The Language of Suicide

As mental health campaigns are seeking to break down stigma around the topic of suicide, health practitioners and journalists are crafting guidelines for media on how best to report this complex topic

By Crystal Mackay, MA’05

Just a decade ago, many journalists held firm to the belief that suicide did not belong in mainstream media. There was an unspoken rule that suicide was to be kept out of the public eye.

As the conversation around mental health gained steam, and campaigns around stigma-reduction were launched, renowned Globe and Mail health columnist André Picard says health practitioners and journalists began to question this edict.

“We didn’t even really know why we had this blanket ban, or why there were exceptions to the rule, for example when Kurt Cobain took his life,” he said. “As the broader societal conversation about mental health geared up, journalists were forced to think about these things and talk about them more.”

Picard says one of the key ways to address stigma is through open dialogue that challenges some of the myths around mental health, but it has to be done thoughtfully.

He has been instrumental in helping to draft guidelines for journalists including the Mindset Guide, written by journalists for journalists about how to talk and write about mental health and suicide in the media.

He also worked alongside Schulich Medicine & Dentistry faculty member Marnin Heisel, PhD, in drafting the new iteration of the Media Guidelines for Reporting on Suicide from the Canadian Psychiatric Association (CPA) published this past year.

“The point of all of the guidelines is not to clamp down or dampen down on the stories of suicide, it is to discuss how best to share information that people should know about in a way that doesn’t cause harm, and, if anything, could actually help get people the help that they need,” said Heisel, a clinical psychologist who is also the research director in Psychiatry, and Canada’s National Representative to the International Association for Suicide Prevention.

The CPA guidelines provide recommendations on ways to reduce the stigma around mental disorders, and to provide information about alternatives to suicide. It suggests that pertinent resources for people contemplating suicide should be provided and linked to in reports that appear online, and that simplistic or glorified depictions of suicide should be avoided. The guidelines also spend considerable time examining appropriate language around suicide.

“When you look back at it retrospectively, we spent years writing ‘committed suicide,’ and if you really look at what that means, it refers to the fact that this used to be a crime that was committed,” said Picard. “When you think about it, the language is really inappropriate.”

Heisel says this small but important piece really reinforces the power of language and the need for health practitioners to collaborate with journalists to shape the guidelines together.

“We need to work together, not to shape or change the message that journalists use, but to share information that we have as mental health professionals and as researchers, so that journalists can do their job well,” said Heisel. “We aren’t telling the journalists what angle they should take with a story, but we hope that whatever the angle is, that it’s done in an appropriate and safe manner.”

Picard is skeptical about the role the media plays in what is referred to as ‘contagion effect.’ “My reading of the research is that what the media influences more is method rather than choice. So, a lot of people are going to die by suicide, that’s a reality, and what the media needs to do is avoid being too gruesome or prescriptive about it.”

The CPA guidelines point out that there is a substantial body of evidence suggesting that media reports of suicide can influence those who may already be vulnerable. Heisel points to a body of research demonstrating that media reports of suicide correlate with a higher subsequent number of deaths by suicide.

“We need to work together, not to shape the message that journalists use, but to share information that we have as mental health professionals and as researchers, so that journalists can do their job well.” —Marnin Heisel, PhD

He also indicates that there is a growing body of evidence demonstrating that articles in mainstream
media depicting people overcoming suicidal crises may in turn lower the number of deaths by suicide.

“This is where more research is needed – to look at the positive aspects of reporting suicide thoughtfully. Is it reducing stigma? Is it having an effect?” he asked.

Another area for future research is how social media affects suicide rates. For the first time, this most recent iteration of the guidelines addresses social media and the implications on the guidelines as a whole. The authors question whether the proliferation of social media makes guidelines like these less relevant.

Picard says that at the moment social media is like the Wild West – a place with no rules where anything goes – however, he has seen a shift in social media platforms starting to take themselves more seriously, and imposing rules where none existed before.

And he says the time is ripe for engaging social media organizations in the discussion as well.

But are the guidelines even being followed by mainstream media? Recent research says, yes. A paper published in the CPA journal used Robin Williams’ death by suicide as a keystone. They found that 65 – 99 per cent of articles adhered to most of Mindset’s 14 specific recommendations.

“As journalists we don’t necessarily think through all the complexities of mental health and suicide in particular so it’s good to have some guidance to give us some things to think about,” said Picard. “I wish these guidelines were around 30 years ago, we could have avoided a lot of awful things that we wrote.”