Suicide Contagion Research Articles

The quality of online media reporting of celebrity suicide in India and its association with subsequent online suicide-related search behaviour among general population: An infodemiology study.

The literature reports increased suicide rates among general population in the weeks following the celebrity suicide, known as the Werther effect. The World Health Organization (WHO) has developed guidelines for responsible media reporting of suicide. The present study aimed to assess the quality of online media reporting of a recent celebrity suicide in India and its impact on the online suicide related search behaviour of the population. A total of 200 online media reports about Sushant Singh Rajput's suicide published between 14th to 20th June 2020 were assessed for quality of reporting following the checklist prepared using the WHO guidelines. Further, we examined the change in online suicide-seeking and help-seeking search behaviour of the population following celebrity suicide for the month of June using selected keywords. In terms of potentially harmful media reportage, 85.5 % of online reports violated at least one WHO media reporting guideline. In terms of potentially helpful media reportage, only 13 % articles provided information about where to seek help for suicidal thoughts or ideation. There was a significant increase in online suicide-seeking (U = 0.5, p < 0.05) and help-seeking (U = 6.5, p < 0.05) behaviour after the reference event, when compared to baseline. However, the online peak search interest for suicide-seeking was greater than help-seeking. This provides support for a strong Werther effect, possibly associated with poor quality of media reporting of celebrity suicide. There is an urgent need for taking steps to improve the quality of media reporting of suicide in India.

“Werther effect” – Media, a potential preventive tool for suicidal behaviour

Suicide, with all its psychosocial impacts, is a major public health problem and needs prompt preventive approaches considering its increasing magnitude. In this era of the internet, people started to rely more on data available at their fingertips than the print media. And this is the time to apply the knowledge we had gained of print media reporting on suicide (its limitations and possibilities) to online media. This article tries to bring attention to some of the recommendations for media reporting on suicide and the need for researches based on the online media platform.

Associations Between Social Media and Suicidal Behaviors During a Youth Suicide Cluster in Ohio

PurposeYouth suicide clusters may be exacerbated by suicide contagion—the spread of suicidal behaviors. Factors promoting suicide contagion are poorly understood, particularly in the advent of social media. Using cross-sectional data from an ongoing youth suicide cluster in Ohio, this study examines associations between suicide cluster-related social media and suicidal behaviors. MethodsWe surveyed 7th- to 12th-grade students in northeastern Ohio during a 2017–2018 suicide cluster to assess the prevalence of suicidal ideation (SI), suicide attempts (SAs), and associations with potential contagion-promoting factors such as suicide cluster–related social media, vigils, memorials, news articles, and watching the Netflix series 13 Reasons Why before or during the cluster. Generalized estimating equations examined associations between potential contagion-promoting factors and SI/SA, adjusting for nonmodifiable risk factors. Subgroup analyses examined whether associations between cluster-related factors and SI/SA during the cluster varied by previous history of SI/SA. ResultsAmong participating students, 9.0% (876/9,733) reported SI and 4.9% attempted suicide (481/9,733) during the suicide cluster. Among students who posted suicide cluster–related content to social media, 22.9% (267/1,167) reported SI and 15.0% (175/1,167) attempted suicide during the suicide cluster. Posting suicide cluster–related content was associated with both SI (adjusted odds ratio 1.7, 95% confidence interval 1.4–2.0) and SA during the cluster (adjusted odds ratio 1.7, 95% confidence interval 1.2–2.5). In subgroup analyses, seeing suicide cluster–related posts was uniquely associated with increased odds of SI and SA during the cluster among students with no previous history of SI/SA. ConclusionsExposure to suicide cluster–related social media is associated with both SI and SA during a suicide cluster. Suicide interventions could benefit from efforts to mitigate potential negative effects of social media and promote prevention messages.

Adherence to suicide reporting guidelines by news shared on a social networking platform.

Rates of suicide in the United States are at a more than 20-y high. Suicide contagion, or spread of suicide-related thoughts and behaviors through exposure to sensationalized and harmful content is a well-recognized phenomenon. Health authorities have published guidelines for news media reporting on suicide to help prevent contagion; however, uptake of recommendations remains limited. A key barrier to widespread voluntary uptake of suicide-reporting guidelines is that more sensational content is perceived to be more engaging to readers and thus enhances publisher visibility and engagement; however, no empirical information exists on the actual influence of adherence to safe-reporting practices on reader engagement. Hence, we conducted a study to analyze adherence to suicide-reporting guidelines on news shared on social media and to assess how adherence affects reader engagement. Our analysis of Facebook data revealed that harmful elements were prevalent in news articles about suicide shared on social media while the presence of protective elements was generally rare. Contrary to popular perception, closer adherence to safe-reporting practices was associated with a greater likelihood of an article being reshared (adjusted odds ratio [AOR] = 1.19, 95% confidence interval [CI] = 1.10 to 1.27) and receiving positive engagement ("love" reactions) (AOR = 1.20, 95% CI = 1.13 to 1.26). Mean safe-reporting scores were lower in the US than other English-speaking nations and variation existed by publisher characteristics. Our results provide empirical evidence that improved adherence to suicide-reporting guidelines may benefit not only the health of individuals, but also support publisher goals of reach and engagement.

13 Reasons Why: can a TV show about suicide be ‘dangerous’? What are the moral obligations of a producer?

The release of the Netflix’s show 13 Reasons Why caused significant public concern about the risk of suicide contagion among teenagers – particularly those who have suicidal thoughts. Practitioners and researchers expressed apprehension about the show for its apparent praise of suicide and for allegedly increasing suicide risk among vulnerable teenagers. However, there is a lack of clear evidence for the influence of fictional content on self-harm. Little is known about variations in media effects between news and fiction. The literature focuses mainly on non-fictional media reporting, without making any distinction between individual vulnerability and the type of media portrayal. The present article criticizes the assumption that risk of self-harm is reduced by sanitizing fictional content. The absence of definite scientific evidence is precisely why this article re-addresses the problem through an ethical perspective by focusing on the moral responsibility of Netflix. Censoring fiction may do more harm than good, but producers have the responsibility to evaluate in advance the potential impact that such content has on vulnerable people, and to support viewers as well as parents, educators, and practitioners through an adequate campaign of prevention.

Examining the Self-Harm and Suicide Contagion Effects of the Blue Whale Challenge on YouTube and Twitter: Qualitative Study.

BackgroundResearch suggests that direct exposure to suicidal behaviors and acts of self-harm through social media may increase suicidality through imitation and modeling, particularly in more vulnerable populations. One example of a social media phenomenon that demonstrates how self-harming behavior could potentially be propagated is the blue whale challenge. In this challenge, adolescents and young adults are encouraged to engage in self-harm and eventually kill themselves. ObjectiveThis paper aimed to investigate the way individuals portray the blue whale challenge on social media, with an emphasis on factors that could pose a risk to vulnerable populations.MethodsWe first used a thematic analysis approach to code 60 publicly posted YouTube videos, 1112 comments on those videos, and 150 Twitter posts that explicitly referenced the blue whale challenge. We then deductively coded the YouTube videos based on the Suicide Prevention Resource Center (SPRC) safe messaging guidelines as a metric for the contagion risk associated with each video.ResultsThe thematic analysis revealed that social media users post about the blue whale challenge to raise awareness and discourage participation, express sorrow for the participants, criticize the participants, or describe a relevant experience. The deductive coding of the YouTube videos showed that most of the videos violated at least 50% of the SPRC safe and effective messaging guidelines.ConclusionsThese posts might have the problematic effect of normalizing the blue whale challenge through repeated exposure, modeling, and reinforcement of self-harming and suicidal behaviors, especially among vulnerable populations such as adolescents. More effort is needed to educate social media users and content generators on safe messaging guidelines and factors that encourage versus discourage contagion effects.

Evaluating News Media Reports on the 'Blue Whale Challenge' for Adherence to Suicide Prevention Safe Messaging Guidelines

The Blue Whale Challenge (BWC) is an online viral "game" that allegedly encourages youth and young adults towards self-harming behaviors that could eventually lead to suicide. The BWC can be situated within a larger phenomenon of viral online self-harm challenges, which may be propagated through both social media and news sources. Research has established that suicide is a global public health issue that is known to be influenced by media reporting. Violation of safe messaging guidelines has been shown to increase imitative suicides, particularly in youth and young adults. Given the confirmed effects of news media reporting, we analyzed 150 digital newspaper articles reporting on the BWC to assess whether they adhered to suicide prevention safe messaging guidelines. Overall, 81% of the articles violated at least one contagion-related guideline, most commonly normalizing suicide, discussing means of suicide, and sensationalizing. Even though the majority (91%) of the articles adhered to at least one health-promotion guideline, such as emphasizing prevention, the articles did not follow these guidelines on a deep and comprehensive level. Through thematic analysis, we also found evidence of potential misinformation in reporting, where the articles unequivocally attributed many suicides to the BWC with little or no evidence. Additionally, articles often stated an individual's reason for participating in the challenge without interviewing the individual or those close to the individual, another aspect of potential misinformation due to lack of evidence. A contribution of the current study is the synthesis of safe messaging guidelines that can be used in future research. This study contributes to the understanding of news reporting practices regarding suicide and self-harm in regard to the BWC and similar online challenges. We discuss how sensationalized news media reports on the BWC could unintentionally propagate suicide contagion effects that normalize self-harming behaviors among youth. We then examine implications for practice and policy, such using automated approaches to aid reporters in adhering to safe messaging guidelines.

Online media reporting of suicidal behaviour in Ghana: Analysis of adherence to the WHO guidelines.

Background:Irresponsible media reporting of suicide is a potential risk for copycat suicide. There is a paucity of studies from sub-Saharan Africa on the quality of media reporting of suicide.Objectives:We assessed the compliance of Ghanaian online media outlets with the World Health Organization (WHO) guidelines for media reporting of suicide.Methods:We searched 10 local media outlets with strong online presence in Ghana, to identify suicide-related news reports from 2000 through 2019. We applied summative content analysis and chi-square test to the data.Results:We included 288 news reports, of which 261 (90.6%) were completed suicides, 7 (2.4%) were attempted suicides and 20 (6.9%) were homicide suicides. Most of the news reports failed to comply with the WHO guidelines: 92.7% mentioned the specific method of the suicide act, 82.6% included ‘suicide’ in the headline and 55.6% included photos of the victims. The tests indicated that privately owned media outlets were more likely than publicly owned to post a photo of the victim, = 17.37, p < .001, and report the incident location in the headline, = 15.00, p < .001. However, generally, there were no statistically significant relationships between the quality of reporting and media outlet ownership. Each of the 288 reports failed to mention any of the potentially helpful features recommended by the WHO guidelines.Conclusion:Regardless of the ownership of the media outlet (whether private or publicly owned), mostly, the online reportage of suicidal behaviour in Ghana deviates sharply from the international recommended best practice by the WHO.

The Relationship Between Suicide-Related Twitter Events andSuicides in Ontario From 2015 to 2016.

Background: Many studies have demonstrated suicide contagion through mainstream journalism; however, few have explored suicide-related social media events and their potential relationship to suicide deaths. Aims: To determine whether Twitter events were associated with changes in subsequent suicides. Methods: Suicide-related Twitter events that garnered at least 100 tweets originating in Ontario, Canada (July 1, 2015 to June 30, 2016) were identified and characterized as putatively "harmful" or "innocuous" based on recommendations for responsible media reporting. The number of suicides in Ontario during the peak of each Twitter event and the subsequent 6days ("exposure window") was compared with suicides occurring during a pre-event period of the same length ("control window"). Results: There were 17 suicide-related Twitter events during the period of study (12 putatively harmful and five putatively innocuous). The number of tweets per event ranged from 121 for "physician-assisted suicide law in Quebec" to 6,202 for the "Attawapiskat suicide crisis." No significant relationship was detected between Twitter events and actual suicides. Notably, a comprehensive examination of the details of Twitter events showed that even the putatively harmful events lacked many of the characteristics commonly associated with contagion. Limitations: This was an uncontrolled experiment in only one epoch and a single Canadian province. Discussion: This study found no evidence of suicide contagion associated with Twitter events. This finding must be interpreted with caution given the relatively innocuous content of suicide-related Tweets in Ontario during 2015-2016.

Geographical clusters and social risk factors for suicide in the city of São Paulo, 2006-2015: An ecologic study.

To identify geographical clusters of suicide in São Paulo, Brazil (2006-2015) and to verify the associations of suicide with sociocultural characteristics of its 96 districts. Spatial scan test was used to detect the geographical clusters. Correlation and multiple regression techniques were used to estimate the association of socioeconomic and cultural variables with suicide. The mean suicide rate was 4.8/100,000. Three clusters were identified which are as follows: one of increased risk in downtown and two of decreased risk in the South and in the Southeast. The mean suicide rate of the high-risk clustered districts (7.99/100,000) presented significantly higher average incomes per household, higher proportion of formally educated, of no religious affiliation, of recent migrants, of all-times migrants and lower proportion of married. The multiple model selected two independent risk factors - people with no religious affiliation (β = 0.182) and of recent migrants (β = 0.278) - and two protective factors - the proportion of married (β = -0.185) and of total migrants (β = -0.075), which jointly explained 58.4% of the variance. Durkheimian social and cultural risk factors for suicide were confirmed. Compared to a previous study period (1996-2005), suicide rates and geographical clusters remained relatively stable in the subsequent decade (2006-2015).

The werther effect revisited: Do suicides in books predict actual suicides?

While most extant studies have suggested that the Werther effect can be found via news and electronic media, whether books would have a similarly independent role on suicide suggestion remains unknown. Based on the Google Books N-gram corpus, we constructed the first macro-level index of suicides via books (ISB) and examined the potential association between ISB and actual completed suicides in the United States between 1950 and 2000. To rule out the possible influence of alternative mass media, we construct relevant measures by using the New York Times corpus and the Internet Movie Database (IMDb). The results from Granger causality test reveals that suicides in nonfiction rather than fiction books significantly predict actual suicide rates during the second half of the twentieth century, extensively controlling for suicides in other media as well as context factors. With such novel application of massive content analysis using data of unprecedented size, we contribute to the extant literature not only by adding to our understandings of the important role of media in shaping the process of suicide contagion but also the dynamics of suicidal behavior and the relevant cultural trends that may not be adequately measured with traditional social science methods.

A Content Analysis and Comparison of Two Peaks of Newspaper Reporting During a Suicide Cluster to Examine Implications for Imitation, Suggestion, and Prevention.

Background: During 2007-2008, media attention focused on a cluster of youth suicides in the UK. There were two peaks (P1, P2) in the volume of newspaper reporting of the deaths. The number of possible suicides was greater than expected at the time of the first peak but not at the time of the second. Aims: To explore any differences in the content of the reporting peaks and to consider implications for imitation and prevention. Method: A content analysis of two peaks of newspaper reporting was conducted. Results: There were 204 articles in P1 (December 27, 2007 to February 19, 2008) and 157 in P2 (February 20, 2008 to March 15, 2008). Four main themes were identified: individual stories; possible causes; features of reporting of the cluster; and educating and informing the public. P1 articles more frequently contained: explicit details of method; photographs of the deceased, and contained more characterization of individuals. Limitations: The focus was on print media, future studies should incorporate online and social media content. Conclusion: The findings provide some support for the hypothesis of a process of suggestion initiated by sensationalist reporting in P1. This contributes to the evidence base of the role of the press in suicide imitation and prevention, highlighting the importance of care when reporting suicides.

The effects of interventions preventing self-harm and suicide in children and adolescents: an overview of systematic reviews.

Background:Self-harm and suicide in children and adolescents are of serious consequence and increase during the adolescent years. Consequently, there is need for interventions that prevent such behaviour. The objective of this paper: to evaluate the effects of interventions preventing self-harm and suicide in children and adolescents in an overview of systematic reviews. Methods:We conducted an overview of systematic reviews (OoO). We included reviews evaluating any preventive or therapeutic intervention. The methodological quality of the included reviews was assessed independently, and data was extracted by two reviewers. We report the review findings descriptively. The certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results:Moderate certainty evidence suggests that school-based interventions prevent suicidal ideation and attempts short term, and possibly suicide attempts long term. The effects of community-based interventions following suicide clusters and local suicide plans are unknown, as are the benefits and harms of screening young people for suicide risk. The effects of most interventions targeting children and adolescents with known self-harm are unknown. However, low certainty evidence suggests that dialectical behavioural therapy and developmental group therapy are equally as effective on repetition of self-harm as enhanced treatment as usual. Conclusions:Research on several recommended practices, such as local suicide plans, prevention of suicide clusters and approaches to risk assessment, is lacking. When such interventions are implemented, the effects should be closely evaluated. There is also need for more research on treatment of repeated self-harm. Further research should include long term follow-up, and investigate possible adverse effects. In prevention of self-harm and suicide in children and adolescents, policy makers and health providers should consider evidence from population-based studies with mixed-age samples, adult samples, and studies on conditions associated with self-harm and/or suicidality, such as depression and psychosis. PROSPERO registration: CRD4201911794208/02/19.

Investigating Google's suicide-prevention efforts in celebrity suicides using agent-based testing: A cross-national study in four European countries.

Google can act as a "gatekeeper" for individuals who seek suicide-related information online (e.g., "how to kill oneself"). The search engine displays a "suicide-prevention result" (SPR) at the very top of some suicide-related search results. This SPR comes as an info box and contains supposedly helpful crisis help information such as references to a telephone counseling service. It remains unknown, however, how Google has implemented the SPR in the especially dangerous context of celebrity suicide for which imitational copycat suicides in vulnerable individuals are most likely. Relying on agent-based testing, a computational social science method, we emulated a total of 137,937 Google searches in April 2019, using both general suicide-related and specific celebrity suicide-related search terms. Given the recently discovered language-based differences in SPR display rates, we held the language constant and focused on German-speaking populations in four European countries. The SPR was never shown in searches for celebrities who died by suicide in all four countries. Furthermore, analyses indicated a digital divide in access to suicide-prevention information with moderately high SPR display rates in Germany and Switzerland, yet with no display in Austria and Belgium. Higher SPR display rates could support global suicide-prevention efforts at virtually no cost by providing preventive information to vulnerable users precisely at the moment when it is apparently needed.

Sjølvmord, smitte og 13 Reasons Why

I 2017 skjedde det uvanleg mange sjølvmord og sjølvmordsforsøk både i Trondheim og i Lillehammer. Trondheim kommune set sjølvmordsåtferda i samanheng med tv-serien 13 Reasons Why. Sjølvmord er eit tema som vekker sterke kjensler, og mange er bekymra for å gjere noko som fører til potensiell smitte. Denne artikkelen er ei usystematisk litteraturgjennomgang som belyser tema smitte, og eg forsøkjer å svare på spørsmålet «Er det noko med tv-serien 13 Reasons Why som potensielt kan fremme sjølvmordståferd hos ungdom?» i lys av forskingslitteraturen. Artikkelen viser òg til verktøy ein kan nytte for å førebyggje smitte og følgje opp ungdom ein er bekymra for.

Suicide postvention practices in schools: School psychologists' experiences, training, and knowledge.

Suicide is a leading cause of death of school-aged youth, with adolescent and young adult populations considered to be most at risk for suicide clusters and contagion effects. Suicide clusters have been documented in school districts across the United States, though the degree to which schools are prepared to provide postvention services in the wake of a suicide is presently unclear. The current study sought to ascertain school psychologists' training, experiences and access to school district protocols in general postvention, and specifically in suicide contagion effect prevention. Perceptions of suicide postvention knowledge and self-efficacy from 111 school psychologists in the state of North Carolina were assessed using the Perceived Postvention Competency Survey. Descriptive and multivariate analyses were conducted to identify associations between school psychologist characteristics and perceived competency. More than half of respondents reported limited knowledge, preparedness, and confidence in suicide postvention, and even lower degrees of competency in preventing suicide contagion effects. Formal training in postvention and years worked were significantly associated with both perceived knowledge and self-efficacy. Recommendations to enhance school psychologists' postvention competence are offered, and directions for future research to expand upon this preliminary work are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Mass media – risk and protective factor against suicidal behaviour in the COVID-19 pandemic

Suicide prevention is an ongoing concern of public health policies, and a pressing requirement both in regular times, and especially during exceptional social contexts. Suicide prevention becomes a challenge and requires a special focus during the management of the COVID-19 pandemic. In the context of overall uncertainty and insecurity, preserving mental health and implementing suicide prevention strategies are valid and confirmed concerns. The role of media in triggering or precipitating suicide risk has been repeatedly outlined. The current article succinctly reviews the protective role of media and the risk factors for suicide which mass media can influence, to the benefit or detriment of persons at risk for suicide. Starting from the most widely known cases of suicide contagion in fiction or printed press, from Goethe to the Vienna case, this article outlines landmarks for mental health promotion and suicide prevention, myths concerning suicide, and the recommendations of World Health Organization for media reporting of suicide. Fact checking, abandoning sensationalistic and dramatic styles of reporting, providing contact information for available help and accurate information for readers are some of the listed recommendations. The current article emphasizes the preventive role of a responsible approach to information and accurate reporting in the media, especially in the context of the COVID-19 pandemic.

Tragedy Following Tragedies: Estimating the Copycat Effect of Media-Covered Suicide in the Age of Digital News

The Werther effect is the name given to the observed relationship between celebrity suicide and the national suicide rate. Media-covered suicides are often followed by a positive shock in the national suicide rate. Using a unique time series comprising media coverage variables collected from Google News and major news websites, combined with several U.S. national trends from various sources, we estimate the magnitude of the Werther effect in the age of digital news media, where news of celebrity suicide spreads farther and more rapidly. We find a speeding up of this effect, which in the last century was only observed in the month following news coverage. Now, the effect appears slightly more prominent in the month of coverage, though it still persists in the following month. We also find evidence that the Werther effect has diminished in magnitude, perhaps due to the increased normalization of both suicide and celebrity suicide. JEL Classifications: Z13, Z19, I19

Anomie or imitation? The Werther effect of celebrity suicides on suicide rates in 34 OECD countries, 1960–2014

Anomie and imitation have been prominent mechanisms explaining the Werther effect, i.e., the effect of celebrity suicides on a general population's suicide rate. This study presents a new approach to empirically disentangle both mechanisms. Imitation theory suggests that celebrities act as role models, and that the Werther effect is triggered by the status of the celebrity in question. Anomie theory, on the other hand, suggests that the Werther effect is triggered by the unexpectedness of the event. To this end, we empirically compare the effects of celebrity suicides with the effects of celebrities who died unexpectedly from causes other than suicide (accidents, illnesses, alcohol abuse). Based on language and page-link data from 3855 Wikipedia pages of the 495 celebrities who died from suicide between 1960 and 2014, we measure the status a celebrity has in a particular country and calculate the potential country-specific imitation effect of their suicide. In the same manner, we measure the status of celebrities who died unexpectedly from accidents, illnesses, or alcohol abuse to reflect anomie-related effects. We use these measures in an ecological study based on a time-series cross-sectional dataset for 34 OECD countries to assess their effects on a country's overall annual suicide rate. Fixed-effects analyses reveal that the country-specific status of celebrity suicides is associated with significant increases in overall suicide rates, while anomie-related, unexpected celebrity deaths are not associated with the overall suicide rates. The findings remain robust across a number of alternative specifications, such as controlling for further anomic factors at the macro level (divorce or unemployment rate, for instance). We conclude that the results support the imitation mechanism as an essential social explanation for the Werther effect.

“None of You Cared Enough”: The Problematic Moralizing of 13Reasons Why

ABSTRACT13 Reasons Why, a television series adapted from the 2007 novelThirteen Reasons Whyby Jay Asher, quickly evolved into a cultural phenomenon following its premiere in 2017. The plot of13 Reasons Whyconcerns the aftermath and fallout of a high school girl's suicide, and was intended by producers to deconstruct social stigmas attached to the act and examine motivations for suicide. While the series has initiated an ongoing dialogue about suicide,13 Reasons Whyhas also generated significant controversy regarding its portrayal, and the ultimate influence of the series has been called into question by professional organizations, who argue that13 Reasons Whycould possibly inspire copycat suicides. Suicide prevention advocacy groups have similar concerns that at‐risk youth who view the series may instead be motivated, instead of deterred, to commit suicide. By applying rhetorical criticism to select episodes of13 Reasons Whyand employing audience reception and social learning theory for its framework, this research essay utilizes13 Reasons Whyas a vessel to examine the greater influence of media texts on audiences and whether they can be held wholly accountable for provoking subsequent audience behaviors.