Reporting on suicidal behaviour and COVID-19—need for caution
Authors: Keith Hawton, Lisa Marzano, Lorna Fraser, Monica Hawley, Eva Harris-Skillman, Yasmine Xavier Lainez
Journal: The Lancet Psychiatry (2020)

News reporting on suicidal behaviour can have a considerable influence on suicide and self-harm in the general population.1Pirkis J Blood W Sutherland G Currier D Suicide and the news and information media: a critical review.https://www.sprc.org/resources-programs/suicide-and-news-and-information-media-critical-reviewDate: 2018Date accessed: September 20, 2020Google Scholar This issue is particularly relevant during the COVID-19 pandemic. With a rising number of deaths from COVID-19 infection and negative effects of the pandemic on key factors that are associated with suicide, including social isolation, unemployment, and financial problems, there is understandable concern that suicide rates might increase.2Reger MA Stanley IH Joiner TE Suicide mortality and coronavirus disease 2019—a perfect storm?.JAMA Psychiatry. 2020; (published online April 10.)https://doi.org/10.1001/jamapsychiatry.2020.1060Crossref PubMed Scopus (651) Google Scholar Importantly, news reporting should not add to the potential risks of suicide. Sensational media coverage of the negative effects resulting from the pandemic, especially when focused on suicidal behaviour, could increase the risk of imitation and contribute to normalising suicidal behaviour as a common and acceptable way to cope with difficulties related to the crisis. Of particular concern is the impact on young people, who are more likely to be influenced by what they see and hear in the media, are disproportionately featured in news coverage of suicide,3Marzano L Fraser L Scally M Farley S Hawton K News coverage of suicidal behavior in the United Kingdom and the Republic of Ireland.Crisis. 2018; 39: 386-396Crossref PubMed Scopus (19) Google Scholar and are at increased risk of imitative suicidal behaviour.4Gould MS Kleinman MH Lake AM Forman J Midle JB Newspaper coverage of suicide and initiation of suicide clusters in teenagers in the USA, 1988–96: a retrospective, population-based, case-control study.Lancet Psychiatry. 2014; 1: 34-43Summary Full Text Full Text PDF PubMed Scopus (100) Google Scholar Concerns about media reporting also apply to public messages given by members of the research community and health experts. Research findings should be presented and disseminated with care, not to conceal important findings, but to ensure that results are presented in a balanced way. Predictions about the potential effects of the pandemic on future suicide rates are of particular concern. There have been several attempts to model these effects, which have resulted in substantial media coverage and pessimistic stories likely to have negative effects on people who might be facing adverse circumstances and are perhaps feeling hopeless. A further concern is the language that some agencies have used to emphasise the extent of potential mental health problems that might develop as a result of the COVID-19 pandemic. This message has sometimes been taken out of context and used to generate sensational headlines directly linked to suicide. Important examples include the use of terms such as tsunami and tidal wave, especially given the association of such phenomena with deaths. When discussing mental health consequences of the pandemic, automatically conflating declining mental health with suicide and suicide risk should be avoided. Importantly, stigmatising mental illness and suicide also needs to be avoided because it might discourage people from seeking help. We acknowledge that striking a balance in this area can be difficult to achieve. However, there is room for optimism, especially if one of the effects of the pandemic is increased social cohesion. Suicide rates have previously been shown to decline in some (but not all) large-scale natural disasters and national crises.2Reger MA Stanley IH Joiner TE Suicide mortality and coronavirus disease 2019—a perfect storm?.JAMA Psychiatry. 2020; (published online April 10.)https://doi.org/10.1001/jamapsychiatry.2020.1060Crossref PubMed Scopus (651) Google Scholar Also, media reporting of suicide is not inevitably associated with suicide rises, and indeed, might even help to prevent suicide. Including links in reports to sources of support and focusing on stories of hope and recovery could have protective effects against suicide, especially among individuals at higher risk.5Niederkrotenthaler T Voracek M Herberth A et al.Role of media reports in completed and prevented suicide: Werther v. Papageno effects.Br J Psychiatry. 2010; 197: 234-243Crossref PubMed Scopus (427) Google Scholar Encouraging people to look out for each other and encouraging those who are struggling to seek help can be a legitimate role for the media. Media reports can model how to cope with suicidal thoughts and difficult circumstances, and provide a power_ful reminder that suicide is preventable and suicidal crises can be overcome (panel).PanelGuidance on reporting suicide in relation to the COVID-19 pandemic•Avoid making speculative comments and predictions about the potential rise in suicide rates, because these can result in sensational stories that oversimplify the issue.•Do not use alarmist language to describe any potential effect of the pandemic, such as surge, spike, crisis, and epidemic. Terms such as these have been used out of context, generating sensational news headlines.•Take extra care when covering long-term implications of the pandemic on mental health and suicidal behaviour (for example economic effects and potential job loss) to avoid unhelpful or sensational media coverage which might contribute to people's anxiety and a sense of hopelessness.•Use media opportunities to promote the importance of supporting people's mental health during this difficult time and to ensure that support is available to those who need it most.•Be aware that stories showing how people manage their mental health and recovery have been linked to falls in suicide rates. These hopeful stories can serve as powerful testimonies to others who might be struggling.•Remind people that suicide is preventable, and encourage help-seeking by signposting to sources of support, such as Samaritans. In the UK and Ireland people can call Samaritans for free 24/7 on 116123, or email [email protected].•When speaking with the media, remind them about the Samaritans' Media Guidelines for Reporting Suicide•Be mindful of these points on social media. Many people will be concerned about the pandemic and will want to talk about it, but they might not always be aware of the risks or have the knowledge of how to do this safely. •Avoid making speculative comments and predictions about the potential rise in suicide rates, because these can result in sensational stories that oversimplify the issue.•Do not use alarmist language to describe any potential effect of the pandemic, such as surge, spike, crisis, and epidemic. Terms such as these have been used out of context, generating sensational news headlines.•Take extra care when covering long-term implications of the pandemic on mental health and suicidal behaviour (for example economic effects and potential job loss) to avoid unhelpful or sensational media coverage which might contribute to people's anxiety and a sense of hopelessness.•Use media opportunities to promote the importance of supporting people's mental health during this difficult time and to ensure that support is available to those who need it most.•Be aware that stories showing how people manage their mental health and recovery have been linked to falls in suicide rates. These hopeful stories can serve as powerful testimonies to others who might be struggling.•Remind people that suicide is preventable, and encourage help-seeking by signposting to sources of support, such as Samaritans. In the UK and Ireland people can call Samaritans for free 24/7 on 116123, or email [email protected].•When speaking with the media, remind them about the Samaritans' Media Guidelines for Reporting Suicide•Be mindful of these points on social media. Many people will be concerned about the pandemic and will want to talk about it, but they might not always be aware of the risks or have the knowledge of how to do this safely. KH is a member of the National Suicide Prevention Strategy for England Advisory Group. LM, LF, MH, EH-S, and YXL declare no competing interests.