Media guidelines and suicide: A critical review

How Do Recommended Elements in Suicide News Coverage Work? An Investigation of the Effect of Responsible Reporting and Readers' Reflectiveness on Suicide Prevention

To examine the effect of positive elements in suicide reporting guidelines, we assessed how responsible reporting on suicide (RRS) affect cognitive and intentional responses. We also investigated the moderating role of audience reflectiveness in news processing. Here, 308 individuals participated in a single-factor between-subject experiment conducted in South Korea. We manipulated the number of positive RRS features in news articles by adding suicide statistics, contact information for helplines, and efficacy-enforcing information. Overall, news articles containing multiple RRS elements had a stronger impact on behavioral intentions to help others in a suicidal crisis than a basic news article without RRS elements. Interestingly, reflectiveness had a stronger influence on individuals who read a suicide news report having the most RRS elements relative to those who read suicide news without any RRS elements, signifying an indirect impact of suicide news on intentions to help. The implications of this RRS effect identified are discussed in terms of suicide prevention.

News Media Framing of Suicide Circumstances and Gender: Mixed Methods Analysis

BACKGROUND

Suicide is a leading cause of death worldwide. Journalistic reporting guidelines were created to curb the impact of unsafe reporting; however, how suicide is framed in news reports may differ by important characteristics such as the circumstances and the decedent's gender.

OBJECTIVE

This study aimed to examine the degree to which news media reports of suicides are framed using stigmatized or glorified language and differences in such framing by gender and circumstance of suicide.

METHODS

We analyzed 200 news articles regarding suicides and applied the validated Stigma of Suicide Scale to identify stigmatized and glorified language. We assessed linguistic similarity with 2 widely used metrics, cosine similarity and mutual information scores, using a machine learning-based large language model.

RESULTS

News reports of male suicides were framed more similarly to stigmatizing (P<.001) and glorifying (P=.005) language than reports of female suicides. Considering the circumstances of suicide, mutual information scores indicated that differences in the use of stigmatizing or glorifying language by gender were most pronounced for articles attributing legal (0.155), relationship (0.268), or mental health problems (0.251) as the cause.

CONCLUSIONS

Linguistic differences, by gender, in stigmatizing or glorifying language when reporting suicide may exacerbate suicide disparities.

Predicting Sensationalism in Suicide Story Headlines

Objective: Suicide is a leading cause of death in the United States, and media publicity plays a role in suicide rates. The United States offers guidelines for the reporting of suicide. This study evaluated guideline adherence in newspaper and newswire publications covering celebrity suicide deaths. The research also assessed whether the sensationalism of article headlines could be predicted by variables reflecting nonadherent reporting. Method: Publications from 2013 to 2018 reporting on nine celebrity suicides were evaluated via content analysis. Adherence was assessed in a two-step hierarchical linear regression to determine which variables predicted sensationalism in headlines. Results: Overall adherence to reporting guidelines was moderate. Newspaper disclosure of suicide method only, suicide method and location, and note contents significantly predicted headline sensationalism in the first regression model, R2 = 22%. The sensationalism in the body of the article and other variables additionally predicted headline sensationalism in the second regression model, R2 = 55%. Limitations: This study is limited to celebrity suicide reporting and may not reflect media reporting trends of noncelebrity suicide deaths. Conclusion: Findings reveal that sensationalism in the body of the article and other variables uniquely contributed to sensationalism in newspaper headlines. This suggests that the public could be at risk for reading harmful content not consistent with reporting recommendations about suicide because of the initial attraction to sensational headlines.

"Breaking the silence" suicide Prevention media campaign in Oregon: Evaluation of impact on help-seeking and suicide mortality

INTRODUCTION

Research has established that suicide-related media can impact suicide rates both positively and negatively, supporting efforts to engage the media in the service of suicide prevention. The goal of the current study is to evaluate the impact of a suicide prevention media campaign implemented April 7-14, 2019 in Oregon.

METHODS

Several indices of help-seeking behavior and suicide risk were employed: suicide-related Google Health API searches, National Suicide Prevention Lifeline (Lifeline) (currently known as the 988 Suicide and Crisis Lifeline) call volume, and state suicide mortality data from April 7, 2016-May 6, 2019. Eight states with similar 2016-2018 average suicide rates were compared with Oregon. Bayesian structural time-series modeling in R was used to test intervention effects.

RESULTS

During the 30 days following the start of the campaign, there was a significant increase in Lifeline calls from Oregon area codes (2488 observed vs. 2283 expected calls, p = 0.03). There were no significant changes in suicide mortality or suicide-related Google searches in Oregon.

CONCLUSIONS

The campaign appeared to increase help-seeking behavior in the form of Lifeline calls, without any indication of an iatrogenic suicide contagion effect. However, the campaign's potential to reduce suicide mortality was unmet.

Suicide in the press: an analysis of newspaper coverage of adolescent versus adult suicides in Italy

BACKGROUND

An association between sensationalized media reporting and subsequent increase in suicidal behavior has been documented, and adolescents are especially vulnerable to imitative influences. The aims of this study were to examine the characteristics of the articles reporting adult and adolescent (under age 18) suicides in the Italian press and to assess adherence to the World Health Organization (WHO) guidelines for responsible reporting. Methods: The print versions of the three newspapers with the widest national distribution in Italy were searched for all the articles on incident suicides printed over a 7-month period (July 2022 to February 2023). Articles were examined for adherence to the WHO guidelines. Results: Overall, 213 articles were identified, reporting on 122 individual suicide cases (88.5% adults and 11.5% adolescents). Of the articles, 78.9% were on adults and 21.1% on adolescents, with a ratio articles/suicide cases of 1.6 for adults and 3.2 for adolescents (p < 0.0001). Adolescent suicide articles had more words (mean 612.5 ± SD 275.6) than adult ones (462.1 ± 267.7, p = 0.001). Potentially harmful reporting features were present in both the adult and adolescent articles (12-82%). Few articles (0-15%) included protective features. Articles on adolescents were more adherent to the WHO guidelines for omitting specific information of suicide method and location. Conclusions: Significant differences were found in the press reporting of adolescent versus adult suicides, with adolescent suicides receiving more attention in terms of the number of articles and article length. Suicide press reporting can be improved. A close collaboration between journalists and suicide prevention experts may be beneficial.

Werther or Papageno? Examining the effects of news reports of celebrity suicide versus non-celebrity peer suicide on intentions to seek help among vulnerable young adults

INTRODUCTION

A large body of literature has examined the Werther effect following news reports of suicide, yet much less attention has been paid to the protective Papageno effect. This research explored the causal relationships between news reports of real celebrity suicides (e.g., pop-rock star Chester Bennington) and real non-celebrity "peer" suicides (e.g., college student Madison Holleran) and intentions to seek help.

METHODS

Two survey experiments confirmed successful experimental manipulation (N = 280) and tested behavioral theory, clinical indicators, and intentions to seek help (N = 641) in samples of college students (18-25).

RESULTS

Participants were motivated to seek help if they believed it could lead to positive outcomes, yet this was less likely among participants with depression. Exposure to news reports of non-celebrity suicides had a small positive effect on help-seeking intentions. Among participants with depression, news reports of celebrity suicides had a small positive effect on intentions.

CONCLUSIONS

This research could not establish Werther effects for either of the news reports. Exposure to news reports of non-celebrity suicides had a small positive effect on intentions overall, but young adults with higher levels of depression were slightly more motivated to seek help after viewing news reports of celebrity suicides.

The role of monocausal versus multicausal explanations of suicide in suicide reporting: A randomized controlled trial

BACKGROUND

Media guidelines for reporting on suicide recommend that journalists should avoid monocausal explanations of suicide, but it is unclear if media items with monocausal explanations elicit different effects as compared to multicausal portrayals.

METHOD

Using a web-based randomized controlled trial (n = 969), we tested five versions of a news article about the suicide of a teenage girl with varying portrayals of reasons for the suicide: (1) bullying as the sole (external) factor (i.e., monocausal), (2) several external social factors, (3) a combination of internal and external factors, (4) a combination of internal and external factors along with a focus on suicide prevention, or (5) no reason for the suicide (control group). We measured perceptions about the cause of suicide, attitudes toward suicide and suicide prevention, and identification with the suicidal protagonist with questionnaires.

RESULTS

Readers of articles that portrayed suicide as being caused by one specific reason or exclusively social factors tended to adopt these misconceptions. Identification with the suicidal protagonist did not vary between interventions groups, but was lower in the control group.

CONCLUSION

Highlighting the multifactorial etiology of suicide in news articles may help to avoid the misconception that suicide is a monocausal issue.

Why Suicide? Suicide Propinquity and Adolescent Risk for Suicidal Thoughts and Behaviors

Suicide represents an international public health concern, and for adolescents aged 14 to 18 in the United States, is the third leading cause of death (Centers for Disease Control and Prevention. 2021 Youth Risk Behavior Survey Data. Available at: www.cdc.gov/yrbs . Accessed on August 30, 2023.). In response to this alarming rate, as well as the relative lack of meaningful progress in the prediction and prevention of suicidal thoughts and behaviors (STB) over the past decades (see Franklin et al., 2017), recent reviews of the suicide literature have advocated for the adoption of novel frameworks and theoretical reexamination of the processes that confer risk for suicide. Currently, the majority of suicide theories emphasize distal factors associated with suicide risk, but these factors also generalize to other types of psychopathology and do not answer the fundamental question of "why suicide?" vs. other maladaptive outcomes. In an effort to address this gap and build off existing theoretical and empirical science from various disciplines, the current theoretical paper will explore the concept of suicide propinquity, the degree of closeness and identification with STB, as a potential moderator of the link between psychological distress and suicide. Specifically, this paper: (1) provides context within the existing theories of suicide, highlighting gaps that might otherwise be explained by propinquity; (2) discusses historical and scientific evidence of suicide phenomena that support the existence of propinquity; (3) explores potential processes of how propinquity may confer risk for STB in adolescence; and (4) suggests future directions for research to examine adolescent suicide from a propinquity perspective.

Trends in Newspaper Coverage of Suicide in Israel: An 8-Year Longitudinal Study

BACKGROUND

The nature of newspaper coverage of suicide events can impact suicide risk. Thus, the World Health Organization published recommendations for reporting suicide in the media. To date, Israel has no data regarding adherence to these media guidelines and no indication of the influence of the Israeli National Suicide Prevention Program (NSPP) on adherence. Aiming to fill these gaps, the current study examined (1) Israeli newspapers' adherence to the guidelines for suicide coverage and (2) the impact of the NSPP on the adherence level of media reporting.

METHOD

Adherence to newspapers coverage guidelines was examined in two leading Israeli newspapers at three time points: T1 (2012, two years before the NSPP's establishment), T2 (2016-2017, 2-3 years after its establishment), and T3 (2018-2019, 4-5 years after NSPP's establishment). All articles reporting on suicide or suicidal behavior were analyzed at each time point regarding their adherence to the media guidelines.

RESULTS

Two hundred articles were assessed and analyzed. The adherence level was 49.35% across all time points. We found improved adherence at T2 (after the initiation of the NSPP) in most of the guidelines but a slight decline at T3. Adherence to guidelines regarding prevention (Do guidelines) showed no significant improvement over time.

CONCLUSIONS

General adherence to guidelines was relatively low. However, steps can be taken to improve media coverage of suicide stories. The NSPP should make greater efforts to promote changes in media coverage of suicide events in Israel, such as providing information about risk factors, prevention, and intervention. HIGHLIGHTSA longitudinal study examined Israeli newspapers over three time points in the last decade.General adherence level to the suicide coverage guidelines was 49.35% across all time points.The National Suicide Prevention Program was linked to improvement in adherence to most guidelines.

Prevention of the Werther effect: compliance of the Italian newspapers to the 'reporting on suicide' recommendations

OBJECTIVES

Suicide media coverage could lead to imitation, the so-called 'Werther effect'. The World Health Organization (WHO) published specific recommendations for reporting suicide news. This study aimed to quantify the compliance of Italian newspapers with the WHO suicide reporting guidelines.

STUDY DESIGN

This was a quantitative content analysis study.

METHODS

All articles published by the three main Italian newspapers from June 2019 to May 2020 describing suicides or attempted suicides were included. The articles were analyzed using a checklist based on the WHO recommendations, which included 18 'negative' items (e.g. 'presence of the word 'suicide' in the title') and nine 'positive' items (e.g. 'the article reports the contacts of a suicide prevention hotline'). Each negative item was scored -1, and each positive item was scored +1. Multivariate linear regressions were performed to identify factors associated with lower adherence to WHO recommendations and higher social media engagement with the articles.

RESULTS

A total of 3483 articles were screened, and 110 articles were included in the final analysis. The suicidal was male in 73.6% of cases. The median checklist score was -6 (interquartile range 3). Five percent of the articles had at least one positive item. The word 'suicide' was found in 90% of the titles. Female suicides were associated with a higher checklist score (coefficient 0.81, P = 0.039). No correlation was found between the checklist score and the social media engagement of the articles.

CONCLUSIONS

Italian newspapers do not adhere completely to the WHO recommendations on reporting suicide, leading to a potential imitation effect. Public health professionals should make decision-makers and journalists aware of the importance of these recommendations.

Suicide reporting of LGBTQI+ population in India: An analysis of online media reports of the past decade

BACKGROUND

Imbalanced portrayal of suicide by the media can have adverse public health consequences. We aimed to evaluate the psychosocial context, as well as the quality of media reporting, of suicide among lesbian, gay, bisexual, transgender people, queer and intersex (LGBTQI+) population.

METHODS

A cross-sectional study was conducted to evaluate online news reports discussing the suicide of LGBTQI+ persons published between January 2011 and January 2021. Psychosocial factors associated with suicide were extracted from the reports. Quality of suicide reporting was checked against international as well as locally relevant reporting guidelines.

RESULTS

A total of 135 suicide reports from five newspapers were analyzed. Multiple psychosocial stressors were reported in 54.5% of the suicides. Social stigma was the most common factor associated with LGBTQI+ suicide. Several breaches of reporting were noted in relation to mentioning the identity (55.6%) and method of suicide (54.3%) in the title of report and inclusion of the deceased's photograph (20.4%). Potentially helpful reporting characteristics, such as including educational information (2.2%), mentioning warning signs (12.6%) and suicide support service details (3.7%), were rarely practiced. Local language news articles displayed more frequent and serious violations compared to English news reports.

CONCLUSION

Indian media reporting of suicide among LGBTQI+ persons is poorly adherent to reporting guidelines.

Suicide among soldiers and social contagion effects: An interrupted time-series analysis

BACKGROUND

Suicide has become an increasingly concerning problem among soldiers in recent years. Previous research has hypothesized that media-related social contagion effects, termed "Werther effects," may contribute to military suicide numbers. Unfortunately, there is limited empirical knowledge on such social contagion effects in soldiers. We contribute to the literature by investigating this phenomenon in the context of a specific historical suicide case, allowing us to provide a longitudinal assessment: Crown Prince Rudolf, heir to the Imperial throne of the Austro-Hungarian Empire, who died by suicide in January 1889. His death was a well-known news story that shook the monarchy to its foundations. Notably, soldiers of the late nineteenth century were an especially vulnerable portion of the population, proven by the fact that the Austro-Hungarian military had one of the highest suicide rates at the time compared to other European countries.

METHODS AND RESULTS

An interrupted time-series analysis, relying on annual military suicide rates between 1873 and 1910, indicated a significant increase in the suicide rate the year of Rudolf's death, a pattern consistent with a social contagion effect. In fact, time series analysis estimated that there were about 30 excess suicides per 100,000 population within the year of Rudolf's death. Additionally, we identified a substantial change in the trend after Rudolf's death, pointing to a long-term decrease in military suicide rates. The latter was not observed in the general population but appeared to be unique to soldiers.

DISCUSSION

Although we are very careful when interpreting causal effects with our historical data, we discuss the latter finding by questioning whether a change in military culture, that is, the establishment of better conditions for soldiers in the aftermath of Rudolf's suicide, contributed to decreasing suicide numbers. Although tentative, these findings are also highly relevant for the study of military suicide today.

Social Media Sentiments on Suicides at the New York City Landmark, Vessel: A Twitter Study

Vessel is a landmark created by Heatherwick Studio where visitors can enjoy views of New York City from different heights and perspectives. However, between February 2020 and July 2021, four individuals jumped to their deaths from the landmark. Effective preventive solutions have yet to be identified, and the site is currently closed. In this study, we examined the trajectory of public sentiment on the suicide-related activity at Vessel on Twitter by investigating the engagement patterns and identifying themes about the four suicides from February 2020 to August 2021 (n = 3058 tweets). The results show increased levels of discussion about each successive suicide case in the first 14 days following each incident (from 6 daily tweets for the first case to 104 for the fourth case). It also took longer for relevant discussions to dissipate (4 days for the first and 14 days for the fourth case, KS statistic = 0.71, p < 0.001). Thematic analysis shows a shift from expressions of emotion to urging suicide prevention actions in the third and fourth cases; additionally, we detected growing support for restricting means. We suggest that, prior to the reopening of Vessel, collective efforts should be made to install safety protections and reduce further suicide risks.

The Impact of a Widely Publicized Celebrity Suicide on Suicide-Related Internet Search Activity

OBJECTIVE

Media reporting of celebrities' deaths by suicide are prone to suicide contagion effects. The aim of the current study is to examine whether the widely publicized celebrity suicide of Ari Behn in Norway was associated with changes in search activity of suicide-related terms.

METHOD

Search activity data for the terms "suicide," "Ari Behn suicide," "how to suicide," and "suicide prevention" were retrieved from Google Trends. We analyzed data as an interrupted time series and used T-tests to compare means before and after the suicide. Crude linear models examining the association between searches for "suicide" over time and an adjusted model controlling for searches after "Ari Behn suicide" were built. The models were tested with structural change tests.

RESULTS

A significant increase in search activity for "suicide" (p = < .001), "Ari Behn suicide" (p = .002), and "how to suicide" (p = .006) was found after the suicide. Searches for "suicide prevention" were not significant (p = .11). The structural change test was significant both for the model that did not control for explicit searches (p = <.001) and for the model controlled for explicit searches (p = <.001).

CONCLUSIONS

A recent widely publicized suicide in Norway was associated with increases in Google searches for suicide. No indications of the Papageno effect were found. The media should be cautious when reporting about the suicides of prominent public persons. Compliance with generally accepted media reporting guidelines may need more attention.HIGHLIGHTSWe found a significant increase in search activity for suicide related terms.More attention should be devoted to careful media reporting on celebrity suicides.Media should consider the volume of publicity carefully.

Contributing factors to suicide: Political, social, cultural and economic

This review summarizes recent research in four environmental areas affecting risk of deaths by suicide. Politically, the weight of the evidence suggests that laws increasing social welfare expenditures and other policies assisting persons with low incomes (e.g., minimum wage) tend to lower suicide rates. Other legal changes such as those restricting firearms and alcohol availability can also prevent suicides. The social institutions of marriage, as well as parenting, continue to serve as protective factors against suicide, although the degree of protection is often gendered. Religiousness tends to be inversely associated with suicide deaths at the individual level of analysis, but the mediators need exploration to determine what accounts for the association: social support, better mental health, better physical health, less divorce, or other covariates. Cultural definitions of the traditional male role (e.g., breadwinner culture) continue to help explain the high male to female suicide ratio. New work on the "culture of suicide" shows promise. The degree of approval of suicide is sometimes the single most important factor in predicting suicide. At the individual level of analysis, two of the strongest predictors of suicide are economic ones: unemployment and low socio-economic status. Attention is drawn to enhancing the minimum wage as a policy known to lower state suicide rates. Limitations of research include model mis-specification, conflicting results especially when ecological data are employed, and a need for more research exploring moderators of established patterns such as that between religiousness and suicide.

Online media reporting of suicidal behaviour in Ghana: Analysis of adherence to the WHO guidelines

BACKGROUND

Irresponsible media reporting of suicide is a potential risk for copycat suicide. There is a paucity of studies from sub-Saharan Africa on the quality of media reporting of suicide.

OBJECTIVES

We assessed the compliance of Ghanaian online media outlets with the World Health Organization (WHO) guidelines for media reporting of suicide.

METHODS

We searched 10 local media outlets with strong online presence in Ghana, to identify suicide-related news reports from 2000 through 2019. We applied summative content analysis and chi-square (χ2) test to the data.

RESULTS

We included 288 news reports, of which 261 (90.6%) were completed suicides, 7 (2.4%) were attempted suicides and 20 (6.9%) were homicide suicides. Most of the news reports failed to comply with the WHO guidelines: 92.7% mentioned the specific method of the suicide act, 82.6% included 'suicide' in the headline and 55.6% included photos of the victims. The χ2 tests indicated that privately owned media outlets were more likely than publicly owned to post a photo of the victim, χ2(1) = 17.37, p < .001, and report the incident location in the headline, χ2(1) = 15.00, p < .001. However, generally, there were no statistically significant relationships between the quality of reporting and media outlet ownership. Each of the 288 reports failed to mention any of the potentially helpful features recommended by the WHO guidelines.

CONCLUSION

Regardless of the ownership of the media outlet (whether private or publicly owned), mostly, the online reportage of suicidal behaviour in Ghana deviates sharply from the international recommended best practice by the WHO.

The Werther Effect, the Papageno Effect or No Effect? A Literature Review

This paper examines the association between media reporting on suicides and the subsequent suicides. Scientific papers from two online bibliographic sources Medline (PubMed) and PsycINFO were searched. The sample included 108 research papers examining the impact of different types of media stories on suicides. The review revealed that although the media can be a double-edged sword and serve both as a risk and a protective factor, the vast majority of research suggests that the relationship between the media reporting and the actual suicide rates is causal and real. Moreover, both the quantity and the quality of media reporting may trigger additional suicides in society. Simultaneously, research suggests that especially non-fictional presentations of celebrities’ suicides in newspapers and on television news have the biggest influence on the subsequent suicides. Additionally, a strong modelling effect of media reporting on suicide is based on nationality, age, and gender. However, research shows that because a negative reporting style can be modifiable and improved, the media can also have an educative or preventive effect and can reduce the risk of contagion. Consequently, it is important to monitor the implementation of media recommendations for the reporting of suicide, and continuous education of reporters is needed.

The Werther Effect, the Papageno Effect or No Effect? A Literature Review

This paper examines the association between media reporting on suicides and the subsequent suicides. Scientific papers from two online bibliographic sources Medline (PubMed) and PsycINFO were searched. The sample included 108 research papers examining the impact of different types of media stories on suicides. The review revealed that although the media can be a double-edged sword and serve both as a risk and a protective factor, the vast majority of research suggests that the relationship between the media reporting and the actual suicide rates is causal and real. Moreover, both the quantity and the quality of media reporting may trigger additional suicides in society. Simultaneously, research suggests that especially non-fictional presentations of celebrities' suicides in newspapers and on television news have the biggest influence on the subsequent suicides. Additionally, a strong modelling effect of media reporting on suicide is based on nationality, age, and gender. However, research shows that because a negative reporting style can be modifiable and improved, the media can also have an educative or preventive effect and can reduce the risk of contagion. Consequently, it is important to monitor the implementation of media recommendations for the reporting of suicide, and continuous education of reporters is needed.

Coverage of Robin Williams' Suicide in Australian Newspapers

Background: Australia's Mindframe guidelines provide media professionals with advice on ways to safely report on suicide. Aims: We aimed to examine the extent to which Australian newspaper articles on Robin Williams' suicide conformed to the Mindframe recommendations. Method: We searched Factiva for relevant articles appearing in Australian newspapers during the 5 months following Williams' death on August 11, 2014. We retrieved the text of these articles from Factiva and, wherever possible, sourced scanned copies from the National Library of Australia. Trained coders rated the articles for quality, using a 10-item coding framework derived from the Mindframe guidelines. Results: Our search yielded 303 articles. In general, there were high levels of adherence to the Mindframe guidelines, with 67% of articles adhering to at least eight (80%) of the Mindframe guidelines. Limitations: We may have missed some articles and the coders' task involved some subjective judgments. Conclusion: Australian newspaper reporting of Robin Williams' suicide was largely consistent with the Mindframe guidelines. In particular, there was good adherence to recommendations designed to minimize the risk of imitative acts, which is positive. The poorer performance of articles in terms of recommendations to do with public education about suicide may be a missed opportunity.