has underlying vulnerabilities. A healthy person is not likely to kill him-or herself as a result of seeing an example of suicide. Different media (e.g., book vs. television) are likely to exert differential effects on different populations. Both the form (headline, placement) and content (celebrity, mental illness, murder-suicide) of suicide coverage clearly impact the likelihood of imitation. Attractive models are more likely to cause imitation.
Similarities between a vulnerable person and the reported suicide victim increase the likelihood of contagion. This has been shown with age effects in both the young (Phillips and Carstensen, 1988) and the elderly (Stack, 1999, cited in Schmidtke and Schaller, 2000). Similarly, ethnicity is an important factor; Stack (1996) found that suicides of foreigners did not cause imitation among native populations.
Many elements of media presentations influence the likelihood of imitation, and these all provide opportunities for prevention. In efforts to prevent contagion, several countries (including Australia, Austria, Canada, Germany, Japan, New Zealand, and Switzerland) and organizations, including the World Health Organization (United Nations, 1996; WHO, 2000b) have formulated guidelines for media coverage of suicide.
The National Strategy for Suicide Prevention in the United States includes as one of its major goals improving “the reporting and portrayals of suicidal behavior, mental illness, and substance abuse in the entertainment and news media” (PHS, 2001). To advance that goal, guidelines for media coverage of suicide were formulated by the Annenberg Public Policy Center of the University of Pennsylvania, the American Association of Suicidology (AAS) and the American Foundation for Suicide Prevention (AFSP) in collaboration with several government agencies (CDC, NIMH, Office of the Surgeon General, Substance Abuse and Mental Health Services Administration [SAMSHA]), the WHO, and other international suicide prevention groups. They were released in August 2001, and the full text of these guidelines can be found on the sites of the partner organizations that developed them, including www.appcpenn.org and www.afsp.org. These guidelines, “Reporting on Suicide: Recommendations for the Media” update those developed in 1989 at a national consensus conference on the topic.
The media guidelines include the stipulation that media accounts of suicide should neither romanticize nor normalize suicide; that is, individuals who kill themselves should not inadvertently be idealized as heroic or romantic. They also urge the inclusion of factual information on suicide contagion and mental illness, provide suggestions for questions to ask of relatives and friends of the victim, and suggest that information on