Philip Batterham
The response to the tragic death of the brilliant comedian and actor Robin Williams is a reminder of the potential negative impacts of stigma towards people with mental illness.
As has been apparent, media reporting of suicide can be helpful in emphasising that help is available for people experiencing distress. Also potentially helpful is the portrayal of suicide as emerging from a complex interaction of multiple risk factors, which may include underlying mental illness, physical health problems, trauma, substance use, social isolation, access to means and psychological factors.
However, reporting the details of a suicide death can be potentially damaging. In Australia, the Mindframe National Media Initiative has been proactive in supporting appropriate media coverage of suicide and mental illness.
The Mindframe initiative has gained significant traction in Australia, with higher quality coverage of suicide in the media over the past decade, despite an increase in stories about suicide. The National Institutes of Mental Health in the United States has similar guidelines for media coverage. However, international media reporting of celebrity suicides has often breached these guidelines.
Given evidence that detailed reporting of celebrity suicides can increase rates of suicide in the community, the media must balance public demand for information with their responsibility to provide information in a way that minimises potential harms to the community. This balance continues to be made more difficult with the rise of social media driving unprecedented public demand for information.
While irresponsible reporting of suicide details can lead to increases in “copycat” suicides, a similarly damaging influence is the perpetuation of stigmatising attitudes toward people experiencing suicidal thoughts or behaviours, or toward people who have died by suicide.
Recent commentary that such people are “cowardly” or “selfish” can be damaging to both people at risk of suicide and families bereaved by suicide.
Research conducted in collaboration with my colleagues at the NHMRC Centre of Research Excellence in Suicide Prevention is identifying the ways in which stigma may impact on people experiencing suicidal thoughts.
We have recently reported that people who hold stigmatising views of people who die by suicide are themselves less likely to seek professional help for suicidal thoughts. Similarly, people with limited knowledge about suicide prevention are reluctant to seek appropriate care.
It should also be noted that the contrasting implication that people who die by suicide are “free”, “in a better place”, or other forms of subtle glorification may inadvertently promote suicidal behaviour as a coping strategy, which can also be highly counterproductive.
It is likely that the perpetuation of stigma towards people who die by suicide and towards people with mental illness constitutes a considerable barrier to appropriate care. The at-risk individual may experience shame about their own symptoms, along with a fear of negative attitudes from other people and discrimination.
By combating these negative attitudes in the community and identifying the potential harms caused by such statements, it may be possible to reduce the number of suicides in Australia.
However, more work is needed, particularly given that the number of suicides in Australia is at a 10-year high, with more than 2,500 deaths in 2012.
Community programs to reduce the stigma of seeking help for suicidal thoughts require a careful approach that is based on evidence. Similarly, evidence-based education campaigns identifying warning signs, risk factors and treatment approaches may increase public awareness and aid in the recognition of at-risk individuals.
Developing services that provide safe alternatives to psychiatric wards for those experiencing serious suicidal thoughts may also assist in reducing barriers to seeking help. However, new service models should not come at the expense of existing mental health services, which are already overburdened and under-resourced.
Furthermore, suicide is not only a mental health issue. There are substantial impacts of social and societal factors, such as unemployment, relationship breakdown, trauma, social safety nets and availability of services. Focusing solely on increasing existing mental health services will likely be ineffective policy for reducing the suicide rate.
Building Australia’s capacity to conduct suicide prevention research is another key element to addressing the issue, as such research has traditionally been under-resourced.
There are many challenges to identifying effective ways to reduce suicide. However, with sustained attention to the issue and funding from government and philanthropic organisations, researchers can work together with consumers, carers, service organisations and other stakeholders to determine how best to identify, treat and support individuals who are at risk of suicide.
Our research is trialling new technologies and methods that may also assist in supporting at-risk individuals, including harnessing social media, trialling online support programs and developing novel therapies.
Suicide emerges in the community and its tragic consequences can have far-reaching impacts on the community. Therefore, preventing suicide requires a whole community approach.
Recognising the importance of community and connection, the theme of World Suicide Prevention Day on Wednesday September 10 is “One World Connected”.
Dr Philip Batterham is a Fellow in Mental Health Research at the National Institute of Mental Health Research, The Australian National University.
Lifeline 13 11 14, www.lifeline.org.au; Suicide Call Back Service 1300 659 467, www.suicidecallbackservice.org.au
