130910 nz suicide prevention conference

Building Community Understanding of Suicide and Suicide Prevention : the role of media and communications

Jaelea SkehanDirector, Hunter Institute of Mental HealthConjoint Fellow, School of Medicine and Public Health, University of Newcastle

Hunter Institute of Mental Health

• Programs related mental health promotion and suicide prevention with children & young people;

• Programs for families and carers;• Programs to build the capacity of a range of professions – e.g

Nurses, emergency services, workplaces;• Programs related to communication – e.g:

–Mindframe National Media Initiative– Conversations Matter.

The Mindframe National Media Initiative aims to influence media representation of issues related to mental illness and suicide, encouraging responsible, accurate and sensitive portrayals by working with the news and entertainment media and a range of other sectors.

Mindframe National Media Initiative

AIM: to improve media portrayals of suicide and mental illness.

SECTORS: media professionals and media organisations, journalism and public relations educators, the mental health and suicide prevention sectors, police, courts, and stage and screen.

THE APPROACH:

• Evidence-based and sector appropriate print and online resources;

• Professional development and sector engagement;

• Changes to policies, procedures and codes of practice;

• National Leadership.

Talking about suicide – what is all the fuss about?

Some assumptions upfront:• Given suicide is a preventable cause of death which is

important to communities, saying NOTHING about how to prevent it makes no sense.

• If you are worried that someone may be at risk of suicide, saying NOTHING makes no sense.

• If you know someone who has experienced a loss, saying NOTHING makes no sense.

But • What do we say? • How do we say it? • Where should we say it?• Who should say it?• What is the role of the media?

Lenses to be considered

• Why? = Focus of discussion – Prevention, Intervention or Postvention;

• How? = Format of discussion – One-on-one, small group, wide-scale (e.g. media);

• Where? = Setting – School, Workplace, Families, Community, Online, Media;

• Who? = Target groups to be considered – Carers, GLBTI, Young People, Older People, Aboriginal and Torres Strait

Islander People, CALD Communities, People with a mental illness, People Living in Rural and Remote Areas, Men, People Bereaved by Suicide .

Forgetting all of our national diversity…

4 broad groups for communication:

1. Not affected and not interested;2. Some level of interest or engagement;3. Vulnerable, at risk; **4. Bereaved.

Let’s look at some myths and facts

General & media related

FACT: Suicide is different

Suicide is different?

• We need to ensure as a community we are not “too afraid” to talk about suicide, while respecting and understanding the risks in certain settings and groups.

• The risk associated with the “discussion” seems to be related to:

– The focus of the information (about death, about how to cope with a death, about the broader issue);

– The status of the individual receiving the information (uninterested, vulnerable, bereaved);

– The format they receive the information (face-to-face, media);

– The place they receive the information.

MYTH: Reducing stigma associated with suicide is straight forward

Stigma and suicide?

• Many agree that there is a stigma associated with suicide. However, the approach to reducing stigma associated with suicide MUST be different;

• Need to reduce “ignorance” without reducing the “fear”;

• That is, we need to address the myths and misconceptions without inadvertedly presenting suicide as something that should be feared less.

FACT: There is confusion about what we mean by “talking about” suicide

Talking about suicide

• Often confusion about what is meant by “discussing” or “talking about” suicide, and confusion about the evidence;– One-on-one conversations;

– Group presentations;

– Media reporting about suicide deaths;

– Media reporting about the issue of suicide.

What we know and don’t know

We know:

• Talking to someone, one-on-one, directly about suicide will not increase their suicide risk (although the empirical evidence is weak);

• Media reporting of suicide deaths has been associated with increased risk for those who are vulnerable to suicide;

We don’t know:

• Whether group presentation about suicide will increase or decrease suicide risk (e.g. evidence from schools);

• Whether more general media reporting about suicide (or awareness campaigns) will increase or decrease risk.

MYTH: We have evidence to support community discussion of suicide

Evidence review – general findings

• There is very little research evidence to either support or refute a number of common assertions when talking about suicide;

• While there is broad support amongst experts in the field that discussing suicide does not increase risk, there appears to be no scientific evidence that discussing suicide has either a positive or negative impact on actual suicidal behaviour or help seeking;

• Emotional discomfort and sense of self-efficacy have been identified in the literature as obstacles to discussing suicide in clinical and educational settings;

• Evidence from specific settings (e.g. schools) is mixed with variable outcomes depending on focus, size of group etc;

• There is some research evidence demonstrating that people do want to discuss suicide despite being difficult.

ProcessLITERATURE REVIEW• Review of research evidence• Review and analysis of existing

resources and approaches

CORE PRINCIPLES Three review panels (experts, target groups, settings) review a series of ‘principles’ to guide prevention-focused, intervention focused, and postvention focused conversations.

ONLINE RESOURCES• New name and branding for the resources;• Community resources for discussing suicide;• Professional resources to support community discussion of suicide.

CONSULTATIONS• Service providers and key informants

across 4 settings• Consultations with community

MYTH: The evidence about media reporting of suicide is weak

• Over 100 studies have looked at media reporting of suicide and its impact on suicidal behaviour;

• 85% of studies have shown an association between media reporting and increases in suicidal behaviour following;

• The risk of copycat behaviour is increased where the story is prominent, is about a celebrity, details method and/or location and where is glorifies the death in some way;

• Whilst healthy members of the community are unlikely to be affected, people in despair are often unable to find alternative solutions to their problems;

• People may be influenced by the report, particularly when they identify with the person in the report.

The evidence: suicide

• While talking about suicide will not generally increase risk, media is not a conversation, it is one way communication;

• Messages in editorial are not “market tested”. That is, we have no way of monitoring how the story is being interpreted by people sitting in their own homes;

• Vulnerable people may take away different messages than those that were intended;

• Raising awareness on its own (e.g. increasing reporting) is not enough to change behaviours;

• Not all media are the same – they don’t all have the capacity to cover the issues well.

Media – challenges

FACT: We don’t know much about the potential benefits of media

reporting about the broader issue of suicide

• While the media has a role to play in raising awareness of suicide as a public health issue, there is generally a lack of evidence supporting any positive benefits of discussing suicide in the media.

• That doesn’t mean media can’t be used as a tool for good.• Single studies suggest that:

– Personal stories about someone who has managed suicidal risk as protective;

– Focussing on the impact suicide could be protective;• Expert opinion suggests that:

– Adding help-seeking information can be helpful;– Adding information about risk factors and warning signs can be helpful.

The evidence: suicide

FACT: People bereaved by suicide want more media reporting of

suicide

MYTH: People bereaved by suicide want more media reporting of

suicide

Suicide Bereavement and the Media Study

• People bereaved by suicide NOTICE stories about suicide and they have an emotional response to them;

• Stories can be seen as having either a positive or negative impact depending on their focus;

• People were usually motivated to participate in a story out of a sense of altruism/ advocacy role;

• Timing of the interview was identified as a key issue. Media interviews around the time of a death were seen as unhelpful by all key informants;

• Some people bereaved by suicide may use media as a platform to deal with their grief when there may be more effective strategies.

MYTH: Media don’t report suicide

The Media Monitoring Project

• Australian newspaper, television and radio items on suicide retrieved over two 12-month periods - 2000/01 and 2006/07

• Almost a two-fold increase in reporting: 4,813 items retrieved in 2000/01 and 8,363 in 2006/07

0

5

10

15

20

25

30

0-9 10.-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-100

2000/01

2006/07

Distribution of total quality scores for suicide

(57.1% in 2000/01 – 75% in 2006/07 - sig)

FACT: We don’t know whether social media has the same or different

impacts to media reporting

The challenge…

It is likely that social media is working across domains:

– One-on-one conversations (with or without onlookers);

– Large group communication about suicide deaths and the issues broadly (driven by the sector and individuals);

– Attempts at social marketing using social media are not evaluated and rarely driven by suicide prevention;

– There are many opportunities for connection and engagement, but little is known about the risks;

– Emerging evidence is mixed (e.g. moderated v non-moderated forums).

In suicide prevention we need to be confident to implement the things we know…. And humble

about what we don’t know.

Contact details

Email:[email protected]

[email protected]@hnehealth.nsw.gov.au

Twitter:@jaeleaskehan

@HInstMH@MindframeMedia

Websites: www.himh.org.au

www.mindframe-media.infowww.conversationsmatter.com.au