Some recent reports on preventing suicide, and providing better support to the bereaved
The 23 June issue of The Lancet has a series of articles on suicide which, amongst other things, make the points that:
• Risk factors for suicide are complex and vary between cultures and countries. Among the many risk factors are mental illness, physical illness, previous suicide attempt, substance abuse, family history of suicide, impulsiveness, hopelessness, isolation, and loss – relationship, social, work, financial. (There is more at The Conversation on specific risk factors in Australia – being a young male in remote areas or lower socioeconomic groups).
• Much of the research on suicide and suicide prevention has been done in wealthy countries, although low-income and middle-income countries account for 84% of all suicides.
• It cannot be assumed prevention strategies that are useful in one setting will help in another. As one article noted, “The complexity of risk factors for suicide suggests that many approaches to suicide prevention should be considered and customised to accommodate local circumstances.”
Meanwhile, a conference for those bereaved by suicide and those working in the field of suicide postvention is underway in Sydney today and tomorrow.
Jaelea Skehan, the Program Manager at the Hunter Institute of Mental Health responsible for the management of the Mindframe National Media Initiative, is also presenting the results of some research exploring the views of those bereaved by suicide about media coverage, and about their experiences with the media.
The findings, Suicide Bereavement and the Media, provide some instructive reading for journalists grappling with reporting on such traumatic issues.
She suggests in the article below that people who have been bereaved by suicide could benefit from some formal support and training in dealing with the media.
Suicide bereavement and the media: opportunities, challenges and ways forward
Jaelea Skehan writes:
Suicide is an emotive and personal issue for many people in Australia. The role and impact of the media often also draws an emotive and personal response.
Even without any formal research, we only need to look to the range of comments posted with online media stories to get a sense of the diversity of views that exist within the community about the way suicide is reported and the impact it has on those with personal experience.
As an illustration of this diversity, the following two comments were posted on the same story on an ABC the Drum article in late 2011:
…I have suffered from depression (though haven’t attempted suicide) and the idea that hushing up media reporting would have any impact on the thought processes of sufferers is patronising and offensive…
…I lost my wife and trying to keep my son alive. Please shut up. The place for talk is not in the media. It is in safe places where the person affected can talk, not just receive media messages…
A National Inquiry into Suicide in Australia during 2010 raised a number of issues around public discussion of suicide and the possible benefits of personal stories about suicide. Personal stories about suicide bereavement may provide opportunities for useful public discussion that focuses on the impact of suicide. It may also go some way to reducing the stigma associated with suicide.
These opportunities, however, may come at a personal cost to those people bereaved by suicide, and their wider family unit. If not handled well, stories may also pose a risk to other vulnerable members of the community. Getting the balance between the needs of the community and needs of the individual can sometimes be a balancing act.
While much is now known about the impact of media reporting about suicide deaths (see Pirkis and Blood, 2010 – http://www.mindframe-media.info/client_images/900016.pdf) and the types of information most likely to increase and decrease risk in stories, this body of evidence has generally ignored the impact of reporting on people bereaved by suicide.
It has also ignored the impact that participating in a media story may have on those personally affected by suicide.
Given the lack of evidence looking specifically at the issue of suicide bereavement and the media, the Hunter Institute of Mental Health worked with an expert reference group during 2011 to conduct a scoping study under the Mindframe National Media Initiative. This scoping study has explored the different views and needs of people bereaved by suicide with regards to managing media interactions.
The outcomes of focus groups with people bereaved by suicide and additional key informant interviews with journalists, police, postvention workers and people bereaved who have participated in media stories, shows the complexity of this issue. People generally identified both opportunities and challenges that need to be addressed.
In general, people were supportive of more media stories about suicide as long as they focussed on the impact that suicide has or on promoting help-seeking behaviour. At the same time, however, they reported that stories about suicide “stood out” to them and that impacts could include “re-traumatisation and increased grief symptoms after reading about another person’s bereavement”.
You don’t think that much about it, you are only shocked that these things happen, but until it happens to yourself suddenly you realize that yes it has a huge impact. And then you notice much more in the newspapers you notice much more on TV [focus group participant].
People bereaved by suicide have generally been motivated to participate in a media story through a sense of altruism compelling them to take on an educative or advocacy role, using the media as a vehicle to raise awareness about suicide.
…hopefully making a difference in breaking down stigma, talking about suicide that ‘s’ word which so often has drawn the awkward silence [person bereaved].
Those people who had participated in a media story reported that it could be either a positive or negative experience for them depending on how the journalist treated them, how the story was framed and the time it occurred.
Most people believed it was unhelpful to participate in a media story at the time of the initial trauma. This can be challenging, because for some media, this is the very time they may be considering a report.
I don’t think it would be helpful when you are going through the initial bereavement and trauma [postvention worker].
… some aren’t ready to talk to you. It’s too new, it’s too fresh, it’s too shocking… [media professional].
Of particular interest to the study was the fact that not one of the people bereaved by suicide had been provided with any support around media engagement at the time they participated in a media interview. Journalists also found interactions to be challenging, often feeling conflicted about how and when it was best to involve someone bereaved by suicide in a story.
Depends on where you are, if it’s recent it can be a real minefield, people are incredibly distressed and probably latching on to anything, they are looking for answers and you don’t have them [media professional].
It is clear that further work to support all stakeholders to navigate this issue is important. And more research is needed. As a community we need to maximise the opportunities that personal stories provide, while managing the potential risks.
What I would like to see is more coordination of the suicide prevention sector, thoughtful planning about media messages at national, state and local level and more formal support and training for people with personal stories who are vital to any media story about suicide.
While the media have formed good relationships with mental health organisations and are generally aware of how to access personal stories about mental illness, the same does not occur with the issue of suicide currently. I know this is an issue some in suicide prevention are working towards addressing.
• Jaelea Skehan is the Program Manager at the Hunter Institute of Mental Health responsible for the management of the Mindframe National Media Initiative in Australia. She is a member of the International Taskforce on Suicide and the Media and has been working in this area for almost 10 years. In the past 12-18 months she has worked with a reference group of suicide bereavement and postvention experts to look more closely at the issue of suicide bereavement and the media.
If you or someone you know needs help, contact Lifeline’s 24-hour helpline on 13 11 14, SANE Australia on 1800 18 7263 or the Beyondblue Info Line 1300 22 4636. See here for more suicide crisis numbers and contacts.