HEAD2HEAD: YESTony Bates says we cannot build the mental health of our society by avoiding the topic of suicide and self-harm. NODerek Chambers says there are ways to highlight the problem without risking imitation or intrusion.
Suicide threatens each of us as much as it distresses us. Particularly when it takes the life of someone close to us, or of someone who has been a role model. Their choice to die can feel like an affront to all that makes life meaningful. Their death calls into question what helps me to live each day and believe that my life makes sense.
The media are no less frightened by suicide than the rest of us. Their wariness of the topic has been reinforced by research findings that demonstrate how media reporting can and does lead to copycat suicidal behaviours, especially among young people.
The World Health Organisation and many local organisations have cautioned the media and provided guidelines to direct them to report suicide in a sensitive "non-sensational" manner: to bear in mind the feelings of relatives, to keep it off the front page, to omit details regarding the means of death and provide information on how to access help for anyone who may be feeling similarly inclined. Above all, to avoid reporting on suicide as something that achieves positive results, eg that it gained sympathy or praise for someone who died in this way. These guidelines are already being adopted (as they should be) but we need to be careful that they aren't used to rationalise avoidance of this important public health issue.
There are examples of media coverage in the wake of suicide that did not lead to increased suicidal behaviour. Following the adoption by the media of guidelines published by the Austrian Association for Suicide Prevention in 1987, the number of suicides on the Viennese subway system actually decreased significantly. A similar example followed the death of the American singer Kurt Cobain. There was no increase in suicide following his death by suicide in his home town Seattle. This was believed to be due to the courage of his partner, Courtney Love, who spoke very openly in the media about his death in a way that differentiated between his brilliance as an artist and her anger at the wastefulness of his death. The Seattle experience was in sharp contrast to the experience of other countries where Cobain's death was reported in a more sensational way.
While responsible reporting is a start to acknowledging the extent of pain that is "out there", we need to move beyond suicide as a mere news item and ask ourselves what it says about the culture we are creating: Why is it that some people can feel so alone, disconnected and trapped that death seems like the only solution?; Why is it that some young people feel they are expected to act in this dramatic way to communicate the depth of their pain and despair? This is a conversation that concerns everyone and above all should include survivors and young people who have made it through really tough times.
Media can play a powerful role in opening up our thinking about the broader issue of mental health. A striking fact about suicide is that it remains a relatively rare phenomenon. Humans have amazing fortitude and resilience in the face of adversity. Media can play a vital role in suicide prevention by modelling in fictional and real-life dramas the positive coping skills that people bring to painful dilemmas in their lives. And for those individuals at high risk for suicidal behaviour, media can be a powerful tool in stimulating our collective political will to make available to them the expertise they need, in a way that is accessible and acceptable to them.
Perhaps the greatest fear of engaging with suicide as a topic is that by talking about it, we will make it more acceptable and therefore more likely to happen. This reticence can even permeate clinical and counselling interviews with vulnerable individuals. What I experienced over the course of my own clinical career is that avoidance of the topic never serves the interest of the client. An exclusive focus on building up a person's sense of well-being is no antidote to hopelessness. Better to listen to and validate the client's most intense feelings of despair no matter how uneasy that may make one feel. Hope is restored when people feel their experience has been acknowledged and understood. When they feel connected to another human being who accepts them, but who can bring their experience into a larger frame of meaning, which reveals potential solutions they had not considered.
Similarly, I do not believe we can build the mental health of our society by avoiding the topic of suicide and self-harm. There is a powerful role for the media to engage us all more deeply in appreciating how we can build a mentally healthy society, where there is less stigma about the wide range of emotions we all experience, and a greater appreciation of how we support one another in finding a sense of place and purpose in life.
Dr Tony Bates is a clinical psychologist and chief executive of Headstrong - The National Centre for Youth Mental Health, www.headstrong.ie .
Some time back, I spoke to a newspaper journalist following a widely reported tragedy involving suicide in a young family which had left the local community devastated. A couple of days later the same journalist called me up again to discuss the article she had written and the circumstances of what had happened. She was obviously upset and in search of her own answers. It reminded me that we're all in this together, trying to make sense of suicide in this apparently happy, wealthy country of ours. I didn't have all the answers; I couldn't tell her what to do or how to report the events that had unfolded.
Suicide is never easy to explain, whether trying to come to some understanding of the terrible loss of someone close, or struggling to analyse the suicide rate of postmodern Ireland. Suicide has always been here but before we could collectively turn a blind eye, leaving the bereaved to their lonely, private, complicated grief.
In the recent past our traditional institutions conspired to maintain an awful silence around suicide, ensuring that we were the last country in Europe where suicide remained a crime (up until 1993). Despite the fact that we have a largely supportive and compassionate clergy, suicide is still considered a sin in a strict doctrinal sense. That we can now have honest and open discussion around suicide is a positive testimony to how much we've matured in a relatively short space of time. The Irish media should take some credit for this.
However, there remains, at times, a certain nervousness as to what might appear in our morning papers when suicide is reported. There are a number of reasons, such as the occasional inclusion of an unnecessarily graphic photograph, or the omission of information on support services. Primarily though, it is because coverage of suicide in Ireland is usually in response to the circumstances of an individual death, and each death by suicide is unique.
After a suicide death, the hurt felt by the bereaved can be compounded by the reaction of others, the not knowing what to say, the awkwardness. If the most intimate grief of the bereaved is played out in the news, those left behind can become increasingly vulnerable. That is not to say that the media should leave the issue alone, should turn a blind eye, but when a death by suicide occurs we all have a responsibility to react in the most sensitive and caring way we possibly can. This requires us to give time and to take care.
Another reason for caution and care in reporting on suicide, beyond the need for sensitivity to those bereaved, is the risk of so-called copycat suicide. The vast majority of us will not be influenced in any significant way by the reporting. However, someone going through a personal crisis could potentially be at risk, particularly if they identify with the person who has died, are of the same gender and similar age and could think "that's me".
Published studies into copycat suicide strongly support the possibility of over-detailed reporting leading to imitation among people who are already vulnerable. This is especially so when coverage is prominent, when the method is described, when the death is portrayed as romantic or in some way glorified, and when the causes are simplified.
There are ways to bring this problem into the open without further intruding on the grief of bereaved families, friends and communities or risking imitation. We can do this by examining the social context of suicide, the possible reasons why people might become so despairing at a time when Ireland has apparently never had it so good. In turn, we can encourage people to talk about problems before they escalate, and encourage people to listen to and look out for others. In short, we can help to tackle the stigma around mental health and getting help. We all have mental health, for better or worse.
The National Office for Suicide Prevention is promoting such a broad-based approach as part of the implementation of Reach Out, the national strategy for suicide prevention. In doing so, the suicide prevention office wants to work with the media as an ally, as an agency for positive change.
At present, coverage of suicide tends to be incidental, in response to an untimely individual death. Treatment of suicide in the wider context, as a social and public health problem, is less common - but perhaps it can be further encouraged in the future. After all, the doubling of our suicide rate since the 1980s, during a time of largely positive economic and social change, is surely worthy of analysis and debate. If we stop to ask questions about postmodern Ireland and all of its symptoms - the suicide rate, the car crashes, the economic growth, the collective pride and the private struggles, we can achieve a greater understanding of the negative symptoms and begin to address them in a coherent and clear way.
Derek Chambers is the research & resource officer of the National Office for Suicide Prevention.
- Irish Times policy on the reporting of suicide is outlined in an one of today's editorials, and we welcome comments on that policy, as well as on the views stated here. If you, or someone you know, needs someone to talk to: Contact Samaritans on 1850 609090 (Republic of Ireland) or 08457 909090 (Northern Ireland). Or contact your local GP.
Join the debate @ www.ireland.com/head2head . Last week we asked: "Was the Treaty of Rome meant to found an economic, and not a political, union?" Here is an edited selection of some of your comments:
The Treaty of Rome was meant to foster both economic and political co-operation, including the principle of "ever greater union". Although, over the years some governments (including the govt of Margaret Thatcher in the UK between 1988 and 1990) have sought to weaken the EU to purely economic objectives, it retains political structures such as the European Parliament. However, I personally would not favour the introduction of a fully fledged "United States of Europe" and would contend that issues such as a European Constitution should require unanimity in order to be passed and not just a dual majority of voters and member states. - Conor, Ireland
All the major advances of the EU have been economical in nature. The free movement of people, goods and services, the introduction of the Euro etc. Although there are questions of the power of the EU over nation states, in reality these powers have more to do with economic factors. The question could be asked is the EU living up to promises in the Lisbon treaty of social reform and responsibility? - Stephen O'Dowd Ireland
All economic decisions by governments are political by nature. Whether the policy involves domestic or foreign policy matters there is ultimately politics involved. The originators of The Treaty of Rome could not speak definitively about a poltical union 50 years ago because the raw wound of nationalism was still dominant in Europe. With time nations have come to see that a joint political structure does not undermine their sense of being a separate political unit . . .
What will exist 50 years from now is unseen to us; yet we cannot say there can be no further integration. Reality has a way of changing dogma. After the American Revolution each of the 13 former colonies viewed themselves as a separate society - not as a local element of a nation . . . The signers of the treaty had expectations of where the document would lead Europe. It is doubtful they intended it to stop at sorting out commercial arrangements among a few nations. - Dan, Ireland
Wasn't it originally called the EEC or European Economic Community? It has never been a secret that the union was established to push forward the economies of its member states. I think a great deal has been achieved both politically and economically, but I don't think we should kid ourselves as to what motivates not just the politicians, but the majority of us as well. - Siobhan Ireland
The writings of early administrators and leaders of the proto-EU make it very clear that the purpose of the process was to engage the EU powers in continuous and detailed negotiation over economic matters in order to make it impossible for the political discord of the previous era to reoccur. So, economic integration was fostered in order to promote political integration. Judging by the vote, it seems people understand both the history and continuing purpose, which is just as well, for the question asked can really only be considered a test of people's understanding of this reality. The alternate view is simply incorrect, irrespective of how the voter feels about it, or thinks the EU should have developed or should develop in the future. - Stephen, Ireland