Touch of Death: Contagion and Teen Suicide

girl in pain

Since Netflix began to air the series, 13 Reasons Why, the subject of suicide, particularly among adolescents, has become a prominent subject of conversation nationwide. The current statistics in the United States are grim.

The Center for Disease Control (CDC) reports that the number of suicides in the United States is at its highest level in 30 years. Their 2016 report revealed a 24% increase in the number of suicides from 1999 – 2014, with the greatest increase occurring after 2006.  Alarmingly, suicide is now the third leading cause of death among persons aged 10-14, and the second among persons aged 15-34 years. (New York Times, April 22, 2016)

Prevention experts are struggling to find an explanation for this shocking escalation in the suicide rate. It is a well-established fact that more than 90 percent of people who kill themselves have a mental disorder, whether it is depression, bipolar disorder, or some other diagnosis. Of course, there are any number of causes of depression, which necessitates resolving multiple factors instead of targeting one specific issue.

The Catholic Church also understands that most of those who take their own lives are not well and views this crisis with compassion:

CCC 2281 Suicide contradicts the natural inclination of the human being to preserve and perpetuate his life. It is gravely contrary to the just love of self.

CCC 2283 We should not despair of the eternal salvation of persons who have taken their own lives. By ways known to him alone, God can provide the opportunity for salutary repentance. The Church prays for persons who have taken their own lives.

Naturally, the suicide numbers among adolescents are of grave concern to the Church, parents, school administrators, and mental health professionals.  Though teens experience many of the same psychological issues as the adult population, research has identified one factor, called contagion, that affects adolescents at a much higher rate compared to older aged populations.

What is Contagion?

Suicide contagion is the exposure to suicide or suicidal behaviors within one’s family, one’s peer group, or through media reports of suicide and can result in an increase in suicide and suicidal behavior. Direct and indirect exposure to suicidal behavior has been shown to precede an increase in suicidal behavior in persons at risk for suicide, especially in adolescents and young adults. (

The word contagion comes from the Latin word contagio meaning “and from touch.” Although the term usually refers to the spread of disease, the fact that suicide is contagious and can be transmitted to other people was confirmed in 1990 by researchers Marilyn Gould et al at Columbia University. Furthermore, a follow-up study by these same investigators revealed that people ages 15-19 are two to four times more prone to suicide contagion than people in other age groups.

When this contagion occurs, it is possible for something called a cluster to develop.

A suicide cluster is defined as multiple suicidal behaviors or suicides that fall within an accelerated time frame, and sometimes within a defined geographical area. [Again,] studies have shown that adolescents are the ones most affected. (Olson, Robert, 2013, “Suicide Contagion & Clusters”)

One common subset of suicide clusters are those created by media coverage of suicide-related stories and are referred to as “mass clusters.”

Mass clusters refer to suicides that cluster in time, regardless of location, and are often related to media reports of a suicide, especially that of a celebrity (Gould, Jamieson, and Romer, 2003).

A famous example is what took place following the suicide of actress Marilyn Monroe in 1962. In the months following her death, there was nearly a 12% rise in the suicide rate in the United States.

Limiting the Influence of Mass Media

In order to minimize the number of such “copycat” deaths, government agencies and psychiatric associations developed guidelines for reporters to follow when covering news stories involving those who kill themselves.  For example, the American Foundation for Suicide Prevention advises journalists to avoid

  • Sensationalizing using strong headlines or prominent placement of the story in the newspaper or telecast.
  • Including photos/videos of the location or manner of death, grieving relatives and/or friends, or of the funeral.
  • Investigating or reporting the suicide as if it was a crime, but to treat it as a public health issue. Articles should include lists of warning signs, hotline phone numbers, and places to go for counselling.

Mass media outlets have, for the most part, conscientiously adhered to these guidelines when reporting suicide deaths of celebrities as well as non-celebrities. However, what has been overlooked is the considerable amount of research pertaining to fictional programming depicting people who choose ti to end their own life. These studies reveal that fictionalized accounts are potentially just as harmful as their real-life counterparts (Gould, et al, 1271). Regrettably, cautionary guidelines for fictional programs have yet to be widely developed. The lack of any defined limits presents a significant problem for the producers of shows like 13 Reasons Why who must draw a balance between civic responsibility and their desire to achieve high ratings.

It is the opinion of many critics that the balance was tipped in favor of ratings.

13 Reasons Why

Based on the novel by Jay Asher, 13 Reasons Why tells the story of a teen, Hannah Baker, who is compelled, for multiple reasons, to take her own life. She leaves behind 13 audio tapes with messages f the individuals she believes influenced her decision which is revealed as each episode unfolds. Although Hannah is a fictional character, she experiences several traumatic events that are sadly familiar to today’s teenagers. The storyline graphically depicts bullying, cyberbullying, sexual assault, and depression.

Despite the reported sensitivity of the producers to avoid sensationalizing the subject matter, a critique that appeared in Rolling Stone magazine (April 2017) points out aspects of 13 Reasons Why which appear to idealize her death. The author, Alexa Curtis, writes

[in] real life, when someone commits suicide, their story ends there. 13 Reasons Why failed to end Baker’s story, since she lives on through the tapes. We become captivated by the drama of the suicide rather than the actual suicide itself.

The use of the taped messages does not allow the viewer to see “the utter emptiness and grief that occur after someone commits suicide.” Furthermore, Curtis points out, nowhere in the story is there any presentation of the benefits of therapy or support groups, which could have informed viewers of alternative solutions to self-harm.

Perhaps the most controversial decision made by the producers of 13 Reasons Why was to graphically present on-screen the act of Hannah killing herself. Although one of the show’s writers, Nic Sheff, defended the decision in an op-ed for Vanity Fair, many fear the scene will become a how-to for at-risk teens. Certainly, given the easy access to the internet possessed by most teenagers, it is a scene that can be viewed again and again, without the benefit of adult knowledge or supervision.

The Impact of Physician Assisted Suicide

In addition to those factors discussed here, there is one more source of this contagion that has not been widely reported on even though it may exert one of the strongest influences–the effect of legalizing physician-assisted suicide (PAS).

In 2015, a study published in the Southern Medical Journal demonstrated a significant correlation between legalizing physician-assisted suicide and increases in the overall suicide rate.  As reported by Melody Wood for The Daily Signal, researchers took suicide rates from states that have already legalized PAS—including Oregon, Washington, and Vermont—and compared them both to the rates in the same states before PAS was legalized, and to the rates in states where it is not yet legal. They found that “legalizing PAS was associated with a 6.3 percent increase in total suicides.” Furthermore, the researchers commented that “the introduction of PAS seemingly induces more self-inflicted deaths than it inhibits” (Wood, 2015).

Unfortunately, because support for physician-assisted suicide has become part of a greater political agenda, this research has been largely ignored. What is worse, in efforts to promote PAS, mass media outlets often eschew the usual precautions for reporting a self-inflicted death. Articles on sites like Yahoo News tend to celebrate these “courageous” decisions, such as that made by Brittany Maynard, with videos and glowing testimonials extolling assisted suicide as a compassionate and peaceful solution.  Certainly, it is enough to confuse, if not encourage, a teenager looking for reasons to end their own suffering by self-destruction.

“Every Suicide is Tragic”

The horrific number of suicides, particularly among adolescents, should be enough to spur society to work towards a solution as quickly as possible. Developing effective strategies to identify those suffering from depression and mental illness and drastically reducing aggravating factors such as bullying are absolutely necessary but will take time. Since “the existence of suicide contagion should no longer be questioned,” ensuring that both fictional and non-fictional accounts of people who take their own lives conform to the same careful guidelines would be an obvious place to start, and easily accomplished (Gould et al, 2003). Doing so would serve to mitigate the problems created by the rapid spread of information and content through social media.

Finally, society needs to confront its incoherent attitude towards suicide. For the 2016 Respect Life program, the United States Conference of Catholic Bishops (USCCB) published a brochure entitled, “Every Suicide is Tragic”. It concludes:

Our laws shape cultural attitudes toward certain behaviors and influence social norms. Laws permitting assisted suicide communicate the message that, under especially difficult circumstances, some lives are not worth living. This tragically false message will be heard not only by those with a terminal illness, but by any person struggling with the temptation to end his or her life.

We don’t discourage suicide by assisting it.

If you or someone you know is considering taking their own life, there is help. The National Suicide Prevention Hotline is available 24/7 with free and confidential support of trained counselors. Call 1-800-273-8255.

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7 thoughts on “Touch of Death: Contagion and Teen Suicide”

  1. Laurence Charles Ringo

    When did the Roman Catholic Church cease condemning suicides to Hell?? I missed that memo!! ?.

    1. I have to say, though, that I wish we still buried suicides at crossroads with stakes through their hearts. Sure, we should pray for their souls, but it sends precisely the wrong message when suicide is made respectable — and it sends it to people who in many cases are longing, above all else, to be celebrated and thought of as respectable. Denying them burial in consecrated ground is a small and entirely ceremonial “punishment”, but it would be worthwhile if it deters one suicide.

    2. So much for mercy, Howard. Suicide is borne from unbearable depression, bullying, hopelessness,,,,,you suggest punishing the mentally ill? I would doubt that this would be Jesus’ position. A cold heart… is not ours to judge. If you want to deter suicide volunteer fir The Samaritans. Compassion always Trumps punishment.

    3. So much for cheap an false mercy, indeed. A successful suicide is beyond our ability to punish, but we can take away an incentive. You would have us offer those who might be willing to kill themselves just to receive attention and respect precisely the pity-party they want, but ONLY If they kill themselves.

  2. I believe that it is important to examine the research and think deeply when probing the nature of teen suicide. Teens kill themselves because they feel that they do not fit, the role of the teenage years is to learn to fit into a meaningful role and to discover who we are.
    Teens commit suicide because they are depressed because they are bullied: they are queer, they are transgender, they are promiscuous, they are fat, they are somehow disordered, they are effeminate and many other adjective which prevent a fit in without allies. If you think it is mainstream religion which labels these kids as “disordered” and discourages the formation of groups in society to engender “allies.” Love all, but remember that many are disordered and being seen as disordered leads to all types of bullying which is tolerated. The cause of self-deprecation and suicide is self-concept formed by religion..

    BTW…there is a very big difference between physician assisted suicide and assistance in dying with dignity….explore the difference. Assistance in the face of inevitable death is not suicide.

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