Wednesday 20 February 2019

Mind & Meaning: Dr Patricia Casey - 'Papageno effect' can save lives

Delicate situation: Alexander McQueen, who died last year, pictured with actresses Elizabeth Banks and Olivia Wilde
Delicate situation: Alexander McQueen, who died last year, pictured with actresses Elizabeth Banks and Olivia Wilde

Patricia Casey

The manner of suicide reporting in the media is a topic that crops up regularly. For example, the suicide of Alexander McQueen last year was treated with relative delicacy by the media. It was made clear that he struggled with depression since the death of his mother, to whom he was very close.

It was regarded as a tragedy that one so talented could also be so troubled as to end his own life.

By contrast, sometimes suicides are excused as being a happy release from a difficult situation and simple explanations, such as bullying, are offered as the whole explanation.

Many countries have now devised guidelines for the media to follow when reporting such cases. These have come from the realisation that the manner in which suicide is covered might in itself be a catalyst for suicide in some vulnerable people.

This is called 'copy-cat suicide' or 'the Werther effect', after the character in Goethe's novel 'The Sorrows of Young Werther', who shot himself with a pistol after his love for a girl was met with rejection. Many young men imitated this behaviour and the book was banned for a time.

Trying to prevent suicide by the method of reporting has very recently been named 'the Papageno effect', after the character of that name in Mozart's opera 'The Magic Flute.'

Papageno fears that he has lost his love, Papagena, and is planning his death when he is prevented at the last minute by three boys who remind him of alternatives to dying.

Evidence is now emerging that for individuals in crisis, the manner of reporting might have a positive or negative influence on their decision.

Risk

It has been recognised for some time that reports describing the victim by name, and detailing the kind of person they were, might increase identification with them.

Mentioning suicide in the headline, providing step-by-step details of the manner of death and the content of the suicide note might also increase the risk, as could the presence of a photograph, sensationalism and single cause attributions.

There are a number of other less- likely aspects of the reporting that are counter-intuitive and that have also been identified as increasing the risk.

These include descriptions of the effects on the bereaved, the effects on public life and suggesting that there is an epidemic.

Such reports add to a negative world image or the 'scary world hypothesis' and might be associated with hopelessness.

A recent study by Thomas Niederkrotenthaler, an Austrian doctor who played a huge role in reducing subway suicide by placing experimental restrictions on reporting, has recently published a paper in the 'British Journal of Psychiatry' outlining 'the Papageno effect' in reducing suicide risk.

He and his team identified a number of protective characteristics in the reporting of suicide in Austria. The most important content that reduced suicide was, surprisingly, focusing on suicidal thoughts rather than suicidal actions.

This is, according to the authors, because reporting suicidal thoughts, as opposed to actions, could help the individual engage with the concept of going on living.

The use of expert opinion and providing contact information for support services are keenly fostered by mental health professionals. Journalists increasingly use these to add gravitas to reports.

However, their use is not always helpful, and if they are embedded in reporting that combines the negative features outlined above, then these too can be unhelpful and associated with increasing, rather than decreasing, suicide rates.

Finally, unembellished, simple brief reports of suicide had neither positive or negative effects.

Suicide is complex, and so too is the reporting of it. What is apparent from this study is that guidelines on reporting suicide are multifaceted, and approaches that are intuitively positive could in fact be harmful.

Perhaps it is time that, here in Ireland, we revisited our media guidelines and developed a more nuanced approach, as the study suggests.

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