Note to media: We have not included specific methods of suicide in the press release and ask that journalists avoid listing them to prevent the kind of contagion found in the study.

A large study examining media reporting of suicide found significant associations between reporting details and suicide deaths, underscoring the need for responsible reporting. The study, conducted by an international research team, is published in CMAJ (Canadian Medical Association Journal).

"It is important for reporters and media outlets to understand that how they report on suicide can have a real impact across the population," says Dr. Mark Sinyor, a psychiatrist at Sunnybrook Health Sciences Centre and the University of Toronto, Toronto, Ontario.

The study supports previous research that has shown that exposure to media reporting on suicide may lead some vulnerable people to similar behaviour, a phenomenon called suicide contagion, and in some circumstances, may also lead to help-seeking behaviour.

"When media reports include resources such as crisis services and messages of hope, it can have a positive impact on the public, and potentially help a person in crisis by reminding them that suicide isn't the only option and that help is available," says Dr. Sinyor.

There is limited evidence for which specific characteristics of media reports influence these behaviours, and there is little Canadian research on the topic. However, there are guidelines to help media outlets with best practices in reporting on suicide.

Researchers from Canada, Austria and Australia examined the relationship between potentially harmful and helpful elements of print and online media reports about suicide. They looked at almost 17,000 articles in 13 major publications (including The New York Times) in the Toronto media market and suicide deaths in Toronto from 2011 to 2014. Specifically, the study looked for a link between certain types of reporting and suicide deaths within the 7 days after publication.

The research team identified associations between several specific elements of media reports and suicide deaths. It suggests that reporting on suicide can have a meaningful impact on suicide deaths and that journalists and media outlets/organizations should carefully consider the specific content of reports before publication.

"This study emphasizes the importance of responsible reporting and identifies that relatively few media reports included helpful information such as crisis resources and messages of hope," says Dr. Sinyor.

From 2011 to 2014, there were 6,367 articles with suicide as the major focus and 947 suicide deaths in Toronto over the same period. Several elements were associated with increased suicides, such as describing the method -- especially in the headline -- describing suicide as inevitable and reporting on suicide in celebrities. Articles about murder-suicides were associated with decreased suicides.

"Contagion is thought to occur when a vulnerable reader identifies with suicide-related media," Dr. Sinyor says. "The fact that reports about celebrity suicide appeared to lead to contagion but the reverse was seen for reports about murder-suicide is very much in keeping with what we know."

"Suicide is a complex phenomenon that is influenced by many factors. We encourage journalists to take extra care to contextualize their reporting, especially when a story is about someone or a situation that people are likely to identify with," says Dr. Sinyor.

"The overwhelming majority of people who think about suicide ultimately find paths to resilience, and they don't die by suicide," he says. "Suicide is almost always accompanied by treatable mental disorders along with life stress and difficulties coping. We have treatments for each of these problems. There is hope. We continue to work with the media in Canada, who do want to get this right, to help them be aware of the issues so that they can inform the public in a way that is safe."

In a related commentary, Dr. Ian Colman, a professor at the School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, writes "Journalists have a key role to play in public discourse on current issues facing society. It is very encouraging that discussions about mental health and suicide have become prominent in recent years, and that the stigma attached to mental health is dropping. The media has likely played an important role in this."

However, he expresses dismay that the study found few media reports that used recommended practices to prevent suicide. "Fewer than one in five articles discussed alternatives to suicide, and less than 2% mentioned community resources for those considering suicide."

"The media have an obligation to report the news, but also have the potential to influence positive change. Responsible reporting can encourage conversations about suicidality, stimulate help-seeking behaviour among individuals considering suicide, and make important contributions in the fight against mental health stigma," he concludes.

The study was conducted by researchers from Sunnybrook Health Sciences Centre and the University of Toronto, Toronto, Ontario; University of Manitoba, Winnipeg, Manitoba; Medical University of Vienna, Vienna, Austria; Melbourne School of Population and Global Health and University of Melbourne, Melbourne, Australia with support from the American Foundation for Suicide Prevention.

"The association between suicide deaths and putatively harmful and protective factors in media reports" is published July 30, 2018.

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