I once tried to commit suicide. Twenty years later, it’s still hard to talk about. I didn’t want to die. Self-esteem issues, depression, alcoholism. I was signaling, in an unhealthy way, that I was in pain and needed help. A better way would have been to call 911 or the National Suicide Prevention Lifeline (1-800-273-8255). It was the age of Nirvana. Depression and suicide were in the air in U.S. teen culture. A close friend had moved away from our small Midwestern town. Beforehand, he started acting out. A few times he lost it, had some public meltdowns. Yelling. Crying. It rattled us all. High drama. Huge audience. I didn’t consciously recognize that his performances garnered him massive attention, and I might do the same, but it was classic modeling behavior.

Suicide contagion is the term social scientists use to describe exposure to suicide or suicidal thoughts resulting in an increase of suicidal behavior. While media coverage has recently heightened concern about the phenomenon, it has been observed for centuries. One term for suicide contagion is the Werther Effect, named after Johann Wolfgang von Goethe’s The Sorrows of Young Werther (1774), a Romantic German novel about a lovesick young artist who takes his own life. An international bestseller partly based on Shakespeare’s Hamlet, the book’s fame led to a rise in young people imitating Werther’s suicide, dressing in his trademark outfit or holding Goethe’s book for their fateful act.

Suicide contagion is a special case of the general phenomenon of social modeling or social learning, where humans follow examples more than rules. The initial exposure can come either directly (someone you know dies by suicide) or indirectly (media reports on suicide). Sometimes suicide is glamorized through its association with a successful, attractive, larger-than-life celebrity, like Robin Williams, Kate Spade, or Anthony Bourdain. Such exposure, especially with an emphasis on the cause and manner of death, makes suicide real, creating new ideas about suicide or triggering pre-existing thoughts, modifying a person’s understanding of typical social behavior, making it seem like an acceptable method of responding to stress, and loosening the restraint we usually exercise with harmful acts.

Once suicide is in the air, it can spread, disease-like. There might be an incubation period of days or weeks. There can be an outbreak or epidemic, a cluster of suicide-related behavior, especially for people with pre-existing vulnerabilities like mental illness, substance abuse, and post-traumatic stress disorder. Some have access to good health care and receive help resisting the epidemic. Others are failed by poor oversight in institutions responsible for monitoring behavior.

The power of suicide contagion, and my experience with it, is one reason I hesitate to assign Hamlet, a play so obsessed with suicide that it’s hard to believe it’s one of the most commonly assigned texts in American high schools. It’s a bit shocking that the most famous speech in the most famous play by the most famous English-language playwright is about suicide—“To be, or not to be”—and we’re fine with that. With schools sending home warnings about suicide triggers like 13 Reasons Why and the “Momo Challenge,” Hamlet’s place in the curriculum merits scrutiny. Then there’s Romeo and Juliet, Julius Caesar, and Othello—all frequent high school texts that involve suicide—plus less common texts like Titus Andronicus, Antony and Cleopatra, and The Rape of Lucrece. And that’s just Shakespeare. Why do we give these works so happily to our children?

“I am not talking about healthy people reading Romeo and Juliet,” epidemiologist Madelyn Gould, a leading expert on suicide contagion, explained in a 2001 workshop on the subject. But what are the odds that every young adult in a classroom of 25 is mentally healthy? In a lecture hall of 300? I’ll admit that I’ve never felt triggered by Hamlet or Romeo and Juliet. But I never read a play by Shakespeare until I was a senior in college and five years sober (to be sure, I was assigned to read many before then). I’m pretty shaken now by the thought of me at age 16 reading, “To be, or not to be.”

Suicide contagion evokes a classic debate in literary theory tinged with the rhetoric of infection. The Greek writer Gorgias thought language could be so powerful as to exert a drug-like control over an audience’s actions: Who could blame Helen of Troy, he asked, when Paris’s seductive words were so strong? That’s one reason Plato banished literature from his ideal state—“poetry deforms its audience’s minds, unless they have the antidote”—and one reason some sought to outlaw theater in Shakespeare’s England. According to the first anti-theatrical work published in England, John Northbrooke’s A Treatise against Idlenes, Idle Pastimes, and Playes (1577), “Satan hath not a more speedy way and fitter school to work and teach his desire, to bring men and women into his snare of concupiscence and filthy lusts of wicked whoredom, than those places and plays, and theaters are.” In the language of epidemiology, Northbrooke concludes, “Beware of such contagiousness.”

Responding to charges that literature is “the nurse of abuse, infecting us with many pestilent desires,” the most famous work of literary theory from Shakespeare’s time, Philip Sidney’s Apology for Poetry, acknowledged the force of literary contagion: “Poesie [can] infect the fancy with unworthy objects.” But, Sidney continued, “whatsoever being abused, doth most harm, being rightly used … doth most good.” If literature can create suicide contagion, it can also, “being rightly used,” dispel it. That shifts the ethical burden from the text to the teachers and critics who discuss it.

The 2012 National Strategy for Suicide Prevention called for coordination across multiple sectors and settings, including schools. It identifies teachers as key gatekeepers, able to refer at-risk people to specialists. Gatekeeper training can improve knowledge about suicide, attitudes toward it, and strategies for recognizing and intervening in cases. And suicide prevention training in schools significantly reduces suicide ideation and attempts in students. Yet teachers, most of whom have directly encountered at least one suicidal student, often receive little or no suicide prevention training, and feel unequipped to recognize and respond to students at risk.

That’s why guidebooks, such as David Schonfeld and Marcia Quackenbush’s The Grieving Student: A Teacher’s Guide, have been published. Education researchers, notably Kristine E. Pytash, have suggested that teachers should themselves read young adult literature involving suicide, and ask how they will respond to crises. In 2017, English Journal, the National Council of Teachers of English’s journal for junior and senior high school educators, published an issue on Death in the English Classroom. In 2018, the education scholars Michelle M. Falter and Steven T. Bickmore edited two companion collections, When Loss Gets Personal: Discussing Death through Literature in the Secondary ELA Classroom and Moving Beyond Personal Loss to Societal Grieving: Discussing Death’s Social Impact through Literature in the Secondary ELA Classroom. As they wrote, “Talking about death head on, rather than tangentially, in the English classroom isn’t easy to do, but it is important.”

English teachers are rarely qualified to provide counseling to suicidal students. But teachers can use suicide texts like Hamlet to better perform the mental health monitoring they are already asked to do.

Suicide contagion is especially associated with adolescence because, as Shakespeare wrote in Hamlet, “In the morn and liquid dew of youth, / Contagious blastments are most imminent.” Teens are “contagious” because their actions exert great influence on one another. Shakespeare invented the word “blastments” from the earlier blasting, “withering or shriveling up caused by atmospheric, electric, or unseen agency.” Blastments are dangerous because they are forceful yet ephemeral, and unavoidable in youth (“most imminent”). The same is true of the circulation of the idea of suicide in society today, making parents everywhere jittery, especially at night when, to quote Hamlet, “hell itself breaks out / Contagion to this world.”

One way Shakespeare conveyed suicide contagion was to fill Hamlet’s suicidal thoughts with water and plant imagery that reappears in his girlfriend Ophelia’s death by suicide. The first line of Hamlet’s first soliloquy points forward to the last moments of Ophelia’s life: “Oh, that this too, too solid flesh would melt, / Thaw, and resolve itself into a dew.” The soliloquy is filled with “tears,” which water the “unweeded garden” that Hamlet compares his country to. Water imagery rushes back into Hamlet’s most famous soliloquy, “To be, or not to be,” which flails in his “sea of troubles” and barrels toward suicide until “currents turn awry.”

But Shakespeare represented suicide contagion even more directly. As in society today, suicide is contagious in Hamlet, at least in the example of Ophelia, the one death by suicide in the play: She only becomes suicidal after hearing Hamlet talk about his own suicidal thoughts in “To be, or not to be.”

It’s easy to forget that Ophelia is onstage during this famous soliloquy, and can hear what Hamlet is saying. Her father, Polonius, and King Claudius are using her to spy on him. They call Hamlet to a room where she is walking about, as if by accident, then hide to observe the interaction between Hamlet and Ophelia. That’s the set-up for “To be, or not to be.”

What happens if we hear that soliloquy from Ophelia’s perspective? She’s a young woman in a man’s world. Whip-smart, confident, courteous, caring, kind, a little deferential. Pretty. She’s in love with Hamlet, or thinks she is, or was, but isn’t anymore. It didn’t end well. Now he’s being an asshole. She’s been dismissed, degraded, domineered, and abused by all the men in her life: her father, Polonius; her brother, Laertes; and her lover, Hamlet. Her mother isn’t around. The queen, a surrogate mom, is cagey with her. Ophelia doesn’t seem to have any friends; or at least doesn’t have an author even remotely interested in exploring her personal life. She’s doing her best to stay afloat. But it’s frustrating. Her father cares more about his job and the national news than her. Her brother, whom she was close with, went off to college. Her ex is playing manipulative mind games. She doesn’t have anyone to talk to. And no one to turn to. The authorities—in this case, Shakespeare—aren’t interested in hearing what she has to say. She’s alone, yet has to perform the monotony of daily responsibilities. The weight is heavy. She’s trying.

So imagine Ophelia hearing Hamlet—“To be or not to be—that is the question”—and what she might be thinking: Never thought of that. Suicide. A new option. Ending it all. Hamlet’s thinking about it, though Lord knows he’s got plenty going for him. Rich, powerful, male. What about my sea of troubles? God, don’t even think about it. But it’s too late. Can’t unthink suicide as a possibility. It burrows in your mind.

Surprisingly, Hamlet and Ophelia don’t appear onstage together until immediately after “To be, or not to be.” That first contact is a moment of contagion. “I’ll give you this plague,” he says to her. Hamlet is sick, and it’s contagious—his mental illness spreads to others.

The contagion of suicide is first registered, symbolically, at the end of this scene, with Ophelia’s first soliloquy. As the Shakespearean vessel for suicidal thoughts, the soliloquy marks Ophelia’s entrance to the realm of Hamlet’s melancholy. The plant imagery of Hamlet’s “unweeded garden” is echoed in Ophelia’s description of him as the “rose of the fair state.” The wind imagery of “contagious blastments” imminent in “youth” is echoed in Ophelia’s lament for “blown youth, / Blasted with ecstasy.” Just as this scene flows from Hamlet’s soliloquy to his dialog with Ophelia to her soliloquy, suicidal thoughts follow a path in Hamlet discoverable through contact tracing.

Ophelia is the epicenter of plant imagery in the second half of the play, handing out flowers to the king’s court as she sings songs about death. That’s a warning sign. She doesn’t talk about wanting to die, or look for ways to kill herself, or say she’s a burden to others. Not all suicides display all warning signs. But she’s feeling helpless and hopeless. She’s anxious, agitated, reckless, displaying extreme mood swings. “I will not speak with her,” says Hamlet’s mother, Gertrude, trying to avoid an awkward situation.

The first thing today’s experts on suicide say: Don’t leave a vulnerable person alone. Claudius gets it. He orders Hamlet’s friend Horatio to follow Ophelia. But clearly someone was negligent. How else did she get out on a tree branch over the brook? Don’t leave the person alone, yes, but also have the vigilance to uphold that commitment amidst the day-to-day grind of time.

As Marlena Tronicke argues in one of the few readings of suicide in Hamlet that centers Ophelia, her act of drowning herself is a reclamation of agency in a misogynistic world that has stripped her of autonomy. That line of thought must be cautious, however, not to romanticize suicide as a valiant response to injustice. How can we think creatively about different ways Ophelia’s story could have gone, about different ways our stories could go when we feel the world is too much?

There is some ambiguity as to whether Ophelia’s death is a suicide. It reminds me of when they found my uncle’s body, and we didn’t know if it was suicide or not. Shakespeare’s gravediggers say Ophelia can’t have a Christian burial because “her death was doubtful.” Yet Gertrude’s famous narrative of Ophelia’s death makes it sound like an accident.

Reporting on suicide can create contagion. Media guidelines—not putting suicide on the front page, shrinking the size of the headline, not describing the details of the death, not sensationalizing the suicide, including suicide crisis hotline numbers, showing examples of successful help-seeking—mitigate suicide contagion. Contrasting this conscientious approach with the Werther Effect, researchers have dubbed it the Papageno Effect, after a character in Mozart’s opera The Magic Flute who is suicidal until three boys offer suggestions for better ways to deal with his stress.

In this context, Gertrude’s famous speech, in which she dramatically narrates Ophelia’s death, is very problematic. One of its memorable features is the repetition of “drowned”: The water imagery established in Hamlet’s “too too solid flesh” soliloquy is recalled. Gertrude details the “brook” that Ophelia drowned in, and its “glassy stream.” The plant imagery returns in the “willow” that grows over the brook, with its “hoary leaves.” Ophelia climbed out on its “pendant boughs” to hang her “crowned weeds” recalling Hamlet’s “unweeded garden.” With this imagery, Shakespeare is asking us to remember Hamlet’s earlier suicidal thoughts when we hear of Ophelia’s end.

An “envious sliver” on the willow snapped, and down fell Ophelia and her “weedy trophies” into the “weeping brook,” nature personified with suicidal emotions. Gertrude’s sentimentalized Ophelia floats on the water “mermaid-like” for a moment, “like a creature native and endued / Unto that element.” But that moment of oneness with nature is belied by the “muddy death” that follows.

How Gertrude knows all this is unclear. If she saw it, why didn’t she try to save Ophelia? If she only heard about it later, why is her account so flowery? If the latter, Gertrude looks very much like a journalist who gathers facts second- or third-hand and embellishes them with narrative gusto.

Reality is less flowery. The day after my suicide attempt, my parents took me to a psychiatrist. I kicked and screamed. Things got worse before they got better. It was a long road to recovery, but I figured out how to ask for help. I learned how to use the medical system. Became a writer. Met my wife. Had some kids. Shakespeare scholar. College professor. Life is good.

After a crisis, it’s awkward. No one wants to talk about it. No one knows what to do. How are people going to respond? There’s even a sense of re-contagion at Ophelia’s funeral. Her despondent brother, Laertes, expresses suicidal thoughts, jumping in her grave, telling the gravediggers to “pile your dust upon the quick and dead.” Hamlet also becomes manic, vowing to Laertes that he, too, would willingly die for Ophelia: “Be buried quick with her and so will I.”

As with Ophelia earlier, Claudius tells Gertrude to “set some watch over your son.” Hamlet soon develops a fatalism that feels resigned to death: “There’s a divinity that shapes our ends.” His murder by duel isn’t suicide, but that tragedy causes contagion in his friend Horatio, who tries to drink from the poisoned cup. Hamlet intervenes, an important moment of containment of suicide’s spread: “Give me the cup.”

Sometimes you have to save a suicidal person from themselves. You might feel like it’s not your place. But in crisis moments it’s your responsibility. “Absent thee from felicity awhile,” Hamlet says in seeking to convince Horatio not to kill himself, “And in this harsh world draw thy breath in pain / To tell my story.”

The play leaves us, therefore, with Horatio as the author of the Hamlet legend, and with Horatio’s narrative of suicidal thoughts, suicide contagion, and suicide prevention as one method of resistance to the pull of despair. All suicidal people have a story to tell. Storytelling, Shakespeare suggests, is one strategy of coping with intense pressure.

Properly framed, Hamlet could be an introduction to the idea of suicide contagion, generating a self-consciousness that might counteract the danger of the phenomenon. When you know what suicide contagion is and how it works, you’re less likely to succumb to it, or perpetuate it. And Hamlet provides, in the final example of Horatio, an example of successful resistance to suicide contagion.

Yet, if hearing Hamlet talk about suicide planted the seed in Ophelia’s mind, could the same happen with Hamlet in our classrooms? Could the text be damaging to someone who has a pre-existing vulnerability?

Some months ago, I was going to invite my teenage niece to a performance of Romeo and Juliet, but decided against it. One of her friends had recently died by suicide. It shook the whole community. Parents were hyper-vigilant about the possibility of contagion. Better not to take any risks with Romeo and Juliet, I thought. It might be an opportunity for a healthy conversation, but I had absolutely no confidence that it would be a positive experience for her. The uncertainty froze me. I went to the play alone.

The production was old-fashioned. Tights and ruffs. In the opening acts, the highlight was the sword fighting. I wouldn’t realize its full significance until later. Romeo’s guttural yell—eyes closed, fists clenched in frustration—before killing Tybalt showed someone with what we now call an anger management problem. Lord Capulet’s possessive anger toward his daughter cut deep. Another angry expression of frustration in the form of misogynistic violence. The contagion of suicide seeped through Acts IV and V. It hit hard. It’s easy to forget—when we hear Taylor Swift’s “Love Song” popping, “Marry me, Juliet, you’ll never have to be alone”—that this is a play about two kids killing themselves. I don’t even want to think about it. It’s brutal. Easier to pretend we’re all fine.

Romeo’s yell again; he kills Paris. He can’t control himself. It’s only now that I recognize the thesis of this production: The hyper-masculinity of this culture, symbolized by those magnificent sword fights, leads to violence and suicide as appealing forms of emotional problem-solving: “These violent delights have violent ends.” I didn’t fully appreciate that line until tonight, though we see it every day—the pain and suffering that some days falls like rain. Our children trying their best to navigate the world we’ve made. Sometimes they fail. It’s devastating when they do. We’ll try to do better. But we won’t be whole again.

We’ll never get rid of suicide. Or Hamlet and Romeo and Juliet. These texts are going to be assigned, and suicides are going to happen and be reported on. And you can’t simply cut the theme of suicide from these texts. Hamlet without suicide isn’t Hamlet.

But you can adopt media guidelines. You can pick your points of emphasis. Maybe a 10th-grade classroom doesn’t need a close reading of Gertrude’s speech about Ophelia’s death. Emphasizing the location and manner of death can create contagion, as can visual representations of the location. Experts would advise using visuals from Ophelia’s life, or the logo of the suicide prevention hotline, rather than John Everett Millais’s famous 1852 painting of Ophelia. Avoid saying suicide is senseless or happens “without warning.” Include up-to-date local and national resources to promote help-seeking behavior. Invite a mental health expert into the class to speak about suicide prevention. Encourage a high schooler’s parents to read Hamlet with their child. Perhaps they’ll have conversations they otherwise wouldn’t.

You can cover the warning signs in Ophelia’s case. You can emphasize that, today, Ophelia’s mental health issues are very much treatable because of a massive health care system that didn’t exist in her Denmark. You can use Hamlet to carry, Trojan Horse-style, information to students about the causes of suicide, treatment options, and recent research on rates and advances in prevention. And, just as psychotherapy can help vulnerable individuals learn to recognize their thought patterns and adjust behavior when suicidal thoughts arise, Hamlet can be used to train students to recognize warning signs and respond effectively.

Some culture warriors will feel this is “snowflake” Shakespeare. When I was in school, we didn’t tiptoe around suicide. Some students will likewise feel such a careful approach to suicide in Hamlet and Romeo and Juliet is unnecessary. It doesn’t apply to them. Hopefully, that is the clear majority. For such students, discussion of Shakespearean suicides can expose them to strategies for recognizing warning signs in others and responding to crises. In fact, the National Institute of Mental Health’s five steps for suicide prevention can be adapted for teaching suicide texts like Hamlet:

1. Ask: It’s a difficult question, especially in a classroom, but when teaching Hamlet, ask students to come speak with you, and to speak with others, if they are having suicidal thoughts. Research suggests that asking about suicide does not increase suicidal thoughts. Ophelia didn’t really have anyone to talk to.

2. Keep Them Safe: When teaching Hamlet, send a note home to parents, and ask any students who may be vulnerable to reduce access to lethal items or places. Ophelia shouldn’t be climbing trees over the brook. Don’t let Horatio have the cup.

3. Be There: When discussing Hamlet, listen to what students say about suicide, and acknowledge their feelings. Research suggests acknowledgement reduces rather than increases suicidal thoughts. Consider Hamlet acknowledging Horatio’s suicidal thoughts, then keeping him safe.

4. Help Them Connect: Give students of Hamlet the National Suicide Prevention Lifeline: 1-800-273-TALK (8255), and the Crisis Text Line: 741-741. Have them save these numbers in their phones. Help any vulnerable students connect with a trusted individual like a family member, friend, or mental health professional. Train them to help others who are vulnerable connect to suicide prevention resources.

5. Stay Connected: Stay in touch after a crisis. Research shows a follow-up from a trusted individual reduces the chance of suicide. Horatio was assigned to keep Ophelia safe, but didn’t stay connected. Take a moment to check in with students a few weeks after you’ve finished Hamlet.

If you are in danger of acting on suicidal thoughts, call 911. For support and resources, call the National Suicide Prevention Lifeline at 1-800-273-8255 or text 741-741 for the Crisis Text Line.