|The development of a guideline and its impact on the media reporting of suicide.|
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|PMID: 22135440 Owner: NLM Status: PubMed-not-MEDLINE|
|CONTEXT: A causal association between media reporting of suicides and the subsequent actual suicides has been observed. There are no studies from India regarding media reporting of suicide. This study examines whether educating media professionals about responsible reporting of suicides can change the quality of reporting.
AIMS: To study the impact of a guideline on the reporting style of suicides by journalists.
SETTINGS AND DESIGN: Newspaper reports in the local language examined by psychiatrists.
MATERIALS AND METHODS: The Department of Psychiatry of a Teaching Hospital conducted a workshop for journalists, with the collaboration of media and mental health professionals and came out with a guideline about responsible reporting of suicide. Using this, a proforma was designed for assessing newspaper reports of suicides. All the suicide reports in the leading newspapers in Kerala were analyzed for one year prior to the workshop, the immediate next year, the second year, and six years later, using the 15 item proforma and whether each report was concordant or discordant to each item in the proforma was noted.
RESULTS: The total concordant responses were 43.7% in the year prior to the workshop, 45.2% during the first year following the workshop, 46.2% in the next year, and 45.7% after six years. When the trend of each item was examined, the concordance rates were increasing in each item, except two. There was no statistical significance.
CONCLUSIONS: A workshop for journalists could bring about positive changes in the media reporting of suicides. The changes persisted over the years, although they did not reach statistical significance.
|Smitha Ramadas; Praveenlal Kuttichira|
|Type: Journal Article|
|Title: Indian journal of psychiatry Volume: 53 ISSN: 1998-3794 ISO Abbreviation: Indian J Psychiatry Publication Date: 2011 Jul|
|Created Date: 2011-12-02 Completed Date: 2012-08-30 Revised Date: 2013-05-29|
Medline Journal Info:
|Nlm Unique ID: 0013255 Medline TA: Indian J Psychiatry Country: India|
|Languages: eng Pagination: 224-8 Citation Subset: -|
|Department of Psychiatry, Government Medical College, Thrissur, Kerala, India.|
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Journal ID (nlm-ta): Indian J Psychiatry
Journal ID (publisher-id): IJPsy
Publisher: Medknow Publications & Media Pvt Ltd, India
Copyright: © Indian Journal of Psychiatry
Print publication date: Season: Jul-Sep Year: 2011
Volume: 53 Issue: 3
First Page: 224 Last Page: 228
PubMed Id: 22135440
Publisher Id: IJPsy-53-224
|The development of a guideline and its impact on the media reporting of suicide|
|Department of Psychiatry, Government Medical College, Thrissur, Kerala, India
|Correspondence: Address for correspondence: Dr. Smitha Ramadas, ‘Swapna’, Shiva Temple Road, Viyyur P.O, Thrissur, Kerala – 680 010, India. E-mail: firstname.lastname@example.org
Suicide is one of the three leading causes of death in the age group of 15-44 years. The total global burden of suicide is 1.8%. Suicide is a public health problem. In India, more than one lakh lives are lost every year to suicide. In the last two decades, the suicide rate has increased from 7.9 to 10.3 per 100,000. Suicide prevention needs a collaborative and multidisciplinary approach. One of the components of preventing suicides is addressing the issue of the media reporting of suicide, although there is no consensus on the method and effectiveness of this.
There is a causal association between media reporting and the subsequent actual suicides.[2–4] Madelyn Gould has performed the most definitive and exhaustive review of media effects on suicides and has concluded that the contagion effects of suicide are valid beyond doubt.
The impact of the media on suicidal behavior seems to be most likely when, the report specifies the method, the details of the act are portrayed dramatically, is in the headlines or is that of celebrities.[6–8] Although difficult, it is not impossible to change journalists’ habits when reporting suicide cases. One approach has been to produce guidelines for the media, of which there are now several.[10–12] These recommendations urge the media not to normalize, idealize, or sensationalize suicide, and suggest that their reporting encourage people to seek help when needed.
Kerala is a state in the south western tip of India, which is densely populated, with a high literacy rate and is far ahead of other Indian states as regards all parameters of physical health; in fact comparable to developed countries. However, the suicide rate in Kerala is four times the national average and it is a state with a very high suicide rate.
There are no studies from India regarding media reporting of suicide. This study examines whether educating the media professionals about responsible reporting of suicide can bring about a change in the quality of reporting.
The Department of Psychiatry of a teaching hospital conducted a workshop on February 3rd, 2001, for journalists, with the active collaboration of the media and mental health professionals. In that one day workshop, professionals of both fields worked together and came out with a 15 item guideline about responsible media reporting of suicide. The guidelines were evolved from the experience of both groups of professionals from their respective fields, also taking into consideration the World Health Organization (WHO) guidelines for responsible media reporting of suicide. Using these guidelines, a proforma was designed for recording newspaper reports of suicide.
The leading daily in Kerala (Malayalam-mother tongue)was selected for the study. All the reports of suicide that appeared in this daily were analyzed, for one year prior to the workshop (2000-2001), the immediate next year (2001-2002), second year (2002-2003), and six years later (2007-2008).
The data was collected by eight, fourth-year medical students, after receiving intense training from a qualified Psychiatrist. A total of 15 hours of training was imparted to the students, during which each item in the proforma and the scoring method were explained in detail and the students were guided to analyze the news items in the same sets of newspapers, to ensure uniformity in rating. Until they attained a consensus in rating they were trained to analyze and rate the newspaper reports.
Every issue of the newspaper,of the above mentioned four years of the seven year study period, was scanned for reports of suicide and attempted suicides. Each report was analyzed using the 15-item proforma. The report was read in detail and whether it was concordant or discordant to each guideline was noted.
Twenty-one delegates participated in the workshop, among which nine were from the media. They were reporters from newspapers and one was a senior editor. The remaining delegates were mental health professionals from different backgrounds.
In each year, there were 352 issues of the daily, as there were 13 holidays for the press every year. The year 2000, being a leap year had 366 days. The percentage of suicide reports showed an increasing trend, with the lowest number of reports in the year 2000-2001 and highest number in the year 2007-2008 [Table 1].
When the pattern of reporting response, year–wise was examined [Table 2], it was found that the total concordant responses in the year 2000-2001, before developing the guideline, were 878 out of a total of 2010 responses (43.7%). This was increased to 1301 out of a total of 2880 responses (45.2%) during the immediate first year (2001-2002) following the development of the guideline. This higher rate continued. It was 1075 out of a total of 2325 responses (46.2%) in the next year (2002-2003) and 1493 out of a total of 3270 responses (45.7%) after six years (2007-2008). The total discordant responses in the year 2000-2001, before developing the guideline, were 1004 out of 2010 (50%). This was reduced to 1392 out of 2880 (48.3%) during the immediate first year (2001-2002) and further lowered to 1101 out of 2325 (47.4%) in 2002-2003. It remained as 1566 out of 3270 (47.9%) in 2007-2008. The ‘not reported’ category remained consistently low during all the study years.
When the trend of each item was examined in Table 3, it was found that the concordance rates were generally increasing in each item. The only exception was item 8 (Avoid reporting suicide as the only method of coping in the situation of personal crisis) and item 12 (Not to glorify victims as martyrs or the method as an acceptable one).
The discordance rates were generally decreasing over the years [Table 4]. The exceptions were item 8 and item 12, which showed an increase. The maximum increase in concordance rate was for item No.11 (Be neutral in reporting).
The results were analyzed using chi square tests. There was no statistical significance in the proportion of the overall total responses and concordance and discordance rates before and after the workshop.
When item No. 13 (Acknowledge the presence of physical and mental illness in the deceased) was examined it was found that in 96% of the reports in the year before the workshop, there was no mention regarding the presence / absence of mental illness. That has remained consistent over the years.
Kerala is a densely populated state with a literacy rate of 90.92%, which is the highest in India (2001 Census report). According to The National Readership Survey (NRS), 2006, an average Indian adult spends 44 minutes per day reading dailies and magazines. The latest findings of the NRS indicate an increase in the reach of the press medium, from 216 million in the year 2005 to 222 million in 2006. In Kerala, the average time spent on reading is more than double the national figure. There are about a dozen newspapers in circulation and a lot more people are reading newspapers daily.
The daily selected for the study–Malayalam Manorama–is the one with the largest circulation in the state. The all-Kerala circulation of this daily is 16, 20,849 copies as per the Audit Bureau of Circulation, 2008, January-June, 2008, report. The National Readership Survey of India, 2006, reported this daily as having the highest readership of 83.07 lakhs.
High literacy rate and large readership indicate the magnitude of potential for media influence on an average Keralite. The study showed that about half the issues of newspapers in a year carry a report of suicide. The mass media is believed to be one of the most important sources of information and is instrumental in the formation of attitudes and beliefs in the public.
The media portrays suicide in a glamorous and biased manner, normalizing the act, and thus prompting the vulnerable and ambivalent individuals to opt for this method in times of distress. A Swiss study found that suicide is clearly treated as a major topic of news sensation in some of the leading dailies. There is reason for concern in view of the danger of imitation effects, as the media reports serve as models.
Organizing a workshop for journalists and mental health professionals toward suicide prevention was the first of its kind in the state. It formed one of the sub-programs of the District-Based Suicide Prevention Program of Thrissur. However, the participation of media personnel was low and that too was limited to juniors in the field.
Reports about both suicide and attempted suicides were taken into consideration, because the actual outcome of the act might not be available at the time of reporting and the boundary between suicide and attempted suicide is blurred. The interest of the study was mainly on the style of reporting the suicides and not the outcome.
The total concordant responses (i.e., responses concordant to the guideline) in the year before developing the guideline were 43.7%. This was increased to 45.2% during the immediate first year following the development of the guideline. This higher rate continued to 46.2% in the next year, and decreased to 45.7% after six years. Although it decreased from the previous years, it was still higher than the year before the workshop. However, the difference in the number of responses did not reach a level of statistical significance. Contrary to the study by Frey et al., in this study, the analysis was done guideline-wise (whether each report was concordant or discordant to each guideline) rather than report-wise. In the referred study, each report was coded and converted into a numerical imitation risk score.
Each guideline was further analyzed. The guideline about ‘Neutrality in reporting’, achieved the maximum increase after the workshop, although there was no statistical significance. All the guidelines showed an increase in concordance rates. The only exceptions were the guideline ‘Avoid reporting suicide as the only method of coping in the situation of personal crisis’ and the guideline, ‘Do not glorify victims as martyrs or the method as an acceptable one.’
In the study by Frey et al., it was shown that collaboration between researchers and the media resulted in a significant improvement in the quality of reporting. They conducted a survey over a period of eight months, and did a qualitative and quantitative analysis of each report. After the publication of the guidelines, a second identical survey was conducted three years later, and it was found that the quality of reporting clearly improved, although the number of articles had increased. There was a significant decrease in the suicide rate .The study indicated that it was not the number of articles that mattered, but the quality of reporting.
In the present study also, the number of reports showed a trend for increase and there were pointers for a better reporting style. In the year 2000-2001, the number of reports were 2010 and in the subsequent two years they were 2880 and 2325. In the year 2007-2008 they were 3270. Nevertheless, there was an improvement in the quality of reporting. This qualitative change spoke more about the positive suicide reporting behavior of media persons. The positive trends were not significant. The participation of the media persons was too low, and that too, limited to the grass root level reporters. Only the editorial board members could influence the reporting style effectively.
In a study conducted in Austria, it was found that the media guidelines had an impact on the quality of reporting as well as on suicidal behavior. They tested the use of the words ‘suicide’ and ‘self-murder’ in the headlines of suicide reports by the Austrian Press agency. A comparison of the five years before and after the introduction of the guidelines showed a very significant decrease in this qualitative feature, in line with the media recommendations. There was also a significant correlation between the number of suicides and this qualitative feature of reporting of suicide headlines.
One question that might be tested is whether the “journalist led guidelines” are more likely to have the desired impact than those that are developed by others, with no reference to media professionals’ views. In this context, it is worthwhile to note that in the present study, the guidelines were generated by the journalists collaborating with mental health professionals.
The presence of physical and mental illnesses were acknowledged only in 3.5% of the reports whereas, studies have found that more than 90% of the people who commit suicide have a mental disorder. This enormous gap could be appreciated on various grounds. The media reports come from the actual field, while the studies are from the clinical setting. Only clinicians can pick up the syndromes, especially when the stigma attached to mental illness is quite significant. The media report can be misleading at times. On the other hand, acknowledging the presence of a mental disorder and using the opportunity for public education, to highlight suicide counters, can go a long way in enhancing the suicide counters.
Literature from India did not find any studies on media reporting of suicides.
No significant conclusions on whether responsible media reporting could translate into the reduction of suicide rates, could be arrived at from this data. This is because the State Crime Record Bureau, the only source of information regarding suicide in the state, is an underreported source; mainly because suicide is still a punishable offence .The bureau do not have any data about attempted suicide. Media influence is only one among the many complex, complicated issues in the behavior of suicide, and control of other factors is just impossible.
The primary attempt to educate the media personnel regarding responsible reporting of suicide has given a positive result, although with modest scores. A one-day workshop can bring about changes in the reporting style of the media with regard to suicides and attempted suicides, and the changes have persisted over the years, although they have not reached statistical significance. Conducting regular workshops with the active participation of media personnel and mental health professionals is called for. This will be a model with a collaborative and multidisciplinary approach, for tackling the growing public health problem of suicide.
Source of Support: State Board of Medical Research, Kerala
Conflict of Interest: None declared
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Keywords: Media reporting, suicide, guideline.
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