The Reporting Of Suicide

In April, the Council convened a roundtable seminar, involving mental health professionals, community groups and the media, to discuss the reporting of suicide. Jack Herman reports.

For some time, the Press Council has been looking at the reporting of suicide. In late 1994, the Council issued a press release outlining principles on the reporting of suicide, particularly youth suicide.

It did not issue extensive guidelines but agreed to convene a seminar involving the psychiatric profession and the press to discuss the question. The press release (GPR 189, which has subsequently been superceded by GPR 246) noted that suicides are rarely reported in newspapers. Judging by its own observations and the relatively few complaints it has received, the Press Council expressed its belief that almost all papers have treated suicides with restraint and responsibility. The Council had also had responses from most of the major papers which indicated that they are all aware of the desirability of avoiding

• extra pain for relatives and friends;
  
• any encouragement of copy-cat suicides; and
• unnecessary details of method, or place.

The Council argued that "motherhood" guidelines were of little value, and firm guidelines were impossible because of the wide variety of circumstances. It noted that the incidence of suicide among young people is extremely high in Australia, and thus the press treatment of such cases must reflect a high degree of concern and responsibility.

Additionally, the Council strongly suggested that articles dealing with suicide should include reference to the counselling services that are available for young people in emotional distress, with contact addresses and phone numbers.

In late 1995, the Council followed up the earlier agreement and organised the seminar. Following contact with the Mental Health Branch of the federal Department of Health, it was agreed that, in addition to psychiatrists and the press, there should be representatives of carer and community groups as well.

The seminar was held in Melbourne on 19 April. Present were 7 psychiatrists (from a list of specialists put together by the College of Psychiatrists), 8 representatives of the print media (ranging from police roundsmen to senior editors) and one from the electronic media, and 8 delegates from organisations such as the federal department, community advisory groups, youth groups and other carer organisations. The Press Council was represented by Prof David Flint, its Chairman, and by its Executive Secretary, Jack R Herman.

Opening

The Chairman opened the seminar by noting the traditional freedom of the press and asking to what extent journalistic standards should be inhibited in the reporting of suicide.

"I have no doubt that all of us, whatever our differences, are unanimous on one point: that human life, the life of every person in our community, is priceless and that we should do everything we can to avoid the loss of life," he said.

Prof Flint then introduced the speakers who presented the points of view of the various groups: Dr Graham Martin, representing the mental health professionals; Bob Gordon and Dermot O'Brien, the media; and Prof Riaz Hassan who is carrying out research to see if there is a link between media reports and increases in suicide rates.

Health Professional

Dr Martin, Deputy Chair of the Youth Suicide Prevention Advisory Group, noted that Australia has a serious problem. For young males in the age group 15 to 24 the death rate from motor vehicle accidents has steadily reduced over the last ten years. In contrast the death rate from suicide has increased substantially over the last 30 years to the point where suicide is second behind motor vehicle accidents as cause of death in this young age group. To all of this must be added the costs of attempted suicide. "The most conservative figures suggest a rate of more than thirty times the rate of completed suicide suggesting that at a bare minimum we have somewhere like twelve thousand attempted suicides a year for this age group in Australia. This too is an enormous cost to the community in terms of health care," Dr Martin observed.

He outlined some of the "risk factors" in youth suicide:

• an association with often undiagnosed mental illness;
• unemployment - "there is an almost perfect relationship between the unemployment rate and the suicide rate for this age group";
• Aboriginality;
• sexual orientation;
• drug and alcohol abuse.

The Commonwealth through its Mental Health Branch has developed a national plan for youth suicide prevention called Here for Life. Dr Martin pointed out that the plan has two principal aims: "finding out what works best in terms of preventing youth suicides and overcoming obstacles to ensure that things that work best are actually incorporated into the regular activities of health, education, welfare and other agencies".

He then turned to the media and pointed out some of the dilemmas involved in the reporting of suicides and suicide issues. Prevention strategies are being developed and these involve early detection of symptoms and vigorous treatment of first episodes. Part of these strategies is an understanding that the community needs to be informed of the problem and of the risk factors. However, there is extensive evidence that reporting of suicides increases suicide attempts, particularly in young men. How can we go about community discussion to raise awareness if we cannot discuss the issues in public?

Dr Martin has completed a study of the possible impact on suicide rates in Australia of the death of Kurt Cobain. He found that the suicide rate dropped quite substantially in the month after his death, despite extensive coverage. "Could it be that young people were switched off perhaps by the circumstances of his death which were widely reported?" he asked.

Print Media

Bob Gordon, the editor of Brisbane's Sunday Mail gave an insight into the media's interest in reporting suicide. He noted that his medical writer, whose exposure of the problems at Ward 10B in Townsville and similar stories have had important effects, avoids suicide issues: 'If one kid tops himself clutching a copy of my column, they'll have me,' Mr Gordon quoted him as saying.

The editor referred to a series of articles his newspaper had run on the Gateway Bridge. He had assigned two of his best investigative reporters to put together an article on the bridge. "The statistics on people jumping from the bridge were officially a state secret, but leaky researchers and policemen were prepared to show us the full extent of the tragedy: more than 50 suicides in nine years. Only one jumper was ever known to have survived."

The Sunday Mail had published a major article, not splashed across the front page, but on an inside page. "We even checked the material and headline with a psychiatrist to try to minimise copycat deaths," the editor noted.

But it was attacked for publishing such an article and even blamed for a subsequent suicide in Ipswich, a nearby provincial city. The newspaper continued its reporting, expanding from the bridge to the youth suicide epidemic at large, checking the articles with a psychiatrist all the way. "The teenagers kept jumping off the bridge ... and it was all still the fault of The Sunday Mail."

The newspaper also received supporting letters from relatives of those who had jumped from the bridge. They formed a lobby group to get a fence on the bridge. They did not see their loved ones as statistics; they were real people. They wanted their stories told, their names recorded.

After some months, Mr Gordon received a call from the Transport Minister who told him that if the newspaper stayed away from the issue for a while, a fence would be erected.

"Since the fence went up - and I have to say it is about 4 feet shorter than it should be - I understand about four people a year have gone over. Many others, running into the 100s, have been reached after they stopped their vehicles on the bridge."

Mr Gordon also argued that, since 1991, when it was accepted that to discuss suicide at all in the media was to encourage it, there has been a turn around. In 1994, the Health Minister said: 'The whole community, including the media, had a major role in preventing youth suicide through discussing the issue and developing solutions.'

While noting that there are no simple solutions, Mr Gordon concluded that our society functions best when matters are thrashed out in public; the debate may be vigorous and often unfair but in the end we seem to get there. The fence gets built.

Electronic Media

Dermot O'Brien, the News Manager of Ten Television Melbourne, gave a practical insight into how and why television reports suicide and into television newsroom attitudes to suicide.

He noted that, in this modern era, the vast majority of Australians receive most of their news information from the electronic media and images often carry great impact. With the restricted time available to tv news, suicide is reported only "when there is an angle and a newsworthy story." The issue of suicide, specifically youth suicide, is occasionally reported. "In the past two years on Ten Melbourne and Sydney, there have been only seven stories on suicide. Five of those stories were on the issue; [two were] on specific suicide cases."

Mr O'Brien outlined the Ten Network's new editorial policy guidelines which state:

If reported at all, suicide must be handled delicately. We should avoid details of the method used. In the case of a shooting the words 'a gun was found next to the body' is sufficient.

Youth suicide has reached alarming proportions. Details of suicides may encourage others, we should not add to the risk.

He suggested this would operate in conjunction with the FACTS Code of Practice, which says:

Reporting of suicide must be straightforward, and not include graphic details or images ... and must be depicted in such a way as to minimise the likelihood of imitation.

Because Ten's News has a high viewership of children and teens they have to be even more careful with stories such as suicide. But he believed that "the rules, the current system of checks and balances, are adequate and working operationally. Television news services and current affairs programs are treating this issue in a mature and responsible manner."

Mr O'Brien said suicides were newsworthy if the death would have been reported anyway; if they occur publicly, like the fan who suicided in front of a model; and if there is a "duty to report", as with black deaths in custody.

He concluded: "To make the reporting of suicide taboo, or too tough so that it is not worth doing, may only go to serve to make suicide more glamorous. It simply cannot be dismissed as a no-go area. From time to time there will be circumstances when suicide should be reported. Media managers have and will continue with responsible self-regulation."

Reports linked to suicide

Prof Riaz Hassan, a Professor of Sociology at Flinders University, has been looking at links between reporting of suicides and further suicides. When he started his study he found that in fact there have been a number of studies of this sort over the last 25 or 30 years. American sociologists had explored the role of imitation, of the 'copycat' factor, in suicide.

He noted David Phillips who, in a pioneering study, found that suicide increased immediately after a suicide story was publicised in newspapers. He also discovered two other dimensions of imitation. First, the more publicity devoted to a suicide story, the larger the rise in suicides thereafter, and, secondly, the rise in suicides was restricted mainly to the area in which the story was publicised.

In a series of follow-up studies Phillips also discovered that three days after a publicised suicide, automobile fatalities increase by 31%. He also discovered that single-car accidents increase more than other types just after the publicised suicide. Fatal crashes of private, business and corporate-executive aeroplanes also increased significantly after publicised murder-suicide. His conclusions from these very systematic studies were that suicide stories help to trigger a rise in suicide, some of which is disguised as motor vehicle or aeroplane accidents.

Steven Stack examined the imitative suicide by focusing on the elites and celebrities. He found the same or similar follow-on effects to those reported by Phillips. However, the effect only held true if the suicide was an American entertainer or a political celebrity.

Prof Hassan looked to replicate these studies in Australia. He took the index of two major metropolitan newspapers, The Sydney Morning Herald and The Age, between 1981 and 1990 and identified the stories that reported suicides. He then took the daily suicide rates between 1981 and 1990 and analysed whether or not the newspaper stories had an effect on the number of suicides in the days following.

The Sydney Morning Herald and The Age were chosen because they had complete indices which could be provided by the Victorian State Library. "I also found that these two newspapers appear to have a national impact," he added.

Prof Hassan classified the newspaper stories by 'impact'. "The impact was measured by the location of the newspaper story, by the size of the newspaper story and headline and by a presence or absence of photographs."

His findings show that the male suicide rates increased significantly in a three day period which included the day of publication of high impact reports and the two subsequent days. The female rate did not increase but the ratio between male and female suicide showed a significant skewing in high impact periods. "The findings clearly suggest some association as far as males are concerned between the publication of the suicide stories in the two metropolitan papers and the suicide rate."

Dr Hassan said that more rigorous studies were needed before it could be said definitively that newspaper suicide stories cause more people to suicide. He suggested that his study could be said to demonstrate no more than that the publication of stories assists to "re-organise the incidence of suicide" rather than increase the rate.

He concluded by asking whether a code of ethics would have any effect on the outcome. "I am not quite sure because in order for the code of ethics to have impact one would have to assume that this would be followed."

[Editor's note: The Council has subsequently commented on Prof Hassan's study in a response to a federal government initiative to issue guidelines on the reporting of suicide.]

The discussion

The introductory speeches set the scene for a wide-ranging discussion of the issues by the participants. The first part of that discussion centred around the validity of Prof Hassan's conclusions. It was noted that his figures on media reports related solely to two metropolitan newspapers with restricted circulation, while his suicide figures were drawn from all over Australia. It was suggested that this lessened the link between the two sets of figures. Prof Hassan, and others, noted that there was a statistical significance in the figures, particularly in the increased rate of young male suicides immediately after the reports appeared. He reiterated his contention that further research was needed.

In the discussion, it was generally agreed that the print media's coverage of suicide does not afford great concern although there were reservations expressed about the coverage in some smaller newspapers which did not have the resources to deal adequately with the area. The dilemma raised by Dr Martin - reporting could lead to an increase in the number of suicides, yet everyone agrees that the high rate of youth suicide has to be brought into the light and discussed - occupied some time. The community groups were also concerned with the extent to which the print media was following the Press Council's advice in GPR 189 to mention counselling services when reporting suicides.

The discussion was very detailed and a brief report could not cover the many issues raised. The Press Council is transcribing the seminar and will publish a complete transcript of it. That publication should be ready in June.

The seminar was seen by all as a first step in a process of dialogue between the mental health professionals, carer groups and the media. It was agreed that further meetings would be needed, involving more directly the electronic media, including the national broadcasters. As the Coalition had gone into the election with a policy of convening such a meeting, it was agreed that the Council should inform the relevant Ministers of the seminar and suggest that it might form the basis of a further meeting they were to convene. The Council would encourage the Ministers to ensure that the community and carer groups, as well as mental health professionals, were included in a meeting of the relevant media organisations convened by the Ministers.

The main recommendation to the Press Council was that it should reconsider its GPR 189 with a view to giving more advice to the print media on the handling of reports of suicides. It was suggested that the electronic media should be issued the same advice. The following points could be included in this reconsideration:

1. Reporting of youth suicides should be straightforward, without graphic details, sensational or dramatic headlines, text or pictures.
   
   
2. Coverage of youth suicide should refer to suicide as an unnecessary and tragic means of resolving emotional problems, emphasising that help is available. Preferably this should include, if only briefly, where such assistance can be obtained.
   
   
3. Fictional depictions of suicide should also stress the inappropriateness of suicide as a response to stress, depression or other problems. Positive and realistic suggestions for alternative methods of problem solving or conflict resolution are recommended. Suicide or attempted suicide ought not to be presented (even if only implied) as the means of achieving a desired result.
   
   
4. The suicide of young people must not be presented as a romantic, heroic, alluring or normal act.

A second suggestion, to be taken up with the federal Ministers, is that a database of resources should be established into which journalists could tap. This database would include the names and contact numbers for mental health professionals, community and carer groups and others with expertise in the area. Such a resource, if established by the federal Government, could be updated regularly and would provide journalists with contact points in their local area where information and assistance could be obtained. This could possibly be maintained (also) as a website.

Further it was agreed that some encouragement be given to the wider reporting of the underlying issues, especially the alarmingly high rate of suicide among young Australian men.

The Council has undertaken to have the transcript of the seminar published and to keep the participants informed of developments. It has agreed to pass along information on the seminar to FARB, FACTS, the ABC and SBS, all of whom evinced interest in the seminar. It should also ensure that further dialogue follows on this matter.

Jack R Herman

see also
GPR 246 - more recent guideline on suicide reporting
1997-98 Freedom of the Press summary - on developments on reporting of youth suicide
Reporting Suicide - The Press Council's reaction to a move for guidelines on the reporting of suicide

Dr Graham Martin on responsible reporting

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