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Suicide

Reporting on Suicidal Ideation: Why Piers Morgan Was Wrong

Important new research on media coverage of suicidal thoughts.

Nan Palmero from San Antonio, TX, USA/Wikimedia Commons
Piers Morgan at CES 2011
Source: Nan Palmero from San Antonio, TX, USA/Wikimedia Commons

Piers Morgan, a controversial British TV host, has left his national broadcasting position after expressing strong skepticism that Meghan Markle’s confessions of having had suicidal thoughts, expressed during her recent interview with Oprah Winfrey, were true.

BBC News reports that Morgan stands by his criticism of the Duchess of Sussex. Ofcom, a regulator of broadcasting in the UK, is investigating his comments after receiving 41,000 complaints about his statements from members of the British public.

The duchess apparently also formally complained to ITV about Morgan's remarks. It is reported that she raised concerns about how his sentiments could affect others contemplating suicide.

Is Morgan right to stand by his comments? Did Markle's interview in fact make it more likely that others will self-harm?

Research has suggested that reporting of suicidal behavior in the media is linked to an increase in suicidal ideation and actual suicides. For example, Google searches for “How to kill yourself” appeared to rise significantly after the release of 13 Reasons Why , a popular Netflix teen drama on the aftermath of a high school student's suicide. One study calculated there were 900,000 to 1.5 million more searches than expected for that time of year during the first two weeks following the release of the series.

Another study, published in the Journal of the American Academy of Child & Adolescent Psychiatry in February 2020, estimated that there were 195 additional suicide deaths among 10- to 17-year-olds between April 1 and December 31, 2017, following the series’ release.

One of the first studies to investigate this effect analyzed 34 newspaper stories that reported on suicides and found a 2.51 percent increase in suicide during the month of the report.

More worrying is research by Steven Stack, an expert on the sociology of suicide based at Wayne State University, which found that studies measuring the presence of a celebrity in a suicide press report are over five times more likely to find a copycat effect, while studies focusing on female suicide were almost five times more likely to report a copycat effect than other research investigating the impact of suicide reporting in the press. Stack also found that in the year of the publication of a book focusing on self-harm by a particular method, suicide by that specific method increased 313 percent in New York City. In almost a third of such cases, a copy of the book was found at the scene of the suicide.

On average, following the media reporting of a suicide, approximately a third of persons involved in subsequent suicidal behavior appear to have seen reporting on that suicide and therefore may be copycats. The suicide of actress Marilyn Monroe, for example,was associated with a 12 percent increase in suicide. Stack has theorized that a vulnerable suicidal person may reason, "If a Marilyn Monroe with all her fame and fortune cannot endure life, why should I?"

Copycat suicides following media reporting of self-harm has been termed the "Werther Effect," after a popular 1774 novel in which the hero kills himself. Goethe's The Sorrows of Young Werther was believed by many to be responsible for an epidemic of suicide in young people. Authorities grew so worried that the book was banned in Copenhagen, Italy, and Leipzig. Goethe is reported to have commented on the phenomenon: “My friends…thought that they must transform poetry into reality, imitate a novel like this in real life and, in any case, shoot themselves; and what occurred at first among a few took place later among the general public…”

However, newer research suggests a very different conclusion: that, by talking about her suicidal ideation, Markle may have indeed performed a positive service that could benefit suicide prevention. This study, entitled "Role of media reports in completed and prevented suicide: Werther v. Papageno effects," refers to the "Papageno Effect," which is the opposite of the Werther Effect, and refers to suicide rates actually dropping following reports of self-harm.

The Papageno Effect, the authors explain, is based on Papageno's overcoming of a suicidal crisis in Mozart's opera The Magic Flute . In Mozart's opera, Papageno becomes suicidal upon fearing the loss of his beloved Papagena; however, he refrains from suicide because of three boys who draw his attention to alternative coping strategies.

Thomas Niederkrotenthaler and Gernot Sonneck of the Medical University of Vienna led a team that analyzed all 497 print media reports from the 11 largest Austrian newspapers which included the term "suicide" between January 1 and June 30, 2005. Reporting of individuals thinking about suicide — and not accompanied by attempted or completed suicide — was associated with a decrease in suicide rates. This study suggests that media reports on suicidal thinking, such as those on Markle's statements, formed a distinctive class of media articles, which have a low probability of being potentially harmful.

The study, published in the British Journal of Psychiatry, found that, in marked contrast, media stories attempting to dispel popular public myths about suicide — in other words, articles one might expect would help to discourage suicide — were associated with increases in suicide rates.

Other articles associated with increases in suicide rates include stories in which the main focus was on suicide research, items containing contact information for a public support service, and also the reporting of expert opinions. In other words, all the previous so-called expert opinions of how the media ought to report suicide were not actually linked to drops in suicide rates but instead increases.

The authors conclude that actual reporting of suicidal thinking may contribute to preventing suicide. Despite whatever Morgan may believe about the Markle interview, the latest research suggests that she may have performed a public service by drawing attention to suicidal thinking.

One theory as to why this might be the case includes the suggestion that reporting that someone has thought about suicide, without attempting it, enhances identification with that individual and thus highlights the reported outcome as "going on living."

This research suggests a potential new public health strategy as regards suicide prevention. This may be most effective when articles are published on individuals who refrained from adopting suicidal plans and instead adopted positive coping mechanisms, despite suffering adverse circumstances. The authors refer to this kind of press story as "Mastery of Crisis." One example they quote: "Before [Tom Jones] had his first hit, he thought about suicide… and wanted to jump in front of an Underground train in London… In 1965, before he made the charts with 'It's Not Unusual,' he thought for a second: 'If I just take a step to the right, then it'll all be over.'"

Whatever else you may think of Markle or the interview, the most important question may be: Did she exhibit Mastery of Crisis?

Dr. Peter Bruggen passed away in 2018. While this post was written by Dr. Raj Persaud, Dr. Bruggen's name is retained biographically as a tribute to his contributions overall.

References

Piers Morgan stands by Meghan criticism after Good Morning Britain exit https://www.bbc.co.uk/news/entertainment-arts-56343768

Internet Searches for Suicide Following the Release of 13 Reasons Why. Ayers JW, Althouse BM, Leas EC, Dredze M, Allem J. JAMA Intern Med. 2017;177(10):1527–1529. doi:10.1001/jamainternmed.2017.3333

Bridge, J, Greenhouse, JB, Ruch, D, Stevens, J, Ackerman, J, Sheftall, A, et al. Association between the release of Netflix's 13 Reasons Why and suicide rates in the United States: an interrupted times series analysis. J Am Acad Child Adolesc Psychiatry 2019; 28 Apr (doi: 10.1016/j.jaac.2019.04.020).

Suicide in the Media: A Quantitative Review of Studies Based on Nonfictional Stories. Steven Stack. Suicide and Life-Threatening Behavior 35(2) April 2005, 121-133

Role of media reports in completed and prevented suicide: Werther v. Papageno effects. Thomas Niederkrotenthaler, Martin Voracek, Arno Herberth, Benedikt Till, Markus Strauss, Elmar Etzersdorfer, Brigitte Eisenwort and Gernot Sonneck. British Journal of Psychiatry, 197(3), 234-243. doi:10.1192/bjp.bp.109.074633

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