It’s no secret to mental health experts that exposure to suicide, either directly or through media and entertainment, may make people more likely to resort to suicidal behaviors themselves. The phenomenon even has a name: suicide contagion.
And a new paper, published Monday in the Canadian Medical Association Journal, says some specific journalistic practices — such as including lots of details about a death by suicide, or glamorizing these incidents — may make suicide contagion worse.
“We’re not saying reporting on suicide is bad,” says Dr. Ayal Schaffer, a psychiatry professor at the University of Toronto and a co-author of the new study. “Our goal is not to blame journalists; it’s not to tell journalists how to do their jobs. But it is to provide a pretty strong research base to support specific guidelines about how reporting on suicide should be done.”
To do so, the researchers analyzed stories about suicide that appeared in 13 publications with wide circulations in Toronto. (Most were Canadian outlets, but the New York Times was also included.) They found almost 17,000 stories that mentioned suicide, including 6,367 articles in which it was a major focus, published between 2011 and 2014. About 950 people in Toronto died by suicide during this timespan.
Next, the researchers analyzed whether specific characteristics of the stories were associated with increases or decreases in suicide deaths in the week following publication, as compared to a control week when no major stories were published and no high-profile people died by suicide.
They found that stories about celebrity suicides, headlines that included information about how a suicide was completed and statements that made suicide seem inevitable were all correlated with suicide contagion. (Other research backs this up: In the four months after Robin Williams’ highly publicized 2014 death by suicide, one study found a 10% increase in suicides across the U.S.) Meanwhile, negative descriptions of suicide and messages of hope were associated with a protective effect, though neither reached statistical significance, perhaps because they appeared in articles so infrequently.
The research comes shortly after a string of stories pushed suicide to the forefront of the news cycle this summer. In June, fashion designer Kate Spade and celebrity chef Anthony Bourdain died by suicide just days apart. The same week, the Centers for Disease Control and Prevention (CDC) released a report about rising suicide rates across the country. More recently were stories about a study linking climate change and rising temperatures to a potential increase in deaths by suicide.
Andrew Seaman, the ethics committee chair at the Society of Professional Journalists and a former health reporter, says he’s seen improvements in the way these stories are covered. He says this points to an evolving understanding that, while a journalist’s first responsibility is reporting the facts, certain issues, such as suicide and school shootings, require more nuanced news judgment than others, particularly given the body of research supporting theories like suicide contagion.
While there’s similar research pertaining to other public health issues that aren’t regulated by journalism guidelines — the ways in which youth exposure to alcohol advertising contributes to risky drinking, for example — Seaman says his philosophy on suicide reporting goes back to one of SPJ’s guiding principles: Minimize harm.
“You really have to think of the story and say, ‘What are my responsibilities here, and where do they end?'” Seaman says. “Do I really need to include the method? Do I need to go into detail here? In most cases, I don’t think you have to.”
Schaffer agrees, noting that journalists should usually omit information about how a death occurred or speculation about causes. The more vivid a depiction of a death, he says, the more it may contribute to suicide contagion.
“The more someone is able, in a very specific way, to get connected to this story — and if they can see themselves in that person or wanting to be that person or admiring that person — that story becomes a very powerful driver to their behavior,” Schaffer explains. The inverse of this theory may explain why including negative details — that a death occurred as part of a murder-suicide, for example — may help dissuade suicide attempts.
The framing of a story is important, too, says Dr. Mark Sinyor, the new study’s lead investigator and a psychiatrist at Sunnybrook Health Sciences Centre, in an email to TIME. “Ideally, journalists would not treat suicide as an entertainment story but as what it truly is: a health story,” Sinyor says. “Suicide invariably arises from treatable mental disorders. Most people who experience suicidal crises find paths to resilience, and there is no reason anyone has to die by suicide.”
Schaffer adds that including “messages of hope” — pointing to states or countries that have seen improvements in suicide prevention, for example, or mentioning people who have recovered from suicidal crises — can also help.
“Part of the message of hope is, at a macro level, the sense that we can actually do something, because we need to fight against this sense that there’s hopelessness and helplessness associated with suicide,” Schaffer says. “We know that there’s lots of things we can do that can actually reduce the rates of suicide — not to zero, but to much less than it is.”