Recommendations for the Media

HOW THE MEDIA CAN HELP
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

SUICIDE CONTAGION IS REAL
Research finds an increase in suicide by readers or viewers when:

DANGEROUS DETAILS

SUICIDE AND MENTAL ILLNESS
Did you know?

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?
If the victim was depressed was he or she openly aggressive, anxious, or agitated?

Helpful Suggestions

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.

Helpful Suggestions

  1. 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
  2. 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:

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:

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

HELP WITH A STORY
Reporters seeking professional consultation with a story can contact Dr. Herbert Hendin, SPI CEO and Medical Director, by phone at 212-427-1500 or by email at hhendin@SPIorg.org

REFERENCES

  1. Sonneck, G., Etzersdorfer, E., & Nagel-Kuess, S. (1994). Imitative suicide on the Viennese subway. Social Science and Medicine, 38: 453- 457.
  2. Etzersdorfer, E., & Sonneck, G. (1998). Preventing suicide by influencing mass-media reporting. The Viennese experience 19801996. Archives of Suicide Research, 4: 67-74.
  3. 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.
  4. 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.
  5. 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.
  6. Schmidtke, A., & Häfner, H. (1988). The Werther effect after television films: New evidence for an old hypothesis. Psychological Medicine 18: 665-676.
  7. 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.
  8. Gould, M.S. (2001). Suicide and the media. In H. Hendin, & J.J. Mann (Eds.), The clinical science of suicide prevention (pp. 200224). New York: Annals of the New York Academy of Sciences.
  9. 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.
  10. 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.
  11. Robins, E. (1981). The final months: A study of the lives of 134 persons. NY: Oxford University Press.
  12. Barraclough, B., & Hughes, J. (1987). Suicide: Clinical and epidemiological studies. London: Croom Helm.
  13. 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.
  14. 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: 521-529.
  15. 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: 339-348
  16. 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: 181-189.
  17. 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: 601-608.
  18. Fawcett, J. (1990).Targeting treatment in patients with mixed symptoms of anxiety and depression. Journal of Clinical Psychiatry, 51 (Suppl.): 40-43.
  19. 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.
  20. 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.
  21. Ness, D.E., & Pfeffer, C.R. (1990). Sequelae of bereavement resulting from suicide. American Journal of Psychiatry, 147: 279-285. .
  22. Barraclough, B., Bunch, J., Nelson, B., & Sainsbury, P. (1974). A hundred cases of suicide: clinical aspects. British Journal of Psychiatry, 125: 355-373.
  23. 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: 362-366.
  24. Wasserman, I. M. (1984). Imitation and suicide: A re-examination of the Werther effect. American Sociological Review, 49: 427-436.
  25. Rosenbaum, M. (1990). The role of depression in couples involved in murder-suicide and homicide. American Journal of Psychiatry, 47: 1036-1039.
  26. 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.
  27. 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.