2009-2008

News Release

REF NO.: 114

SUBJECT: Responsible suicide reporting saves lives

DATE: March 12, 2009

Dr. Ted Callanan, chair of the Discipline of Psychiatry at Memorial University, endorses a newly released Policy Paper on Media Guidelines for Reporting Suicide, published by the Canadian Psychiatric Association (CPA).
“Media coverage of suicide is proven to lead to copycat suicides,” said Dr. Callanan. “But when journalists are educated about copycat suicide, they modify their reporting and reduce the likelihood of copycat suicide due to media coverage.”
The policy paper said that while reporting on suicide can’t be banned, it can be responsible. “We urge all journalists to become better acquainted with the expert guidelines,” said Dr. Susan Abbey, president of CPA. “Specifically we suggest Canadian journalists implement the Canadian Association for Suicide Prevention and the Center for Disease Control guidelines on reporting. The evidence is convincing that some simple precautions will save lives.”
Dr. Abbey noted that although these guidelines exist, most journalists are unaware that reporting suicide can cause copycat suicides.
“These guidelines need to be taken up widely, not just by the individual journalist, but by media organizations and need to be taught in journalism schools,” said Dr. Jitender Sareen, author on the paper. The paper also suggests that there may be a role for policymakers in monitoring the media to reinforce the guidelines where necessary.
The guidelines suggest that how suicide is reported can either promote or prevent copycat suicide. Journalists should avoid exciting reporting, repetitive or excessive coverage, front page coverage, giving details of the method, using the word “suicide” in the headline, expressing admiration of the deceased or approval of the suicide, offering romanticized or simplistic reasons for suicide, or referring to suicide as inexplicable. Photos of the deceased are also to be avoided. Coverage should include alternatives to suicide such as treatment, community resource information for those thinking about suicide, examples of a positive outcome of a suicidal crisis like calling a suicide hotline, the warning signs of suicidal behaviour and how to approach a suicidal person.
The Canadian Psychiatric Association is the national voice for Canada’s 4,100 psychiatrists and more than 600 psychiatric residents. Founded in 1951, the CPA is dedicated to promoting an environment that fosters excellence in the provision of clinical care, education and research.
 
Media Guidelines for Reporting Suicide
Josh Nepon, MD
1 , Sarah Fotti, MD, FRCPC
1 , Laurence Y. Katz, MD, FRCPC
1 Jitender Sareen, MD, FRCPC
1,2 and The Swampy Cree Suicide Prevention Team Summary
There is a significant evidence-base demonstrating that media reporting of suicides is linked to copycat suicides among youth and young adults under 24 years of age. Suicidologists, public health officials, researchers, psychiatrists, psychologists, and news media professionals with the Canadian Association for Suicide Prevention (CASP) and the Center for Disease Control (CDC) have provided specific guidelines for the media to report suicide. There is evidence in the literature that implementation of guidelines for media reporting of suicide actually decreases the rate of copycat suicides and the incidence of suicide. Although guidelines exist, most journalists are unaware of the impact of reporting suicide with regard to copycat suicides. They are often unacquainted with or do not follow the guidelines.
For the Canadian Psychiatric Association (CPA) to have a Policy Paper on media reporting guidelines, it is necessary to establish a collaborative approach between health professionals and the media in order to promote a non-reinforcing attitude toward suicide without increasing stigma towards those with mental
health problems. Since media often call psychiatrists to comment on suicide, it is crucial for psychiatrists to have this knowledge readily available. These requests can be an opportunity for educating the media and ultimately saving lives.
CPA Policy Paper Page 1
Media Guidelines for Reporting Suicide
1Department of Psychiatry, University of Manitoba.
2Department of Community Health Sciences, and Psychology, University of Manitoba
© Copyright 2009, Canadian Psychiatric Association. This document may not be reproduced without written permission of the CPA.
Members’ comments are welcome. Please address all comments and feedback to: President, Canadian Psychiatric Association,
141 Laurier Avenue West, Suite 701, Ottawa, ON K1P 5J3; Tel: 613-234-2815; Fax: 613-234-9857; e-mail: president@cpa-apc.org.
Reference 2009–3PP.
This paper was developed in collaboration with the Canadian Psychiatric Association’s
Scientific and Research Affairs Standing Committee and was approved by the
Canadian Psychiatric Association’s Board of Directors on November 10, 2008.
POLICY PAPER
Introduction
There is a significant evidence-base demonstrating that media reporting of suicides is linked to copycat suicides among youth and young adults under 24 years of age.1–10 It has been deemed reasonable to believe that a causal link exists between the reporting of suicides in newspaper and television and copycat suicides in the community.11 This association has satisfied the criteria of consistency, strength, temporality, specificity, and coherence in a systematic review conducted by Pirkis and Blood.12,13 A decrease in the suicide rate was observed in Detroit when the newspaper was on strike.14 Interestingly, once the strike was over and the newspaper resumed publishing, the suicide rate
increased back up to previous levels.14 This phenomenon was also observed during a newspaper strike in New York in which the rate of
suicide decreased with respect to young women.15 Correlations have been made about sensational reporting and suicide rates.6,7,16 In the mid-1980s, an alarming amount of the Austrian population was committing suicide by means of the subway.18 These suicides were praised, glorified and rewarded to such a degree that the copycat effect became obvious to media as well as to policy-makers and psychiatrists.17 The evidence that exists about imitative effects in suicidal behaviour prompted the Austrian Association for Suicide Prevention, Crisis Intervention and Conflict Resolution to produce media guidelines for safe reporting.18 Journalists were not blamed for how they had been reporting, nor were told to stop reporting all together.18 Instead, they were educated through guidelines on how to report in a way that was hypothesized to decrease copycat behaviour.18 After the media guidelines were put in practice, suicide rates and suicide methods in Austria revealed that the hypothesis of safe reporting was valid. Over the next five years, aware of their importance, the media complied with guidelines and the suicide rate decreased (by as much as 75% by way of the subway).18 The importance of continuous monitoring of the media cannot be
underscored enough for suicide prevention. The evidence attests that implementation of guidelines for media reporting of suicide decreases the rate of copycat suicides and the incidence of suicide.18,19 Furthermore, a dose response-effect was revealed in Austria during the implementation of guidelines.20 The guidelines were ignored by a popular tabloid, which was distributed unevenly throughout the country.20 Through analysis of suicide rates, use of firearms for suicide, and distribution of the tabloid; it was revealed that 40% of the variance in suicides by firearm can be attributed to dangerous reporting of suicide by firearm from the tabloid.20 It has been argued, namely by Stack,21,22 that it is unknown whether a victim of suicide has been exposed to the reporting in question. This issue was addressed by Cheng23 through directly interviewing suicide attempters from the same time after media exposure. Data indicated that 89.2% of them reported exposure to media coverage. Psychological autopsies (reconstruction of lifestyle, circumstances, behaviours and events which led to the death of the individual) suggest that indirect exposure to suicide from the media has been the source for contagion – the process in which one suicide brings about another.3,24 Suicidologists, public health officials, researchers, psychiatrists, psychologists, and news media professionals with the Canadian Association for Suicide Prevention (CASP) and the Center for Disease Control (CDC) have provided specific guidelines to the media for safe reporting of suicide, which hold over North America.25,26 Although these guidelines exist, most journalists are unaware of the impact of reporting suicide with regards to copycat suicides. They are often unacquainted with or do not follow the guidelines.27 This suggests that the media have not been monitored with reinforcement of guidelines when it was necessary.
Page 2 CPA Policy Paper
Canadian Psychiatric Association—Media Guidelines for Reporting Suicide
Media Perspective
Anonymous phone interviews of journalists and professors of journalism across Canada were conducted by writer, which verified what Chris
Frost, head of the Journalism Department at John Moores University in Liverpool, UK, discussed.28 Key points include that suicide is a newsworthy event, firm deadlines necessitate easily available guidelines if they are to be used, and that there is a finite amount of print for a suicide story.28 This last point causes problems when guidelines necessitate that information about suicide and treatment be included in the article.28 However, the media feel it is necessary to be sensitive to the risk of copycat suicides.28 Education of the media, readily available guidelines, and on-hand expert opinion are the best ways to decrease copycat suicides.8
Media Guidelines for Reporting
Suicide
The many different guidelines throughout the world aimed to promote safe reporting of suicide are based on the same general ideas, and were
incorporated by the CDC.26 Suicide will be reported; it would be futile to prevent this.26 Experts need to provide more than “No Comment”
when approached by the media covering suicide.26 They should educate the media with the aid of this position paper about suicide contagion, so that the media will be motivated as they were in Austria to implement safe reporting techniques.17–19,26 Suicide prevention workers should not tell journalists how to do their job, but make them want to change.26 Simplistic explanations of suicide, repetitive/excessive reporting, sensational/morbid reporting (photographs of deceased, funeral, or place of death), details of suicide method, the idea.
CPA Policy Paper Page 3
Canadian Psychiatric Association—Media Guidelines for Reporting Suicide
Table 1 Canadian Association for Suicide Prevention and Center for
Disease Control, Guidelines for Media Reporting Suicide
AVOID CONVEY
• Details of the method
• The word “suicide” in the headline
• Photo(s) of the deceased
• Admiration of the deceased
• The idea that suicide is unexplainable
• Repetitive or excessive coverage
• Front page coverage
• Exciting reporting
• Romanticized reasons for the suicide
• Simplistic reasons for the suicide
• Approval of the suicide
• Alternatives to suicide (i.e. treatment)
• Community resource information for
those with suicidal ideation
• Examples of a positive outcome of a
suicidal crisis (i.e. calling a suicide
hotline)
• Warning signs of suicidal behaviour
• How to approach a suicidal person
*CDC Guidelines available at:
http://www.cdc.gov/mmwr/preview/
mmwrhtml/00031539.htm
*CASP Guidelines available at:
http://casp-acps.ca/Publications/
MEDIA%20GUIDELINES.doc
that suicide is a solution to problems, and only
focusing on the deceased’s positive characteristics
are generally regarded to promote suicide
contagion.26
The Goal of this Position Paper
The Canadian Psychiatric Association has issued this Policy Paper to promote a non-reinforcing attitude toward suicide without increasing stigma towards those with mental health problems. Since media often call psychiatrists to comment on suicide, it is important for psychiatrists to have this knowledge readily available.8,29 These requests can be an opportunity for educating the media and ultimately saving lives.8–10,18,30,31
Areas for Improvement
Unfortunately, this information is not covered in the curricula of many journalism programs nor is it well known by journalists, as was established during unidentified phone interviews with reporters and professors of journalism across Canada. Kisely’s study27 in Nova Scotia was reviewed and provides evidence that dangerous reporting exists in Canada. When asked if they were aware of guidelines for
reporting suicide, the majority of journalists answered simply that they do not report suicide . . . unless it is a celebrity, happened in a public place, used unusual means, or was indicative of a greater social problem.32,33 The dilemma is that any suicide can be considered newsworthy and few people writing the news are aware of the devastating impact not knowing or not following guidelines has on human life.2,33
The majority of countries that have developed a suicide prevention strategy have included improving the reporting of suicidal behaviour in
the media.34 An important source of information on mental illness is the media, which can directly impact the attitude of the community.2,9,35,36 The suicide prevention movement as a whole deserves criticism for lacking a logical media strategy, undervaluing the power of media support, and its insufficiency in getting across the message.30 As a rule, approaching the media in a positive manner is necessary to form a constructive alliance in suicide prevention.37
Recommendations
1. Advocate for teaching of suicide reporting in journalism schools.2 When the media understands the importance of the issue, they
have enhanced their reporting and suicides have decreased as was witnessed in Austria.18 This can be accomplished through increasing
contact with psychiatrists and professors of journalism via phone calls or meetings. 2. Focus educational efforts on the editors of
print media and producers of television and radio news, as they have the power to enforce change.2,10,18,38 3. Create credit card size summary of guidelines and website info for up-to-date and more comprehensive information for journalists.10 (See Table 1) The media perspective makes this request as they deem it necessary for a positive change in reporting practices.8 4. Policy-makers at the provincial and national
level need to consider methods of continuous monitoring of the media. 5. More information is needed about the impact of suicide coverage and suicide method available on the internet. This is a very important future direction of research.39–42
Acknowledgements
The authors thank the members of the Canadian Psychiatric
Association’s Scientific and Research Affairs Standing
Committee for their comments on this manuscript.
Preparation of this article was supported by a Canadian
Institutes of Health Research (CIHR) operating grant
(#166720) to establish the Swampy Cree Suicide Prevention
Team, and a CIHR New Investigator Award to Dr. Sareen
(#152348). The Swampy Cree Suicide Prevention team
includes: Dr. Jitender Sareen, Dr. Brenda Elias, Mr. Garry
Munro, Dr. Laurence Y. Katz, Dr. Murray Enns, Dr. Brian J.
Cox, Dr. John O’Neil, Dr. Catherine Cook, Ms. Shay-Lee
Belik, Ms. Natalie Mota, Ms. Corinne Isaak and Mr. Mike
Campeau, Dr. James Bolton, and Ms. Jina Pagura
(www.suicideresearch.ca).
Page 4 CPA Policy Paper
Canadian Psychiatric Association—Media Guidelines for Reporting Suicide
References
1. Gould M, Greenberg T, Velting D, Shaffer D. Youth Suicide
Risk and Preventive Interventions: A Review of the Past 10
Years. Journal of American Academy of Child and Adolescent
Psychiatry. 2003;42(4):386-405.
2. Gould M, Kramer R. Youth Suicide Prevention. Suicide and
Life-Threatening Behavior. 2001;31(Supplement to Issue
1):6-31.
3. Gould M, Wallenstein S, Kleinman M, O’Carroll P, Mercy J.
Suicide Clusters: An Examination of Age-Specific Effects.
AJPH. 1990;80(2), February.
4. Gould M, Jamieson P, Romer D. Media Contagion and Suicide
Among the Young. The American Behavioral Scientist.
2003;46(9):1269-1284.
5. Shoval G, Zalsman G, Polakecitch J, Shtein N, Sommerfeld E,
Berger E, Apter A. Effect of the Broadcast of a Television
Documentary About a Teenager’s Suicide in Israel on Suicidal
Behavior and Methods. Crisis. 2005;26(1):20-24, DOI
10.1027/0227-5910.26.1.20.
6. Tousignant M, Mishara B, Caillaud A, Fortin V, St-Laurent D.
The Impact of Media Coverage of the Suicide of a Well-Known
Quebec Reporter: the Case of Gaetan Girouard. Soc Sci Med.
2005;60:1919-1926.
7. Gould M. Suicide and the Media. Annals of the New York
Academy of Sciences. 2001;932(April):200-224.
8. Norris B, Jempson M, Bygrave L. Covering Suicide Worldwide:
Media Responsibilities. The PressWise Trust . 2001;September.
(http://www.mediawise.org.uk/display_page.php?id=169).
9. Deshapriya S, Hattotuwa S, Jempson M. Suicide Sensitive
Journalism Handbook. Centre for Policy Alternatives &
PressWise Trust . 2003. (http://www.cpalanka.org/
research_papers/suicide_report.pdf).
10. Appleby L, Jempson M, Cookson R, Williams T, Thorsen E,
Khan A, Thevanayagam P. Sensitive Coverage Saves Lives:
Improving Media Portrayal of Suicidal Behavior.
The MediaWise Trust . 2007. (http://www.mediawise.org.uk/
files/uploaded/Sensitive%20Coverage%20Saves%20Lives.pdf).
11. Ranson DB. Suicide and the Media – A Critical Review. Journal
of Law and Medicine. 2001;Vol. 9.
12. Prikis J, Blood W, Beautrais A, Burgess P, Skehan J. Media
Guidelines on the Reporting of Suicide. Crisis.
2006;27(2):82-87.
13. Pirkis J, Francis C, Blood R, Burgess P, Morley B, Stewart A,
Putnis P. Reporting of Suicide in the Australian Media.
Australian and New Zealand Journal of Psychiatry.
2002;36(2):190-197.
14. Motto JA. Newspaper Influence on Suicide. Archives of General
Psychiatry. 1970;23(2):143-148.
15. Blumenthal S, Bergner S. Suicide and Newspapers: A Replicated
Study. Am J Psychiatry. 1973;130(April):468-471.
16. Phillips DP. The Influence of Suggestion on Suicide: Substantive
and Theoretical Implications of the Werther Effect. Am Sociol
Rev. 1974;39:240-354.
17. Wilkie C, Macdonald S, Hildahl K. Community Case Study:
Suicide Cluster in a Small Manitoba Community. Can J
Psychiatry. 1998;43(October):823-828.
18. Sonneck G, Etzersdorfer E, Nagel-Kuess S. Imitative Suicide on
the Viennese Subway. Soc Sci Med. 1994;38(3):453-457,
February.
19. Mercy J, et al. Is Suicide Contagious? A Study of the Relation
between Exposure to the Suicidal Behavior of Others and Nearly
Lethal Suicide Attempts. Am J Epidemiol. 2001;154(2):120-127.
20. Etzersdorfer E, Voracek M, Sonneck G. A Dose-Response
Relationship Between Imitational Suicides and Newspaper
Distribution. Archives of Suicide Research. 2004;8(2):137-145.
21. Stack S. Media Coverage as a Risk Factor in Suicide.
J Epidemiol Community Health. 2003;57:238-240.
22. Stack S. Suicide in the Media: A Quantitative Review of Studies
Based on Nonfictional Stories. Suicide and Life-Threatening
Behavior. 2005;35(2):121-133.
23. Cheng A, Hawton K, Lee C, Chen T. The Influence of Media
Reporting of the Suicide of a Celebrity on Suicide Rates: a
Population Based Study. Int J Epidemiol.
2007;36(6):1229-1234.
24. Gould M, Wallenstein S, Davidson L. Suicide Clusters:
A Critical Review. Suicide and Life-Threatening Behavior.
1989;19(1):17-29.
25. Canadian Association for Suicide Prevention (CASP). Media
Guidelines. Edmonton: CASP, 2004. (http://casp-acps.ca/
Publications/MEDIA%20GUIDELINES.doc).
26. CDC, MMWR, Suicide Contagion and the Reporting of Suicide:
Recommendations from a National Workshop . April 22, 1994.
(http://www.cdc.gov/mmwr/preview/mmwrhtml/00031539.htm).
27. Kisely S, Denney J. The Portrayal of Suicide and Mental Illness:
A Province-Wide Survey of Nova Scotia. Canadian Journal of
Community Mental Health. 2007;26(1).
28. Crane C, Hawton K, Simkin S, Coulter P. Suicide and the Media:
Pitfalls and Prevention. Crisis. 2005;26(1):42-47.
29. Sudak H, Sudak D. The Media and Suicide. Academic
Psychiatry. 2005;29:5, November-December.
30. Bale C. The Media as Partners in Suicide Prevention. Crisis.
2001;22(4):141-142.
31. Schafer R, et al. Media Coverage on Suicide in Nuremberg’s
Daily Papers – Frequency and Form of the Reporting Before and
During Media-Intervention with Guidelines. Psychiat Prax.
2006;132-137.
32. Kisely S, Denney J. The Portrayal of Suicide and Mental Illness:
A Province-Wide Survey of Nova Scotia. Canadian Journal of
Community Mental Health. 2007;26(1), Spring.
33. Kisely S, Slavin J. The Esperence Primary Prevention of Suicide
Project. Australian and New Zealand Journal of Psychiatry.
2002;36:617-621.
34. Cheng A, Hawton K, Chen T, Yen A, Chen C, Chen L, Teng P.
The Influence of Media Coverage of a Celebrity Suicide on
Subsequent Suicide Attempts. J Clin Psychiatry. 2007;68(6),
June.
35. Kisely S. Surveying the Portrayal of Mental Illness Across a
Jurisdiction: Is More Than One Method Appropriate? Public
Health. 2007; doi:10.1016/j.puhe.2007.07.019.
36. Prikis J, Burgess P, Blood W, Francis C. The Newsworthiness of
Suicide. Suicide and Life-Threatening Behavior. 2007;37(3),
June.
37. Au J, Yip P, Chan C, Law Y. Newspaper Reporting of Suicide
Cases in Hong Kong. Crisis. 2004;25(4):161-168.
38. Michel K, Frey C, Wyss K, Valach L. An Exercise in Improving
Suicide Reporting in Print Media. Crisis. 2000;21(2):71-79.
39. Sisask M, Varnik A, Wasserman D. Internet Comments on
Media Reporting of Two Adolescents’ Collective Suicide
Attempt. Archives of Suicide Research. 2005;9(1):87-98.
40. Hawton K, Williams K. Influences of the Media on Suicide.
BMJ. 2002;325(December):1374-1375.
41. Hagihara A, Tarumi K, Abe T. Media Suicide-Reports, Internet
Use and the Occurrence of Suicides between 1987 and 2005 in
Japan. BMC Public Health. 2007;7(November),
doi:10.1186/1471-2458-7-321.
42. Mishara B, Weisstub D. Ethical, Legal, and Practical Issues in
the Control and Regulation of Suicide Promotion and Assistance
over the Internet. Suicide and Life-Threatening Behavior.
2007;37(1):58-65.
CPA Policy Paper Page 5
Canadian Psychiatric Association—Media Guidelines for Reporting Suicide
NOTES:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
REMARQUES :




- 30 -