World Health Organization Suicide Research Articles

Assessing the quality of suicide reporting in Portugal: 6 case studies of celebrities and non-celebrities over 25 years

Multiple studies from various countries have found evidence of suicide increases after media reports of suicide, which are known as the Werther effect, but responsible suicide reporting can contribute to suicide prevention, a phenomenon known as the Papageno effect. This study aims to assess adherence by the Portuguese media to the suicide reporting guidelines released by the World Health Organization (WHO) and to determine whether there are differences in reporting style between them and over time. News items about six suicides of public and non-public figures between 1996 and 2020 were collected from several Portuguese media—two newspapers, three radio stations, three television channels, and a few websites—in the periods following those deaths, and they were subsequently examined for adherence to the WHO guidelines. A total of 374 news items were analyzed. The majority of them complied with most of the WHO recommendations for suicide reporting, especially the ‘don’t do’ guidelines. However, most of the news items that were analyzed did not follow the recommendations regarding putatively preventive information, notably the inclusion of support contacts and citation of mental health experts. The Portuguese media mostly adhered to the WHO suicide reporting guidelines and there was a positive evolution over time in the level of compliance with them. Nevertheless, there is room for improvement.

Prevention of the Werther effect: compliance of the Italian newspapers to the ‘reporting on suicide’ recommendations

ObjectivesSuicide media coverage could lead to imitation, the so-called ‘Werther effect’. The World Health Organization (WHO) published specific recommendations for reporting suicide news. This study aimed to quantify the compliance of Italian newspapers with the WHO suicide reporting guidelines. Study designThis was a quantitative content analysis study. MethodsAll articles published by the three main Italian newspapers from June 2019 to May 2020 describing suicides or attempted suicides were included. The articles were analyzed using a checklist based on the WHO recommendations, which included 18 ‘negative’ items (e.g. ‘presence of the word ‘suicide’ in the title’) and nine ‘positive’ items (e.g. ‘the article reports the contacts of a suicide prevention hotline’). Each negative item was scored −1, and each positive item was scored +1. Multivariate linear regressions were performed to identify factors associated with lower adherence to WHO recommendations and higher social media engagement with the articles. ResultsA total of 3483 articles were screened, and 110 articles were included in the final analysis. The suicidal was male in 73.6% of cases. The median checklist score was −6 (interquartile range 3). Five percent of the articles had at least one positive item. The word ‘suicide’ was found in 90% of the titles. Female suicides were associated with a higher checklist score (coefficient 0.81, P = 0.039). No correlation was found between the checklist score and the social media engagement of the articles. ConclusionsItalian newspapers do not adhere completely to the WHO recommendations on reporting suicide, leading to a potential imitation effect. Public health professionals should make decision-makers and journalists aware of the importance of these recommendations.

Nigerian newspapers coverage of suicide: Assessment of adherence to WHO suicide reporting guidelines.

Despite an increase in research evidence on media compliance with suicide reporting guidelines globally, evidence from Nigeria seems to be relatively limited. This study assessed the prevalence of World Health Organization (WHO) helpful/harmful suicide reporting cues in suicide stories reported by Nigerian newspapers in 2021. The setting is the entire Nigeria and the design is descriptive. Quantitative content analysis method was adopted and 205 online suicide-related stories from news portals of 10 purposefully selected newspapers were analyzed. The newspapers selected were among the top 20 in Nigeria and had higher circulation/coverage and considerable online presence. Evaluation framework was designed following moderated WHO guidelines. Descriptive statistics (frequencies and percentages) were used for the analysis. The study suggested high prevalence of harmful reporting and near absence of helpful suicide reporting cues among Nigerian newspapers. Majority of the stories, 95.6% mentioned suicide in the headline; 79.5% provided details on the suicide methods employed; 66.3% offered mono-causal explanation to suicide; and 59% featured images of suicide victims and/or suicide-related graphics. Helpful reporting cues were almost nonexistence as only less than 4% of the stories traced warning signs, reported mental health experts/professionals' opinions, featured research findings/population level statistics, and provided details on the identity/contact of suicide prevention programs/support services. Prevalence of harmful suicide-reporting practice among Nigerian Newspaper presented a gloomy future for suicide prevention in the country. There be training and motivation programs for health/crime reporters/editors on responsive media coverage of suicide following (a domesticated) WHO guidelines.

Newspaper reporting of suicide in Nepal: Quality assessment against World Health Organization media guidelines.

BackgroundSensible media reporting of suicide is a population‐based suicide prevention strategy. However, the quality of media reporting of suicide has not been assessed in Nepal.ObjectivesWe aimed to assess the newspaper reporting status of suicide in Nepal with reference to World Health Organization (WHO) media guidelines for suicide reporting.MethodWe retrospectively searched eight major newspapers in Nepal between January 2020 and May 2021 and assessed 167 news reports against WHO suicide reporting guidelines.ResultsPotentially harmful characteristics were found to be reported in both the title and main text of the reports. About half of them mentioned sex (48.5%) and 38.3% mentioned the location of suicide in the title. Of the 167 reports, 74.3%, 95.2%, 34.7%, 92.2%, 98.8%, and 52.7% mentioned the name, sex, occupation, method of suicide, the location of suicide, and life events, respectively, in their main content. On the other hand, only 6% and 2.4% of reports mentioned linkage of suicides with mental illness and substance abuse, respectively. While lesser than 1% of reports narrated educative information regarding suicide prevention, none mentioned contact information for help‐seeking for the vulnerable.ConclusionNewspaper reporting of suicide in Nepal poorly adheres to WHO guidelines, substantiated by the high presence of potentially harmful characteristics and negligible presence of potentially helpful characteristics.

Information and Communication Technology Use in Suicide Prevention: Scoping Review.

BackgroundThe use of information and communication technology (ICT) in suicide prevention has progressed rapidly over the past decade. ICT plays a major role in suicide prevention, but research on best and promising practices has been slow.ObjectiveThis paper aims to explore the existing literature on ICT use in suicide prevention to answer the following question: what are the best and most promising ICT practices for suicide prevention?MethodsA scoping search was conducted using the following databases: PubMed, PsycINFO, Sociological s, and IEEE Xplore. These databases were searched for articles published between January 1, 2013, and December 31, 2018. The five stages of the scoping review process were as follows: identifying research questions; targeting relevant studies; selecting studies; charting data; and collating, summarizing, and reporting the results. The World Health Organization suicide prevention model was used according to the continuum of universal, selective, and indicated prevention.ResultsOf the 3848 studies identified, 115 (2.99%) were selected. Of these, 10 regarded the use of ICT in universal suicide prevention, 53 referred to the use of ICT in selective suicide prevention, and 52 dealt with the use of ICT in indicated suicide prevention.ConclusionsThe use of ICT plays a major role in suicide prevention, and many promising programs were identified through this scoping review. However, large-scale evaluation studies are needed to further examine the effectiveness of these programs and strategies. In addition, safety and ethics protocols for ICT-based interventions are recommended.

Changing trends in quality of media reporting of suicide in the community following a celebrity suicide in India.

Little is known about changes in quality of media reporting of suicide in the community following a celebrity suicide. Our objective was to compare trends in quality of media reporting of suicide, before and after the suicide of an Indian entertainment celebrity, against the World Health Organization suicide reporting guidelines. Online news portals of English and local language newspapers, as well as television channels, were searched to identify relevant suicide-related news articles. Comparison of reporting characteristics before and after the celebrity suicide was performed using chi-square test or Fisher's exact test. A total of 3867 eligible news reports were retrieved. There was a significant increase in harmful reporting characteristics, such as reporting the name, age and gender of the deceased (p < 0.001 for all comparisons), mentioning the location (p < 0.001) and reason for suicide (p = 0.04) and including photos of the deceased (p = 0.002) following the celebrity suicide. Helpful reporting practices were less affected; there was a significant rise in inclusion of expert opinion (p = 0.04) and mention of suicide-related warning signs (p = 0.02). Following a celebrity suicide, significant changes in the quality of media reporting of suicide were noted with an increase in several potentially harmful reporting characteristics.

Relationship and Effects of Community Problems on Anxiety and Suicide: A Case-Control Psychological Autopsy Study.

This study aimed to explore the relationship and the effects of community problems on anxiety and suicide. Data were from a case-control psychological autopsy study (392 suicides and 416 community living controls) carried out in 16 rural counties from three provinces in China. The World Health Organization Suicide Prevention-Multisite Intervention Study on Suicidal behaviors scale of community stress and problems and Spielberger State-Trait Anxiety Inventory were used to measure the community problems and trait anxiety. Spearman's correlation and multivariable regression methods were used to probe the effect of community problems on anxiety and suicide. There were 12 and 6 community problems correlated with anxiety (rs = 0.169, p < 0.001) and suicide (rs = 0.081, p = 0.022), respectively. Medical care, alcohol abuse, superstition, and job security were important community problems for anxiety and suicide. Community problems had stronger correlation with anxiety than suicide. It might be an effective method to reduce anxiety and suicide risk by solving different community problems.

Indonesian online newspaper reporting of suicidal behavior: Compliance with World Health Organization media guidelines.

Despite the lack of attention, suicide is a major public and mental health problem in Indonesia. Research on how Indonesian newspapers portray suicide case has been lacking. To assess the quality of Indonesian online newspaper reporting suicide news and its compliance with the World Health Organization (WHO) mass media reporting guidelines. The content of suicide news reported in online newspapers was searched and scrutinized against the WHO suicide reporting guidelines. Within the duration of 6 months, there were 548 suicide news reported. This consisted of 16.8% attempted suicide and 83.2% completed suicide. Approximately 90.3% reported age, 97.3% reported gender and 64.3% reported the marital status of the victims. Furthermore, 68% reported the methods of suicide in headline or title, 40.5% shown the picture of the victims and 56.6% shown illustration only, and 67.2% reported life event related to suicide act. The vast majority of online newspapers in Indonesia exaggerate suicide news. They rarely inform the readers that there is hope and help available. The majority also do not conform to the WHO media guidelines.

A433 - Meta-analysis of Suicide and Self-harm following Bariatric Surgery

Background: Bariatric surgery dramatically improves quality of life in several domains. However, several researchers have reported an increased risk for suicide and self-harm following surgery. Others have failed to find an increased risk, and reasons for the disparity are not obvious. This meta-analysis examined the association between bariatric surgery and suicide or self-harm. It also explored possible moderators of this association. Twenty-eight studies of persons who had undergone bariatric surgery were identified. Two independent researchers coded studies by outcome measure (e.g., completed suicide, attempted suicide, psychiatric hospitalization, suicide-related questionnaires), and potential moderators (i.e., patient, procedure, and study characteristics). Odds ratios (ORs) for studies without a comparison group were extrapolated using World Health Organization suicide rates for the country and year of the study. ORs for studies with a prospective design used pre-surgical values as comparisons. Mean OR for all studies and outcomes suggests that bariatric surgery patients had an approximately 75% increased risk of suicide or self-harm than those who did not have this surgery [OR = 1.76 (95% CI: 1.69, 1.83)], p<0.001 using a fixed-effects model. Moderator analyses did not yield any significant predictors of study-level odds ratios; however, the length of time since surgery and suicide approached significance (p=0.06), indicating greatest risk for suicide or self-harm in the first years after the procedure. This meta-analysis does not address the issue of a nonequivalent surgical group (i.e., persons at greater risk for suicide/self-harm are more likely to seek or obtain bariatric surgery) and analyses for publication bias were inconclusive.

Quality of online news reporting of suicidal behavior in Bangladesh against World Health Organization guidelines.

Suicide is a major, however under attended public health problem in Bangladesh. There is dearth of research regarding how newspapers communicate it to the mass population. We assessed the quality of online newspapers reporting of suicidal behaviors in Bangladesh against World Health Organization suicide reporting guidelines. We searched and scrutinized published contents of 8 Bangla online news portals against the World Health Organization suicide reporting guidelines retrospectively. About 85% of the reports were connected to suicide, 93% reported single suicide, single person was involved in 82.50% of reports, and associated homicide was found in 7.50% of reports. About 96% of reports mentioned the name of the victims, 97% mentioned occupation, 96% mentioned method of suicide, 69% mentioned life events, and 64% reported certain mono-causality. Suicide in headline was found in about 94% of reports, 19% mentioned method in headline and 32% reported life events in headline. About 14% reports posted images of victims and no article provided any potentially helpful reporting practices. Media reports of suicidal behavior in Bangladesh in online portal were found to be poor quality when assessed against WHO suicide reporting guidelines. Details of victims, methods, life events and mono-causal explanations were being mentioned regularly. Substantial lacking has been noticed in approaches of educating the population and introducing preventive measures in the reports.

Assessing the quality of media reporting of suicide news in India against World Health Organization guidelines: A content analysis study of nine major newspapers in Tamil Nadu.

Suicide rates in India are among the highest in the world, resulting in an estimated 250,000 suicide deaths annually. How the media communicates with the Indian public on the topic of suicide has thus far gone without sufficient scrutiny. The objective of our study was to assess the quality of newspaper reporting of suicide-related news in India against World Health Organization suicide reporting guidelines. We used content analysis to assess the quality of suicide reporting against World Health Organization guidelines in nine of the most highly read daily newspapers in the southern state of Tamil Nadu between June and December 2016. Five of the nine newspapers under review were in the top 20 most circulated daily newspapers in the country. A total of 1681 suicide articles were retrieved. The mean number of suicide articles per day per newspaper was 0.9%, and 54.5% of articles were 10 sentences or less. The vast majority (95.9%) of articles primarily focused on reporting specific suicide incidents. Harmful reporting practices were very common (e.g. a detailed suicide method was reported in 43.3% of articles), while helpful reporting practices were rare (e.g. just 2.5% gave contact details for a suicide support service). We observed that a daily diet of short and explicit suicide-related news was served up to readers of newspapers. Attempts should be made to understand the perspectives of media professionals in relation to suicide reporting, and to devise strategies to boost the positive contribution that media can make to suicide prevention.

Testing Brief Intervention and Phone Contact among Subjects with Suicidal Behavior: A Randomized Controlled Trial in French Polynesia in the Frames of the World Health Organization/Suicide Trends in At-Risk Territories Study.

The World Health Organization Suicide trends in at-risk territories study is a multi-site regional research program operating first in French Polynesia and countries of the Western Pacific, then extended to the world. The aims of the study were to establish a monitoring system for suicidal behaviors and to conduct a randomised control trial intervention for non-fatal suicidal behaviors. The latter part is the purpose of the present article. Over the period 2008-2010, 515 patients were admitted at the Emergency Department of the Centre Hospitalier de Polynésie Française for suicidal behavior. Those then hospitalized in the Psychiatry Emergency Unit were asked to be involved in the study and randomly allocated to either Treatment As Usual (TAU) or TAU plus Brief Intervention and Contact (BIC), which provides a psycho-education session and a follow-up of 9 phone contacts over an 18-months period. One hundred persons were assigned to TAU, while 100 participants were allocated to the BIC group. At the end of the follow-up there were no significant differences between the two groups in terms of number of presentations to the hospital for repeated suicidal behaviors. Although the study could not demonstrate the superiority of a treatment over the other, nevertheless – given its importance – the investigation captured public attention and was able to contribute to the awareness of the need of suicide prevention in French Polynesia. The BIC model of intervention seemed to particularly suit the geographical and health care context of the country.

Testing brief intervention and phone contact among subjects with suicidal behavior: a randomized controlled trial in French Polynesia in the frames of the World Health Organization/Suicide Trends in At-Risk Territories study

The World Health Organization Suicide trends in at-risk territories study is a multi-site regional research program operating first in French Polynesia and countries of the Western Pacific, then extended to the world. The aims of the study were to establish a monitoring system for suicidal behaviors and to conduct a randomised control trial intervention for non-fatal suicidal behaviors. The latter part is the purpose of the present article. Over the period 2008-2010, 515 patients were admitted at the Emergency Department of the Centre Hospitalier de Polynésie Française for suicidal behavior. Those then hospitalized in the Psychiatry Emergency Unit were asked to be involved in the study and randomly allocated to either Treatment As Usual (TAU) or TAU plus Brief Intervention and Contact (BIC), which provides a psycho-education session and a follow-up of 9 phone contacts over an 18-months period. One hundred persons were assigned to TAU, while 100 participants were allocated to the BIC group. At the end of the follow-up there were no significant differences between the two groups in terms of number of presentations to the hospital for repeated suicidal behaviors. Although the study could not demonstrate the superiority of a treatment over the other, nevertheless – given its importance – the investigation captured public attention and was able to contribute to the awareness of the need of suicide prevention in French Polynesia. The BIC model of intervention seemed to particularly suit the geographical and health care context of the country.

To what extent does the reporting behavior of the media regarding a celebrity suicide influence subsequent suicides in South Korea?

This study investigated the nature of media coverage of a national entertainer's suicide and its impact on subsequent suicides. After the celebrity suicide, the number of suicide-related articles reported surged around 80 times in the week after the suicide compared with the week prior. Many articles (37.1%) violated several critical items on the World Health Organization suicide reporting guidelines, like containing a detailed suicide method. Most gender and age subgroups were at significantly higher risk of suicide during the 4 weeks after the celebrity suicide. Results imply that massive and noncompliant media coverage of a celebrity suicide can cause a large-scale copycat effect.

Trend of attempted suicide and its related factors in Bojnurd city 2006 -2011

Background & Objective: Suicide as a major health problem is a priority in health system, caused by different risk factors that differ in each society. Base on definition of world health organization suicide is a conscious act that the person try to end his/her life with lethal action. Since suicide is the most important psychological emergency, this study aimed to assess the suicide trend and its related factor in Bojnurd. Material & Methods: study population consisted of all attempted suicide who admitted to the Emam reza hospital (2748-person) from 2006 until 2011. We used data from the hospital records and a check list was filled for each case. Descriptive statistics and chi square test were calculated using SPSS version 16. Results: mean age of the study population was 23.44 ± 8.66. Suicide rate were 67.1 and 38.3 percent in women and men respectively. Most suicide was done by pills (87.5%) and after that by poison (7.4%). Most suicide was occurred in unemployed people (50.4%) and fewer rates were observed in civil servants (2%). In regard to season, the lowest has occurred in spring and the highest in autumn. Sex, marital status, and education were significantly correlated with suicide (P-value<0.05). Conclusion: since the suicide was high among youth and women the precise training program should be designed for families by health policy makers to solve the problem of this group of people

Global Suicide Mortality Rates – A Light at the End of the Tunnel?

n 1999, as part of the efforts to raise awareness about the magnitude and importance of suicide mortality, the World Health Organization (WHO) posted two graphs on its website. One showed the evolution of the global suicide mortality, 1950-1995, according to sex, and the other showed a projection about how those rates could evolve should no effective action be taken (Figure 1). Those two graphs became a constant reference in presentations and conferences around the world as well as a frequent quote in papers and books (Wasserman & Wasserman, 2009). They were also instrumental in leading the WHO's high management to adopt suicide prevention as one of its priorities, which in turn led to the establishment of SUPRE, the WHO Suicide Prevention Program (Fleischmann et al., 2008). Now, more than a decade after those graphs were popularized, it may be of interest to have another look at the evolution of suicide mortality and try to hypothesize factors behind possible changes. In doing so, we followed exactly the same methodology used by the WHO in the original calculations. A global reduction in suicide mortality rates seems apparent for the last 20 years. With the exception of the very young females, the reductions observed are consistent across sex and age group. Although these findings are exciting, we should not forget that, when we consider natural population growth, the reduction of the absolute number of deaths from suicide might not be as impressive as that of rates. This calls for renewed efforts to further reduce suicide mortality, particularly in the age groups where results have been less marked (the youngest) and in age groups whose population is increasing (middle-aged and older).

Role of social welfare in European suicide prevention

Yur'yev A, Värnik A, Värnik P, Sisask M, Leppik L. Role of social welfare in European suicide preventionThe aims of this study were to assess the relationship between suicide mortality and social expenditure in 26 European countries, explore attitudes towards welfare systems and their relationship with suicide mortality, and compare attitudes towards welfare provision in Eastern and Western Europe. The World Health Organization suicide data and Organisation for Economic Co‐operation and Development social expenditure data for 1980–2005 were used. Data on attitudes towards welfare systems were taken from the European Social Survey. Differences between mean scores for attitudes in Western and Eastern European countries were calculated. Correlations between social expenditure and suicide trends were negative in most countries for both genders. Inverse correlations between attitudes towards welfare provision and suicide mortality rates were demonstrated for males only. Differences in attitudes were found between Eastern and Western European countries; for example, confidence in the welfare system was found to be stronger in Western Europe. Higher social expenditure and greater confidence in welfare provision appear to have suicide‐preventive effects.

A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson's disease

Subthalamic nucleus deep brain stimulation improves motor symptoms and quality of life in advanced Parkinson's disease. As after other life-altering surgeries, suicides have been reported following deep brain stimulation for movement disorders. We sought to determine the suicide rate following subthalamic nucleus deep brain stimulation for Parkinson's disease by conducting an international multicentre retrospective survey of movement disorder and surgical centres. We further sought to determine factors associated with suicide attempts through a nested case-control study. In the survey of suicide rate, 55/75 centres participated. The completed suicide percentage was 0.45% (24/5311) and attempted suicide percentage was 0.90% (48/5311). Observed suicide rates in the first postoperative year (263/100,000/year) (0.26%) were higher than the lowest and the highest expected age-, gender- and country-adjusted World Health Organization suicide rates (Standardized Mortality Ratio for suicide: SMR 12.63-15.64; P < 0.001) and remained elevated at the fourth postoperative year (38/100,000/year) (0.04%) (SMR 1.81-2.31; P < 0.05). The excess number of deaths was 13 for the first postoperative year and one for the fourth postoperative year. In the case-control study of associated factors, 10 centres participated. Twenty-seven attempted suicides and nine completed suicides were compared with 70 controls. Postoperative depression (P < 0.001), being single (P = 0.007) and a previous history of impulse control disorders or compulsive medication use (P = 0.005) were independent associated factors accounting for 51% of the variance for attempted suicide risk. Attempted suicides were also associated (P < 0.05) with being younger, younger Parkinson's disease onset and a previous suicide attempt. Completed suicides were associated with postoperative depression (P < 0.001). Postoperative depression remained a significant factor associated with attempted and completed suicides after correction for multiple comparisons using the stringent Bonferroni correction. Mortality in the first year following subthalamic nucleus deep brain stimulation has been reported at 0.4%. Suicide is thus one of the most important potentially preventable risks for mortality following subthalamic nucleus deep brain stimulation for Parkinson's disease. Postoperative depression should be carefully assessed and treated. A multidisciplinary assessment and follow-up is recommended.