Reporting on suicide? Take note of what to put in story

In 2019, the World Health Organization (WHO) estimated that annually 4.3 per 100,000 people died by suicide and at the same time, this was approximately 2,500 lives lost in a year.

Again, in 2023, WHO further reported that Tanzania is one of the 23 countries worldwide, where suicidal behaviour is considered a crime in its Penal Code of 2019.

With this in mind, while commemorating World Suicide Prevention Day recently on September 10th, I shared evidence and experiences around suicide reports in Tanzania-as a licensed and practicing psychiatrist.

In Tanzania, news outlets are increasingly drawing attention to deaths by suicide; publications including ‘Daily News and The Citizen’ have reported on recent incidents. Suicide is widely considered an unusual and shocking circumstance and may cause feelings of uncertainty and anxiety and, therefore, captures the attention of audiences countrywide.

The media plays an essential role in reporting suicide. It can help to promote awareness and initiate positive conversations around mental health, and reduce stigma around psychological and social challenges.

When such news is reported responsibly, it can also offer hope to individuals who are struggling or at risk.

However, media reports unfortunately also have the potential to trigger and worsen the risk of suicide.

More than 100 studies worldwide have reported that suicidal behaviour may be contagious.

Media reporting of suicide is associated with an increased likelihood of people considering suicide themselves, particularly when those reports include details on the suicide method, location of the incident, and the content of a suicide note.

Articles that share personal and emotional details of the individual, oversimplify the cause of death, romanticize suicide, or present suicide as a normal or acceptable response to adversity also heavily influence this increased risk.

In my clinical practice, I once attended to a teenager who had recently attempted to end her own life. Her attempt was impulsive, as it is common with adolescents.

The incident was also very similar to an attempt by one of her neighbours who had died by suicide one week prior.

She felt triggered and overwhelmed by the community’s constant narration of the graphic details of her neighbour’s death, as if it were mere storytelling.

She reported feeling as if this was a painful yet “easy way out”. Fortunately, her parents interrupted her own attempt and brought her for mental health support.

Within the following months, our clinic received reports of several more individuals from the same part of Kilimanjaro Region who had attempted – and in some fatal cases – ended their own lives.

The tragic yet inescapable truth of incidences such as this one, is that many of these deaths are preventable. The precipitating factors, or triggers, are also avoidable.

Often, people who are struggling mentally to a point of considering suicide feel extremely lonely and overwhelmed. They may not see the logic in seeking help or “opening up”.

They may be not be able to process news and move on so easily like others. Triggers such as being exposed to assumptions and irresponsible reporting on other people can be the final factor that induces someone’s attempt to end their own life.

Fortunately, considerable research efforts have resulted in strong evidence to inform the responsible reporting of suicide globally.

In 2023, the World Health Organization shared an online resource for media professionals with guidance on how to achieve this.

While it is acceptable to report death by suicide, this should not contain specific information on the means, location, or presumed cause of death.

Particular caution should be taken when reporting on celebrities or other prominent social figures as these individuals are often considered role models.

It is of prime importance to educate the public on the warning signs and risk factors for suicide.

Using language such as “successful attempt” or “commit” suicide is discouraged as this frames suicide as a positive choice and instils fear of seeking help due to illegality, respectively.

Media reports should always include accurate information on where to seek help, such as the mental health departments at many regional, zonal and national hospitals and private mental health practitioners countrywide.

Furthermore, articles demystifying suicide, promoting positive psychology, coping with stress, and thriving in life are highly needed and should be encouraged.

I am currently an investigator on a research project that aims to reduce suicide and depression among people living with HIV.

Working with Duke University School of Nursing Licensed Psychologist and Assistant Professor Brandon Knettel, on this project, and now having preliminary evidence of its impact, we aim to extend the reach of this work beyond the HIV-positive population.

While exploring the reasons that contribute to individuals feeling depressed and/or suicidal, many of them identify challenges in their lives that are chronic, yet with the appropriate support are manageable; conflict within families, financial challenges, and other health conditions.

Another step on this project is to identify acceptable interventions to lower suicidal risk and depression severity.

Remarkably, many of these individuals wish suicide was not criminalized in Tanzania.

They comment on these laws either as being a barrier to seeking help, or as being unhelpful in a situation where one feels overwhelmed and alone.

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Most of these individuals expressed fear that they would be reported to some authority where they could face persecution.

However, patient confidentiality is respected in recognizing that most people in this situation are experiencing severe mental health challenges, may not be able to make appropriate decisions, and therefore need mental health support. In situations where someone is clearly at risk of harming themselves, extra precaution is taken to protect rather than punish them.

The trend towards the decriminalization of suicide is an important and global effort, especially since mental health challenges are a present in every culture across the globe.

In summary, suicide news should not be for entertainment purposes. When news on suicide is shared irresponsibly, it can cause more harm than good. Media outlets can share news of these events in an impactful yet responsible manner.

This is an official call to media platforms in Tanzania to foster open and positive dialogue around mental health, and improve their approach to reporting on suicide.

• The writer is a Medical Specialist/Psychiatrist