Sunday, April 1, 2012

We Don't Seem To Be Learning About Suicide Clusters And Contagion

The recent loss of another young person in Lake Forest to an apparent suicide appears to have taught us little. Lake Forest Illinois has now had three highly publicized deaths of adolescents since January 1st of this year. Before that it was Barrington Illinois where 5 individuals took their lives over a three year period and where the media focused it's attention. Before that it was St. Charles, Naperville and Elgin that caught our attention.

Many have rightfully suggested that suicide clusters have been spurred by contagion, also known as the "Werther Effect" (a synonym for media induced imitation effects of suicidal behavior).

A suicide cluster is defined by scientists as three or more suicides in a specific location that occur over a short period of time. Contagion is a term used to identify those situations where there is some linkage between the deaths such as personal knowledge of each other, a shared identity as in school attendance or simply an age range within a specific geographical location. While the term cluster denotes a linkage of location, contagion describes an hypothesized relationship that is in some way related to cause and effect.

As a police psychologist in an affluent northern Illinois suburb I am directly aware of the various numbers and types of death that occur within our Village limits. Some are suicides, some due to accidents and some related to the normal aging process and health deterioration. Few of them are publicized except when the local press takes special interest such as obvious suicides or car accidents. I can tell you that each and every year there are more than enough self inflicted deaths that meet the criteria of a cluster, yet are not publicized. If I include the number of attempted suicides in our town (as well as others that touch our Village limits, based on the radio traffic of dispatchers) then there are easily 4 or more per month within a population of approximately 50,000.

An interesting side point here is that for years, local writers have tried to get at some measure of how many actual suicides there are in the affluent North Shore Suburbs. When you combine that number with the suicides of persons who live here but take their life at other locations (downtown, at weekend homes or on trips of various types) my educated prediction would be it easily tops two per month and more. This prediction covers all age ranges and is not limited to adolescents who comprise a much smaller segment. A careful review of the local obituaries for a 6 month period should get you all the information necessary to concur.

Getting back to the issue at hand; are we learning from any of this? The answer is sadly, no. We continue to publicize suicides, especially those of adolescents and young adults, in a manner and fashion that promotes contagion. But please, before you try and burn me at the stake for my position consider the studies that have been done and the information learned from them. Then decide for yourself if we have learned anything.

Johansson, Lindqvist, and Eriksson (2006) found in Sweden that it is important to bear in mind the risk of further suicides and the risk of cluster formation in a society struck by a teenager suicide.

Niederkrotenthaler, Herberth, and Sonneck (2007) found that in "Austria, "Media Guidelines for Reporting on Suicides", have been issued to the media since 1987 as a suicide-preventive experiment. Since then, the aims of the experiment have been to reduce the numbers of suicides and suicide attempts in the Viennese subway and to reduce the overall suicide numbers. After the introduction of the media guidelines, the number of subway suicides and suicide attempts dropped more than 80% within 6 months. Since 1991, suicides plus suicide attempts - but not the number of suicides alone - have slowly and significantly decreased. The increase of passenger numbers of the Viennese subway, which have nearly doubled, and the decrease of the overall suicide numbers in Vienna (-40%) and Austria (-33%) since mid 1987 increase the plausibility of the hypothesis, that the Austrian media guidelines have had an impact on suicidal behavior."

The Austrian guidelines can be found here;

The World Health Organization (WHO) has also published guidelines for media coverage of suicidal acts (2008).
  1. Avoid language which sensationalizes or normalizes suicide, or presents it as a solution to problems.
  2. Avoid prominent placement and undue repetition of stories about suicide.
  3. Avoid explicit description of the method used in a completed or attempted suicide.
  4. Avoid providing detailed information about the site of a completed or attempted suicide.
  5. Photographs or video footage of the scene of a given suicide should not be used, particularly if doing so makes the location or method clear to the reader or viewer.
  6. Use of the word ‘suicide’ in the headline should be avoided, as should be explicit reference to the method or site of the suicide.
  7. Take particular care in reporting celebrity suicides.
  8. Show due consideration for people bereaved by suicide.
  9. Provide information about where to seek help.

When you take both guidelines into consideration, you can see that our press has learned very little when judging the reporting of the most recent Lake Forest tragedy.

I for one, fully expect even more sensational headlines and the resultant increase in adolescent suicides. I wish it wasn't so but it doesn't look like anyone is putting into practice what we've learned. I wish they would learn.


Anonymous said...

Thank you! -- A Lake Forest Parent

Dr. John Conlin said...

I'm a parent as well. You're welcome.