By Professor David Gunnell
There have been some truly moving suicide prevention media campaigns recently. For example, Samaritans “Small Talk Saves Lives” campaign tells the story of a woman whose life was saved (from suicide) because someone took the time to talk to her when she was planning to kill herself.
Project 84: CALM’s recent high-profile campaign, based around the sobering statistic that 84 men die by suicide in the UK every week, however, has raised concerns amongst a number of people in the suicide prevention community.
The campaign, which tells the real life stories of 84 men who died by suicide, was launched with a haunting display of 84 life-sized statues of men on the edge of the roof top of ITV studios in London. Friends and families of the bereaved, working alongside a sculptor took part in making the statues. The display reminds one of the moment before someone jumps from a high building.
Over the years CALM have done a huge amount of work raising awareness about the major public health problem of male suicide. However this particular campaign raises concerns. There is a large body of research evidence concerning the impact of reporting / media portrayal of suicide methods on subsequent imitative suicides and the uptake of suicide by populations.
It is thought that raising awareness of suicide methods can increase their “cognitive availability” and might influence method choice. A number of research studies – including work by @SASHBristol’s Dr Lucy Biddle – have drawn attention to how the media (print / on-line) may influence people’s preference for particular suicide methods and provide them with knowledge about how to use these. And if this influences them towards more lethal methods, this may result in a rise in suicide rates. Most people who survive a suicide attempt do not repeat the act. Importantly, people don’t have to be suicidal to be affected by the images and reporting. Information may be stored away at the back of someone’s mind and perhaps retrieved later at the time of a suicidal crisis.
Pictures of the statues in the Project 84 campaign have been widely reported by news websites in the UK. The display, which is on the top of a tall building in central London, is highly visible. Samaritans and WHO guidelines on responsible reporting of suicide are clear. Samaritans guidelines state “Avoid giving too much detail. Care should be taken when giving any detail of a suicide method” .
A series of recent studies have shown rises in method-specific (and sometimes overall) suicide incidence may follow high profile media attention given to a particular method of suicide, most often following a celebrity’s suicide. A recent research paper indicated that in the 6 months after Robin Williams’ death by suicide there was a 9.8% rise in suicide deaths (1841 additional fatalities) in the USA over and above expected levels based on recent trends. The excess in deaths was largely due to a rise in deaths using the very method used by Williams.
Jumping from a tall building is a highly dangerous suicide method (and in some parts of the world is one of the most frequently used methods). Here in the UK, suicide deaths by jumping account for approx. 250 deaths per year (around 4% of all suicides). The risk of the Project 84 campaign lies in increasing awareness of this method in the wider population. More deaths might follow as a result of increasing the “cognitive availability” of the method. Indeed these concerns led Australia’s Mindframe Media Advisory Group, putting out a call to Australia’s media advising against sharing imagery from Campaign84.
In many parts of the world suicide prevention teams work closely with local media to reduce risk associated with their reports of deaths from local landmark sites. For the same reason, here in Bristol, we work with our local media on their reporting of suicide deaths from a local site which has in the past often attracted considerable publicity. Of course, it is possible that some reports / approaches to reporting deaths by particular methods may actually deter some people from using those methods. One of our PhD students, Helen Fay, is working on this very issue.
Whilst it’s good to see the important issue of male suicide highlighted, it would be tragic if it were to inadvertently backfire and lead to a rise in deaths by jumping. Of course, as with any public health intervention such as a media campaign, we must careful weigh up the benefits and potential risks. Research on public awareness campaigns is in its infancy. Professor Jane Pirkis and team’s recent systematic review identified relatively few studies that looked at their impact on the incidence of suicide. Whilst there is some evidence of their effectiveness the authors caution about the importance of taking care “to ensure that campaign developers get the messaging of campaigns right, and further work is needed to determine which messages work and which ones do not, and how effective messages should be disseminated.”
David Gunnell is Professor of Epidemiology in the Department of Population Health Science, University of Bristol. He has a long-standing research and policy interest in the epidemiology and prevention of suicide in the UK and internationally.
You can follow @SASHBristol on Twitter.
Thanks to @dee_knipe @LucyABiddle @HelenAmyFay for their input
If you or anyone you know is affected by the issues covered in this blog, you can contact the Samaritans for free from any telephone on 116 123 in the UK. Alternatively you can email jo@samaritans.org for details of your nearest branch, where you can talk to one of their trained volunteers face to face. The International Association for Suicide Prevention (IASP) has details of support organisations in other countries.