A popular TV series that showed a teen ending her life may have triggered a surge in online searches for suicide, including how to do it.
That's according to a new study about the show "13 Reasons Why." Netflix released all 13 episodes on March 31.
Researchers found that for almost three weeks afterward, there were at least 900,000 more than expected Google searches including the word "suicide." That's a 19-percent increase based on forecasts using Google Trends and historical search trends. Searches included suicide methods, suicide hotlines and suicide prevention.
The study doesn't prove a link and didn't examine any connection with actual suicides or attempts. It was published Monday in JAMA Internal Medicine.
A journal editorial said it's not clear if the searches "were made out of idle curiosity or by suicidal individuals contemplating an attempt." But it argues that the producers could have done more to emphasize suicide prevention, including listing resources for where to find help before and after each episode.
Some mental health advocates say the show glamorized suicide, and many U.S. schools sent parents warning letters about the show.
The series is about a high school girl who left behind 13 audiotapes where she revealed sexual assault, substance abuse and bullying that led to her decision to take her own life. The finale shows her suicide.
Episodes with the most explicit material included warnings and a website Netflix created with crisis hotlines and other resources for the more than 30 countries where the series was available. It has been renewed for a second season.
John Ayers, a San Diego State University researcher who led the research, said the series could trigger troubled teens and that the producers should remove and edit the episodes to focus on suicide prevention before reposting.
"Far more people go to the brink and come back and have satisfaction with that decision," he said.
In a written statement, Netflix said, "We always believed this show would increase discussion around this tough subject matter. This is an interesting quasi experimental study that confirms this. We are looking forward to more research and taking everything we learn to heart as we prepare for season 2."
Madelyn Gould, a Columbia University suicide prevention researcher, noted the study design was less rigorous than some research methods, but said the results "should be taken seriously."
"My main concern was that suicide was portrayed sort of as the inevitable consequence of life's adversities rather than depicting what would be an actually more appropriate message, which is that there's help when you're feeling suicidal rather than resorting to killing yourself," Gould said.