Appendix C

Key systematic reviews of the evidence

Pirkis and Blood “Suicide and the news and information media: A critical review” (2010)113

This review examined 97 studies over the past 50 years on the imitative effect of presentations of suicide in newspapers, television, books and the internet. It specifically considered methodological issues associated with each body of studies, and critically examined whether those issues limited the inferences that could be made about the interpretation of findings.

The review examined the strength of the association between the portrayal of suicide in the media and actual suicidal behaviour, and the extent to which that association could be considered causal. In determining causality, it examined five features of the findings:

Newspapers

The review examined 41 studies of differing types. The vast majority suggested an association between newspaper reports of suicide and actual suicidal behaviour. From that body of evidence the review found that it was reasonable to regard the association was causal, because:

Despite the finding of causality, the review noted that only a limited number of studies permitted a determination of whether the media stimuli preceded an increase in suicide rates, and only a few studies were able to demonstrate that a reasonable proportion of those who subsequently died by suicide were exposed to the media stimulus.

Other media

The review examined 11 studies about television (all of a similar design), 20 studies of the internet (mostly descriptive studies), and 20 studies of mixed media (of differing designs). The review found that the studies provided cautious support for a causal association:

The review also examined five studies about books, but they were all about the book Final Exit, which advocates suicide for the terminally ill. It found that the association between that book and suicidal behaviour was causal.

Sisask and Varnik “Media Roles in Suicide Prevention: A Systematic Review” (2012)114

The purpose of this review of 56 studies was to give an overview of the research and to find out the effects of media reporting of suicide on actual suicidality. The review pulled 1180 studies from electronic databases and whittled them down to 56 eligible analytical research reports on non-fictional portrayals of suicide behaviour. The review found that the vast majority of studies support the idea that media coverage of suicidal behaviours and actual suicidality are associated. Only four studies found no significant associations (all before 1990) and a further five expressed hesitations about clear associations or reported incoherent results. The review warned, however, of a risk of reporting bias in that “researchers are eager to report meaningful positive results, but could keep silent if the results are not beneficial”.

Niederkrontenthaler “Changes in suicide rates following media reports on celebrity suicide: a meta-analysis” (2012)115

This study was a meta-analysis of 10 previous ecological studies covering 98 celebrity suicides. This is a particularly strong study design as it systematically re-analysed the published aggregate data from the previous studies and provided cumulative insights into the association between media reports of celebrity suicides and subsequent suicides.

This study found that:

Stack “Suicide in the Media: A Quantitative Review of Studies Based on Nonfictional Stories” (2005)

This review suggested that the variation in findings across the studies examining the impacts of media coverage of suicide may be explained by their different methodologies. The review examined 419 findings from 55 different studies. It found:

Gould “Suicide and Media” (2001)116

This narrative review reported on the range of studies examining the association between suicide reporting and subsequent suicidal behaviour that had been conducted to date. It placed particular emphasis on identifying the different characteristics of non-fictional reporting or of the vulnerable person that influence the size of the contagion effect. It found:

113Jane E Pirkis and Warwick Blood Suicide and the news and information media: A critical review (Commonwealth of Australia, 2010).
114Merike Sisask and Airi Varnik “Media Roles in Suicide Prevention: A Systematic Review” (2012) 9 Int J Environ Res Public Health 123.
115Thomas Niederkrotenthaler “Changes in suicide rates following media reports on celebrity suicide: a meta-analysis” (2012) 66 J Epidemiol Community Health 1037.
116Madelyn S Gould “Suicide and the Media” (2001) 932 Annals of the New York Academy of Sciences 200–224.