Media reporting of suicide and adherence to media guidelines

Public health measures related to the transmissibility of suicide

Transmission is an important concept in suicide prevention. It can occur when exposure to another person's death by suicide (or to suicide-related information more generally) draws attention to suicide or highlights specific suicide methods. In this paper, the fourth in a Series on a public health approach to suicide prevention, we contend that the transmissibility of suicide must be considered when determining optimal ways to address it. We draw on five examples of how transmission might occur and be prevented. The first two examples relate to transmission initiated by representations of suicide in traditional and new media. The third concerns transmission that leads to suicide clusters, and the fourth considers a specific setting in which transmission occurs, namely secondary schools. Finally, we discuss how suicide risk might be countered by the transmission of suicide prevention messages in media campaigns.

Suicide prevention: reflections on progress over the past decade

Interest in preventing suicides has increased greatly in recent years. In this Personal View, we consider the general global developments related to suicide prevention that have occurred in the decade since The Lancet Psychiatry was first published in 2014. We then review specific advances during this period, first, in relation to public health initiatives, and second, with regard to clinical developments. Finally, we examine some of the challenges that currently confront individuals and organisations responsible for designing and implementing suicide prevention measures.

Assessing the quality of suicide reporting in Portugal: 6 case studies of celebrities and non-celebrities over 25 years

Multiple studies from various countries have found evidence of suicide increases after media reports of suicide, which are known as the Werther effect, but responsible suicide reporting can contribute to suicide prevention, a phenomenon known as the Papageno effect. This study aims to assess adherence by the Portuguese media to the suicide reporting guidelines released by the World Health Organization (WHO) and to determine whether there are differences in reporting style between them and over time. News items about six suicides of public and non-public figures between 1996 and 2020 were collected from several Portuguese media-two newspapers, three radio stations, three television channels, and a few websites-in the periods following those deaths, and they were subsequently examined for adherence to the WHO guidelines. A total of 374 news items were analyzed. The majority of them complied with most of the WHO recommendations for suicide reporting, especially the 'don't do' guidelines. However, most of the news items that were analyzed did not follow the recommendations regarding putatively preventive information, notably the inclusion of support contacts and citation of mental health experts. The Portuguese media mostly adhered to the WHO suicide reporting guidelines and there was a positive evolution over time in the level of compliance with them. Nevertheless, there is room for improvement.

Adherence to the WHO guidelines of newspaper-reporting on suicides in Pakistan: a content analysis

There is a lack of evidence regarding the rate of adherence to the World Health Organization (WHO) media guidelines of vernacular newspapers reporting on suicides in Pakistan. Also, the relevance of this report is based on the lack of official data regarding the number of suicides across the country. The aim of this study was to explore the rate of adherence to the WHO guidelines of two popular newspapers in reporting on suicides in Pakistan. We daily analysed the online version of two popular newspapers in Pakistan, the daily Jeejal (in Sindhi) and daily Jang (in Urdu), from 1 August 2021 to 31 July 2022; we performed a content analysis of news reporting on national suicides and evaluated their rate of adherence to the WHO media guidelines. One hundred and seventy-three reports of suicides were identified and analysed; 84% of them reported the names of victims, 70% reported their age, and 46% included information regarding their occupation. Characteristics of suicide methods were reported in 87% of reports, reasons for suicide in 66%, as well as locations in 87%. In general, 84% of newspapers reported incomplete information regarding suicide prevention and help-seeking, so we may conclude they were not fully adherent to the WHO recommendations. This study indicates that national vernacular newspapers may improve their reporting on suicides and should revise their policy in order to be adherent to the WHO guidelines. Also, better and responsible reporting may provide an accurate epidemiological source regarding suicide where official data are missing at the national level.

"Dressed like boys, hair trimmed, a nalla kutti otherwise": construction of queer suicide in Indian online news media

Suicide is a significant newsworthy event, and the media often cover cases involving queer individuals. However, there is a notable lack of research on the quality of reporting of queer suicide cases within the Indian context. This article aims to address the existing gap in Indian online news media by investigating the portrayal of queer suicide via content analysis. Content analysis involves qualitatively condensing and interpreting data to extract key consistencies and meanings from a plethora of qualitative material. The newspapers considered span from 2005 to 2022, with data collection conducted in 2023. The author alone identified news articles on queer suicide and conducted the subsequent content analysis. The study reveals that reporting on queer suicide tends to divide queer couples into the gender binary and describes what it deems to be careless sexual conduct driven by obsessive queer love, which, in turn, is blamed for the suicide. Moreover, these reports often do the following: feature families who refuse to accept their children's identities, adopt dread-filled tones, and cite experts who provide incorrect information while engaging in victim blaming. As a result, the quality of queer suicide reporting in Indian newspapers is deemed substandard and offensive. To address this issue, the study proposes the need for training and curriculum updates in journalistic courses. This way, reporters can develop the skills necessary to sensitively and respectfully report on queer individuals in general and on queer suicide in particular.

The impact of media reporting of suicides on subsequent suicides in Asia: A systematic review

Introduction

This systematic review is aimed at (1) evaluating the association between media portrayals of suicides and subsequent copycat suicides or attempts among the general public in Asia, (2) understanding the factors associated with copycat suicides and (3) determining the positive impacts of the media reporting of suicides (e.g. increased help-seeking, coping).

Method

A systematic review and narrative synthesis of English and Chinese articles from 8 electronic databases (i.e. PsycINFO, MEDLINE, Embase, CINAHL, Web of Science, Ariti, China National Knowledge Infrastructure and OpenGrey) from January 2000 to May 2023 was conducted. Observational studies were included, and the data were analysed through narrative synthesis. The protocol was registered with PROSPERO (CRD42021281535).

Results

Among the 32 studies included (n=29 for evidence synthesis) in the review, there is good-quality evidence to show that copycat suicides and suicide attempts increase after media reports of a suicide, regardless of country, celebrity status, study design, type of media, mode of suicide or follow-up period. Females, younger age groups and those sharing similar characteristics as the deceased in publicised suicides (age, gender) were more susceptible to negative impact. Reporting of the mode of death of the deceased increased suicides by the same method among the public.

Conclusion

Media portrayals of suicide appear to have a negative impact on copycat suicides at the population level in Asia. Thus, in addition to tighter media control, healthcare systems, professional medical bodies and community outreach services should work collaboratively to promote early help-seeking in those with psychological distress.

Little Strokes Fell Big Oaks: How Repeated Recommendations for Suicide Reporting Drive the Quality of Suicide News in South Korea

This study investigates how far repeated releases of recommendations for responsible reporting on suicide (RRS) are associated with changes in the quality of suicide reporting. A content analysis was conducted on suicide news articles (N = 606) by the Korean newspapers Hankyoreh Sinmun and Chosun Ilbo in four six-month periods from 2004 to 2019, which covered the periods before and after the releases of three versions of suicide reporting guidelines. Elements for RRS served as a proxy for the reporting quality, which includes both avoiding negative elements and providing positive ones. Not only the number of suicide news stories reduced by half in the last two observation periods, overall RRS scores and most individual RRS elements increased in the third period, compared to the first or second period. The avoidance RRS for headline, however, was not significantly improved. Korean news media also tended to be sensationalistic in using photos.

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.

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.

Long-Term Changes in the Quality of Media Reporting of Suicide Following a Celebrity Suicide in India

Online portals of selected English and local language newspapers and television channels were searched to identify suicide news reports published one year after the celebrity suicide (ACS). These reports (n = 1952) were compared with the corresponding period of the previous year, immediately following the celebrity suicide (ICS) (n = 2486), and a three-month period before the celebrity suicide (BCS) (n = 1381) to assess longitudinal changes in quality of media reporting. There was a decline in reporting of several potentially harmful characteristics over time such as mentioning the deceased's age and gender (p < .001 for both), and location of suicide (p < .001). The quality of media reporting of suicide was significantly better at one year compared to the period immediately following celebrity suicide. This change was mainly driven by an improvement in the reporting quality of English news reports while local language reports continued to remain poorly adherent to reporting 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.

Preliminary Evaluation of Lived Experience of Suicide Training: Short-, Medium- and Longer-Term Impacts of Our Voices in Action Training

Despite increased participation and multiple workforce roles of those with lived experience in suicide prevention, there are no evaluated training programs to support this population. This study evaluated a training program aimed to prepare people for these important roles. Survey data at pre-, post- and at three- and 12-month follow-up were used measuring knowledge, attitudes, and self-efficacy, as well as psychological distress as a safety measure. Participants experienced significant gains in knowledge after training, although not all aspects of knowledge were maintained at follow-up. Self-efficacy was examined through confidence and empowerment. Confidence gains were significant at immediate and longer-term follow-up but gains in empowerment were not maintained over time. Participants' positive attitudes improved but this was not significant. There was no indication of increases in psychological distress in participants throughout the training and follow-up periods. Implications of these outcomes are discussed.

Content analysis of reports of student suicide deaths in South African print medium newspapers

Purpose

The aim was to assess the quality of newspaper reporting of university student suicides in South Africa, using the World Health Organisation guidelines. Suicide among university students is a growing public health problem. The media has an important role to play in preventing student suicides by adhering to international best practice guidelines on ethical reporting of suicides.

Design/methodology/approach

This study conducted a content analysis of print medium newspaper articles in the 13 most widely read English language South African newspapers from the period of January 2017 to January 2020.

Findings

The initial search yielded a total of 28 news reports, of which 19 met this study’s inclusion criteria and were analysed using content analysis. The quality of reporting showed both potentially harmful and helpful characteristics. Poor adherence to international reporting guidelines were found in the description of method and location of suicide, sensational headlines, publishing photos of the deceased, linking suicide to criminality, simplistic narration of the life events leading to the suicide and use of sensational and potentially triggering language. No reports adhered to all reporting guidelines. Findings suggests that there are widespread potentially unhelpful practices in the reporting of student suicides and a need for suicide prevention experts to work with journalists to promote critical reflexivity and ethical reasoning when writing about student suicides.

Research limitations/implications

This study only included news reports published in English in the most widely read newspapers.

Originality/value

To the best of the authors’ knowledge, this is the first study of its kind to systematically examine media reporting on suicide in South Africa.

The Tool for Evaluating Media Portrayals of Suicide (TEMPOS): Development and Application of a Novel Rating Scale to Reduce Suicide Contagion

Research suggests that media adherence to suicide reporting recommendations in the aftermath of a highly publicized suicide event can help reduce the risk of imitative behavior, yet there exists no standardized tool for assessing adherence to these standards. The Tool for Evaluating Media Portrayals of Suicide (TEMPOS) allows media professionals, researchers, and suicide prevention experts to assess adherence to the recommendations with a user-friendly, standardized rating scale. An interdisciplinary team of raters constructed operational definitions for three levels of adherence to each of the reporting recommendations and piloted the scale on a sample of articles to assess reliability and clarify scale definitions. TEMPOS was then used to evaluate 220 news articles published during a high-risk period following the suicide deaths of two public figures. Post-hoc analyses of the results demonstrated how data produced by TEMPOS can be used to inform research and public health efforts, and inter-rater reliability analyses revealed substantial agreement across raters and criteria. A novel, wide-reaching, and practical approach to suicide prevention, TEMPOS allows researchers, suicide prevention professionals, and media professionals to study how adherence varies across contexts and can be used to guide future efforts to decrease the risk of media-induced suicide contagion.

Quality of media reporting of suicide in Iraq

BACKGROUND

Mass media has an important role in influencing the suicidal behavior of the general population. However, the quality of news reporting of suicide has not been assessed in Iraq.

AIM

We aimed to assess the quality of news reports in Iraq while reporting the suicidal behaviors.

METHODS

The search was done on Google in November and December 2020 with the search term 'suicide news in Iraq' and accessible news reports distributed in Kurdish, Arabic, and English languages were taken out. We scrutinized the news reports to identify the reporting characteristics and compared them with the World Health Organization (WHO) guidelines.

RESULTS

A total of 130 news reports were analyzed; among them 23.8% were Kurdish, 63.8% were Arabic, and 12.3% were in the English language. About 31.5% of the reports mentioned the name and 40.8% mentioned the occupation. The name of method was mentioned in 88.5%, mono-causality was found in about 34.6%, the term 'suicide' was mentioned in the headline in 94.6%, and method of suicide was mentioned in the headline of about 27.7% of the reports. Only 5.4% of the reports traced mental illness, 6.9% mentioned expert opinion, and none of the reports mentioned prevention program, and educative information.

CONCLUSION

The study revealed that news reports of suicidal behavior in Iraq are poorly adherent to the WHO reporting guidelines. Further studies are warranted to identify the responsible factors and culture-specific prevention strategies.

Quality of newspaper reporting of suicide in Odisha, India, against the World Health Organization guidelines

BACKGROUND

Imbalanced media reporting of suicide may increase suicide risk among vulnerable individuals.

AIM

This study aims to assess the quality of suicide reporting in print newspapers of Odisha, a high suicide burden state in Eastern India.

MATERIALS AND METHODS

We analyzed all eligible media reports of suicide in selected English and local language printed newspapers of Odisha between October 1, 2019, and September 30, 2020. Quality assessment was carried out against international as well as local reporting guidelines.

RESULTS

A total of 248 news reports were analyzed. Majority of the articles reported identifying details (such as name [74.2%], age [60.9%], and gender [98.4%] of deceased) as well as a detailed description about the suicide event (suicide method [87.5%] and location [84.3%]). More than half (54.8%) of the reports attributed suicide to a single cause.

CONCLUSION

Suicide reports in print newspapers of Odisha are poorly adherent to local and international suicide reporting guidelines.

Popular media as a double-edged sword: An entertainment narrative analysis of the controversial Netflix series 13 Reasons Why

13 Reasons Why is a Netflix original series adapted from Jay Asher's 2007 young adult novel with the same title. Season 1 premiered on March 31, 2017 and featured the sensitive issue of teen suicide along with bullying, substance use, depression, and sexual assault. Unlike the typical teen dramas on popular streaming platforms, this show was created not only for entertainment, but also to stimulate conversations about taboo topics that people often shy away from. However, it also caused significant controversy, especially criticism around the main character Hannah's suicide scene. More than three years into the initial controversy and at least two dozen scholarly publications later, this study is the first to examine the entertainment narrative content of 13 Reasons Why Season 1 to better understand how these health and social issues were portrayed in the show, what specific examples we could identify as potential behavioral modeling, and to what degree it complied with the 2017 WHO guidelines for media professionals. We used the framing theory and social cognitive theory in communication research and media studies as our guiding conceptual frameworks and a narrative analysis approach to investigate a total of 660 cut scenes in all 13 episodes. Our findings provided empirical evidence, along with contextual information and detailed examples, to demonstrate that a popular entertainment program like the Netflix series 13 Reasons Why serves as a double-edged sword. The production team's good will and due diligence are commendable. Yet, additional steps can be taken in the future to effectively promote professional resources and reduce viewers' risks, especially the most vulnerable groups.

Newspaper reporting of suicide news in a high suicide burden state in India: Is it compliant with international reporting guidelines?

BACKGROUND

Mounting evidence points to a substantial link between detailed media portrayals of suicide and imitative suicidal behaviour. We assessed the quality of media reporting of suicide in Kerala, a high suicide burden state in India against the World Health Organization (WHO) reporting guidelines.

METHODS

We conducted a year-round content analysis of all suicide-related news articles in four (two local language and two English) of the most widely read daily newspapers in Kerala. We used a data extraction form, prepared a priori in accordance with the WHO reporting checklist, and coded each item based on the guidelines.

RESULTS

A total of 377 suicide news articles were retrieved. Harmful reporting practices such as reporting the name (93.9 %) and age (93.6 %) of the deceased, method of suicide (93.1 %), location of suicide (88.9 %), monocausal explanations (48.8 %), and including photograph of the deceased (37.7 %) were commonly noted. On the other hand, less than a fifth of articles complied with helpful practices such as including details of suicide support helpline (19.1 %) or a link with mental health issues (14.9 %). Local language newspapers displayed more frequent violations in reporting compared to English newspapers.

CONCLUSION

Media reporting of suicide in Kerala, India is poorly adherent to international reporting guidelines, with very little focus on educating the public. These findings point to the need for framing comprehensive media reporting guidelines for India and a collaborative approach to highlight the primary role of media in suicide prevention efforts.

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.

Media guidelines and suicide: A critical review

By providing information on help-seeking resources (HSR), Google's Suicide Prevention Results (SPR) fill a void, because less than 30% of news reports provide such information. This article addresses larger issues on media guidelines and suicide prevention. First, studies on the effects of providing HSR provide little support for a reduction in suicide. Second, research on the effects of other media guidelines often does not report the anticipated reductions in suicide. Third, although research does tend to support an increase in suicide after publicized suicides of celebrities, it does not necessarily happen for all categories of celebrity suicides. Fourth, there has been a lack of integration of (a) research on imitative effects of publicized suicides and (b) content analysis of stories' adherence to guidelines. Fifth, an associated puzzle is that (a) most research findings (64.2%) show no increase in suicide rates after suicide stories, while (b) most content analyses document widespread violations of media guidelines. Apparently, stories often violate media guidelines, but there is often no anticipated increase in suicide deaths. Rigorous research is needed to fully evaluate which media guidelines matter, and to determine the efficacy of Google's SPR program.

Adherence to World Health Organization guideline on suicide reporting by media in Taiwan: A surveillance study from 2010 to 2018

BACKGROUND/PURPOSE

Significant associations between suicide behaviors and inappropriate suicide reports in the media have been reported. The study aimed to examine the quality of long-term suicide reports under surveillance by the Taiwan Suicide Prevention Center (TSPC).

METHODS

The TSPC conducted daily surveillance with timely feedback and interactive approaches with the media professionals. To examine the reporting trends under the surveillance, daily adherence to the 12-item World Health Organization (WHO) guidelines was analyzed for print media published between 2010 and 2018, and for online media in 2017 and 2018. The trend analysis using the Cochran-Armitage test was performed to estimate the significance of adherence changes.

RESULTS

In total, 5529 print reports and 16,445 person-event items from online media were reviewed. The number of suicide reports in print newspapers markedly decreased while it increased for online media. Surveillance of print media showed statistical significance of the improvement of reporting adherence to all guideline items except one item ("Do not publish photo or suicide notes"). Adherence rates were high (∼90%) for 6 of the 12 items over the study duration. Marked improvement was observed in three items: reporting details, giving simplistic reasons, and providing helpline resources. However, both "Highlight the alternatives to suicide" and "Work closely with health authorities to present the facts" items had the lowest adherence. Online media had similar findings and adherence profile as the print media.

CONCLUSION

The quality of suicide reports significantly improved in most WHO guideline items. Development of psychiatric-media liaisons may be beneficial for further improvement.

Suicide in Northern Ireland: epidemiology, risk factors, and prevention

The rates of suicide and self-harm in Northern Ireland are high, and have increased from 143 registered suicides in 1996 to 313 in 2010 and 318 in 2015. This Review summarises the epidemiology of suicidal behaviour, as well as the evidence from a small number of studies that have identified risk factors associated with high suicide rates in Northern Ireland. These risk factors were mental illness, trauma, exposure to the conflict known as the Troubles, deprivation, relationship problems, employment difficulties, financial difficulties, being LGBT, childhood adversities, and alcohol or drug use. We highlight the key challenges and opportunities for suicide prevention, emphasising a so-called lifespan approach. More needs to be done to address the relationship between substance misuse and suicide. Future research and prevention efforts should also focus on the transgenerational effect of the conflict, youth suicide, suicide prevention in minority groups, and the criminal justice context. The provision of and access to suicide-specific psychosocial interventions need to be prioritised, more support for people in crisis is required, as well as interventions for mental illness. Protect Life 2, the national suicide prevention strategy, needs to be implemented in full. Given the legacy of conflict in Northern Ireland, all suicide prevention efforts should be trauma informed.

The experiences of people bereaved by suicide regarding the press reporting of the death: qualitative study

Background

Media guidelines on suicide reporting of suicide have two purposes: to prevent further suicides, and to minimise distress to the bereaved, who are themselves at increased risk of suicide. We aimed to describe the subjective experiences of people bereaved by suicide regarding media reporting of the suicide of their friend or relative.

Methods

We conducted a cross-sectional study of staff and students aged 18–40 at 37 United Kingdom higher educational institutions in 2010 to recruit adults who had experienced bereavement by the suicide of a close contact. We analysed free-text responses to a question probing experiences of the press after the suicide, using thematic analysis to identify key themes.

Results

We analysed responses from 140 eligible respondents, and identified 3 main themes: value placed on respecting the privacy or wishes of the bereaved; respect accorded to the deceased; and the role of the press in promoting suicide prevention messages. Many respondents described negative experiences of the press, with sub-themes capturing distressing experiences relating to perceptions of journalists’ intrusive behaviour, failure to consult appropriately with the bereaved, journalists releasing private information, negatively misrepresenting the deceased, and breaching the anonymity of the deceased or bereaved. We identified considerable variation in people’s views over acceptable levels of detail reported in the press, and in some cases objections were in relation to journalists following media guidelines. These divergent views illustrate the tensions between the twin purposes of media guidelines: to prevent further suicides, and to protect the bereaved.

Conclusions

The findings from our British sample provide journalists with personal perspectives from bereaved relatives on the impact of media intrusion, speculation, and misrepresentation, and an insight into disparate views on the nature of information relatives feel comfortable disclosing. These findings suggest a need for journalists’ training to include exposure to such views, to heighten awareness of potentially distressing effects and the nuances of bereaved people’s preferences. This should aim to encourage journalists to consult with bereaved relatives more sensitively, whilst also remaining mindful of media guidelines on the reporting of suicide.

[News coverage on suicides published in Brazilian news media channels]

This study analyzed how news coverage about suicides is published in the Brazilian electronic media and evaluated if the recommendations of the World Health Organization (WHO) were complied with in the online media. This quantitative, documentary and retrospective study investigated 89 published news items about suicide in 2017 in the Brazilian newspaper sites with the largest circulation. Descriptive statistics and tests of association were used for data analysis. The majority of news items contained neither content to be avoided nor aspects recommended by the WHO. The most frequent characteristics of the reported cases do not correspond directly to the epidemiological profile of suicidal behavior, but to media interests. Actions are needed to foster media involvement in suicide prevention, dissemination of resources and strategies to support and reduce stigma and the contagion effect.

Media coverage of Robin Williams' suicide in the United States: A contributor to contagion?

Evidence suggests that suicide rates can increase following the suicide of a prominent celebrity or peer, sometimes known as 'suicide contagion'. The risk of contagion is especially high when media coverage is detailed and sensational. A recent study reported a 10% increase in U.S. suicides in the months following the suicide of comedian Robin Williams, who died in August 2014. The authors tentatively linked this increase to sensational media coverage; however, no content analysis of U.S. media was performed. As such, the aim of the present study is to formally examine the tone and content of U.S. newspaper coverage of Williams' suicide. The primary objective is to assess adherence to suicide reporting guidelines in U.S. newspapers after his suicide. The secondary objective is to identify common emerging themes discussed in these articles. The tertiary objective is to compare patterns of results in the U.S media with those in the Canadian media. Articles about Williams' suicide were collected from 10 U.S. newspapers in the 30-day period following his death using systematic retrieval software, which were then examined for adherence to suicide reporting recommendations. An inductive thematic analysis was also undertaken. A total of 63 articles were included in the study. We found that 100% of articles did not call it a 'successful' suicide, 96.8% did not use pejorative phrases and 71% did not say 'commit' suicide. However, only 11% included information about help-seeking, 27% tended to romanticize his suicide and 46% went into detail about the method. The most prominent emerging theme was Williams' struggles with mental illness and addiction. These findings suggest that U.S. newspapers moderately adhered to best practice recommendations when reporting Williams' suicide. Key recommendations were underapplied, which may have contributed to suicide contagion. New interventions targeting U.S. journalists and media may be needed to improve suicide reporting.

Systematic comparison of recommendations for safe messaging about suicide in public communications

BACKGROUND

The diversity of guidelines for safe public messaging about suicide and the heterogeneous scientific research on the topic warrants comparisons of guidelines and analysis of the relevance of research findings to determine best practices.

METHODS

We searched databases and websites for organizations' guidelines concerning safe public messaging on suicide, and relevant research articles.

RESULTS

We identified 24 public messaging guidelines, 11 terminology guidelines and 44 research papers. No recommendations were in all guidelines, with more agreement on what not to do than on what to do. Recommendations in over half of guidelines are: avoid glorifying suicide, do not describe suicide methods, don't say suicide in inexplicable or explain simplistically, do not state that suicide is frequent in specific circumstances, encourage help seeking. There were disagreements on including personal details about people who died by suicide, and agreement to avoid: "committed suicide," "completed suicide," "successful suicide," "failed suicide/attempt" "unsuccessful suicide/attempt". Only "died by suicide" was recommended by a majority. Some recommended and some said to avoid: "Suicide attempt," "attempt to end his life," "attempted suicide," "non-fatal attempt at suicide," "unintentional (death)," "intentional self-harm," "suicidal ideation," "completed suicide," "survivor," "suicide loss survivor." Research papers had a wide range of objectives, methodologies, media studied and target populations. None provided empirical data that could help support or refute any recommendations.

LIMITATIONS

Lack of justifications for guidelines and scarce relevant research makes validation of recommendations challenging.

CONCLUSIONS

Research is needed to validate recommendations and terminology and develop consensus on guidelines for public messages, and determine if media guidelines for reporting on suicide are relevant for public messaging who's goal is to inform and educate rather than report news.