Media

Dempsey Rice, M.A.
Daughter One Productions, Inc.
Brooklyn, New York

1. Findings

   Today's media play a major role in influencing peoples' images and ideas about mental illness and suicide. Negative stereotypes are too often the only image the public receives about these subjects and, in effect, become the only sources of their knowledge about them. Many New Yorkers continue to associate mental illness with people who are dangerous and pose a threat to public safety and welfare. The stigma that accompanies mental illness is a major barrier for people who are struggling to manage their illness through medication and therapy.

   Despite advances in treatment that enable people to live and work successfully in the community, mental illness continues to be regarded as a social disease rather than a neurobiological disorder. This lag in the public mind does a profound disservice to thousands of New York citizens who suffer from a mental illness. Feelings of internalized shame and low self-esteem continue to plague these individuals, compounding the effects of the illness.

   It contributes to the reality that only 1 person in 5 will seek professional help for an emotional disorder and choose instead to suffer silently, but not painlessly. The media must take responsibility for the misinformation and stereotyping projected daily about people with mental illness, including those who lose their lives to suicide. Fortunately, the potency of the media means they must be part of the solution as well.

   Research shows that media alone do not cause suicide - healthy people, even teenagers - don't normally "up and kill themselves" due to what they see or read. But media are unhelpful when they present an inaccurate, overly dramatized image of mental illness and its treatment, thereby discouraging help-seeking. Moreover, media can also play a real role in preventing suicide - compassionate reporting and accurate representation can both educate and reduce stigma, leading to treatment and eventually, healthy people.

   1. The Annenberg Report (2001)
      1. Four years ago, the Annenberg Public Policy Center at the University of Pennsylvania, in collaboration with the American Association of Suicidology and the American Foundation for Suicide Prevention, issued a report, Reporting on Suicide: Recommendations for the Media.

      Highlights of the Report are these:

      • The media can play a powerful role in educating the public about suicide prevention. Stories about suicide can inform readers, viewers, and listeners about the likely causes of suicide, its warning signs, trends in suicide rates, and recent treatment advances. They can also highlight opportunities to prevent suicide. Media stories about individual deaths by suicide may be newsworthy and need to be covered, but they also have the potential to do harm.

      Implementation of recommendations 6for media coverage of suicides has been shown to decrease suicide rates. Unfortunately, many media practices can have negative effects on the public:

      1. Certain ways of describing suicide in the news contribute to what is called "suicide contagion" or "copycat suicides." This is especially potent within the adolescent population. (See Chapter on Adolescents for more information)
      2. Research suggests that inadvertently romanticizing suicide or idealizing those who take their own lives by portraying suicide as a heroic or romantic act may encourage others to identify with the victim.
      3. Exposure to suicide method through media reports can encourage vulnerable individuals to imitate it. Clinicians warn the danger is even greater if there is a detailed description of the method. Research indicates that pictures or other detailed information of the site of a suicide also encourages imitation.
      4. Presenting suicide as the inexplicable act of an otherwise healthy or high-achieving person may encourage identification with the victim, and engender a "copycat behavior."
      5. The media should know that 90% of suicide victims have a significant psychiatric illness at their time of death. These are often undiagnosed, untreated, or both. Mood disorders and substance abuse are the two most common diagnoses.
      6. When both mood disorders and substance abuse are present, the risk for suicide is much greater, especially for adolescents and young adults.
      7. Research has shown that when open aggression, anxiety or agitation is present in individuals who are depressed, the risk for suicide increases significantly.
      8. The cause of an individual suicide is typically more complicated than a recent painful event, such as a break-up of a relationship or the loss of a job. Social conditions alone do not explain a suicide.
      9. People who appear to become suicidal in response to such events, or in response to a physical illness, generally have significant mental problems, though they may be well-hidden.
2. Action Steps for Working with the Media
   1. If you don't know what good and bad examples of how the media reports on suicide are, educate yourself. Read the Annenberg Report and go to the American Foundation for Suicide Prevention's web site for current examples (www.afsp.org ).
   2. Once you understand the issues and have some examples to back yourself up, tell others. Helping the media understand the issue and educating them about how they might do a better job is a concrete way that you can bring about change.
   3. Reach out to the news and health editors at your local newspapers - big or small - and at your local broadcast newsrooms. Often a suicide in a specific neighborhood or borough is reported in the neighborhood paper and not the major paper. If you live in a college town, get in touch with the editor of the student newspaper or student-run radio and television station: young adults need this information as well.
   4. Get phone, fax and e-mail contact information for these individuals, but open your communication with something written: a letter, fax or e-mail that explains who you are and why you care about suicide prevention (and its coverage). If you can help your reader understand why you are writing and that you are truly invested in suicide prevention, they will take you more seriously. Include a copy of Reporting on Suicide with your letter.
   5. Offer to meet with editors, reporters and copy editors at your local media outlets. Each of these groups plays a key role in how the media represents suicide: the editor by assigning the story to a reporter, a reporter by telling that story and a copy editor by writing the headline and photo captions for that story.
   6. Maintain ongoing communication and dialogue with your local news agencies. Let them know you are available to consult as an "expert" or that you can help them get the information they need when reporting on a suicide. Keep them abreast of mental health and suicide related legislative news at the state and federal levels.
   7. In addition to working with your local media outlets, get in touch with professors at the local university or community college. Offer to speak to journalism classes or at schools of communications. We need to educate today's students before they begin working as professional journalists.
   8. If you find examples of "bad" reporting in your local news outlets, let them know in a calm, intelligent, educational manner. Refer them to the Annenberg Report. Help them to understand where they went wrong and how they could have done better without alienating them. Provide examples of how they could have done better and make yourself available for ongoing communication about the issue.
   9. If you find examples of "good" reporting….praise them. Many mental health associations, including the National Mental Health Association, offer media awards for positive representations of mental health in the press and fictional media. If it's very good, nominate it for an award.
   10. Use the media to educate your local community by asking local health editors to assign stories about depression and mental illness at any time of the year, but specifically when a suicide occurs in your community. Stories about warning signs for suicide, stories that profile local organizations or individuals who work in suicide prevention, and stories about mental health and suicide related legislation can all be effective uses of media to de-stigmatize mental health, educate the public and, ultimately, combat suicide. If information about warning signs and prevention is presented along side a story about a local suicide your community will learn something from the tragedy.
   11. If a local mental health organization is having a rally or educational event, invite the media. This is a great opportunity to educate them and to provide them with "content" for a story.
   12. If a television program or (fictional) film misrepresents suicide or mental illness, media watchers can do several things:
       • Write a letter to the production company that created the program and the distribution outlet. Most films are produced and distributed by studios but some are produced by one company and then distributed by a studio or distribution company. All of this information is found in the opening credits of the film…take notes. To comment on a television program, look for the production company's credit at the end of the show and write to the broadcast outlet (the television channel).
       • Write a letter to the editor of your local newspaper about the program or film, ask a local columnist to do an opinion piece, or find out if your local news station will let you read a commentary on air. Many television stations do program commentary by local residents.
       • Hold an awareness event and invite local media to cover the event.
   13. Deliver the message yourself. Give presentations to local houses of worship, community centers and libraries. Collaborate with institutions in the community, and ask them to help spread the word about suicide and mental illness…Talk helps to spread information and de-stigmatize the issues. If you live in a college or university town, volunteer to coordinate a public awareness campaign on campus. If your community has a web site, ask for a link to the local suicide prevention council. Better yet, ask the webmaster to include information about suicide and mental illness.
3. III. Guidelines for Media Coverage of Suicides *
   1. In covering a story about suicide, find out if the victim ever received treatment for depression or any other mental illness. Did the victim have a substance abuse problem? Conveying the message that effective treatments for most of these conditions are available but underutilized may encourage those with such problems to seek help.
   2. Acknowledging the deceased person's problems and struggles as well as the positive aspects of his/her life or character contributes to a more balanced picture.
   3. During the period immediately following a suicide death, grieving family members or friends may have difficulty understanding what happened. Responses may be extreme, problems may be minimized, and motives may be complicated.
   4. Studies of suicide based on in-depth interviews with those close to the victim indicate that, in their first, shocked reaction friends and family may find a loved one's death by suicide inexplicable or they may deny that there were warning signs. Accounts based on these initial reactions are often unreliable.
   5. Thorough investigations generally reveal underlying problems unrecognized even by close friends and family members. Most victims do, however, give warning signs of their risk for suicide.
   6. Some informants are likely to suggest that a particular individual - a family member, school employee, health service provider - played a role in the victim's death by suicide. Thorough investigation almost always finds multiple causes for suicide and fails to corroborate a simple attribution of responsibility.
   7. A concern exists about dramatizing the impact of suicide through descriptions and pictures of grieving relatives, teachers or classmates. This may encourage potential victims to see suicide as a way of getting attention or as a means of retaliation against others.
   8. Using adolescents on TV or in print media to tell the stories of their suicide attempts may be harmful to the adolescents themselves or may encourage other vulnerable young people to seek attention this way.
4. The Significance of Language.
   1. A cautionary note on language: referring to a "rise" in suicide rates is usually more accurate than calling such a rise an "epidemic", which implies a more dramatic and sudden increase than what we generally find in suicide rates. Similarly, research has shown that the use of the word "suicide" in headlines and reference to the cause of death as "self-inflicted" increases the likelihood of contagion.
   2. Unless the death took place in public, the cause of death should be reported in the body of the story, not in the headline.
   3. In deaths that will be covered nationally, such as celebrities, or those apt to be covered locally, such as persons living in small towns, consider phrasing headlines such as "Marilyn Monroe dead at 36" or "John Smith dead at 48." How they died could be reported in the body of the article.
   4. In the body of the story, it is preferable to describe the deceased as "having died by suicide" rather than as "a suicide," or having "committed suicide." The latter two expressions reduce the person to the mode of death, or connote criminal or sinful behavior.
   5. Contrasting "suicide deaths" with "non-fatal attempts" is preferable to using terms such as "successful," "unsuccessful" or "failed."
5. Special Situations.
   1. Celebrity deaths by suicide (e.g. Marilyn Monroe, Kurt Cobain) are more likely than non-celebrity deaths to produce imitations. While suicides by celebrities will receive prominent coverage, it is important not to let the glamour of the individual obscure any mental health problems or use of drugs.
   2. Homicide - suicide coverage should be aware that the tragedy of the homicide can mask the suicidal intent of the act. Feelings of depression and hopelessness present before the homicide and suicide are often the impetus for both.
   3. Suicide pacts are mutual arrangements between two people who kill themselves at the same time, and are rare. They are not simply the act of loving individuals who do not wish to be separated (e.g. Romeo and Juliet). Research shows that most pacts involve an individual who is coercive and another who is extremely dependent.
6. Stories To Consider Covering.
   1. Trends in suicide rates
   2. Recent treatment advances
   3. Individual stories of how treatment was life-saving
   4. Stories of people who overcame despair without attempting suicide
   5. Myths about suicide
   6. Warning signs of suicide
   7. Actions that individuals can take to prevent suicide by others

References

For reporting on Suicide Recommendations for the Media: American Foundation for Suicide Prevention www.afsp.org or 1-888-333-AFSP
The Annenberg Public Policy Center of the University of Pennsylvania www.appcpenn.org or (215) 898-7041
American Association of Suicidology www.suicidology.org or (202) 237-2280
Articles and Papers: Goldsmith, SK; Pellmar, TC; Kleinman AM; Bunney, WE; Reducing Suicide: A National Imperative (Washington: The National Academies Press, 2002) www.nap.edu
Gould, M.; Jamieson, P.; Romer, D., Media Contagion and Suicide Among the Young American Behavioral Scientist, Vol.46, No.9, May 2003, 1269-1284
Mann, J.John, MD, A Current Perspective of Suicide and Attempted Suicide, Annals of Internal Medicine, 2002; 136: 302-311
Web Site: The Advertising Council provides advice to not-for-profits that want to work with the media on their web site. www.adcouncil.org
Book: Jason Salzman, Making the News: A Guide for Nonprofits and Activists. (Westview Press, May 1998)