Suicide prevention and media reporting: an evaluative study from Chandigarh

INTRODUCTION

Suicide is major public health problem where approximately 800, 000 people die due to suicide every year, which equates to one person every 40 seconds. It is the second leading cause of death in age range 15-29 years globally.¹ As per WHO’s report India recorded maximum number of suicides in South East Asia region, that has led on to label India as the suicide capital of South East Asia.² This complex public health menace is preventable with multi-sectorial concerted efforts and collaborations.

Responsible media reporting is a well recognized approach on suicide prevention. Literature provides a consistent finding that irresponsible/inappropriate media reporting of suicide can provoke suicidal behaviors which is labelled as ‘Werther effect’.^3,4, Media items about suicide are associated with increase in actual suicide. The harmful impact of suicide reports in media vary as a function of age, gender as well as the individual characteristics of news items.⁴ Elements of news items that tend to be most associated with increase in suicide rates are the statements on inevitability of suicide, detailed description on specific methods of suicide especially in the headline and front page placements etc. Also responsible/protective suicide reporting can serve to dispel the myths related to suicide and promote help seeking in the masses.⁴ The news items that highlight the unfavourable characteristics of deceased or the articles that include the interview with bereaved have an evidence for putative protective effects.³

There is evidence, albeit from fewer studies, that modification of reporting on suicidal behaviour is feasible and can be effective. Thus, several countries and organisations have disseminated the resources to educate media professionals.⁷ There are studies that have reported an overall improvement in the quality of media reports as well as a significant reduction in the number of suicides after implementing such national guidelines on suicide reporting.^8,9 Despite such strong commitments and evidences at international and national levels, the media reporting for suicide tend to be poor, negative and non responsible.^10-15 Considering the significant role that media plays in suicide prevention , the present study was undertaken to evaluate quality of media reporting on suicide. The present investigation aims to critically assess the print media news items in selected newspapers of Chandigarh from 2015-2016 in terms of compliance to desirable media reporting guidelines issued collaboratively by WHO and International Association of Suicide Prevention (IASP).¹⁶

METHODS

A retrospective review was undertaken following approval from the Ethics Committee of the institute. All the suicide reports in newspaper from January 2015 to December 2016 in ten selected newspapers in city five each in English and Hindi language were evaluated on the basis of a 12 items checklist based on the resource guide for media professionals published by WHO and IASP was developed by mental health professionals. The criteria for newspaper selection were based on the average issue readership.¹⁶ The checklist was validated (face validity) by experts from the field of psychiatry, psychology and media industry). The checklist comprised of a total of 12 items. Scoring on all the items was on a dichotomous pattern in terms of Yes/ No. To avoid any form of subjectivity in assessing/ scoring each item in checklist was carefully defined. The interrater reliability was assessed in pilot work on 30 news items yielding a kappa of 0.8.

The researcher collected all suicide related news items from January 2015 to December 2016 from the library database. By the virtue of departmental policy clippings of all the news items published in selected newspapers of Chandigarh are systematically saved and sent to the head of the department of Psychiatry of Medical College which is a regional nodal centre for suicide prevention for the purpose of suicide monitoring. This database of news items was utilized by the researchers in present study. All the news items in this database were screened by researchers. The inclusion criteria were news items describing a suicide report during Jan 2015 to Dec 2016 in selected newspapers. The news items on suicide prevention awareness, suicide bombers or general educative articles on depression were excluded. In case same event was reported in different newspapers or different languages then it was counted as independent news item and was included in the analysis. However, the repeat news item was labelled as duplicate to avoid overestimation of reported suicides. Two independent evaluators read the content of each news item word by word so as to evaluate the printed news objectively based on developed checklist. The items in which the scores on dichotomous checklist didn’t match were reassessed collaboratively to reach at an agreeable consensus to get the final scores on all items. The content analysis of each news item was also performed to analyse the harmful reporting in terms of normalizing the event or depicting suicide as a simple event, as inevitable, as a coping method with well established mono-causal etiology in similar manner. Quantitative analysis was performed to describe degree of compliance to media guidelines in terms of percentages. The analysis on content of news item in terms of language and overall message conveyed in general is presented separately.

RESULTS

Table 1 depicts the details of all news items published during two years study period. There was a total of 285 news items in two years duration. There were 184 original news items and 101 duplicate items. Out of total 285 items, 170 items were from hindi newspapers while 115 were published in English newspapers.

Table 2 shows compliance to media reporting guidelines in news items evaluated. 92% of the news items published did not comply to the guideline of using news item as an opportunity to educate public on the complex issue of suicide and related mental illness while 65% did not comply to guideline on avoiding prominent placement. In 81% items headlines were not worded as per guidelines and 99 % revealed the identity of the deceased. None of the news items published used this as an opportunity to provide information to the general public about sources to seek help.

It was heartening to see that 89% did not unduly repeat the event in the item published, 93% did not mention an explicit description of the method and 90% did not provide a detailed description about the site of suicide. Table 2 also shows the comparison in compliance between items published in hindi vis-a-vis English newspaper. The hindi newspapers complied upon better in prominent placement avoidance while English newspapers complied better to guidelines on wording headlines and avoidance on undue repetitions. The detailed content reading of items revealed that 100 % news items depicted suicide in a simplistic manner; 55% of news items depicted suicide as a means of coping with personal problems while 53% reported suicide to be mono causal.

DISCUSSION

Rising prevalence of suicide, particularly among the adolescents and youth, embarks upon the need to have strong measures for ‘suicide prevention’ globally. The best practice elements and strategies for suicide prevention include range of initiatives including awareness programs, screening, gatekeeper training, access to means restriction, follow up care and responsible media reporting etc. Responsible reporting represent an evidence based population-level strategy for suicide prevention.¹⁸ The present study aimed at evaluating the media reporting of suicide (as per WHO guidelines) in newspapers published in city Chandigarh from January 2015 to December 2016.

One of the key recommendations of WHO resource for media professionals is to use media report as an opportunity to educate public on complex issue of suicide and related mental illness.¹⁶ Some of the myths about suicide can be easily dispelled through appropriate reporting while educating public on multi factorial and complex nature of suicide, association of suicidal behaviour with mental illness and personality traits etc. However, as per our findings, surprisingly 92% of media reports missed such opportunity to educate public and promote awareness among masses. These findings reflect ignorant and passive role of the media industry in educating public. Similar findings were reported from India and Korea.^13,14,19 Media reporting guidelines specifically re-iterate the need to use language which does not sensationalizes the act. There is a special mention to avoid the use of phrase “committed” as it reflects criminality and thus propels the existent stigma. In the present study, more than half of the reports violated this guideline. The common positive reporting practices in our study which were congruent to guidelines were avoiding explicit description of method, avoiding undue repetitions as well as avoidance of description of site etc. The guidelines mention that giving detailed description about means and site can trigger similar behaviour and few sites get symbolized as suicide spots. In present data almost 10% reports mentioned certain sites including hospital balconies, parks and railways tracks as major suicide spots. The media has been sensitive enough to avoid publishing of photographs of deceased in more than 90 % of the reports. Another similar study from India also reflected the same by not publishing photographs in deceased in ~ 80% of reports.²⁰

The present study also explored into some of the other factors which are known to add to the ‘Werther’ effect based upon the content of the news item. Three important factors explored in present study were whether suicide was presented in a simplistic way with a mono causal hypothesis and worded in such a way that suicidal act is presented as a means of coping. In present study in almost half of the reports suicide was projected as mono causal as well as a means of coping. These forms of reporting are thought to contribute to the ‘Werther effect’ explained in line of social learning where readers revere with the model in their circumstances and demographics.⁶ Moreover, oversimplifying the issue of suicide somehow desensitizes the readers about this major social issue and also conveys an overt message that suicide is a desirable outcome.

One guideline which is not complied with across various settings is providing information on various help seeking resources. In the earlier studies also, the figure was reported to be as low as 2% in China print media, 0 % in Rajasthan (India) and 1.4% in Korea.^10,13,19 Another important finding of the study is that there are significant differences in the degree of compliance in hindi versus english newspapers. The compliance is significantly better in hindi newspapers in terms of placements while English newspapers show better compliance in terms of wording of the headlines and avoidance of undue repetition. Another study from Bangalore highlighted differences in reporting in English and vernacular language for both harmful and protective characteristics. They found that vernacular language newspaper had better reporting on most of the items in harmful characteristics but English newspaper had better reporting on protective characteristics like focus on prevention program, focus on suicide research, expert opinion reported, mental disorder related to suicide and suicide-related statistical data reported from reliable sources.²⁰

In the earlier studies, responsible media reporting’ has been recognized as one of the key elements of ‘brief low cost intervention for suicide prevention’ in the national plan especially in developing country.¹⁸ In a country like India, where print media still occupies the major portion of disseminating news and information regarding socio-political, educational and other issues, the news on suicide is not disseminating information in a responsible manner and fails to use an opportunity to educate public on complex issue of suicide and related mental illness. The findings showed that none of the news item provided information on help providing agencies.

The present study has certain limitations. The scope of the present investigation was limited to the newspapers only. An equally influential and popular medium i.e social media remained unexplored. Moreover, the data is not recent. The newspapers included did not cover vernacular language newspapers. Also, the study was evaluative in nature and the actual protective and harmful impact of media reporting in quantitative and concrete terms can’t be commented upon. The present study reflects upon the social responsibility of the media industry which though is an autonomous body yet requires an intrinsic check to achieve balance between the freedom of expression and the vital societal interest at large.

CONCLUSION

Overall, the compliance to media reporting guidelines is poor for both english as well as hindi newspapers. None of the news item has reported the sources for help seeking. The present study highlights a strong need for a country like India to develop and implement media reporting guidelines at a policy level. Although, certain steps have already been initiated (example: IPS statement) but dedicated and concerted effort from policy makers, stakeholders and general public may give the required impetus. Although, media in India is mostly self-regulated, still the existing bodies for regulation of media such as the Press Council of India and the News Broadcasting Standards Authority can further issue standard guidelines.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

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