The Science Behind Suicide Contagion

By Margot Sanger-Katz, New York Times - The Upshot

Aug. 13, 2014

When Marilyn Monroe died in August 1962, with the cause listed as probable suicide, the nation reacted. In the months afterward, there was extensive news coverage, widespread sorrow and a spate of suicides. According to one study, the suicide rate in the United States jumped by 12 percent compared with the same months in the previous year.

Mental illness is not a communicable disease, but there’s a strong body of evidence that suicide is still contagious. Publicity surrounding a suicide has been repeatedly and definitively linked to a subsequent increase in suicide, especially among young people. Analysis suggests that at least 5 percent of youth suicides are influenced by contagion.

People who kill themselves are already vulnerable, but publicity around another suicide appears to make a difference as they are considering their options. The evidence suggests that suicide “outbreaks” and “clusters” are real phenomena; one death can set off others. There’s a particularly strong effect from celebrity suicides.

“Suicide contagion is real, which is why I’m concerned about it,” said Madelyn Gould, a professor of Epidemiology in Psychiatry at Columbia University, who has studied suicide contagion extensively.

She’s particularly concerned this week, after the high-profile death of the comedian and actor Robin Williams.

ImageA sign at Kurt Cobain Memorial Park at Young Street Bridge in Aberdeen, Wash., his hometown. Coverage of his death was closely tied to messages about treatment for mental health and suicide prevention.

A sign at Kurt Cobain Memorial Park at Young Street Bridge in Aberdeen, Wash., his hometown. Coverage of his death was closely tied to messages about treatment for mental health and suicide prevention.Credit...Dana Nalbandian/WireImage

Suicide prevention advocates have developed guidelines for news media coverage of suicide deaths. The idea is to avoid emphasizing or glamorizing suicide, or to make it seem like a simple or inevitable solution for people who are at risk. The guidelines have been shown to make a difference: A study in Vienna documented a significant drop in suicide risk when reporters began adhering to recommendations for coverage.

That aim has to be weighed against a journalistic duty to keep the public informed. And in the Internet era, a person who wants to know details of a suicide won’t have a hard time finding them. Most of the research on suicide contagion predates the rise of social media.

Few of the experts’ recommendations make much sense in the case of Mr. Williams. Studies suggest avoiding repetitive or prominent coverage; keeping the word suicide out of news headlines; and remaining silent about the means of suicide. “How can it not be prominent?” Ms. Gould said.

Experts also say articles should include information about how suicide can be avoided (for instance, noting that the National Suicide Prevention Lifeline is available 24 hours a day at 800-273-8255).

They also recommend avoiding coverage that describes death as an escape for a troubled person. One example was the 1994 death of Kurt Cobain of Nirvana, who was beloved among young music fans, including in Seattle, where his career rose and where he was found dead. Local coverage of his suicide was closely tied to messages about treatment for mental health and suicide prevention, along with a very public discussion of the pain his death caused his family. Those factors may explain why his death bucked the pattern. In the months after Mr. Cobain’s death, calls to suicide prevention lines in the Seattle area surged and suicides actually went down.

“It’s different from any other cause of death,” said Christine Moutier, the chief medical officer at the American Foundation for Suicide Prevention. “When someone dies of cancer or heart disease or AIDS, you don’t have to worry about messaging it wrong.”