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Better Health for All
PREVENTING SUICIDES: SAFE MESSAGING & WORKING
WITH THE NEWS MEDIA
Joy Alexiou, Public Information Officer, May 2019
Better Health for All© 2018 County of Santa Clara Health System
Why this matters
2
• 2015: suicide accounted for 50% of all violent deaths in
men and 71% of all violent deaths in women.
• 2016: Nearly 45,000 suicides occurred in the United
States — more than twice the number of homicides —
making it the 10th-leading cause of death. Among
people ages 15 to 34, suicide is the second-leading
cause of death.
• 2017: suicide remained the 10th leading cause of death
in the US.
• 2017: approximately 1.4 million adults made at least
one suicide attempt.
Source Centers for Disease Control and Prevention (CDC)
Better Health for All© 2018 County of Santa Clara Health System
Why this matters
3
WHO identified media reporting as a priority prevention
strategy.Early identification & treatment
Training of health workers
Follow-up care & community support
Restricting access to means
Responsible media reporting
Introducing alcohol policies
Researching tech-based solutions
Better Health for All© 2018 County of Santa Clara Health System
Why this matters
4
- Change public
misperceptions and
correct myths.
- Promote awareness of
resources and the
preventability of
suicide.
- Reduce the risk of
contagion.
Reporting on suicide carefully
can:
Better Health for All© 2018 County of Santa Clara Health System
Contagion effect is based on a
disease model. Contagion refers
to:
• When one or more suicides are
publicized in a way that contributes
to another suicide.
Additionally,
• People do not need to know each
other personally.
• Publicity can be via news
reporting, social media, etc.
• YOUTH are especially vulnerable
to clusters.
Suicide contagion is real
5
An increase in suicides
following media
reporting is impacted
by:
• Frequency of
reports
• Placement of
reports
• Language used
(graphic, details,
dramatic, headlines)
Better Health for All© 2018 County of Santa Clara Health System
RECOMMENDATIONS FOR SAFE
REPORTING
6
Better Health for All© 2018 County of Santa Clara Health System
7
Suicide is complex and rarely can
be attributed to a single cause. Avoid
writing that suicide is the result of
common life events like stress, job
loss, break-up, etc.
Avoid describing that a suicide had
no cause. This may reinforce the
belief that suicide is normal and
cannot be prevented.
Portraying suicide as a heroic,
romantic, or honorable act may
encourage vulnerable people to view
it more positively or lead them to
desire the positive attention garnered
by someone who has died by suicide.
www.reportingonsuicide.org
Recommendations for safe reporting: The Don’ts
Better Health for All© 2018 County of Santa Clara Health System
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Do not describe or write the method
or location of death – may lead to
copycat.
Do not share many personal life
details of the person who died – may
lead to identification.
Avoid portraying suicide as a
common response to life’s hardships.
And the use or overuse of certain
data can normalize the problem of
suicide.
Avoid speculation, it is too
complicated of a problem to
speculate about it.
Recommendations for safe reporting: More Don’ts
Better Health for All© 2018 County of Santa Clara Health System
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Explain the complexity of suicide.
Most people who die by suicide
exhibit warning signs. Include the
warning signs in the sidebar of
the story whenever possible.
Try to present a balanced story
on the person.
Limit the details to facts the
audience needs to know.
Include resources like hotlines,
crisis text and websites.
Recommendations for safe reporting: The Dos
Better Health for All© 2018 County of Santa Clara Health System
Recommendations for safe reporting
10
The work we do includes:
• Safe message trainings for news
organizations and community
members.
• Analysis of stories and Rapid
Response, primarily to local
reporters.
• Testing going into newsrooms to
provide recommendations. NBC Bay
Area to be scheduled in May.
Note: I have seen really good comments from the public about online
stories. Now that you have the recommendations, you can help by
weighing in when a reporter strays.
Better Health for All© 2018 County of Santa Clara Health System
MEDIA ANALYSIS
11
Better Health for All© 2018 County of Santa Clara Health System
Media Analysis
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• Pilot conducted in June 2018.
• Analyzed 226 articles on suicide.
• Developed novel coding instrument:• Based on safe messaging guidelines;
• 10 characteristics; and,
• Rated each article from 10-50.
Better Health for All© 2018 County of Santa Clara Health System
Media Analysis
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Article Characteristics Local Media
Terminology 4.76
Photo/video 4.13
Most recent data 3.46
Report on suicide as public health issue 3.39
Spokespeople quoted 3.24
Method 3.22
Titles 3.17
Suicide Note 3.11
Resources/Numbers 1.93
Warning Signs/What to Do 1.28
Better Health for All© 2018 County of Santa Clara Health System
Media Analysis
14
Overall Findings
The media overall does not fully comply with
safe messaging guidelines.
National media does not have a higher average
total score of compliance than local media.
Worth continuing media analysis, which lead to
…
Better Health for All© 2018 County of Santa Clara Health System
Rapid response to media stories on suicide
15
Email reporters and news organizations about their stories:
1. If the story meet all safe reporting recommendations: Acknowledge and
thank.
2. If the story met one or two of the safe reporting recommendations (partial
message below): thank for the best practice, offer other recommendations.
3. If the story did not meet any of the safe reporting recommendations:
emphasize the recommendations and the risk.
Thank you for covering this important topic. All of us – medical professionals, reporters and news
organizations, as well as members of the general public – have an important role in preventing suicides. I
appreciate that you included suicide and crisis resources in your story. There are a few other
recommendations to keep in mind:
• The reasons why suicides happen are complex and not always clear.
• For vulnerable and at-risk individuals, the content and volume of media coverage can be factors
that lead to more suicidal behavior.
• Do not provide the details of a suicide, e.g. the method used for suicide, or details of a suicide note.
• Use language that helps to reduce stigma around mental health issues. People "die by suicide" or
“completed suicide,” not "commit suicide." The word “commit” relates to committing a crime or sin.
When also used with suicide, this word adds to the stigma around mental health.
We always attach information about Safe Reporting on Suicides as a
reference.
Better Health for All© 2018 County of Santa Clara Health System
Activity
16
Three stories:
Write down what safe reporting recommendations were
followed.
What went against the recommendations?
What recommendations are missing?
Discussion:
What would you say to the reporter about this story?
Better Health for All© 2018 County of Santa Clara Health System
CASE STUDY
17
Better Health for All© 2018 County of Santa Clara Health System
Suicides & Media
18
The situationIn less than a week there were two celebrity deaths by suicide and a CDC report on the
increase in suicide rates in the US.
• Kate Spade – June 5, 2018
• In between, CDC issues report on US suicide rates.
• Anthony Bourdain – June 8, 2018
The concern
• Stories on Spade provided details (hanging, red scarf, suicide note). By Bourdain’s suicide,
the detail that he also hanged himself appeared only in early stories, but the fear was he
may have been an early “copycat”.
• Research and data show that extensive news coverage and details of a suicide increase
likelihood of copycat suicides.
• The only celebrity suicide previously studied showed suicides in the US rose 10% after
Robin William’s death by suicide (2014).
CDC data showed 18,690 deaths by suicide for the four months following William’s death. Significantly more than the 16,849
from past data and trends.
Better Health for All© 2018 County of Santa Clara Health System
Strategies
19
• Local news media: the recommendations and the
importance of safe reporting.
• Social media sites: post to increase awareness of
available resources and what action people can take to
prevent suicides.
• Partners: ask for help.
Resources• For those who may be vulnerable or at-risk, provide the crisis hotline:
1-855-278-4204
• For community: promote trainings and knowing the signs.
• Play an important role in preventing suicides, trainings can be found
at www.sccbhsd.org/suicideprevention
• Know the Signs – suicideispreventable.org
Better Health for All© 2018 County of Santa Clara Health System
20
Media
• Develop talking points and
emphasize resources.
• Respond to request for interviews
with Behavioral Health experts –
Suicide Prevention Program
Manager. Note: PIO did one interview when
no one else was available.
• Issue news release to encourage
safe reporting, attached training
document and recommendations.
• Follow-up with reporters working on
stories.
• Talk to the Mercury News about an
editorial on the topic.
Tactics
Better Health for All© 2018 County of Santa Clara Health System
21
Digital & Social Media
• Post to internal and external
websites (news release and opinion
editorial).
• Screen saver on Health System
desktops with hotline number.
• Develop post for social media,
distribute to Health System social
media sites.
Partners
• Provide post to County and other
partners and ask them to post too
(thank you!).
• Respond to community posting,
provide hotline or other resources.
Tactics
Better Health for All© 2018 County of Santa Clara Health System
22
Media Coverage
• KTVU and Mercury News covered the
CDC report and the suicides. Other
news agencies requested interviews
regarding suicides.
• Media coverage of CDC report help
frame suicides with a broader view of
the issue.
• KTVU’s first story on Spade did not
follow recommendations. Subsequent
stories improved and included
resources and the role of the news
media. Note: KTVU reporter pushed
back on media and contagion effect
but came around.
• Local stories all included the hotline
number.
• Powerful editorial with call to action.
Results
Better Health for All© 2018 County of Santa Clara Health System
Results
23
Behavioral Health Social Media
• Facebook views increased 29%. Page likes increased 9%.
• Boosted Clendaniel opinion column – reach increased 148%.
Better Health for All© 2018 County of Santa Clara Health System
Results
24
Suicide & Crisis Hotline had a 25% increase in calls
following the celebrity suicides (average before the
suicides was 750 per week).
Outreach and promotion of the hotline # supported
getting more people to seek help.
Still waiting on US, California and Santa Clara County data
on suicides in the four months after the 2018 celebrity deaths.
Better Health for All© 2018 County of Santa Clara Health System
On this topic:
• Previously held a “get to know you” session with Ed Clendaniel which helped
facilitate the editorial discussion.
• Quick message approval is critical. This news release was approved quickly,
given the topic.
• Need to regularly send reminders to reporter: semi-annually at a minimum.
• Get information distributed with the first suicide that is generating a lot of media
coverage.
Lessons Learned
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In general:
• Starting with a news release (or any write-up) provides most of the content
needed for other communications.
• Having relationships helps, and get partners information as early as possible.
• Ask for help.
• Develop a check list of distribution steps/considerations.
• Consider online training for the news media, and/or visits to a newsroom meeting
(go to them).
Better Health for All© 2018 County of Santa Clara Health System
News Stories
Feedback to reporters: make it positive and instructive.
• Remind reporters of the significance of these stories, and to follow the
recommendations to help those who are vulnerable and at-risk.
• Thank those who follow the recommendations. If the story meets the
recommendations, share on social media.
You can help save lives
26
Trainings
Question Persuade Refer: training covers how to ask questions and
persuade someone in crisis to seek help, and refer them to resources.
This one is free to anyone 18 and older who lives in SCC, and online
training is available.
Youth Mental Health First Aid: teaches a 5-step action plan to offer
initial help to young people showing signs of crisis or mental illness, and
how to connect them to help. Also free.
Better Health for All© 2018 County of Santa Clara Health System
New support for suicide prevention
27
Better Health for All© 2018 County of Santa Clara Health System
QUESTIONS? COMMENTS?
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