Image: Netflix

13 Reasons Why, Netflix’s recent drama about the suicide of a teen, was a big hit when it premiered in March, but it also inspired fierce debate among critics about whether its depiction of suicide was irresponsible. Now, new research shows a significant uptick in suicide-related searches after the show premiered, a finding that one expert says confirms his worst fears.

The research letter was published on Monday in the Journal of the American Medical Association. John W. Ayers, a computational epidemiologist based at San Diego State University spearheaded the research after learning about the controversy surrounding the show. He found more than 600,000 news articles and more than 11 million tweets about 13 Reasons Why during the three weeks after the show’s premiere. “There was a tremendous amount of debate going on all based on deeply personal experiences that wasn’t going anywhere,” Ayers told Wired. He hoped to be able to deliver some hard data about the show’s influence.

13 Reasons Why tells the story of a high school student who has left behind a series of cassette tapes explaining how various people in her life were responsible for her suicide. The show was criticized for not following the World Health Organization’s guidelines for responsible depictions of suicide, as well as its lack of discussion about mental illness. Critics worried that its treatment of the subject would do more harm than good for young and vulnerable viewers.

Ayers and his team decided to take a look at Google search data relating to suicide in the weeks following 13 Reasons Why’s premiere. The researchers gathered Google trends data between the show’s March 31st premiere date and April 18th. Former NFL star Aaron Hernandez’s suicide occurred on April 19th, so they decided to make that the cut off date. From the research letter:

We obtained search trends including the term “suicide,” except those also mentioning “squad” (a popular film), emerging from the United States. Using the related search terms tool, we also monitored the top 25 terms and the next 5 most related terms to those, yielding 20 terms after ignoring duplicate, unrelated (eg, “suicide slide”), or unclear (eg, “suicide bridge”) terms.

To create a dataset of average searches relating to suicide, the team pulled data from January 15th to March 30th and used an autoregressive integrated moving average (ARIMA) algorithm to create a forecast of expected searches. The discrepancy between expected and actual suicide-related searches following the shows premiere was startling.

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On average, the searches were 19 percent higher than forecast model. On one day, April 18th, the searches were 44 percent higher. But the volume wasn’t the most concerning part for Ayers. He found that the increase in searches that related to suicidal ideation were the most significant. “How to commit suicide” showed a 26 percent increase, while “suicide songs” was over 50 percent higher than the forecast.

CDC info on its free database of deaths by cause only goes through 2015, so Ayers isn’t able to definitively show whether or not suicides increased after the show’s release. But previous research has shown a correlation between “searches for explicitly suicidal terms with conventional measures of self-reported suicide risk in estimating completed suicides.”

Still, the shows creators and defenders have argued that the show could raise awareness and help prevent suicide. The team’s data did find upticks in searches for “suicide hotline number” (21 percent) and “suicide prevention” (23 percent).

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This research isn’t going to resolve the debate about Netflix’s approach to 13 Reasons Why. Ayers tells Motherboard that he believes the show should be taken off the air, because it’s simply “not worth the risk.” That’s unlikely to happen, as a second season is already in production and scheduled for release in 2018.

But the data is something for its creators to take into account as they work on the new episodes. The streaming service added a trigger warning and information for suicide prevention in May. Now that the producers have received so much feedback, they could make a concerted effort to follow the W.H.O.’s guidelines, and bring in professional medical experts to help make the show as responsible as possible. Some of the data indicates that 13 Reasons Why may have helped some viewers. That’s all more reason to get it right the second time around.

The National Suicide Prevention Hotline in the US is available 24 hours a day at 1-800-273-8255. A list of international suicide hotlines can be found here.

[Journal of the American Medical Association via Wired, Motherboard]