Can journalists prevent suicide clusters?
This story was originally published in 2014.
Suicides sometimes happen in clusters. Epidemiologists and suicide prevention experts have often claimed that media coverage is partially to blame for this. Thus that old-fashioned and often ignored rule: Don’t cover suicides.
Of course that rule came with a couple of caveats. Celebrity suicides were fair game. So too were suicides that happened in public places. Because of those carve-outs and others (if it’s really interesting, or if people are talking about it) the rule never really worked. The news media have always covered suicides, sometimes badly.
While suicide prevention advocates cite the potential for contagion in their effort to get newsrooms to change their standards, journalists, including me, have responded with skepticism. That’s because there has never been a conclusive study in a peer-reviewed journal that specifically tied contagion to media coverage.
Until now. A study published in the Lancet Psychiatry Journal confirms that certain types of media coverage do indeed make suicide contagion more likely to happen, particularly among teenagers and young adults.
The author, Dr. Madeline Gould, professor of epidemiology in psychiatry at Columbia University Medical Center, conducted the statistical analysis as part of a larger autopsy study, then compared suicides associated with a cluster, to suicides that were not part of a cluster, and media reporting.
Her conclusions: Stories about an individual with the word suicide in the headline, stories on the front page of a newspaper, photos of the dead person, detailed descriptions of the act of suicide and portrayals of the suicide victim as noble, angelic or heroic, are associated with more suicides in the same community. It's not a causal relationship, but rather they are related. Brandy Zadrozny's Daily Beast article does a good job translating the study into layman's English.
But here's the problem for journalists. Those are the devices of good story-telling and effective headline writing. Suicides are tragic events. And when you decide a story is interesting enough to tell, you want to pack it full of emotional punch. But those details can be a factor that contributes to a suicide cluster.
Why? There are both biological and sociological reasons, she said.
Biologically, the frontal cortex doesn’t fully mature in humans until the early 20s. An immature cortex is associated with impulsive behavior. Teens and 20-year-olds are also at the age when serious psychiatric problems can emerge.
Sociologically, during the teen years, family becomes less important and social peers become more important. That reverses for most people in their 20s. Young people also have not had the experience of watching difficult problems come and go. So when they experience serious depression or anxiety, it seems like life will always be that way, Gould said.
“I’m not saying that this will occur in a vacuum with healthy people,” Gould said. Instead, she is suggesting that media attention to individual suicide victims can be harmful to people already at risk for suicide.
But there's a catch with this study: All the data was gathered between 1988 and 1996. And the media examples most likely to lead to contagion all came from newspapers.
It’s hard to believe that newspapers could have the same influence with the modern under-25 set, who are more likely to consume information through social media and mobile devices. Instead we have to extrapolate her findings into an environment that’s harder to measure and control.
Along those lines, just today, celebrity shrink Dr. Drew Pinsky lead the announcement of Social Media Guidelines for Mental Health Promotion and Suicide Prevention, a more general set of best practices which seem to address the general public, suicide prevention advocates, and journalists.
The guidelines acknowledge something that suicide researchers have been talking about for some time, that all stories about suicide and attempted suicides are not equally harmful. In a social media setting, it is impossible to prevent people from discussing suicide. The guidelines suggest best practices about language choices, audience engagement, privacy concerns and how to address suicidal content.
Several organizations including Facebook, RTDNA and the Entertainment Industries Council endorsed the guidelines.
Journalists may find more practical advice from the Reporting on Suicide guidelines, which were developed in collaboration with a number of journalists and journalism education institutions.
Will any of this matter? While suicide rates are declining among teen and young adults, they are rising among baby boomers and veterans. Because true statistical analysis takes so long, it's hard to say what really contributes to pattern changes.
"Suicide behavior is complex, contagion is one piece of the puzzle," Gould said. "But it’s worth addressing every piece of the puzzle."
In addition to avoiding the behaviors that might lead to contagion, journalists can find stories of hope and recovery among people who have contemplated or attempted suicide. Those stories were taboo among suicide prevention advocates for a long time, for fear of contributing to contagion. But that community has opened up, and as a result it's possible that journalists will find new ways to tell compelling stories about suicide and mental health.
And even if they don't, Gould suspects the public will do its own storytelling, using social media. Once the underlying stigma of seeking treatment for mental health issues diminishes, there may be real progress in reducing rates of suicide.