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News reporting of suicide in ex-military personnel

In this month’s PLoS Medicine editorial, we discuss the public health risks associated with sensationalized media reporting of suicide, including the risk of promoting copycat suicides.

We decided to write the piece because we knew we were going to publish a study about suicide, and we were concerned that reporters might sensationalize the findings.

The study, by Nav Kapur and colleagues, examined the suicide rate in those who had left the UK Armed Forces. During the study period 233,803 individuals left the Armed Forces and 224 died by suicide. The researchers found that the overall suicide rate in the ex-military personnel was similar to that in the general population. However, young men aged 24 years or less who left the UK Armed Forces had a two to three times higher risk of suicide than young men in the general population or those still in active service. The absolute risk in these young ex-military personnel was small (the crude rate of suicide was 29.9 per 100,000 person years in 16-19 year olds, and 34.0 per 100,000 person years in 20-24 year olds).

As we say in our editorial, there are previous examples of dramatic media portrayals of suicide in soldiers. In 1995, for example, there was a stream of dramatic Canadian newspaper reports about military personnel who committed suicide during or after UN peacekeeping duties in Bosnia. Yet a subsequent case control study found no increased suicide risk in peacekeepers as a whole (although it did find an increase in a subgroup of air force personnel).

One of the problems with sensationalized media reporting of suicide is that some research has found that it can be associated with “copycat” suicides. In our editorial, we therefore addressed three related questions: What types of media reports are most likely to have an effect upon suicidal behavior? What constitutes safe media reporting? what could PLoS Medicine do to promote the responsible reporting of the study?

Media portayals of suicide, we say, “are more likely to be associated with suicidal behavior when they are prominent on the page (e.g., large headlines, photos of the body), appear in multiple places (e.g., several TV networks and newspapers), report celebrity deaths, and are based on real rather than fictional (e.g., TV soap opera) suicides.”

Several organizations, such as the US Centers for Disease Control, the Samaritans, and the Canadian Psychiatric Association (CPA), have issued guidelines to the media on safe reporting of suicides. The CPA, for example, urges reporters to avoid the following: giving details of the suicide method; repetitive, excessive, or front page coverage; “exciting” reporting; romanticized or simplistic reasons for the suicide; and the idea that suicide is unexplainable.

So what steps did we take to encourage non-sensationalized reporting of Kapur and colleagues’ study? We wrote a sober press release, adopting principles that we laid out in a previous editorial. In the press release about the study, we included links to guidelines on safe media reporting and suggested to journalists that they include in their reports information about organizations (e.g. the Samaritans) offering support to those with suicidal thoughts. And, with Professor Kapur’s consent, we contacted these organizations ahead of the paper’s publication to let them know about the study’s findings and the likely upcoming media attention.

What kind of news coverage did the study elicit, and what was the quality of the reporting?

The study was covered internationally (the UK, Spain, India, the US, and elsewhere), in print, online, and on TV, and as a whole the coverage was factually accurate and not overly hyped. There were, however, a few exceptions.

For example, the Sunday Mirror broke the embargo in what they called an “exlusive” (“Young War Veterans are Three Times More Likely to Kill Themselves-Exclusive”). The reporter, Rupert Hamer, called the study “a shocking new report” and stated that it “shows that suicide rates among vets from the Army, Navy and RAF have rocketed in recent years.” Rocketed in recent years? The study found no such thing.

And The Times did go into detail about the suicide methods used by the young ex-military personnel, something that the CPA advises reporters to avoid.

One of the best reports was by BBC News. They interviewed Nav Kapur to ask him what he thought might be the explanation for the higher suicide rate in young ex-military personnel. The news report gave the absolute numbers of people in the cohort study and of those who killed themselves. It gave one of the fullest pictures of the study’ findings–for example, it stated that “the overall suicide risk was no greater for ex-military personnel than for civilians when all age groups were considered, from 16 to 49 years” and that “men aged 30-49 years had a lower rate of suicide than the general population.” And the BBC included a helpful figure showing the age-related risk of suicide in ex-military personnel compared with the general population.

It was disappointing that reporters failed to give readers details about organizations that can offer help and support to those experiencing suicidal thoughts. And I’d also argue that, by and large, they missed an opportunity to discuss and de-mystify suicide more broadly, including the fact that suicide is usually related to a treatable mental illness. As Jeremy Paxman says in his introduction to the Samaritans’ guidelines on safe media reporting: “Positive outcomes of suicide reporting include bringing a subject that remains somewhat taboo into the public arena, helping to de-mystify it and challenging the stigma that still surrounds people willingly taking their own lives.”

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