The harm from reporting suicide
2.1The policy objectives behind the present statutory restrictions on reporting suicide are to protect public health by reducing the risk of copycat behaviour; to avoid an “inquest by media” before the coroner has had a proper opportunity to determine the manner of death; and to protect the privacy of bereaved persons.
2.2In this chapter we begin by describing the evidence supporting the public health concerns behind the first objective. We also discuss the harm that reporting suicide may cause to people bereaved by suicide and the harm that may be caused to the integrity of the coronial system.
2.3The critical questions that need to be squarely asked are: do the risks to public health of reporting suicide merit consideration of a special regime? And if so, is the harm such that a prudential restriction is required, notwithstanding the provisions of the New Zealand Bill of Rights Act 1990?
2.4Publishing details of a suspected suicide is presently treated as a “special case” in our law because of the risk of a “contagion” effect. Normally, such comment would be left to be constrained, to the extent it is constrained at all, by the general law. If, however, a contagion effect of a sufficient degree cannot be demonstrated on an evidential basis, there is no justification for a “special” legal constraint.
The evidence of a contagion effectTop
2.5A contagion effect occurs when an already vulnerable person emulates the suicide of another person that they know about, either through personal knowledge or through reports. This is sometimes referred to as a “copycat suicide”. This effect has been recognised for over 200 years and is sometimes called “the Werther Effect”. That name derives from Goethe’s 1774 novel The Sorrows of Young Werther, which depicted the suicide of a young man who fell in love with a woman who was to marry another man. After the novel was published a spate of suicides were noticed that closely aligned with the circumstances depicted in the novel.
2.6A contagion effect has been suggested as a cause of suicide clusters. A cluster occurs when there are more suicides within a time period than would normally be expected. When the cluster occurs within a geographical region it is referred to as a “point cluster”. This type of cluster is not specifically associated with media reporting. Rather, the contagion effect is said to occur through social learning within communities. However, it has also been suggested that point clusters are not the result of contagion at all, but occur because people who are vulnerable to suicide tend to associate or “cluster” together through the natural formation of relationships and communities.
2.7When a cluster occurs within a time period but not within a defined geographical region, it is referred to as a “mass cluster”. Mass clusters tend to be associated with media reports of suicide deaths by celebrities or high profile people. An example of a mass cluster was the suicide of Marilyn Monroe, which was thought to lead to a further 303 suicides in the United States (an increase of 12 per cent).
2.8For more than 200 years, but particularly in the past three decades, scientists have studied the contagion effect of reporting suicide. More than 80 studies have been produced, many of which provide evidence of a copycat effect from media reporting – that is, evidence of a rise in the suicide rate following a suicide story in the media. However, many of the studies did not demonstrate that the person who died by suicide actually saw the media report, so it is not possible to say that the media report caused the suicide.
2.9We examined a significant body of those studies to understand causes, mechanisms and size of the contagion effect. We placed particular emphasis on systematic reviews of the studies. In systematic reviews scientists have gathered all published studies on the subject and analysed them for their relevance, quality and findings. While individual studies will always have limitations, these systematic reviews across a broad range of studies applied scientific method to the analysis of the body of evidence and were able to draw conclusions about the general trend of the data and the strength of that trend. A summary of the findings of the systematic reviews is attached as Appendix C.
The mechanism of the contagion effect
2.10Media reports of a suicide do not affect everyone equally. While most readers will not be affected, a minority of already vulnerable people may be affected. The research shows young people and those with mental health problems may be particularly vulnerable to suicide reports. People bereaved by suicide have a higher risk of suicide and so may also be particularly vulnerable.
2.11The mechanism of the contagion effect of a media report is understood under the framework of social learning theory – that is, behaviour is learned through a process of observation and is then copied. People learn through the media that some people “solve” their problems by suicide. This learning process is stronger when the person observing identifies with the person observed, or the person observed is presented as a successful person. The process is particularly strong when the person observed is a celebrity or famous person. Copying the general behaviour of “successful” people, particularly those who share similar characteristics to the person copying, is seen as an effective means of acquiring similar success.
2.12Reports of suicides contribute to other suicidal behaviour if they create more positive definitions of suicide (advertising the method of suicide, glorifying the suicide, providing sensational coverage, normalising the suicide) than negative definitions (focusing on the pain of suicide, promoting alternatives to suicide). The remainder of this section describes the different ways in which media reports of suicide may promote those positive definitions of suicide.
“Advertising” the method of suicide
2.13A number of studies have found that reporting the method of a suicide has a significant imitative effect on subsequent suicides, especially when the victim was a celebrity and when people identify with the age and sex of the victim. Reading of the “successful” use of a method may make that option appear more readily achievable to a vulnerable person. Although information on suicide methods is readily available if a person searches for it, removing the requirement to actively search for methods may make a suicide more likely. Publishing the specific location of a suicide, where that location is specifically linked to the method of suicide, has been shown to have a similar effect. For example, reports that state that a body was found under a high bridge, cliff or building is an indication that the person died by jumping from that place.
2.14There is some evidence that the suicidal behaviour that follows suicide reporting is not merely inevitable behaviour in vulnerable people that was moved forward in time by exposure to the media report. A 1974 study examined suicide rates in American populations following suicide reporting. It found that although a discernable rise in the suicide rate occurred following media reporting, there was no subsequent discernable trough, indicating an overall rise in the rate.
2.15A commonly cited case of a contagion effect following the reporting of the method of suicide is that of intentional carbon monoxide poisonings by burning charcoal in a confined space in Hong Kong. Before the publicised case, no cases of suicide by burning charcoal were reported. Jumping and hanging were previously the most common methods of suicide. In the two-year period after the first publicised case there were 56 cases of suicide by charcoal burning and 39 per cent of those cases were in the first three months. The table below describes the findings of other similar studies on the effects of reporting the method of suicide.
|Studies on the effect of reporting the method of suicide on subsequent suicidal behaviour |
|Year ||Country ||Method ||Findings |
|1978/79 ||England and Wales ||Burning ||Burning was an uncommon method of suicide until an extensively publicised politically motivated suicide in 1978. In the following year there were 82 suicides by that method, most involving individuals with strong psychiatric histories. None had political overtones apart from the index case. |
|2012 ||Taiwan ||Charcoal burning ||A significant increase in suicide deaths following a media report of a celebrity suicide. There was also a marked increase in suicides by the same method used by the celebrity. |
|2004 ||Austria ||Firearm ||In the three weeks following extensive coverage in the largest Austrian newspaper of a suicide by gun, the number of suicides by firearm increased above the number in the three weeks before the reports. |
|1999 ||United Kingdom ||Anti-freeze ||While the mean number of intentional anti-freeze poisonings for 1995–1997 was around two per month, the number of such poisonings for the month following media coverage of an inquest into an anti-freeze poisoning was nine. For the month following the depiction of such a poisoning in the popular drama Casualty the number was six. |
2.16A normalising effect may occur when suicide is represented (often inadvertently) as a reasonable or common response to problems or a crisis. By being presented as relatively common, a person may feel that it is more acceptable. Normalisation in suicide reporting can occur in different ways. For example, an increase in the quantity of suicide reporting or reporting on high suicide statistics may make suicide appear to be an increasingly normal event. Alternatively, presenting suicide as a consequence of particular problems, for example bullying or relationship breakup, can lead to other people with those problems considering suicide as an option. Research has shown that normalisation has a stronger effect on vulnerable populations when the person identifies with the deceased or the deceased is a celebrity.
2.17It has been suggested to us that a normalisation effect may also occur if the ethnicity of the victim is mentioned in a report. The inadvertent result can be that suicide is presented as a more frequent (and consequently more normal) response within that ethnic population. This normalisation by the media is counterproductive to efforts to reduce suicide rates within those populations.
Glamorising or sensationalising suicide
2.18Similarly to normalising suicide, glamorising or sensationalising suicide may increase the risk of a vulnerable person choosing suicide as a way of addressing their problems. Glamorising suicide may occur through the material selected to report, the use of words or photos in the report, or in the extent of coverage of a suicide. For example, emphasising community expressions of grief instead of the problems faced by the person who died may give the impression that the person who died is receiving a lot of positive attention, which may make suicide a more attractive option. Glamorising suicide is a particular risk in reporting the suicide deaths of celebrities or high profile people.
2.19Sensationalising suicide sometimes occurs when reports aim to raise awareness of a perceived problem. For example, this may happen by presuming connections between suicides that may also be a mere coincidence, by describing a rise in the rate of suicide within a population as a suicide epidemic, or by describing a location associated with suicides as a “hot spot”.
The size of the contagion effect
2.20We noted above that the media reporting following the suicide death of Marilyn Monroe was thought to increase subsequent suicides by 12 per cent. Generally, however, the size of the effect of media reporting of suicide on subsequent suicides is thought to be much smaller than the effect in that particular case. One American researcher has estimated that generally the effect may be in the order of 2.5 per cent. However, another study found the increase in suicide rates after reports of celebrity suicides to be 0.26 per cent.
2.21It is true that the size of the effect of media reporting is significantly smaller than that of other psychiatric and psychosocial risk factors for suicide. For example, a history of mental health problems or familial suicidal behaviour is much more strongly associated with suicide than is media reporting. However, all risk factors for suicide fall on a spectrum of modifiability, with many being fixed or very difficult to modify. In contrast to many of the other risk factors, the risk of media reporting is relatively easy to modify through education of journalists and the public at large.
2.22The terms of reference for this review require us to specifically consider the application of our recommendations for different forms of media such as bloggers and social media (new media).
2.23The proliferation of internet-based modes of communication is having an impact on suicide in New Zealand. In summary:
- People (particularly young people) are receiving information (including about individual suicides) from an increasing range of sources.
- Many of those sources are designed and structured in ways that inhibit effective control of their content.
- It is common for people to discuss the details of a suicide death on social media, often in ways that would breach the guidelines for mainstream media reporting of suicide.
- There is a significant level of “convergence” between mainstream media and new media, with mainstream media using new media as a source of information for its reports and conversely providing links to further information on new media sites.
In Chapter 5 we describe the impact of the internet in more detail.
2.24Unfortunately we have found very few studies from New Zealand or internationally examining whether reports on new media of individual suicides have a contagion effect. We consider that it cannot necessarily be assumed that reports of suicides in new media would have the same effect as reports in mainstream media. People working in suicide prevention have speculated to us that, despite them being accessed far less frequently, reports of suicide in mainstream media are likely to be much more authoritative for young people than reports in social media. They also draw a distinction between the “one-way” communication of mainstream media and the “conversation-like” communication on social media. The often rapid, multi-faceted nature of social media may mean that the impacts of any reports of suicide that may breach the guidelines for safe reporting of suicide are diluted.
2.25Even if the effect of new media is not the same as that of mainstream media, it is still likely that certain forms of reporting in new media may influence subsequent suicidal behaviour. For example, there is particular concern that online memorial pages for people who died by suicide may inadvertently glamorise the deceased person or sensationalise the death. Resources have been developed in New Zealand and internationally for the publication of “safe” memorials after a suicide death. It is likely, however, that these currently reach only those people working in suicide prevention or with young people.
2.26From our investigation of the evidence outlined in this chapter and in Appendix C we have concluded that:
- The evidence is irrefutable that some forms of reporting are strongly associated with a risk of further suicides. It is likely that the potential for harm extends to reports of suicide on the internet and social media.
- There is some evidence of a causal link between some forms of reporting suicide and subsequent suicide (as opposed to merely an association). However, those proven causal links are tightly confined to specific types of reporting.
- There are gaps in the research. For example, much of the research does not distinguish good quality suicide reporting from poor quality suicide reporting. Much of the research does not show that subsequent suicide victims actually read the media reports of the earlier suicide.
Bereaved families and breaches of privacyTop
2.27The grief process following a suicide death is often different from other forms of bereavement. Studies have shown that people bereaved by suicide may:
- struggle more with questions of meaning around the death;
- show higher levels of feelings of guilt, blame and responsibility;
- experience greater feelings of rejection or abandonment by the person who died by suicide, or anger towards them;
- experience greater social isolation and stigmatisation;
- experience greater difficulties with family relationships, including long-term effects; and
- have an increased risk of suicide themselves.
2.28These features of the grief process following a suicide death make the bereaved particularly vulnerable to reports of the suicide. During our consultations, we spoke to a number of people bereaved by suicide. A common theme was that their grief process was inhibited by a general lack of understanding about suicide in society and wariness in talking about it. Consequently they favoured more public discussion of suicide in a general sense as a public health issue.
2.29However, they told us that inaccurate reporting and breaches of privacy increased the burden of grief felt by bereaved families. Examples given of inaccurate reporting included when the media speculated about and over-simplified the causes of suicide without an in-depth knowledge of the circumstances. We were also given examples of breaches of privacy causing significant relationship problems between the surviving family members. From speaking with families it was apparent their idea of what should be private differed from what is generally accepted by the media. For example, they felt that it was an invasion of privacy to publish personal information publicly available on social media sites. In their view, no information about the person who died should be published without the consent of the family and whānau.
2.30People bereaved by suicide sometimes wish to share their stories with the intent of helping other people in similar situations or of exposing poor practice in public institutions. Some felt that the current legislative prohibitions prevented them from speaking openly about their own experience of suicide. Conversely, some families had agreed to speak with the media after a suicide, but had later regretted it.
The integrity of the coronial processTop
2.31In Chapter 5 we describe our research into current media practice of reporting suicide and analyse the extent to which that practice complies with the statutory restrictions and guidelines for reporting suicide. In the course of that research we found a not insubstantial amount of reporting by mainstream media of individual suicide deaths. In many cases the media did not specifically call a death a suicide but said something like “the death has been referred to the coroner”, or “there are no suspicious circumstances”. However, in some cases the death was described as a suicide.
2.32Leaving aside the question of whether describing a death as a suicide is a breach of section 71 of the Coroners Act (we discuss that further in Chapter 3), we consider that significant harm is caused to the integrity of the coronial system by such a description. Parliament has determined that it is a coroner’s role to determine the cause of death. This makes the cause of death a legal determination. If broad public comment and discussion on the cause of death is permitted before a coroner has made a finding on that point, it may usurp the role of the coroner or undermine the significance of that finding when it is made.
2.33Harm could possibly be caused to the administration of justice by describing a death as a suicide before that has been determined by a coroner. While we must assume that a coroner is capable of ignoring any prior public discussion of the matters he or she is to determine, there is a risk that such public comment may influence the evidence of witnesses to the coronial proceeding. Public reports that a death was in fact a suicide may affect a witness’s evidence by making that person either more confident or less confident in their recollection of events. We note, however, that in Beckett v TV3 Network Services Ltd Robertson J was not persuaded that a television broadcast prior to a coronial inquest would be likely to affect the recollection of witnesses to that inquest. He held that the plaintiffs had not demonstrated that “the integrity of that process might be affected by what was contemplated by the defendant”.
2.34Beckett was not a case of suicide, but we agree the effect on witnesses is likely to be similar. Reports that a death was in fact a suicide are unlikely to have a significant impact on a witness’s recollection of events at a coronial inquest. The greater harm in this case is to the integrity of the coronial process.