Health prevention messages may have paradoxical effect

Suicide and the media. Part III: Theoretical issues

The body of evidence suggests that there is a causal association between nonfictional media reporting of suicide (in newspapers, on television, and in books) and actual suicide, and that there may be one between fictional media portrayal (in film and television, in music, and in plays) and actual suicide. This finding has been explained by social learning theory. The majority of studies upon which this finding is based fall into the media "effects tradition," which has been criticized for its positivist-like approach that fails to take into account of media content or the capacity of audiences to make meaning out of messages. A cultural studies approach that relies on discourse and frame analyses to explore meanings, and that qualitatively examines the multiple meanings that audiences give to media messages, could complement the effects tradition. Together, these approaches have the potential to clarify the notion of what constitutes responsible reporting of suicide, and to broaden the framework for evaluating media performance.

Suicide and the Media

Summary: The association between the portrayal of suicide in fictional media and actual suicide has been debated since 1774, when it was asserted that Goethe's The Sorrows of Young Werther had led people to take their own lives. Since that time, a plethora of studies considering the association has been conducted. This review considered 34 studies examining the impact of fictional portrayal of suicide (in film and television, music, and plays) on actual suicidal behavior. It asked the question: “Is there any association, and if so, can it be considered causal?” Using strict criteria to establish causality, we found that the evidence was more equivocal than was the case for nonfictional reporting.

Suicide and the media

Evidence continues to amass on the significant impact of media coverage on suicide. The research literature on the impact of news reports of nonfictional suicides as well as fictional suicide stories is reviewed in order to determine the nature and scope of the influence of the mass media on suicide. The current review, building upon earlier reviews, is limited to English language publications or English translations of articles and/or abstracts. The interactive factors that may moderate the impact of media stories are also reviewed. Such interactive factors include characteristics of the stories (agent), individuals' attributes (host), and social context of the stories (environment). Recommendations are presented for the reporting of suicide stories, which may minimize the risk of imitative suicides. The media's positive role in educating the public about risks for suicide and shaping attitudes about suicide is emphasized. In summary, the existence of suicide contagion no longer needs to be questioned. We should refocus our research efforts on identifying which particular story components promote contagion under which circumstances and which components are useful for preventive programming.

Media influence on parasuicide. A study of the effects of a television drama portrayal of paracetamol self-poisoning

BACKGROUND

Paracetamol self-poisoning, which carries a significant risk of fatal liver damage, is increasing in the UK, especially among adolescents. There is concern that media portrayal of suicidal behaviour may influence its occurrence. We have investigated the effects of two broadcasts of a television drama showing a teenage girl's overdose of paracetamol.

METHOD

Data from the Oxford Monitoring System for Attempted Suicide were used to examine changes in the number of overdoses and the use of paracetamol in the three week period before and after both broadcasts. An analysis of log-linear models was carried out, using additional data from two previous years, in order to control for the effects of gender, age group, time period, season, year and drug. A questionnaire was used to ascertain whether the programme had influenced patients' decisions to take an overdose or their choice of drug.

RESULTS

An increase in paracetamol overdoses occurred following the first broadcast, but when data from the two previous years were examined and the log-linear analysis was used there was no evidence of significant effects attributable to the broadcasts. The questionnaire study revealed that very few people had seen either episode, and only two claimed that it had influenced them (one in terms of getting help).

CONCLUSIONS

It is important to use sound methodology to avoid interpreting chance fluctuations as a media effect. The potential positive benefits of such programmes should also be investigated.

Changes in the pattern of deliberate self-poisoning presenting at Craigavon Area Hospital: 1976, 1986 and 1991

Deliberate self-poisoning presenting at Craigavon Area Hospital in 1991 was examined and compared to the years 1976 and 1986. Self-poisoning has not declined over the 15 year period 1976-1991. The reduction in the use of benzodiazepines, and increase in paracetamol, previously reported, continues. Possible reasons for this are examined, in relation to local and national drug prescribing.