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Reporting on Suicide: Recommendations for the Media
American Foundation for
Suicide Prevention
American Association of Suicidology
Annenberg Public Policy Center
Developed in collaboration with Office of the
Surgeon General • Centers
for Disease Control and Prevention • National Institute of Mental Health • Substance
Abuse and Mental Health Services Administration • World Health Organization • National
Swedish Centre for Suicide Research • New Zealand Youth Suicide Prevention
Strategy
The media can play a powerful role in educating the public about suicide prevention.
Stories about suicide can inform readers and viewers about the likely causes
of suicide, its warning signs, trends in suicide rates, and recent treatment
advances. They can also highlight opportunities to prevent suicide. Media stories
about individual deaths by suicide may be newsworthy and need to be covered,
but they also have the potential to do harm. Implementation of the following
recommendations for media coverage of suicide has been shown to decrease suicide
rates.1,2
Suicide Contagion is Real
Between 1984 and 1987, journalists in Vienna covered the deaths
of individuals who jumped in front of trains in the subway system. The
coverage was extensive and dramatic. In 1987, a campaign alerted reporters
to the possible negative effects of such reporting, and suggested alternate
strategies for coverage. In the first six months after the campaign began
subway suicides and non-fatal attempts dropped by more than eighty percent.
The total number of suicides in Vienna declined as well.1-2
Research finds
an increase in suicide by readers or viewers when:
- The number of stories about individual suicides increases3,4
- A particular death is reported at length or in many stories3,5
- The story of an individual death by suicide is placed on the front page
or at the beginning of a broadcast3,4
- The headlines about specific suicide deaths are dramatic3
(A recent example: “Boy, 10, Kills Himself Over Poor Grades”)
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Recommendations
The media can play a powerful role in educating the public about suicide
prevention. Stories about suicide can inform readers and viewers about the
likely causes of suicide, its warning signs, trends in suicide rates, and recent
treatment advances. They can also highlight opportunities to prevent suicide.
Media stories about individual deaths by suicide may be newsworthy and need
to be covered, but they also have the potential to do harm. Implementation
of recommendations for media coverage of suicide has been shown to decrease
suicide rates.1,2
- Certain ways of describing suicide in the news contribute to what
behavioral scientists call “suicide contagion” or “copycat” suicides.7,9
- Research suggests that inadvertently romanticizing suicide or idealizing
those who take their own lives by portraying suicide as a heroic or romantic
act may encourage others to identify with the victim.6
- Exposure to suicide
method through media reports can encourage vulnerable individuals to imitate
it.10 Clinicians believe the danger is even greater if there is a detailed
description of the method. Research indicates that detailed descriptions
or pictures of the location or site of a suicide encourage imitation.1
- Presenting
suicide as the inexplicable act of an otherwise healthy or high-achieving
person may encourage identification with the victim.6
Suicide and Mental Illness
Did you know?
- Over 90 percent of suicide victims have a significant psychiatric
illness at the time of their death. These are often undiagnosed, untreated,
or both. Mood disorders and substance abuse are the two most common.11-15
- When both mood disorders and substance abuse are present, the risk for
suicide is much greater, particularly for adolescents and young adults.14,15
- Research has shown that when open aggression, anxiety or agitation is
present in individuals who are depressed, the risk for suicide increases
significantly.16-18
The cause of an individual suicide is invariably more complicated than a
recent painful event such as the break-up of a relationship or the loss of
a job. An individual suicide cannot be adequately explained as the understandable
response to an individual’s stressful occupation, or an individual’s
membership in a group encountering discrimination. Social conditions
alone do not explain a suicide.19-20 People who appear to become suicidal in
response to such events, or in response to a physical illness, generally have
significant underlying mental problems, though they may be well-hidden.12
Questions to ask:
- Had the victim ever received treatment for depression or any other
mental disorder?
- Did the victim have a problem with substance abuse?
Angles to pursue:
- Conveying that effective treatments for most of these conditions
are available (but underutilized) may encourage those with such problems
to seek help.
- Acknowledging the deceased person’s problems and struggles
as well as the positive aspects of his/her life or character contributes
to a more balanced picture.
Interviewing surviving relatives and friends
Research shows that, during the period immediately after a death by
suicide, grieving family members or friends have difficulty understanding
what happened. Responses may be extreme, problems may be minimized,
and motives may be complicated.21
Studies of suicide based on in-depth interviews with those close to the
victim indicate that, in their first, shocked reaction, friends and
family members may find a loved one’s death by suicide inexplicable or they may deny
that there were warning signs.22,23 Accounts based on these initial reactions
are often unreliable.
Angles to Pursue:
- Thorough investigation generally reveals underlying problems unrecognized
even by close friends and family members. Most victims do however
give warning signs of their risk for suicide (see Resources at the end of
this section).
- Some informants are inclined to suggest that a particular
individual, for instance a family member, a school, or a health service provider,
in some way played a role in the victim’s death by suicide. Thorough
investigation almost always finds multiple causes for suicide and
fails to corroborate a simple attribution of responsibility.
Concerns:
- Dramatizing the impact of suicide through descriptions and pictures
of grieving relatives, teachers or classmates or community expressions of
grief may encourage potential victims to see suicide as a way of getting
attention or as a form of retaliation against others.
- Using adolescents
on TV or in print media to tell the stories of their suicide attempts may
be harmful to the adolescents themselves or may encourage other vulnerable
young people to seek attention in this way.
Language
Referring to a "rise" in suicide rates is usually more accurate than
calling such a rise an "epidemic," which implies a
more dramatic and sudden increase than what we generally find
in suicide rates.
Research has shown that the use in headlines
of the word suicide or referring to the cause of death as self-inflicted
increases the likelihood of contagion.3
Recommendations for language:
- Whenever possible, it is preferable to avoid referring to suicide
in the headline. Unless the suicide death took place in public, the cause
of death should be reported in the body of the story and not in the headline.
- In deaths that will be covered nationally, such as of celebrities, or
those apt to be covered locally, such as persons living in small
towns, consider phrasing for headlines such as: “Marilyn Monroe dead at
36,” or “John Smith
dead at 48.” Consideration of how they died could be
reported in the body of the article.
- In the body of the story, it is
preferable to describe the deceased as “having
died by suicide,” rather than as “a suicide,” or
having “committed
suicide.” The latter two expressions reduce the person
to the mode of death, or connote criminal or sinful behavior.
- Contrasting “suicide deaths” with “non-fatal
attempts” is
preferable to using terms such as “successful,” “unsuccessful” or
“failed.”
Special Situations
Celebrity Deaths
Celebrity deaths by suicide are more likely than non-celebrity
deaths to produce imitation.24 Although suicides by celebrities
will receive prominent coverage, it is important not to let the
glamour of the individual obscure any mental health problems or
use of drugs.
Homicide-Suicides
In covering murder-suicides be aware that the tragedy of the homicide can
mask the suicidal aspect of the act. Feelings of depression and
hopelessness present before the homicide and suicide are often the impetus
for both.25,26
Suicide Pacts
Suicide pacts are mutual arrangements between two people who kill
themselves at the same time, and are rare. They are not simply the
act of loving individuals who do not wish to be separated. Research
shows that most pacts involve an individual who is coercive and another
who is extremely dependent.27
Stories to consider covering
- Trends in suicide rates
- Recent treatment advances
- Individual stories of how treatment was life-saving
- Stories of people
who overcame despair without attempting suicide
- Myths about suicide
- Warning signs of suicide
- Actions that individuals can take to prevent
suicide by others
References
- Sonneck, G., Etzersdorfer, E., & Nagel-Kuess, S. (1994). Imitative
suicide on the Viennese subway. Social Science and Medicine, 38, 453- 457.
- Etzersdorfer, E., & Sonneck, G. (1998). Preventing suicide by influencing
mass-media reporting. The Viennese experience 1980-1996. Archives
of Suicide Research, 4, 67-74.
- Phillips, D.P., Lesyna, K., & Paight, D.J. (1992).
Suicide and the media. In R.W. Maris, A.L. Berman, J.T. Maltsberger et al.
(Eds.), Assessment and prediction of suicide (pp. 499-519). New York: The
Guilford Press.
- Hassan, R. (1995). Effects of newspaper stories on the
incidence of suicide in Australia: A research note. Australian
and New Zealand Journal of Psychiatry, 29, 480-483.
- Stack, S. (1991). Social correlates
of suicide by age: Media impacts. In A. Leenaars (Ed.), Life
span perspectives of suicide: Timelines in the suicide process (pp. 187-213). New York: Plenum
Press.
- Fekete, S., & A. Schmidtke. (1995) The impact of mass media
reports on suicide and attitudes toward self-destruction: Previous studies
and some new data from Hungary and Germany. In B. L. Mishara (Ed.), The
impact of suicide. (pp. 142-155). New York: Springer.
- Schmidtke, A., & H_fner,
H. (1988). The Werther effect after television films: New evidence for an
old hypothesis. Psychological Medicine 18, 665-676.
- Gould, M.S., & Davidson,
L. (1988). Suicide contagion among adolescents. In A.R. Stiffman, & R.A.
Feldman (Eds.), Advances in adolescent mental health (pp. 29-59). Greenwich,
CT: JAI Press.
- Gould, M.S. (2001). Suicide and the media. In H. Hendin, & J.J.
Mann (Eds.), The clinical science of suicide prevention (pp. 200-224). New
York: Annals of the New York Academy of Sciences.
- Fekete, S., & Macsai,
E. (1990). Hungarian suicide models, past and present. In G. Ferrari (Ed.),
Suicidal behavior and risk factors (pp. 149- 156). Bologna: Monduzzi Editore.
- Robins, E. (1981). The final months: A study of the
lives of 134 persons.
NY: Oxford University Press.
- Barraclough, B., & Hughes, J. (1987).
Suicide: Clinical and epidemiological studies. London: Croom Helm.
- Conwell
Y., Duberstein P. R., Cox C., Herrmann J.H., Forbes N. T., & Caine
E. D. (1996). Relationships of age and axis I diagnoses in victims of completed
suicide: a psychological autopsy study. American Journal
of Psychiatry, 153,
1001-1008.
- Brent, D.A., Perper, J.A., Moritz, G., Allman, C., Friend,
A., Roth, C., Schweers, J., Balach, L., & Baugher, M. (1993). Psychiatric
risk factors for adolescent suicide: a case-control study. Journal
of the American Academy of Child and Adolescent Psychiatry, 32 (3), 521-529.
- Shaffer, D., Gould, M.S., Fisher, P., Trautman, P., Moreau, D., Kleinman,
M., & Flory, M. (1996). Psychiatric diagnosis in child and adolescent
suicide. Archives of General Psychiatry, 53 (4), 339-348.
- Mann, J.J.,
Waternaux, C., Haas, G.L., & Malone, K.M. (1999). Toward
a clinical model of suicidal behavior in psychiatric patients. American
Journal of Psychiatry, 156 (2), 181-189.
- Soloff, P.H., Lynch, K.G., Kelly, T.M.,
Malone, K.M., & Mann, J.J.
(2000). Characteristics of suicide attempts of patients with major depressive
episode and borderline personality disorder: a comparative study. American
Journal of Psychiatry, 157 (4), 601-608.
- Fawcett, J. (1990). Targeting
treatment in patients with mixed symptoms of anxiety and depression. Journal
of Clinical Psychiatry, 51 (Suppl.), 40-43.
- Gould, M.S., Fisher, P.,
Parides, M., Flory, M., & Shaffer, D. (1996).
Psychosocial risk factors of child and adolescent completed suicide. Archives
of General Psychiatry, 53, 1155-1162.
- Moscicki, E.K. (1999). Epidemiology
of suicide. In D.G. Jacobs (Ed.), The Harvard Medical
School Guide to suicide assessment and intervention (pp. 40-51). San Francisco: Jossey-Bass.
- Ness, D.E., & Pfeffer, C.R. (1990). Sequelae of bereavement resulting
from suicide. American Journal of Psychiatry, 147, 279-285.
- Barraclough,
B., Bunch, J., Nelson, B., & Sainsbury, P. (1974). A
hundred cases of suicide: clinical aspects. British
Journal of Psychiatry,
125, 355-373.
- Brent, D.A., Perper, J.A., Kolko, D.J., & Zelenak,
J.P. (1988). The psychological autopsy: methodological considerations for
the study of adolescent suicide. Journal of the American
Academy of Child and Adolescent Psychiatry, 27 (3), 362-366.
- Wasserman, I. M. (1984).
Imitation and suicide: A re-examination of the Werther effect. American
Sociological Review, 49, 427-436.
- Rosenbaum, M. (1990). The role of depression in
couples involved in murder-suicide and homicide. American
Journal of Psychiatry,
47 (8), 1036-1039.
- Nock, M.K., & Marzuk, P.M. (1999). Murder-suicide:
Phenomenology and clinical implications. In D.G. Jacobs (Ed.) The
Harvard Medical School guide to suicide assessment and intervention (pp. 188-209).
San Francisco: Jossey-Bass.
- Fishbain, D.A., D'Achille, L., Barsky, S., & Aldrich,
T.E. (1984). A controlled study of suicide pacts. Journal
of Clinical Psychiatry,
45, 154-157.
These recommendations were produced in the spirit of the public-private partnership
recommended by the Surgeon General’s National Strategy for Suicide Prevention.
We would like to thank the many journalists and news editors who assisted
us in this project.
The Annenberg Public Policy Center’s involvement was funded by The Robert
Wood Johnson Foundation.
Recommendations for the media are available at
www.afsp.org/education/newrecommendations.htm
Resources
United States
International
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