Suicide contagion and lurid journalism

Some news organizations have broadcast the details of how Robin Williams killed himself. This is irresponsible, because suicide is contagious. I have a source in a Canadian health agency who tells me that they have already seen a cluster of suicides similar to Williams’.

Margot Sanger-Katz has a great piece on the contagion of suicide.

When Marilyn Monroe killed herself in August 1962, the nation reacted. In the months afterward, there was extensive news coverage, widespread sorrow and a spate of suicides. According to one study, the suicide rate in the United States jumped by 12 percent compared with the same months in the previous year.

Mental illness is not a communicable disease, but there’s a strong body of evidence that suicide is still contagious…especially among young people. Analysis suggests that at least 5 percent of youth suicides are influenced by contagion.

People who kill themselves are already vulnerable, but publicity around another suicide appears to make a difference as they are considering their options. The evidence suggests that suicide “outbreaks” and “clusters” are real phenomena; one death can set off others.

Let me add a few words to explain this. The novelist David Foster Wallace killed himself in a similar way to Williams. He wrote that

The so-called ‘psychotically depressed’ person who tries to kill herself doesn’t do so out of quote ‘hopelessness’ or any abstract conviction that life’s assets and debits do not square. And surely not because death seems suddenly appealing. The person in whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who leap from burning windows. Their terror of falling from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire’s flames: when the flames get close enough, falling to death becomes the slightly less terrible of two terrors. It’s not desiring the fall; it’s terror of the flames.

That is, the suicide of the depressed is an attempt to escape from flames. It is a rational act, although not a reasonable one.

Nevertheless, as Wallace makes clear, killing yourself is extremely difficult. You have to know about and have access to effective means. Moreover, suicide is a painful, violent act, and victims contemplate it in terror. Some victims have to make multiple, successively more violent attempts before they succeed.

Lurid journalism about the means of suicide is harmful in two ways. It provides the person at risk with data about what works. And by modeling how a suicide was accomplished, it lowers the psychological barrier of terror.

So how should journalists report on suicides? The public interest is best served by simply reporting that a person has died by suicide, with no additional details provided. If that’s too much to ask, then at least such details should not be placed in headlines or featured in a way that calls attention to them. This guidance is found in many ethical standards for journalists.

Williams’ suicide has also prompted a lot of constructive journalism about suicide prevention. I am all for that: suicide prevention is one of my research areas. But the most important thing to do is to find more effective treatments for the cause of many suicides: depression. And to find these treatments we need to be conducting more mental health research.

Remember, some of the people you pass in the street are actually in hell. In Marlowe’s Dr. Faustus, Faustus is surprised that the demon Mephistopheles is on earth, in the same space/time as Faustus is.

FAUSTUS. Where are you damn’d?

MEPHIST. In hell.

FAUSTUS. How comes it, then, that thou art out of hell?

MEPHIST. Why, this is hell, nor am I out of it.

@Bill_Gardner

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