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After a Suicide Tragedy, Will There Be Copycats?

Does press coverage of tragedies like Robin Williams' death encourage self-harm?

Co-written with Professor Sir Simon Wessely (President of the United Kingdom Royal College of Psychiatrists)

In the wake of the extensive media coverage of Robin Williams' death last year, there has been concern that press coverage of suicide in itself might encourage copy-cat self-destructive behaviours.

Robert Enke, a very famous German football goalkeeper, killed himself on the railway on November 10, 2009. A recently published study entitled "One followed by many? Long-term effects of a celebrity suicide on the number of suicidal acts on the German railway net," found that the number of railway suicidal acts in the following two weeks more than doubled in Germany.

Raj Persaud
Source: Raj Persaud

The research, published in the Journal of Affective Disorders, found there was also an increase of railway suicides of 19 percent in the following two years, as compared to the two years before this tragic event.

The authors of the study, Ulrich Hegerl, Nicole Koburger, Christine Rummel-Kluge, Christian Gravert, Martin Walden, and Roland Mergl, found that the 25 percent increase of fatal railway suicides between 2007 and 2010 was significantly greater than the 6 percent increase in the total number of suicides in Germany over the same period.

The authors based at the University of Leipzig, and Deutsche Bahn AG (the German Railway Company), conclude that Enke's suicide probably led to copycat suicidal behaviour on the railways.

The authors point out that the media attention of the footballer's suicide was exceptional and enduring, and this may have had an impact. For example, television broadcasts of a public mourning ceremony, held in the team's stadium, were viewed by almost 7 million German viewers.

Thirty railway suicidal acts occurred in the two-week interval before Encke's suicide, and 71 railway suicidal acts occurred in the two-week interval following this event—an increase of 137 percent. But what is more ominous is that this research found an elevated long-term "attractiveness" of railway suicidal acts after Enke's suicide.

The authors conclude that their findings are a strong argument for improving media coverage of suicides, and community suicide preventive programs.

A study entitled "To What Extent Does the Reporting Behavior of the Media Regarding a Celebrity Suicide Influence Subsequent Suicides in South Korea?" just published in the journal Suicide and Life-Threatening Behavior, investigated the world record copycat effect thus far. This was the suicide of the Asian star actress Choi Jin-shil; starring in 18 films, she has been described as South Korea's equivalent of Julia Roberts.

Raj Persaud
Source: Raj Persaud

The authors, Jesuk Lee, Weon-Young Lee, Jang-Sun Hwang, and Steve Stack, found that her death on October 2, 2008, was subsequently associated with 429 additional suicides in South Korea, which is a record copycat effect.

Another recent investigation entitled, "Changes in suicide rates following media reports on celebrity suicide: A meta-analysis," examined 10 studies from around the world, probing for similar copycat effects, examining 98 suicides by celebrities.

The team of authors, led by Thomas Niederkrotenthaler, King-wa Fu, Paul Yip, Daniel Fong, Steven Stack, Qijin Cheng, and Jane Pirkis, report a change in suicide rates of on average roughly almost three suicides per 1,000,000 in the month after a celebrity suicide across the world.

Extrapolating from these figures, the worst-case scenario would be almost an additional 200 suicides over the month following the death of Robin Williams in the UK, and approaching 1,000 in the U.S. Whether or not that happens remains to be seen, but these non-celebrity suicides are unlikely to make the headlines.

The study, published in the Journal of Epidemiology and Community Health, reports suicides by an "entertainment celebrity" had the greatest impact in Europe, in terms of copycat incidents, followed by a slightly smaller impact in the U.S.

The authors—based at the University of Vienna, The University of Hong Kong, Wayne State University, and the University of Melbourne—found a particular celebrity impact on copycat behaviour by entertainment celebrities, as opposed to other prominent people, such as politicians.

Thomas Niederkrotenthaler and co-authors argue the suicide of an entertainment celebrity is so influential perhaps because of audience identification. Celebrities are revered and may therefore act as particularly strong role models, even when it comes to taking their own lives.

Guidelines for media reporting of suicide include that detailed discussion of the particular method should be avoided, and as images of the death scene are highly influential, these should not be broadcast.

But by writing this article, are we ourselves violating the media guidelines? Not so, we contend, because the recommendations do not say there should be no media reporting, but that it should be sober and responsible.

Thomas Niederkrotenthaler points out that not all celebrity suicide reporting is associated with increases in suicides subsequently. This is exemplified by the suicide of rock star Kurt Cobain. His suicide was widely reported, but there was no copycat phenomenon afterward, Dr. Thomas Niederkrotenthaler maintains.

This may be due to Cobain's widow, Courtney Love, expressing both her sadness and anger about her far too early loss in the media. What's more, contacts to support services were published, along with her statements, immediately after his suicide. Indeed, research showed that these mental health services experienced an increase in clients, but there was no upsurge in suicides.

Perhaps the celebrity obsession of the media is in fact a reflection of a deeper problem with journalism, of which suicide reporting is merely a symptom. Reporting of celebrities' lives, in general, tends to remain somewhat naïve. Being rich and famous, according to the classic simplistic media analysis, inoculates against any serious psychological problems.

In a study entitled "Psychological strains found in the suicides of 72 celebrities," the tensions experienced throughout the lives of 72 celebrities were systematically investigated. The authors, Jie Zhang, Jiandan Tan, and David Lester found that of 72 "celebrity" suicides, only one had no "strains" at all.

The authors, from Shandong University School of Public Health and Central University of Finance and Economics, China, and The Richard Stockton College of New Jersey, USA, found the most common pressure was "aspiration strain," found in 97 percent of the lives of celebrities who kill themselves.

Raj Persaud
Source: Raj Persaud

"Aspiration strain" was defined in this study, published in the Journal of Affective Disorders, as a gap between an individual's aspiration and the reality of their life—for example, wishing to be much richer than you actually are. The study found that 30 celebrities who killed themselves suffered at least two contrasting life strains, while 36 had endured three different "strains."

Perhaps the take-home message should be that despairing sadness may happen to anyone, irrespective of fame or wealth. But what many people still do not know is that depression, and also other mental health problems, including personal crises, can be treated, and that there is help available.

That should be the headline story.

If you have been affected by any of the issues raised in this article, visit the Samaritans Helpline at www.samaritans.org.

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