Communicating about suicide

Suicide is a complex issue. It is often not preceded by a single event or condition, and is more likely to arise from an interaction between many vulnerabilities and risk factors in a person’s life. Suicide may also be influenced by social and economic circumstances and differences between cultures and individuals’ experiences within society.

When talking about suicide, inaccurate language can stigmatise members of the community, and language choices can inadvertently present suicide as glamorous or as an option for dealing with problems. This problematic communication is sometimes linked to imitative behaviour. However, when done safely and respectfully, talking about suicide can help to reduce stigma and improve an individual’s willingness to help-seek.

Should we talk about suicide?

Suicide and suicide prevention are issues that are worthy of public interest. Having safe, person-centred and respectful conversations are essential to breaking down barriers and overcoming the stigma and myths associated with suicide.

Suicide is still regarded as taboo in many Australian cities and towns, and people are hesitant to talk about it out of fear they will 'put something in their head'. However, evidence suggests acknowledging and starting conversations about suicide may reduce suicidal ideation.1 Talking about suicide is a meaningful conversation, and one that we can have safe and respectfully.

How do we talk about suicide?

There are many ways people communicate about suicide. It might be online, with individuals commenting on others' content or posting their thoughts and feelings. People may also communicate about suicide when responding to someone thinking about suicide or in memory of a person who has died by suicide. Orygen's #chatsafe guidelines examine these contexts to help young people communicate safely about suicide online.

Suicide is also discussed widely in society, and substantial evidence indicates the way suicide deaths are reported can impact suicidal behaviour in the community.2 Researchers theorise this effect is mediated by social learning; people may identify with those represented in media and be inclined to imitate their behaviour.3,4 Media often comment on suicide deaths, particularly for celebrities. Reporting around a celebrity suicide is associated with an 8-18% increase in population suicides in the following 1-2 months.5 In writing, media may source information from police, courts, health professionals or people with lived experience. It is also vital that these media sources safely communicate suicide to minimise risk.

Portraying suicide in film and drama is widespread. Suicide dramatisations can be lengthy, more intensely modelled, and are likely romanticised, glorified, or condoned. The TV series, 13 Reasons Why attracted attention for its explicit portrayal of suicide centred on a young, identifiable character. Niederkrotenthaler et al. note it differs from previous depictions of suicide as it was streamed on Netflix rather than broadcast weekly at a fixed time.6 Mindframe worked closely with Netflix to remove explicit scenes from the first season, in line with the Mindframe guidelines.

Considerations when communicating about suicide

Using safe and inclusive language

How we describe suicide can inadvertently contribute to it being presented as glamorous or a solution to problems. For instance, suicide is sometimes presented using language that suggests it is a desired outcome (i.e. 'successful suicide' vs. 'unsuccessful suicide'). However, using phrases such as 'died by suicide', 'suicide attempt', or 'non-fatal suicide attempt' is preferred. Additionally, gratuitous use of the term 'suicide' (e.g. 'political suicide', 'suicide mission') is also problematic. It is recommended to avoid using 'suicide' out of context. These language choices are heavily ingrained in our culture, and many people might not recognise them as a problematic part of their vocabulary. More information on safe and respectful language can be found on the Mindframe website.

Not discussing method and location

Studies show that explicit descriptions and images of methods and locations are associated with increased suicide rates.5 For instance, around the death of Robin Williams, there was a marked increase in suicide deaths using the same means among men aged 45-64.7 It is therefore best to omit specific method and location details when communicating about suicide.

Include help-seeking pathways

Including help-seeking information when communicating about suicide encourages individuals to reach out for support. It is best to include at least two 24-hour crisis numbers (e.g. Lifeline, Beyond Blue, or the Suicide Call Back Service). It can also be helpful to provide other helplines that target groups of a similar age, gender or identity. For example, when communicating about suicide in the LGBTQIA+ community, it would be prudent to include QLife details. The Mindframe website provides more information on help-seeking information, including examples of help-seeking cards for various populations.

Using lived experience

People with lived experience provide a vital contribution to suicide prevention and offer invaluable insights to help achieve better outcomes for all. However, as evidence suggests, sharing explicit details of suicide attempts or ideation can result in imitative behaviour, there are specific considerations when speaking about suicide from personal experiences. The inclusion of lived experience can help improve people’s understanding of suicide, correct myths and stereotypes and reduce fear, stigma and shame. Sharing relatable experiences can also encourage people to seek support if they or someone they know is struggling. For example, an appropriately trained lived experience speaker might want to highlight the importance of early intervention and share their personal experience.

More information on sharing stories of lived experience of suicide can be found here.

Guidance available

Mindframe

Mindframe is an evidence-based national program supporting the safe reporting, portrayal and communication of suicide. The program covers tertiary education, news media, fictional portrayal, and media sources (e.g. lived experience, police, courts, etc.).

SANE StigmaWatch

Developed in partnership with Mindframe, SANE StigmaWatch helps ensure media safely reports on mental ill-health and suicide. Anyone can report a media item if it breaches media reporting guidelines, and StigmaWatch will provide constructive feedback.

Orygen

Orygen is the world-leading organisation for youth suicide research. Their #chatsafe guidelines have been developed to support young people responding to suicide-related content on social media or wanting to share their feelings and experiences.

Conversations Matter

Conversations Matter is an online resource that helps support safe and effective discussions about suicide in the community. Their website hosts resources for various contexts, including group discussions, communication to children, bereavement, talking to the media, communities affected by suicide, and priority populations.

R U OK?

R U OK? is a grassroots campaign that aims to support people in having conversations about suicide. R U OK? has everyday resources you can use to champion the message. Whether it is in your school, university, workplace or community, they have resources for priority populations (e.g. LGBTQI and Aboriginal and Torres Strait Islander communities) and various professions.

The National Communications Charter (The Charter)

The Charter is a resource and uniting document that guides the way people in the mental health and suicide prevention sectors, government, business and community members communicate about mental health and suicide prevention. The Charter's guiding principles and messages serve as a formal commitment to working together to reduce stigma and promote help-seeking behaviour.

Notes

1

Dazzi, T., Gribble, R., Wessely, S., & Fear, N. T. (2014). Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence?. Psychological medicine, 44(16), 3361–3363. https://doi.org/10.1017/S0033291714001299

2

RANZCP. (2019). Suicide reporting in the media. Retrieved 18 February 2022, from https://www.ranzcp.org/news-policy/policy-and-advocacy/position-statements/suicide-reporting-in-the-media

3

Pirkis, J. E., Burgess, P. M., Francis, C., Blood, R. W., & Jolley, D. J. (2006). The relationship between media reporting of suicide and actual suicide in Australia. Social science & medicine (1982), 62(11), 2874–2886.

4

Niederkrotenthaler, T., Fu, K. W., Yip, P. S., Fong, D. Y., Stack, S., Cheng, Q., & Pirkis, J. (2012). Changes in suicide rates following media reports on celebrity suicide: a meta-analysis. Journal of epidemiology and community health, 66(11), 1037–1042. https://doi.org/10.1136/jech-2011-200707

5

Niedederkrotenthaler, T., Braun, M., Pirkis, J., Till, B., Stack, S., Sinyor, M., Tran, U. S., Voracek, M., Cheng, Q., Arendt, F., Scherr, S., Yip, P., & Spittal, M. J. (2020). Association between suicide reporting in the media and suicide: systematic review and meta-analysis. BMJ (Clinical research ed.), 368, m575. https://doi.org/10.1136/bmj.m575

6

Niederkrotenthaler, T., Kirchner, S., Till, B., Sinyor, M., Tran, U. S., Pirkis, J., & Spittal, M. J. (2021). Systematic review and meta-analyses of suicidal outcomes following fictional portrayals of suicide and suicide attempt in entertainment media. EClinicalMedicine, 36, 100922. https://doi.org/10.1016/j.eclinm.2021.100922

7

Pirkis, J., Currier, D., Too, L. S., Bryant, M., Bartlett, S., Sinyor, M., & Spittal, M. J. (2020). Suicides in Australia following media reports of the death of Robin Williams. The Australian and New Zealand journal of psychiatry, 54(1), 99–104. https://doi.org/10.1177/0004867419888297