Detailed, high-profile newspaper stories about individual suicides may have played a role in creating suicide clusters among young people, at least in the 1980s and 1990s, a new study suggests.
The study, published online Thursday in Lancet Psychiatry, provides new evidence for a long-suspected connection. Studies over several decades have shown increases in suicide after high-profile suicides, especially by celebrities. The death of Marilyn Monroe was followed by a 12% increase nationwide; other highly-publicized suicides have been followed by increases averaging 2.5%, according to previous studies.
The new study looks not at nationwide trends, but at what happens in communities when one youth suicide is followed by several more within a few months. The authors say it is the first time a study has compared a possible risk factor – in this case, newspaper coverage – in communities in which such clusters did and did not occur after an initial youth suicide.
"Suicidal behavior is complex. It's not going to be just one thing," and coverage is likely to affect only youths who already are vulnerable, says lead author Madelyn Gould, a suicide prevention researcher with the New York State Psychiatric Institute. But previous studies suggest printed newspaper stories, possibly because of their length and staying power, have a greater impact than TV stories. A study from 2011 found teens still were more likely to read about suicides in newspapers than online, Gould says.
The new study looks at an earlier era. Researchers collected information on 48 communities where clusters of suicides in youths ages 13 to 20 occurred between 1988 and 1996. For each community, they found two similar communities where a single youth suicide occurred and was not followed by others. They looked at any coverage of suicide that ran in papers widely read in the communities between the first and second deaths in the clusters.
They found more stories, an average of 7.4 vs. 5.1, in the cluster communities. The stories were more likely to be on front pages, mention suicide in the headline or provide detailed descriptions of methods. Stories about the initial youth suicides were published in 25% of the cluster communities vs. 13% of the other communities. Other stories were about local adults, distant celebrities or broader issues related to suicide.
"This is the most rigorous data I have seen of its kind," says Steven Stack, a professor of criminal justice at Wayne State University in Detroit, who has studied suicide contagion.
While the study does not prove the stories contributed to subsequent suicides, it does suggest that many of the guidelines for the media developed over recent years – which call for avoiding detailed, sensational coverage of individual cases and methods – are on track, Gould says. Such guidelines are not always followed, even today, she says.
Most newspaper editors realize that sensitivity is needed when covering suicide, says Arnie Robbins, executive director of the American Society of News Editors, Columbia, Mo. "Many editors will take a look at this," he says. "There will be some internal conversations in newsrooms."
An obvious next step is looking at whether discussions of suicide in social media might lead to copycat cases, an editorial accompanying the study says.
"It makes intuitive sense ... that less regulated, more volatile and more interactive media might have an even greater effect, particularly because young people are not only major consumers of these forms of media, but also the creators of their content," write Jane Pirkis and Jo Robinson, researchers at the University of Melbourne, Australia.
Gould says she would advise people writing in any form to consider the power of their words when they write about suicide: "Try not to sensationalize what just happened."
The American Foundation for Suicide Prevention, which provided some funding for the study, was among groups that developed guidelines for writing about suicide. The guidelines have been endorsed by journalism, government and medical groups. They include tips for bloggers and online commentators, such as:
* Provide links to treatment services, warning signs and suicide hotlines.
• Include stories of hope and overcoming suicidal thinking.
• Monitor social networking sites, which often become memorials for the deceased, for hurtful comments and for statements that others are considering suicide.
The National Suicide Prevention Lifeline is 800-273-TALK (8255).