Media reports of celebrity death by suicide appear to increase the rates of suicide in the general population, results of a systematic review and meta-analysis have shown. Reporting of the method used by the celebrity also increases deaths by the same manner.
However, general reporting of suicide appears to have no meaningful impact on suicide, but associations for certain types of reporting cannot be disregarded.
“Our results support the continued use and promotion of guidelines on responsible media reporting of suicide, which are the best available interventions to address and prevent imitation effects in the population,” the investigators said.
The databases of PubMed/Medline, PsychInfo, Scopus, Web of Science, Embase and Google Scholar were searched up to September 2019. Inclusion criteria for studies were as follows: comparison of at least one time point before and one time point after media reports on suicide, follow-up of ≤2 months, outcome of death by suicide, and media reports about nonfictional suicides.
The investigators reviewed data from studies adopting an interrupted time series design or single or multiple arm before and after comparisons. Thirty-one studies were identified, of which 20 had moderate risk of bias and were included in the meta-analysis.
Suicide risk rose by 13 percent in the period following media reports of a celebrity death by suicide (rate ratio [RR], 1.13, 95 percent confidence interval [CI], 1.08–1.18; 14 studies; median follow-up, 28 days; range, 7–60 days). [BMJ 2020;368:m575]
Reports of suicide method used by the celebrity resulted in a 30-percent increase in deaths by the same approach (RR, 1.30, 95 percent CI, 1.18–1.44; 11 studies; median follow-up, 28 days; range, 14–60 days).
General reporting of suicide did not show a meaningful effect, with a rate ratio of 1.002 (94 percent CI, 0.997–1.008; five studies; median follow-up, 1 day; range, 1–8 days) for a one article increase in the number of reports on suicide.
Heterogeneity was large and partially explained by celebrity as well as methodological factors. Some publication bias existed in literature as suggested by enhanced funnel plots.
The following mechanisms could help explain the increase in suicide rates associated with reporting of suicide among celebrities: identification with the deceased person, which commonly occurs when reported suicides are about those with high social standing; increased media reporting of suicide leading to normalization of suicide as an acceptable way to cope with problems; and information on suicide method, which might influence the choice of suicide approach by a vulnerable individual. [Soc Sci Med 2009;69:1085-1090]
“Caution should be exercised in reporting suicides by celebrities in particular,” the investigators said. “The media will continue to report on newsworthy suicides but have a social responsibility to mitigate the likelihood of the Werther effect,” defined as imitation of suicide after a highly publicized suicide.
In a linked opinion, the authors stressed the importance of responsible reporting of suicide by the media “if we want to be serious about tackling the stigma and ultimately help more individuals to seek help and prevent suicide.” [https://blogs.bmj.com/bmj/2020/03/19/responsible-communication-on-suicide-in-the-media-is-essential-if-we-want-to-be-serious-about-tackling-the-stigma-surrounding-suicide/]