Suicide and the Media New Zealand Worksop September 2013

The purpose of the Hunter Institute of Mental Health is to promote mental health and wellbeing and to prevent mental ill-health and suicide, through education and training, health promotion, research and evaluation. 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.

What are the first things that spring to mind when I ask you to think about media coverage of suicide?

Upfront Suicide is a legitimate issue to be covered by the media. Mindframe does not suggest that media should refrain from covering this issue - media need to be aware of the potential impact of covering suicide.

Let’s first take a brief look at outcomes 10 years on

Summary of outcomes One of only two countries where the introduction of guidelines or strategies have resulted in a change in reporting (media Monitoring study, Pirkis et al. 2009): – Both suicide and mental illness items increased in volume, with approximately a two-and-a-half-fold increase. – In terms of quality, suicide items increased from 57% to 75%, and mental illness items increased from 75% to 80%. The only country that has shown evidence that media are aware of the resources and use the resources in their practice (Skehan et al., 2006; Pirkis et al., 2006). Uptake in journalism curricula and improvements in student knowledge and skills (Skehan et al., 2009).

Dissemination has been Australia’s point of difference internationally

Mindframe Funded by Department of Health & Ageing NSPP; Guided by national advisory groups (*media, health, police, universities, entertainment); Comprehensive strategy to disseminate evidence based information to a range of sectors about media coverage of suicide and mental illness.

Research into practice Research evidence related to media reporting and portrayal of suicide Development of Australian guidelines Evidence based strategies to enhance program dissemination Dissemination of Australian guidelines (integration into policies, professional development, partnerships, leadership) Consultation and sector engagement to identify qualities about journalists and the media environment in Australia

The Mindframe model AIM: To improve media portrayals of suicide and mental illness. SECTORS: Collaborative approach with 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.

Mindframe National Media Initiative (Guided by advisory groups – media, MHSP, police, universities, stage & screen.

Improved media coverage of suicide and mental illness Media Monitoring Study 2001, 2007 Media developing stories about suicide and mental illness Mindframe Media SANE Media Centre & Stigma Watch Training of Journalism and PR Students Mindframe – the logic Sources of information for journalists Mindframe for the health sector Mindframe for police and courts. Stage and Screen portrayals

Capacity building model 1.Support organisational development across target groups through embedding Mindframe information and core principles into curriculum, policies, codes and organisational plans; 2.Contribute to workforce development across target groups through relevant direct engagement with sectors; 3.Continue to allocate resources across target groups through the update, maintenance and dissemination of print and online resources;

Capacity building model (cont.) 4.Support partnerships between each target group and the project team and build partnerships (where relevant) across target groups; 5.Continue to provide and support leadership for this kind of work through maintenance of reference and advisory groups, strategic partnerships with organisations and supporting champions across sectors; 6.Monitor and evaluate the impact and effectiveness of the project strategies.

Recent Context Mental Health Context… The Hidden Toll: Suicide in Australia - Report of the 2010 Senate Inquiry into Suicide. Australian of the Year and GetUp campaign for increased Mental Health and Suicide Prevention funding. Increased media comment about issues of reporting of suicide. Media Context… Independent Inquiry into Media and Media Regulation; National Convergence Review; ACMA review of Privacy Guidelines; Review of Media Codes of practice and editorial policies (e.g. APC, ABC).

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; Is the reporting “alerting” or “alarming” people? Media – challenges

SUICIDE Lets start by exploring some things we know…

Talking about suicide Suicide is an important issue of community concern. It is important that all members of the community are engaged with the issue Often confusion about what is meant by “discussing” or “talking about” suicide, and confusion about the evidence – One-on-one conversations; – Large 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 generally not increase their suicide risk Media reporting of suicide deaths has been associated with increased risk for those who are vulnerable to suicide We don’t know: Whether more general media reporting about suicide (or awareness campaigns) will increase or decrease risk.

Let’s look at the evidence for media reporting

Target audience for media about suicide Potentially includes 4 broad groups: 1.Not affected and not interested; 2.Some level of interest; 3.Vulnerable, at risk; 4.Bereaved.

The evidence: negative 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: positive 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.

What evidence is there that a suicide toll will be more helpful than harmful? – Evidence related to hyer-reporting & hotspot tolls? – Impact on people bereaved by suicide? What evidence is there that a suicide prevention campaign would be successful? – Evidence of effectiveness? – What are we trying to achieve? What evidence is there that “personal stories” will contribute to a reduction in suicide deaths? – Let’s explore in more detail Let’s tackle some topical issues

So what might this mean for the suicide prevention sector?

Consider whether to participate Who is the most appropriate organisation/person to make comment? Do you have a media policy and who is your authorised media spokesperson(s)? Who in your organisation is ‘good media talent’? Will this story benefit community understanding and/or promote help seeking? What might be the impact of saying ‘no’? How will you say ‘no’? Will you refer them to someone else or provide them with general information?

Avoid sensationalism Be mindful not to sensationalise the issue with statistics Need to ‘alert’ not ‘alarm’ the community. – “Youth suicide epidemic” Use your promotional opportunities to dispel common myths e.g. – “People who attempt suicide are attention seekers.”

Use appropriate language - suicide Limit use of the word ‘suicide’ where possible Use language which does not glamorise, normalise or sensationalise suicide Use… ‘non fatal’ or ‘attempt on his/her life’ ‘took their own life’ or ‘died by suicide’ ‘cluster of deaths’ Rather than… ‘unsuccessful suicide’ ‘successful suicide’ or ‘committed suicide’ ‘suicide epidemic’

Avoid description of suicide Avoid discussing method and location, discourage use of visual images. Provide alternatives to specific descriptions e.g. Say… ‘took her own life in a hospital room’ ‘he fell to his death from a local building’ Rather than… ‘used her bed sheet to hang herself from the ceiling fan’ ‘he jumped from the top floor of the Skyline building on Smith Street’

Place the story in context – suicide Provide information about suicide and its relationship to known risk factors. Avoid simplistic explanations that suggest suicide might be the result of a single factor or event. Provide suicide prevention information e.g. warning signs. Discuss current trends – do we have a “youth suicide epidemic”? Discuss alternative approaches to ‘suicide prevention’ stories – i.e. do they always have to be about people who have lost their life?

Provide crisis counselling services, helpline numbers and websites that are RELEVANT to the story Think online with young people Think about cultural and geographic issues Think about different media and how to integrate these. Provide help-seeking information 32

Involvement of people bereaved by suicide Stories of coping or survival may be a good way to deliver suicide prevention messages; If you are coordinating a spokesperson who has personal experience support them to make an informed decision about participation; Duty of care - ensure access to support during and after the interview;

34 If supporting people with personal stories One way to become clearer about which parts of your story to share is: 1. Write out your story in full; 2. Take out any information you would not want everyone you have ever met, or will ever meet, to know about you; 3. Take out DETAILED references to self-harm, suicide; 4. Highlight the parts of your story that support your key message (your talking points).

Some tips for working with the media. A tweet rather than feature article! 35

Media and mental health sector relationship ?

PROACTIVE RESPONSIVE Developing rapport with media professionals Developing rapport with media professionals Approaching media for coverage Approaching media for coverage Responding to media reports Responding to media reports Responding to media requests Responding to media requests

Planning Questions to ask : What is the purpose of our media interaction? How will we achieve that purpose? What do we want to tell the public? What resources do we need? How will we know if we have been successful? Communications plan.

Process Develop a list of what you will and won’t do (as an organisation and as individuals); Be clear about your key message; Identify how you want to communicate your key message; Check in with the Mindframe issues to consider; Identify local media to approach; Meet and greet with local journalist.

What is a key message? Main point that you want to communicate; Able to be captured in a short memorable sentence; Compatible with organisation’s position; Supported by ‘talking points’; Supported by current & accurate information; Remember Mindframe issues.

Key message Key message = seeking help is not a sign of weakness Talking point = personal experience of seeking support or of supporting someone else to seek help early.

What are your talking points? These are the ‘hooks’ or ‘angles’ that bring your story to life and make it of interest. People are interested in things that affect their lives or those of people they care about; or that they can relate to.

Target your approach Identify the audience you hope to reach; Identify the media they access; Plan the angle you will emphasise; Consider the language you use; Identify spokespeople; Plan how you will contact the media e.g. face to face, , telephone.

Summary Develop a communications plan; Create key messages; Choose communication tools; Cultivate relationships with local media; Be consistent, reliable and accurate.

Thank you

Things I am excited about Social media provides an opportunity for social connection that MAY mitigate risk. Evidence of people linking up with like-minded people and reporting personal benefits (e.g. #RuralMH); People can monitor and intervene in the wellbeing of others; If services use the technology they reach a large audience cheaply; There is an opportunity to build TRUST in suicide prevention services and brands by being part of the conversation;

Things I am excited about Partnerships with google and facebook to start intervening with potential risk; We can see the sorts of conversations people are having and may be able to transition them into services online (e.g. reachout); Opportunities for social media applications of interventions such as “postcards” to reduce suicide risk.

Things I am concerned about Social media is unregulated and so provides a platform for transferring potentially harmful information (both intentionally and unintentionally); There may be unintended recipients of your communication and it goes internationally (e.g. #suicide); I may now have to think about not only how this room will interpret what I am saying, but potentially people I didn’t know I was talking to (anyone tweeting?); While I am optomistic about some social marketing like campaigns that have arisen, they are not being driven by the suicide prevention sector and have not been market-tested or evaluated to test for unintended consequences.