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What happens when a suicide is highly publicized in the wrong way: The suicide contagion effect

Robin Williams in 2007. (Eric Thayer/Reuters file)

The outpouring of grief and public mourning for comedic legend Robin Williams has included an emerging conversation around mental health. Williams, his media agent said, had been battling severe depression, and the Marin County Sheriff’s Office said his death was suicide by asphyxia.

Suicide is a substantial public health issue. Instances have risen over the past decade, according to a 2013 Centers for Disease Control and Prevention study, particularly among the middle-aged. More people die in the U.S. by suicide than in car accidents. But focusing media attention on suicide — while well-intentioned — can lead to the tragic outcome of fueling more if such a national conversation is not handled in the right way.

A coalition of journalists, along with a group of suicide prevention groups, including the American Association of Suicidology and the American Foundation for Suicide Prevention, have issued a set of recommendations on how to talk about suicide in the media. "Recommendations for Reporting on Suicide," which cites more than 50 research studies, notes that the amount, duration and prominence of suicide news coverage “can increase the likelihood of suicide in vulnerable individuals.” It can be especially harmful when the media goes into detail about how a person died, uses dramatic images or glamorizes the person’s death, according to the report.

It’s the suicide contagion effect.

For instance, the American Foundation for Suicide Prevention points to two 1990s studies that found an 80 percent drop in subway-related suicide attempts in Vienna, Austria, following a concerted effort for less sensational media coverage and fewer stories about such deaths. In another study published in 2013, PLoS ONE  researchers found that extensive newspaper reporting on charcoal burning suicides in Taiwan contributed to a rapid rise in so-called "copycat" suicides by this method.

Even publishing photos of grieving family and friends, or of the place where a suicide took place, can contribute to the contagion effect, the coalition's report warns. Rather, experts suggest using photos from a person's school, work or with family.

But media attention on suicide, when done carefully, can help spread awareness that is beneficial. Even such brief media coverage “can change public misperceptions and correct myths, which can encourage those who are vulnerable or at risk to seek help,” the coalition's report notes. Including information about available resources (such as the U.S. National Suicide Prevention Lifeline, 800-273-TALK) can help. Additionally, suicide is complex, and there is no “one” reason why it happens, according to CDC. Most people who commit suicide do exhibit warning signs such as talking about wanting to die or about feeling hopeless and without a purpose; increasing alcohol or drug use; displaying extreme mood swings; or withdrawing and feeling isolated.

Much literature on suicide prevention focuses on the way it's discussed via traditional media outlets. But information is spread through informal channels with greater frequency in the digital age. My colleague Caitlin Dewey flagged this tweet from the Academy of Motion Picture Arts and Science, which seeks to pay tribute to Williams but may go against public health recommendations:

"Suicide should never be presented as an option," AFSP chief medical officer Christine Moutier told Dewey. "That’s a formula for potential contagion.”

Elsewhere on Twitter, many expressed their sorrow about Williams's death while spreading awareness of suicide prevention for those in need of help. Reddit added a hotline number and links to Williams’s AMA, where many grieving fans are visiting. The hashtag #SuicidePrevention trended worldwide on Twitter after news broke of Williams’s death. And everyone from humble fans to major stars publicly grieved on social media by not discussing the details of Williams’s suicide but rather the impact the comic had on their lives.

Williams’s widow, Susan Schneider, released this statement after Williams’s death: “As he is remembered, it is our hope the focus will not be on Robin’s death, but on the countless moments of joy and laughter he gave to millions.”

[An earlier version of this story incorrectly reported the American Foundation for Suicide Prevention's name. This version has been updated.]

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