Intended for healthcare professionals

Letters Suicide on TV

Using the power of the media to reduce the risk of suicide

BMJ 2017; 359 doi: (Published 17 October 2017) Cite this as: BMJ 2017;359:j4742
  1. Thomas Ungar, associate professor1,
  2. Stephanie Knaak, assistant professor2,
  3. Cameron Norman, principal and president3
  1. 1University of Toronto, Toronto, Ontario, Canada M5B 1W8
  2. 2University of Calgary, Calgary, Alberta, Canada
  3. 3Cense, Toronto
  1. ungart{at}

Arendt and colleagues argue that international guidance on suicide and the media should be strengthened, implemented, and enforced.1

This approach can be enhanced by framing the matter as a human centred design challenge. Media and audiences are then considered to be cultural and contextual variables that can be designed for or around to produce a desired outcome. This may be particularly useful in a rapidly changing social media landscape where patients, providers, and the public come together in the same space. We described human centred design as an overarching method and conceptual model for developing anti-stigma interventions.2

One of us (TU) applied this model to produce a reality TV style web series Think You Can Shrink?3 The design strategically leveraged the popularity of entertainment and the power of the media to encourage viewers to seek help for mental health problems, or encourage others to do so, in the hope of improved health outcomes for men. Actors portray suicidal depression and other mental health problems. Lay people who think they are good at giving advice—for example, bartenders and hairdressers—are contestants. Through modelling, viewers learn about depression, suicidal ideation, and how to communicate with others to encourage them to get help. We designed for the protective and beneficial effects of narratives and media.

Our proof of concept study showed the “edutainment” design works, with viewers finding the show entertaining and being more likely to seek help or know what to say to someone who is suicidal after watching an episode. 4

In addition to policy efforts to regulate responsible portrayals, health promotion efforts may meet greater success using the media as a powerful vehicle and tool to reduce and prevent suicide. Human centred design can bring this about.


  • Competing interests: TU received a peer reviewed innovation grant funding from Movember Foundation Canada to produce Think You Can Shrink? and is the creator and owner of the intellectual property.

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