International media guidance for portraying suicide should be strengthened, implemented, and enforced to minimise the risk to vulnerable viewers, argue experts in The BMJ today.
Their call follows widespread concerns that a recent Netflix series, 13 Reasons Why, could trigger self harm among vulnerable viewers by romanticising suicide and portraying it as the only option to cope with negative experiences.
Thomas Niederkrotenthaler, Associate Professor at the Medical University of Vienna, and colleagues say a recent study found that Google searches for suicide - a potential marker of suicidal ideation - increased after the series’ release. So far, however, no studies about actual increases in self harm rates have been published.
The authors point to similarities with a German television programme, Tod eines Schülers (Death of a Student), broadcast in the 1980s that showed the fictional railway suicide of a 19 year old man - and was followed by a statistically significant increase in railway suicides in Germany, particularly among young men.
“Although we cannot infer causality from this study, the identified associations are consistent with a potential Werther effect, which describes media-induced increases in self harm,” they write.
Clinicians need to be aware of the current heightened media attention to adolescent suicide, and ask vulnerable young patients about possible exposure so that potentially harmful effects can be discussed and minimised, they say.
At a policy level, there is also a need for wider implementation of international guidelines and for more intensive reinforcement by monitoring agencies.
In addition to the wide implementation of media recommendations, they say specific safety standards for broadcast material about suicide are needed. Furthermore, media training related to suicide for parts of the entertainment industry seems warranted.
The producers of 13 Reasons Why have recently announced a second season to be released in 2018. As such, the authors call for a broad collaborative effort “to minimise the risk of self harm, including conversations with young people within families, schools, and clinical practice about exposure to suicidality through the media; implementation and enforcement of media guidelines; and the development of safety standards for the entertainment industry.”
A collaboration between the producers of 13 Reasons Why and suicide prevention experts would give considerable leverage to all of these efforts, they conclude.
Journal: The BMJ
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