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Suicide Prevention and Intervention: Summary of a Workshop SUICIDE CONTAGION I am not talking about healthy people reading Romeo and Juliet. Madelyn Gould Dr. Madelyn Gould reviewed two issues, the role of the media in fostering suicide contagion in adolescents, and suicide clusters. She described characteristics of media portrayals of suicide, and characteristics of individual adolescents that increase susceptibility to suicide contagion. She discussed approaches to addressing contagion at the institutional level, including the description of specific guidelines for media coverage, as well as the barriers and challenges to successfully reducing contagion. She also gave a brief overview of the current state of information on suicide clusters. Media coverage of suicides has been shown to significantly increase the rate of suicide, and the magnitude of the increase is related to the amount, duration, and prominence of coverage. Madelyn Gould The Media. Contagion of a behavioral disorder is generally defined as increased risk upon affliction of someone in the same social sphere. This definition, however, is limited according to Dr. Gould because it assumes that direct interpersonal experience with the incident and the suicide victim is necessary for contagion to occur. Yet Dr. Gould described studies showing that indirect influence occurs as well for both real and fictional characters portrayed in the media. Thus, suicide can have contagious effects far beyond the immediate social network of the victim. According to Dr. Gould, the majority of studies on contagion in the United States and other countries indicate that media coverage of suicides significantly increases the rate of suicide. This poses an essential conflict for the media between producing compelling stories and avoiding contagion. (The code of ethics of the Society of Professional Journalists is “Seek truth in reporting and minimize harm”). One response of the media to contagion has been to cease reporting on suicide, but this is not the best option, according to Dr. Gould, since silence on the subject can foster shame and hinder help-seeking by those at risk. Instead, Dr. Gould calls for reporting that is informed by the data, and building alliances between the health and media communities to balance needs of the media and public health as discussed below. Dr. Gould pointed out that not all media presentations of suicides have a negative impact. Some are neutral, and some have a positive effect providing a powerful opportunity for reducing suicide. Characteristics of the media presentation, the individual, and interactions between media and individual factors impact suicide contagion. According to Dr. Gould, content analysis studies revealed the following eight media factors that increase suicide contagion, especially for young people. (1) Repeated news coverage of the same story. (2) Front-page coverage. (3) Larger size
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Suicide Prevention and Intervention: Summary of a Workshop headlines. (4) Celebrity suicides have greater impact. (5) Portrayal of “rewards” such as the grieving family and boy/girlfriend can foster revenge motivations for suicide, especially among angry and dejected youth. (6) Media reporting indicating suicide as something that is “unavoidable,” that “someone will be next.” (7) Presenting suicide as a political issue, e.g., as due to desegregation or job stress. (8) Victims shown as possessing desirable, high status qualities. Dr. Gould indicated that teenagers are especially vulnerable to contagion of suicide from portrayals in the media, as well as through direct knowledge of the person (clusters). The stronger the similarities between the individual and the victim portrayed in a media story, the greater is the impact of the story. Dr. Gould described a study of media coverage of suicide in Japan that showed that if the story was about a Japanese individual the rate of completed suicide went up in Japan, but not if the story was about a non-Japanese person. Editors say they want to report responsibly, but at the time they wrote the story, they didn’t know who to contact, and didn’t know how to make it a pro-social story, and it turned out wrong. Madelyn Gould The media can have an impact on suicide, not only by avoiding deleterious effects, but also to increase public health and wellbeing. Dr. Hemenway cited such examples in the injury field. The media now include the status of any smoke detectors when a fire is reported. Likewise, helmet use is indicated when reporting a bicycle. Dr. Gould underscored the importance of reporting correct information about suicide. Anecdotal data reveal numerous instances of misleading and/or incomplete information about risk factors, implicating trivial triggers, with no or minimal coverage of antecedent mental disorders, and rare or absent listing of local services. Dr. Gould highlighted this opportunity for media to have a positive and proactive impact on suicide prevention. We really need a media-public health partnership. Madelyn Gould Dr. Gould made recommendations for pro-social media reporting on suicide. The foremost overarching need is to establish and then to institutionalize working relationships, and possibly new organizations, linking public health, mental health, and the media. Such relationships and/or institutions would necessarily include media professionals and training program leaders, researchers, and advocacy groups. They would serve as a ready source of information for journalists and would develop national media guidelines. Courses in ethical and pro-social reporting should be mandatory in all journalism programs. Continued education about the newest data for journalists is indicated. A venue for continued dialog among all stakeholders should also be established. Dr. Kay Jamison expressed concern that attempts to encourage responsible reporting
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