Stories of resilience may be linked to lower suicide rates. Will media organizations listen?

“We’re asking [media organizations] to not talk about the emotional appeal of the story, which is what good journalism often does.”

The first time Thomas Niederkrotenthaler heard of the rapper Logic, his ears perked up. It was 2020, three years after Logic had released a song titled “1-800-273-8255” — the phone number of the National Suicide Prevention Lifeline — which depicts a person who comes to the brink of suicide but ultimately gets help and survives. The song had hit its peak and faded from Billboard and streaming charts, but, for Niederkrotenthaler, it was a rare find: a survival story about suicide that garnered as much public attention as stories about celebrity deaths by suicide.

Niederkrotenthaler is a mental health and suicide prevention researcher at the Medical University of Vienna in Austria who has spent decades studying the media’s effects on suicide rates. In a study published late last year in the British Medical Journal, Niederkrotenthaler’s team chose three major publicity events surrounding Logic’s song — its release and live performances at the 2017 MTV Video Music Awards and the 2018 Grammy Awards — then tracked U.S. suicide rates, daily calls to the National Suicide Prevention Lifeline, and social media posts over 34 days when these events had strong public attention.

They found that the song was not only linked to a sharp increase in calls — a phenomenon anecdotally reported by other crisis hotline centers after the song and corresponding video’s releases — but was also associated with a 5.5% decrease in national suicide rates. That translated to about 245 fewer suicide cases compared to previous years, Niederkrotenthaler says, and while this was an observational study and could not establish causation, it offers further evidence that narratives about deaths by suicide and surviving suicidal thoughts have real-world effects.

“In any community, in any family, in any setting, you have stories of hope and recovery, but you don’t have them so much in the media,” Niederkrotenthaler says. “That’s a real problem, and I think it gets down to the question of what is considered newsworthy.”

For media producers who are covering stories about suicide or suicidal ideation, a wealth of scientific literature shows that language and framing of these narratives have serious impacts. More than 100 studies confirm a phenomenon researchers call the Werther effect — upticks in real-world suicide rates that happen in the wake of widespread coverage of high-profile deaths by suicide. In the months following Robin Williams’ death, for instance, Columbia University researchers documented a nearly 10% increase in national suicide rates, with the largest spike among men ages 30 to 44. Similar trends followed the deaths of Kate Spade and Anthony Bourdain as well as politicians and entertainers across the globe, with larger increases among similar age and gender demographics as the celebrity and in cases using the same suicide method.

But a growing body of research suggests that the opposite might also be true: Stories of survival can have positive contagion effects and potentially reduce real-world suicide risk. Called the Papageno effect — a reference to the protagonist in Mozart’s “The Magic Flute” who considers suicide but ultimately takes another path — the protective aspects of survival stories further underscore how crucial it is for media producers to approach stories involving suicide carefully, says Niederkrotenthaler, who coined the term “Papageno effect” in 2010.

“There is actually very strong evidence that suicidal thoughts and feelings are very prevalent in the U.S. population, but also in European populations,” he says, adding that these ideations are much more common than suicide attempts. “That is recovery and hope and resilience, and it’s everywhere. It’s really important for media to pick up those stories and to feature them.”

Several suicide prevention and public health groups, including the World Health Organization, offer guidelines for covering suicide. Reportingonsuicide.org, a website operated by the nonprofit Suicide Awareness Voices of Education (SAVE), publishes the U.S. Best Practices for Media Reporting on Suicide, which includes things like framing suicide as a public health issue, avoiding publishing images of grieving family members or language that ties suicide to heroism, and including information on how readers can get help themselves. (The full list is available here.)

Dan Reidenberg, executive director of SAVE and a media trainer who runs workshops for journalists, says that individual reporters sometimes follow these best practices, but they aren’t widely implemented across publications. Since publishing the recommendations in 2011, “there’s been some change in language, for example, not using the word ‘committed’ suicide in stories, but not significantly,” he says. (A quick search through The New York Times and The Washington Post showed that both have run multiple stories since 2018 that included headlines with that phrase.) “We still see a lot of [journalists] including the method or the location of death. We see a lot of sensationalism in the stories and the narratives.”

Studies from around the world confirm that media guidelines for reporting on suicide often aren’t followed. That’s partially because guidelines in some ways contradict what journalists are trained to do, say Vicki Harrison and Song Kim, leaders of the Media and Mental Health Initiative, a program within Stanford University’s Department of Psychiatry and Behavioral Sciences that’s aimed at improving the media’s impact on overall mental health.

“We’re asking them to not talk about the emotional appeal of the story, which is what good journalism often does,” Harrison explains. When it comes to reporting on a suicide, details like descriptions of the scene of the event or speculation about the cause of suicide can be dangerous. “It really takes a journalist going against those instincts in order to follow the guidelines,” she says. Harrison and Song point to specific stories in The Washington Post and New York Daily News about former Miss USA and television host Cheslie Kryst’s death as examples of pieces that depict death by suicide with complexity and that increase awareness and stigma-reducing conversations around mental health and suicide.

But media organizations often don’t provide any training on how to do that, leaving it up to individual journalists to create systems for scoping their stories appropriately, and for navigating interviews and fact-checking calls without re-traumatizing sources.

Rory Linnane, an education reporter at the Milwaukee Journal Sentinel, has covered youth mental health issues since 2016, including extensive reporting on teen suicide cases. Over the years, she’s learned to spend time building trust with sources and ensure that they understand the potential impacts of going on record. Now, when interviewing minors (with guardian consent), she’s careful to ask if they’ve talked to a counselor or therapist about whether they’re ready to share their story and if speaking to the media is a good idea. She also asks if they’ve thought about the lasting impact of having their story online.

“This could be on the internet forever. When you apply for a job, people can search for it,” she says. “Especially with young people, it’s important to talk through all of that.”

Linnane adds that stories about suicide also require contextualization. In addition to featuring survival stories and information that suicidal ideation is far more common than deaths by suicide, highlighting social factors that influence mental health in marginalized demographics with higher suicide rates is crucial for helping readers get a full picture of the issue.

For example, “LGBT[Q] students and students of color have higher rates of suicide. When you talk about that, make sure to say that it’s because they’re facing discrimination at school and they don’t have services that are tailored to them,” she says. “LGBTQ youth are shown in studies to have fewer mental health challenges when they’re supported at school. Talk about the programs that help with that.”

Rhitu Chatterjee, a health correspondent at NPR who covers mental health, focuses on giving sources who have never spoken to the media before as much agency as she can. When possible, she plans in advance to do multiple interviews with sources who have been through trauma, and, instead of recording the first one, she takes notes and uses that time to build rapport, understand why the source agreed to speak to the media, get a sense of what the source is comfortable talking about, and let them know that if they become uncomfortable or later decide they don’t want to have personal details on record, Chatterjee will honor that.

“I also ask them about things they’re doing to cope with the trauma. I always ask them how they’re doing,” Chatterjee says. “People really appreciate just some level of humanity from a journalist.”

For Andrew Meissen, an early career science reporter who has been open about his own mental health struggles, showing humanity sometimes means simply being quiet — allowing sources to take the time they need to tell their story, even if they wander. It also means providing clear information up front about how an interview may or may not be used in a story and letting sources know that their input is valuable. Meissen adds that feelings of loneliness and fears of being perceived as a burden are common among those struggling with suicidal thoughts. Journalists who offer extra reassurance that they’re listening and value the source’s time can help ease those anxieties.

“The main thing is you want people to feel safe,” he says.

Linnane, Chatterjee, and Meissen all point out that this kind of conscientious reporting takes time and often requires editors to value the story being right over being first. There are some tools designed to help journalists stick to best reporting practices. TEMPOS — a free tool the Stanford team created in collaboration with the Santa Clara’s Suicide Prevention Program — offers a checklist and self-rating scale to help editors and journalists assess their stories for appropriate nuance and sensitivity, while SAVE’s free online news app scans article drafts for language that might stigmatize suicide, assign blame, or give readers sensitive details, and offers suggestions to help keep stories in line with best practices.

Tools and guidelines are only effective if media organizations use them, says Alexandra Pitman, an associate professor at University College London who studies suicide risk factors and prevention. Research shows that getting individual media producers on board is easier with a positive approach — rewarding those who adhere to guidelines and create exemplary models of work rather than punishing those who don’t. But making widespread change requires media leaders to ensure that the content they commission follows best practices, she says.

“It really does require media organizations leading from the top,” she says, “[making it clear] that they will follow media guidelines so that the journalists working for them are more likely to adhere and, ultimately, end up saving lives.”

By Christina Couch 

Freelance science journalist and head of professional development initiatives for the MIT Graduate Program in Science Writing. Her bylines can be found in The New York Times, NOVA, Wired, and Vogue.com.

Courtesy: NiemanLab