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What I Chose:
Enhancing Suicide Prevention
through Young Adult (YA) Fiction
Madisyn Uekawa
Office of Public Health Studies &
Department of English
University of Hawai‘i at Mānoa
Significance
Methods
Results
Conclusion/Recommendations
• Suicide is the leading cause of death of university
students in the United States (Suicide Prevention
Resource Center, 2014).
• Approximately 1,100 college students die each year as
result of suicide (as cited in The Jed Foundation, 2006).
• For Hawai‘i (2011-2015), suicide has been in the
number one spot for causes of fatal injuries for the 16-29
age group, 30-44 age group, and 60-74 age group
(Galsnis, 2016).
• Suicide = highest overall for causes of fatal injuries in
Hawai‘i (Galsnis, 2016).
• Although the intended audience of Young Adult (YA)
books is typically below 18, 77% of the YA buyers and real
audience are 18+ (PBS Newshour, 2014).
• The largest age group of buyers for YA fiction is 18-29 (43%)
which happens to correlate with the highest population at risk
for suicide for Hawai‘i specifically (PBS Newshour, 2014).
• Read and evaluated six popular YA fiction books
with themes of suicide.
• Attempted to emulate effective literary techniques
from these best-selling authors into writing my
novella while also integrating safe messaging.
• Looked at a Penguin Books Curriculum for Jay
Asher’s Thirteen Reasons Why then interviewed
Jane Raissle, an Assets teacher who has used
books with themes of suicide in her class, to
compare the two.
Jane Raissle, Teacher Penguin Book Curriculum
• Discussion questions and activities directly
related to the book
• Article readings for non-fiction context
• Had a counselor come in and talk to the class
• Discussion questions and activities directly related to the
book
• The expansion of this genre would be advantageous if done appropriately.
• Investment in this area for intervention could be a possible method to reach a wide
audience as these books can be used in formal or informal educational settings.
• Ideally, it would work to open discussion, raise awareness of the self and of others,
improve holistic well-being, and reduce detrimental behaviors.
Author Author Intent Protagonist/
Suicidal
Character
Relationship Brief Synopsis Themes
Jay
Asher
Afterword:
He had a close relative attempt suicide but
survive. Wanted to show how “everything
affects everything.”
Clay/Hannah Classmates Clay listens to audio tapes that
reveal Hannah’s 13 reasons for
suicide (mainly involving
bullying). The more he listens,
the more he wishes he reached
out.
Bullying and how one
thing affects another.
Treat others well.
Reach out to others
and reach out when
needed.
Gayle
Forman
Afterword:
Inspiration from Suzy who died by suicide
and had depression. Discusses suicide signs
and includes information on depression,
and resources available.
Cody/Meg Best friends Cody investigates the story
behind Meg’s suicide and tries to
find someone to blame. She
discovers Meg had depression.
Accepting and
forgiving yourself.
Slight address to
stigma around
depression.
Ned
Vizzini
Foreword:
Written by Rachel Cohn. Vizzini struggled
with depression and died by suicide.
Includes suicide hotline number. Rachel
Cohn, she says, “The book throws a lifeline
to those dealing with depression, as if Ned
is there to reassure them: Your pain is real. I
understand. I’m with you. We’ll get through
this.”
Craig/Craig Self Craig suffers from depression
and anxiety. When he
contemplates suicide one day, he
ends up calling the suicide
hotline. He is put in an adult
psychiatric hospital for a few
days.
Overcoming suicidal
thoughts,
depression, and
anxiety. Hope.
Reaching out.
Cynthia
Hand
Afterword:
Brother died by suicide at 17. She struggled
to finish the book, but felt a kind of relief
after.
Lexie/Ty Brother Lexie struggles with coping her
brother’s death but eventually
comes to terms with. Brother
had depression.
Coping and coming
to terms with reality.
How to move
forward and find
hope after a tragedy.
Jennifer
Niven
Afterword:
A list of resources for suicide prevention.
Lost her grandfather to suicide, faced a lot
of stigma. Loved a boy who died by suicide;
she was the one to find him.
Violet/Finch Boyfriend Finch and Violet become unlikely
friends. Finch struggles with
suicidal thoughts and fears being
labeled. Finch helps Violet see
hope in life, but he dies by
suicide at the end.
Importance of
reaching out. Stigma
and the barriers it
can cause. Hope for
life.
Suzanne
Young
No intent was included in book. Sloane/Brady Brother Sloane struggles with brother’s
death. Resists being sad to avoid
The Program by her parents.
Program brainwashes all
teenagers to keep them from
killing themselves.
Resisting.
Understanding
human emotions are
okay to have.
• Popular YA fiction with themes of health issues can influence
popular culture (large readership)  potential to be an effective tool
in the promotion of good health.

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  • 1. What I Chose: Enhancing Suicide Prevention through Young Adult (YA) Fiction Madisyn Uekawa Office of Public Health Studies & Department of English University of Hawai‘i at Mānoa Significance Methods Results Conclusion/Recommendations • Suicide is the leading cause of death of university students in the United States (Suicide Prevention Resource Center, 2014). • Approximately 1,100 college students die each year as result of suicide (as cited in The Jed Foundation, 2006). • For Hawai‘i (2011-2015), suicide has been in the number one spot for causes of fatal injuries for the 16-29 age group, 30-44 age group, and 60-74 age group (Galsnis, 2016). • Suicide = highest overall for causes of fatal injuries in Hawai‘i (Galsnis, 2016). • Although the intended audience of Young Adult (YA) books is typically below 18, 77% of the YA buyers and real audience are 18+ (PBS Newshour, 2014). • The largest age group of buyers for YA fiction is 18-29 (43%) which happens to correlate with the highest population at risk for suicide for Hawai‘i specifically (PBS Newshour, 2014). • Read and evaluated six popular YA fiction books with themes of suicide. • Attempted to emulate effective literary techniques from these best-selling authors into writing my novella while also integrating safe messaging. • Looked at a Penguin Books Curriculum for Jay Asher’s Thirteen Reasons Why then interviewed Jane Raissle, an Assets teacher who has used books with themes of suicide in her class, to compare the two. Jane Raissle, Teacher Penguin Book Curriculum • Discussion questions and activities directly related to the book • Article readings for non-fiction context • Had a counselor come in and talk to the class • Discussion questions and activities directly related to the book • The expansion of this genre would be advantageous if done appropriately. • Investment in this area for intervention could be a possible method to reach a wide audience as these books can be used in formal or informal educational settings. • Ideally, it would work to open discussion, raise awareness of the self and of others, improve holistic well-being, and reduce detrimental behaviors. Author Author Intent Protagonist/ Suicidal Character Relationship Brief Synopsis Themes Jay Asher Afterword: He had a close relative attempt suicide but survive. Wanted to show how “everything affects everything.” Clay/Hannah Classmates Clay listens to audio tapes that reveal Hannah’s 13 reasons for suicide (mainly involving bullying). The more he listens, the more he wishes he reached out. Bullying and how one thing affects another. Treat others well. Reach out to others and reach out when needed. Gayle Forman Afterword: Inspiration from Suzy who died by suicide and had depression. Discusses suicide signs and includes information on depression, and resources available. Cody/Meg Best friends Cody investigates the story behind Meg’s suicide and tries to find someone to blame. She discovers Meg had depression. Accepting and forgiving yourself. Slight address to stigma around depression. Ned Vizzini Foreword: Written by Rachel Cohn. Vizzini struggled with depression and died by suicide. Includes suicide hotline number. Rachel Cohn, she says, “The book throws a lifeline to those dealing with depression, as if Ned is there to reassure them: Your pain is real. I understand. I’m with you. We’ll get through this.” Craig/Craig Self Craig suffers from depression and anxiety. When he contemplates suicide one day, he ends up calling the suicide hotline. He is put in an adult psychiatric hospital for a few days. Overcoming suicidal thoughts, depression, and anxiety. Hope. Reaching out. Cynthia Hand Afterword: Brother died by suicide at 17. She struggled to finish the book, but felt a kind of relief after. Lexie/Ty Brother Lexie struggles with coping her brother’s death but eventually comes to terms with. Brother had depression. Coping and coming to terms with reality. How to move forward and find hope after a tragedy. Jennifer Niven Afterword: A list of resources for suicide prevention. Lost her grandfather to suicide, faced a lot of stigma. Loved a boy who died by suicide; she was the one to find him. Violet/Finch Boyfriend Finch and Violet become unlikely friends. Finch struggles with suicidal thoughts and fears being labeled. Finch helps Violet see hope in life, but he dies by suicide at the end. Importance of reaching out. Stigma and the barriers it can cause. Hope for life. Suzanne Young No intent was included in book. Sloane/Brady Brother Sloane struggles with brother’s death. Resists being sad to avoid The Program by her parents. Program brainwashes all teenagers to keep them from killing themselves. Resisting. Understanding human emotions are okay to have. • Popular YA fiction with themes of health issues can influence popular culture (large readership)  potential to be an effective tool in the promotion of good health.