Media recommendations on reporting suicidal behaviour and suggestions for optimisation

Portrayal of suicidal behaviour in the media carries the risk of imitation (suicide contagion, copycat suicide, Werther effect; 1-3). Considerate reporting, in contrast, might decrease suicide and suicide attempt rates 4. Recommendations for media professionals have been introduced in many countries to promote responsible reporting of suicidal behaviour, and to balance the public's ‘right to know’ against the risk of causing harm. These recommendations, prepared by the World Health Organization (WHO; 5) and (non-) governmental suicide prevention organisations, give detailed proposals on the portrayal of suicidal behaviour. Press codes of ethics, developed by media councils, aim to generally ensure ethical reporting and to hold editors and journalists accountable for their actions. Responsible reporting of suicide events might be among the mentioned criteria for professional journalistic behaviour. To our knowledge, systematic analyses of the existence of media recommendations (also in the context of national suicide prevention programmes), of press codes including a paragraph on portraying suicide, and the included aspects of reporting are not yet available. A survey to systematically assess the contents of media recommendations and press codes of ethics was conducted within the optimizing suicide prevention programmes and their implementation in Europe (OSPI-Europe) project, which aims to establish a best practice and evidence-based approach to reduce suicidal behaviour by community-based multilevel interventions 6, 7. For 74 (38%) of the 193 member states of the United Nations (UN), information on the existence or non-existence of national suicide prevention programmes was found via online search engines and/or a survey among the representatives of the International Association for Suicide Prevention. Of these 74 countries, only 38% have national suicide prevention programmes, 38% media recommendations and 25% press codes of ethics mentioning suicide reporting. A combination of national suicide prevention programmes, media recommendations in the national language, and a section on reporting suicide in the press codes is found in 11% of 74 countries only. All 34 media recommendations advise against describing suicide methods in detail. Most of them (>75%) warn against simplistic explanations and glorification of suicide, and recommend to refer to help in general, to report non-sensationally, and not to use photos. More than half of the recommendations suggest to list warning signs, to link suicide to mental illness and to refer to help agencies. A systematic assessment of media recommendations and press codes of ethics revealed some deficiencies in format, content, up-to-dateness, accessibility and availability, and thus a need for optimisation. The existing media recommendations vary considerably in word count (range, 76–3189). All relevant factors can only be included if the media recommendations have a minimum number of words. However, if recommendations are too extensive, they might not be feasible for journalists who are always pressed for time. Thus, short handouts (‘at-a-glance-cards’), with a summary of criteria for considerate reporting and contact details of a help service, should be combined with more elaborate versions, including background and additional information. Less than 25% of the media recommendations include the following factors which potentially prevent imitation: A section on fictional portrayal of suicidal behaviour should be added to the media recommendations, as fictional reports can also lead to imitative behaviours 8. The media landscape, and thus, research on imitation, has developed from print media over radio and TV broadcasts to new media. The Werther effect has been demonstrated for traditional media, including first approaches to examine the effects of public obsequies broadcasted on TV 9. Up to now, there are no comprehensive studies on imitation following reports in new media, including chat rooms, social networks, video-sharing websites, blogs, and micro blogs. New media developments entail completely different communication channels and enable high-speed information distribution. Only 15% of the analysed recommendations include a section on the portrayal of suicidal behaviour on the Internet. Media recommendations should emphasise these differences and provide suggestions for considerate reporting in new media. The target group of media recommendations has to be broadened from editors and journalists to website providers and the virtual community itself. Nevertheless, reports and comments in new media can significantly less be moderated than in traditional media. Also, the audience of new media largely consists of younger persons which have proved to be especially vulnerable to imitative behaviours 10. New media, however, can constitute an important platform for increasing awareness for mental illness and suicidality and, thus, for suicide prevention. Fifty-nine per cent of the media recommendations were published before 2007 and have not been revised and reissued since. The responsible organisations should update their recommendations on a regular basis, keep track with research on imitation and with new media developments, and include these aspects in new editions. Twelve of the analysed 74 countries have a translation of the WHO recommendations in their national language. Translations into further languages seem to be a cost- and time-effective way of introducing media recommendations in all 193 UN member states. Recommendations should be distributed in journalism schools and institutions, and workshops for editors and journalists should be held on a regular basis. Lobbying and disseminating media recommendations with stakeholders might increase awareness among media professionals. Of the 71 press codes in this sample, only 25% include a paragraph on reporting suicidal behaviour. As journalists are expected to be familiar with the contents of their press codes of ethics, this seems to be an effective way of raising awareness for the risk of imitation of suicidal behaviour. Thus, a paragraph on reporting suicidality should be part of every press code. The recommendation of referring to help in general when reporting on suicidal behaviour is only included in 11% of the existing paragraphs and needs to be added to the remaining ones. Media monitoring agencies should observe the implementation of recommendations for considerate reporting and respond to cases of inadequate reports. In conclusion, based on a systematic survey, the authors would like to put several suggestions for media recommendations up for discussion: i) media recommendations on reporting suicidal behaviour should be available in two formats: a short handout and a longer version with detailed information; ii) findings on the prevention of imitation after reports on suicidal behaviour in new media should be added to the recommendations to keep their practical relevance; iii) media recommendations need to be updated on a regular basis and refer to all relevant preventive factors, and, most importantly; iv) translations of the WHO recommendations into further languages would significantly increase the availability and accessibility of resources for media professionals across the world. The work leading to these results has received funding from the European Commission within the Seventh Framework Programme under grant agreement no 223138.