Speaking of suicide

April has been a cruel month here in southwestern Minnesota, where the lives of four teens were recently lost to suicide.

For their families, friends, classmates, teachers and others who knew them, the grief is deep and personal. For the community at large, it has focused attention on a mental health issue that needs to be named and recognized.

Somewhere in the middle of this is the uneasy presence of the news media. Which aspects of the story ought to be shared with readers and, by extension, the public? What should be left private? Should these kinds of stories not be covered at all, or do they represent an opportunity to educate the public about suicide prevention?

There’s in fact a sizable body of literature suggesting that the way suicide is portrayed in the print media, on television and in the movies can have an influence on how people behave. When the portrayal is handled well, it can counteract misinformation and encourage vulnerable individuals to seek help. When it’s not, it sometimes can result in copycat suicides or what behavioral scientists call “suicide contagion.”

More than 40 studies worldwide have examined the connection between media coverage and copycat suicides. The evidence is mostly indirect; indeed, it’s very difficult to accurately gauge the impact of media coverage on increased risk of suicide. It’s entirely possible that the real factor is heightened attention by the public overall, rather than media coverage per se. But at least one study, which analyzed 42 previous studies, found that news stories about entertainment or political celebrities who died by suicide were 14.3 times more likely to produce a copycat effect. Newspaper coverage also appeared to be more likely to produce this effect than television coverage.

How a death by suicide is covered in the media also seems to matter. In a report following a national workshop in the late 1980s, the U.S. Centers for Disease Control and Prevention identified several characteristics that appear to be linked to suicide contagion: offering overly simplified reasons for a suicide; coverage that’s excessive, repetitive or sensationalized; reporting details on how a suicide was carried out; idealizing or romanticizing suicide and individuals who die in this manner.

Several organizations have issued guidelines to help the media navigate this sensitive issue. The most recent recommendations come from the U.S. Substance Abuse and Mental Health Administration. They echo other recommendations from organizations such as the Suicide Prevention Resource Center, Suicide Prevention International and the World Health Organization.

By now, readers might be wondering what all of this has to do with them. After all, if you don’t report or produce the news, why would these guidelines matter to you?

But they do matter, in the sense that deaths due to suicide often lead to intense community discussions that may or may not be based on accurate information. Members of the public can be just as guilty as the media of oversimplifying suicide, downplaying the element of mental health or looking for an obvious answer to the question “why?”.

Some information and general guidelines from the Suicide Prevention Resource Center:

- Avoid using the terms “committed suicide” or “failed” or “successful” suicide attempt. The reasoning: the word “committed” carries moral or criminal overtones, and it’s more accurate to view suicide in the context of behavioral health. “Successful suicide” and “failed suicide” also imply judgment about the outcome. Experts recommend using the terms “death by suicide” or “non-fatal suicide attempt” instead.

- Avoid romanticizing someone who has died by suicide or glamorizing the suicide of a celebrity.

- Avoid oversimplifying the causes of suicide. Although it might appear as though a triggering event such as bullying, the end of a relationship or some other kind of loss is responsible, there usually are multiple and complex factors involved in a death by suicide. In the vast majority of cases, a mental health issue and/or substance abuse is involved.

- Avoid treating suicide as inexplicable or without warning. Many – although not all – individuals who attempt or complete suicide show warning signs ahead of time.

Finally, some statistics:

According to data from the U.S. Centers for Disease Control and Prevention for 2007, the most recent year for which complete numbers are available, suicide was the 11th leading overall cause of death in the United States.

Among the 15-to-24-year-old age group, it was the third leading cause of death. But the greatest number of suicide deaths per 100,000 isn’t among the young – it’s among the middle-aged and elderly. In 2007 there were 17.7 suicide deaths per capita among adults aged 45 to 54 – the highest rate per 100,000 of all age groups. The second highest? 16.3, among adults aged 75 to 84. In contrast, there were 9.7 suicide deaths per 100,000 among adolescents and young adults aged 15 to 24.

When communities talk about strategies for suicide prevention, the statistics make it clear that efforts need to extend beyond the young and to address what’s happening among the middle-aged and older population as well.

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