It is well known that the mass media has a far-reaching influence, shaping attitudes and behaviours in a whole range of areas, including suicide. Psychologists too have influence. They are generally trusted by the community; have a good understanding of human behaviour and good communication skills.
In recent years there has been diverse commentary from the health and mental health sector about the validity of guidelines for media on reporting suicide, the strength of research evidence, whether media should report more or less often, and the type of cases that should be reported. The media and the community need trusted professionals to help them navigate through what can sometimes be a complex area, and psychologists can definitely play a role here.
Potential harms
‘Copycat’ suicides following media portrayals of suicide have been of concern to communities since 1774, after the release of Goethe’s novel The Sorrows of Young Werther. The novel tells the tragic tale of Werther, a young man who takes his own life because he is in love with a woman who is betrothed to and subsequently marries another man. A spate of suicides occurred in Europe when the novel became publicly available, and there was direct evidence that it influenced many of those who died; some were dressed in the same manner as Werther and/or used the same suicide method, some left notes referring to the novel, and some were found with copies of the novel at the scene of their death.
There is a wealth of evidence on the potential harms that can be caused by media reporting of suicide. In 2010, we identified nearly 100 studies that examined the relationship between media reporting of suicide and subsequent suicidal acts (Pirkis & Blood, 2010), and we know that since that time numerous additional studies have been done. The vast majority of these studies provide support for what has come to be known as the ‘Werther effect’ (Phillips, 1974). Most employ quantitative methodologies, but some use qualitative approaches. The quantitative studies typically find unexpectedly high numbers of suicides in given areas after prominent media reports of individual suicides. These peaks in suicides are not usually followed by subsequent troughs, suggesting that these suicides represent additional deaths, rather than deaths that have been ‘brought forward’. The qualitative studies tend to involve interviews with individuals who have survived near-fatal suicide attempts, and often find that they cite the media as a key influence on their actions.
Potential benefits
In recent times, there has been an increasing emphasis on the media’s potential to play a positive role in suicide prevention. Studies have shown that certain types of reporting may encourage adaptive behaviours (e.g., help-seeking) in vulnerable individuals. Most notably, there is mounting evidence that stories that describe mastery of a suicidal crisis are associated with reductions in suicides (Niederkrotenthaler et al., 2010). This positive phenomenon has been termed the ‘Papageno effect’ after a key character in Mozart’s opera The Magic Flute. Papageno becomes suicidal because he fears losing his true love, Papagena, but is rescued by three boys who suggest better ways to deal with the problem. He takes up these suggestions and is reunited with his love. The ‘Papageno effect’ on audiences is protective against suicide in the same way that the ‘Werther effect’ confers risk.
Beyond reporting suicide stories in a safe and constructive manner, there is also interest in harnessing the potential of the media through media campaigns. The commonly-stated rationale for this is that there is a silence surrounding suicide, and that if it was more broadly discussed then individual deaths could be averted. Various media campaigns have been conducted around the world, most of which have community service announcements (CSAs) at their core. We recently identified 35 such CSAs via an internet search and found that they promoted open discussion about suicide, indicated that the life of a suicidal person was important, acknowledged the suffering associated with suicidal thoughts and feelings, stressed that suicide is preventable, and/or focused on the devastating impact of suicide for those left behind. Most promoted some sort of support for people at risk of suicide, usually a helpline or website. It is fair to say that these sorts of campaigns have not yet been well evaluated (Dumesnil & Verger, 2009), but there is certainly a community appetite for them and they are gaining traction.
A role for psychologists
Suicide prevention is everybody’s business. Different individuals and organisations have different parts to play, and the role of psychologists has typically been viewed as being at the intervention end. However, the role of psychologists may be much broader than this because their skills and expertise are well suited to work in the area of suicide and the media.
Understanding the evidence and the differences between talking about suicide and media reporting of suicide is important. In general, having a discussion with someone about suicide or their suicide risk will not increase suicidal behaviour if it is done appropriately. However, the mass media is mostly one way communication, not a discussion, where the evidence for potential risk is very different and messages need to be reviewed carefully.
Psychologists can play a role in minimising the potential harm that can be caused by certain ways of reporting of suicide. They are trusted sources of information for the media and can help to frame the issues in a way that breaks down stigma, increases community understanding and encourages people to seek help.
Although journalists craft suicide stories, there are often many other players who help to shape them. Psychologists and other mental health and suicide prevention professionals are often the first port of call for journalists wanting expert comment for a story. This creates opportunities for psychologists to influence how stories are presented and, consequently, how at-risk individuals might receive and interpret them.
The Mindframe National Media Initiative (Mindframe), funded by the Australian Government and implemented by the Hunter Institute of Mental Health, can provide assistance to psychologists who are in contact with the media. Mindframe provides access to up-to-date, evidence-based information to support the reporting, portrayal and communication about suicide for the media and a range of other sectors, including the mental health and suicide prevention sector (see http://www.mindframe-media.info/for-mental-health-and-suicide-prevention). The resources contain practical advice to support professionals in their work with the media, including when their opinions are sought for a story on suicide.
Whether a psychologist is proactively approaching the media or responding to a media request, there are best-practice elements they can bring to any interaction with the media. They can:
- Encourage journalists not to report the specific method of suicide in any detail and remove that information from any interview on the basis that reporting of particular suicide methods has been associated with increased rates of suicide by those methods (and overall suicide rates in some instances);
- Encourage the inclusion of reference to crisis telephone services to support anyone who is distressed by the story, as well as information about other services people can access, including psychologists;
- Be sure to understand preferred language in public communication about suicide and avoid language that might glamourise (e.g. ‘successful suicide’), sensationalise (‘suicide epidemic’) or stigmatise those who have died by suicide (‘committed suicide’), and ask journalists to do the same;
- Ensure that journalists are provided with accurate facts, statistics and hopeful messages to include as part of the story;
- Urge caution if the media professional is planning to approach people who may have been bereaved by the person’s death, given that these individuals may be quite vulnerable in the period after the death; and
- Refer the media professional to the Mindframe resources and website.
In addition to minimising harm in media stories, psychologists can play an important role in promoting suicide prevention messages. When discussing the issue of suicide in the media, psychologists can assist by participating in or promoting stories that:
- Improve the community’s understanding of factors that increase risk, as well as factors that protect individuals, families and communities;
- Increase awareness of the impact of suicide on families, friends, schools and other educational settings, workplaces, and communities;
- Model how people can seek help and the types of strategies and services that can make a difference to those who may be experiencing suicidal thoughts, perhaps by using the personal stories of people who have experienced suicidal thinking to describe what worked for them.
Psychologists also have a role to play in ensuring that any media campaign that is rolled out is consistent with the best available evidence. They may be called upon to help determine campaign content, and, in some cases, may even be among the ‘faces’ of a given campaign. Their expertise in understanding how particular messages might impact on negative thinking will come to the fore here. Discussing suicidal ideation with clients is core business for many psychologists working in clinical settings, and there are lessons that will be applicable here.
To improve our overall messaging about suicide in Australia, whether it comes through the media or not, we need to draw on the expertise and skills of many different sectors. Psychologists are one of those important players.
The first author can be contacted at [email protected]