/Story.aspx?StoryID=87e60f37-e6df-41ba-b293-c05b7bb117ac">learn how you can help</a>. 
And remember: Never ignore suicidal thoughts or actions, even in young children. If someone needs help right away, call the <a target="_blank" href="https://suicidepreventionlifeline.org/">National Suicide Prevention Lifeline</a> at 800.273.8255.

Does '13 Reasons Why' spur suicides? 

Suicide is a leading cause of death for people 10 to 24 years old in the U.S. 