The effects of suicide portrayal on screen
There are very clear journalistic guidelines on how suicide should be reported in the Irish and international media. In this country they have been drawn up jointly by the Irish Association of Suicidology and the Samaritans. This is in order to prevent copy-cat suicide and to respect the sensitivities of bereaved families.
While guidelines exist for the print media, none exist for the arts, such as opera, theatre and film. Indeed it is difficult to imagine how they could be implemented without infringing on artistic freedom.
Suicidality has been widely covered, most famously in Mozart's opera, The Magic Flute, where Papageno plans his suicide when he thinks he has lost his love, Papagena. Ultimately he is deterred when he meets three boys who remind him that there are solutions other than death.
The protection against suicide that is afforded by the manner of its presentation has been described as 'the Papageno effect', after the character in that opera.
The possible role of film in triggering suicide is an important one since cinema attendance in the UK has been undergoing a resurrection in recent years, and Ireland, with the highest cinema attendance rate in Europe, boasts 12 million admissions. Many films deal with suicide including The Dead Poet's Society, Ordinary People, and Elvira Madigan. The possible risk they pose to people's lives is surely an important question to ask and answer.
With regard to fictional suicide portrayed in films, the evidence is inconclusive, but some studies have reported increases, especially when the suicide method portrayed in a film is matched by that particular method in the population.
However these studies examined population-based data and this is unsatisfactory, because it does not allow an evaluation of whether the individual who contemplates suicide or engages in suicidal behaviour has even actually seen the film.
Benedikt Till and colleagues from Austria have recently carried out a laboratory-type experiment to evaluate the impact of different movies, dealing with aspects of suicidal behaviour. The findings are published in the July issue of the British Journal of Psychiatry and the study is unique in being able to assess individuals in face-to-face interviews.
He advertised in newspapers for volunteers and divided them into three groups; each viewed a single movie - Night Mother, A Single Man or Elizabethtown. The first describes a woman with epilepsy, whose marriage has failed and when her drug-addicted son runs away she telephones her mother to tell her about the planned suicide. Despite her mother's plea, she fatally shoots herself off-screen. A Single Man is about a middle-aged man whose long-term partner dies. Bereft, he plans his suicide but then meets and falls in love with somebody and abandons his plan to end his life, but shortly afterwards drops dead from a heart attack.
Elizabethtown, a romantic comedy, describes a shoe designer who is told by his boss that he is being sacked because the product isn't selling and his mistake has cost the company billions of dollars. His girlfriend also leaves him. As he develops a suicide plan his is contacted by his sister who has to see him urgently. He boards the flight and en route meets a woman whom he falls in love with.
Questionnaires were used to analyse the effects of the films on mood, depression, life satisfaction, self-worth, assumed benevolence of the world, suicidality, and identification with the protagonist. Measures were taken before and after viewing the film.
Night Mother, which ended with the protagonist's suicide, led to a deterioration in mood, particularly in those with low baseline suicidality, but there was no increase in suicidal thinking.
On the other hand participants with stronger suicidal tendencies initially, experienced a rise in suicidality and this was related to their level of identification with the protagonist. This suggests that suicidal individuals may have problems distancing themselves from the drama, thereby identifying with the protagonist who dies by suicide.
The film, A Single Man, was associated with a drop in mood in both low and higher suicidality groups but no change in the suicidality ratings.
Finally, Elizabethtown was associated with an increase in life satisfaction, particularly among those vulnerable participants with higher suicidal tendencies. In other words, seeing an individual cope with their problems was beneficial - an example of the Papageno Effect described earlier.
The identification of vulnerable people with suicidal portrayals in movies is of importance. It is relevant for any suicide awareness material, especially if shock tactics, such as showing the aftermath of a suicide, are used.
The possibility of movies carrying warnings about suicide portrayal is also deserving of consideration. However, further studies are required.
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