For more than a quarter of a century, suicide prevention experts have advised journalists against providing too many details about specific suicide methods, or presenting stories about suicide in a prominent way, due to the risk of copycat deaths.
So a New York Times front page headline left me shocked: “Where the Despairing Learn Ways to Die.” The investigative piece looked into a website where visitors shared suicide methods and encouragement.
Was my former employer really flouting these guidelines and offering details that could be read by anyone of any age who was already considering the act? As someone who has written about suicide for the Times and other outlets, devoting periods of my life to the agony of figuring out how to convey the subject in a compelling way without seeming to exalt it, I couldn’t help worrying that featuring such a website represented yet another slip in professional standards.
Yet with suicide now the second leading cause of death among children ages 10 to 14, and the coronavirus pandemic contributing to a wave of despair in high school students, I recognized the newsworthiness of this urgent social crisis. Shouldn’t reputable news organizations be leading the way in providing coverage that is insightful, responsible and helpful?
More than two centruries ago in Europe, officials in multiple countries noticed a dreadful pattern: soon after local residents read a popular novel by Johann Wolfgang von Goethe featuring a protagonist who takes his own life, there was a spike in actual suicides.
Two centuries later, a sociologist in the United States undertook an empirical analysis of how discussion of suicide — this time in newspapers — might be similarly influential. Among his findings: In the month immediately following every front-page story about suicide in a major newspaper between 1947 and 1968 in the United States and Britain, suicide rates consistently increased, and only in the specific region where the article was published. The author of the study, David P. Phillips, dubbed this copycat phenomenon the “Werther Effect,” a reference to Goethe’s protagonist.
Phillips’ analysis also revealed that the duration of front-page coverage and circulation size likewise correlated with suicide increases — a phenomenon that became more troubling to public health officials with the growing popularity of cable television in the 1980s. Whereas newspapers and books delivered a story in a contained physical space that required active engagement by a reader, televised broadcasts could potentially reach millions more people who hadn’t affirmatively decided to consume disturbing content.
In 1989, concerned about what was by then four decades of increasing rates of suicide among American adolescents and young adults, the U.S. Centers for Disease Control and Prevention convened a national workshop to examine the possibility of reducing media-related suicide contagion. The conclusions from that workshop advised journalists to avoid publishing suicide-related photographs and to “attempt to decrease the prominence of the news report.” The communiqué also warned that “engaging in repetitive, ongoing, or excessive reporting,” or providing “how-to” descriptions could contribute to contagion, as could overly reverential portrayals that omit any mention of the decedent’s problems.
Few journalists seemed to know about the guidelines, or to care; in 1995 the Los Angeles Times identified the specific means used by Cheyenne Brando, the adult daughter of Marlon Brando, to end her life. In 2018, a number of local television stations in Los Angeles interrupted children’s programming to live-broadcast a police standoff with a distraught man on a freeway; some stations continued broadcasting even after the man set himself aflame and fired a shotgun into his head.
The CDC reconvened in 1994 and further updated their recommendations, but the warnings again “received little interest or use by media,” recalls Dr. Daniel Reidenberg, the managing director of the National Council for Suicide Prevention. Some local newsrooms continued to abide by a longstanding custom that suicides should not be covered at all unless they involved a public figure or took place in a public setting; national outlets, newly competing with 24-hour news channels and an array of blogs and news-like websites, increasingly prioritized engagement. After the Aspen Daily News reported specific details about Hunter S. Thompson’s suicide in 2005, CBS News quickly re-published them.
Frustrated by the gap in awareness, Reidenberg in 2009 convened meetings that allowed mental health professionals, suicide prevention and public health organizations, journalists, schools of journalism, and others to develop a single, consensus-based set of best practices for reporting on suicide. In 2011, “Recommendations for Reporting on Suicide” was released with extra guidance for reporting “unusual circumstances” such as mass shootings and homicide-suicides.
The recommendations encouraged journalists to avoid saying “committed suicide” or referring to a suicide as “successful,” language that could further stigmatize the act or seem to depict it in a positive light. (Neutral phrases like “died by suicide” or “killed him/herself” are preferred).
They called for not describing the method or location, nor reporting the content of any suicide notes (as the sentiments expressed can lead some folks to “over-identify” with the person who died or the stated reasons for the act). Journalists are encouraged to frame stories in ways that “emphasize help and hope.”
Other key features were a request to provide information on warning signs as well as a visually distinctive sidebar with hotline and treatment resources.
The subtleties of language in the recommendations were designed to avoid encouraging copycats, but also to provide a type of prophylaxis. In 2010, Thomas Niederkrotenthaler, a public health researcher at the Medical University of Vienna, and colleagues documented how media that minimized sensationalism, debunked myths and provided information about prevention and support not only didn’t cause a suicide increase, but actually led to a measurable suicide reduction. This gave rise to what the authors conceived of as a “Papageno effect,” this one named for a character in Mozart’s “The Magic Flute” who plans his suicide, but is discouraged from acting.
The Papageno effect is baked into the recommendations, as is a call for journalists not to avoid covering suicide, but to do so carefully. “Covering suicide carefully can change perceptions, dispel myths and inform the public on the complexities of the issue,” the website reportingonsuicide.org says.
Media ethicist Nicole Dahmen agrees. “It can be harmful not to cover suicide because audiences don’t know it’s a problem,” Dahmen said. “So we have a journalistic and ethical responsibility to cover suicide as a mental health issue. But, as professionals, we need to know how to do it correctly.”
In most coverage areas, journalists would bristle at the suggestion of allowing outside experts to dictate how they should or shouldn’t report a story. From the perspective of public health officials, however, the press has a role to play in suicide prevention. The data is clear, confirmed by more than 100 studies from all over the world: following utilization of the recommendations can prevent unnecessary deaths.
Soon after reportingonsuicide.org went live in 2012, the Poynter Institute hosted regional workshops and a webinar to train journalists on best practices. Other one-off efforts happen sporadically or when individual professors include the recommendations in an ethics class, but curricula vary widely across schools and don’t reach the whole industry.
Other countries take a different approach. In Norway, the press is governed by an independent, self-funded association that operates a commission to review violations of its ethics code. Although a complete ban on reporting on suicide was in effect for many years, since 2006, reporting on it has been allowed, provided journalists avoid descriptions of methods and all but the barest of details.
In New Zealand, lawmakers in 1988 outlawed the reporting of details on suicide methods and required the media to abstain from describing an act as a suicide until after a coroner’s official ruling; instead, journalists would frequently employ phrases like “no suspicious circumstances” or “the death has been referred to the coroner,” which became well-known euphemisms.
In the absence of regulation, a licensing body, or professional training standards in the U.S., most journalists, like KFF Health News senior correspondent Aneri Pattani, learn best practices while on the job — if at all. Pattani said her first lesson about covering suicides came informally while participating in an internship-type program at The Boston Globe and from monitoring bulletins released by the transit police. “At some point we had a discussion, I can’t remember who it was with … but the explanation to me was if someone got hit by a train”— meaning a likely suicide — “we wouldn’t write about it.”
It was later when working at The Philadelphia Inquirer and interviewing suicide researchers and clinicians, that one of them mentioned the online recommendations, and she began to use them. “I worked in four different newsrooms before I graduated college. There’s limited training anywhere, never mind sensitivity training on mental health,” Pattani said.
Pattani credits the guidelines for helping her write stories that go beyond tragedy to shed light on potential solutions, like a piece she wrote in 2021 examining “suicide postvention,” a growing area of research about effective steps that can be taken after a suicide “to help communities grieve, restore a sense of stability and limit the risk of more deaths.”
University of Oregon’s Dahmen similarly learned about the issue of suicide contagion only by accident: after a mass shooting-suicide, she began studying the role of media coverage in motivating killers, and encountered reportingonsuicide.org.
In 2019, Dahmen joined more than 30 news organizations across Oregon for a coordinated week of suicide coverage, aiming to both destigmatize the issue and avoid the risks of contagion. At the time, the state had a suicide rate 36% higher than the national average, according to Willamette Week. “Breaking the Silence,” the coordinated campaign, included enterprise pieces such as Capi Lynn’s “Behind the badge: Suicide’s toll on police, other first responders” for Statesman Journal, which recounted the wide-ranging effects of a single suicide — without providing details that could inspire copycat behavior. Nigel Jaquiss of Willamette Week profiled a Republican state senator who, after his 31-year-old stepson fatally shot himself, teamed up with a gun control advocate to pass new legislation, amplifying the well-established links between suicide and firearm access.
Still, without any oversight, American news organizations are free to cover suicide however they wish. When Robin Williams died in 2014, the New York Daily News ran Williams’ portrait on its front page underneath a single boldfaced word: “Hanged.” A 2018 study by epidemiologists at Columbia University documented how news of Williams’ death was associated with a nearly 10% rise in the number of suicides in the United States in the four months that followed. And there was a 32.3% spike in the number of suicides through suffocation.
In 2020, six researchers from Canada and Austria examined whether news of the suicides of Kate Spade and Anthony Bourdain, which occurred three days apart in 2018, affected suicide rates in the U.S. Using predictive statistical models, they found that in the two months after the deaths there were 457 excess suicides. There was also a 14.5% increase in suicides by the same method with no significant increase in all other methods combined.
With the onset of the coronavirus pandemic in 2020, young Americans began spending even more time at computer screens, and health professionals witnessed what they described as “soaring rates of mental health challenges among children, adolescents, and their families.”
Newsrooms have responded to the crisis in various ways. Jason Cherkis, a journalist who has covered mental health for about 20 years, wrote for The Guardian about a struggling teenager who died by suicide after his counseling sessions moved online. Cherkis’ story carefully examines the shortage of therapists to treat children and teens; how a large network of mental health clinics responded to the pandemic; the limits of virtual therapy; and, without too many graphic details, how the teen used a gun to end his life.
In other instances, news organizations appear more concerned with maximizing website traffic than serving the public interest. How else to explain why, 27 years after the singer’s death, CBS News published “Kurt Cobain death scene photos”?
Hoping more journalists will get acquainted with best practices for reporting on suicide, Pattani, who is studying for a master of public health at Johns Hopkins, joined two faculty members who specialialized in suicide prevention to create a free online training program for journalists. The class, on Coursera, includes an array of readings and short videos. It also includes tips for how to handle potential pushback from newsroom colleagues who believe stories about suicide should be handled like any other. “Like any culture change,” Pattani notes, “it will take time to win over everyone in the newsroom.”
A December 2021 New York Times front page story, “Where the Despairing Learn Ways to Die,” by Megan Twohey and Gabriel J.X. Dance, delivered on the headline’s promise, taking readers into one of the darkest corners of the internet and documenting how at least 45 people, including teenagers, used a pro-suicide website to learn how to kill themselves or found encouragement to compete the act.
The exposé contains graphic details about suicide planning, and agonizing excerpts of individuals being coaxed by strangers to end their lives. It also contains the name of a specific but little-known method for enacting suicide; and the name of the website, which was still active and heavily trafficked at the time of publication.
The story also exposed the shadowy figures who created and maintained the site — two men who operate it and the absence of commercial and regulatory oversight that allowed the site to continue, even after multiple complaints to hosting companies from devastated families.
While neither Twohey nor Dance had previously written about suicide, they both believed that the potential benefits of exposing the website and naming the preservative were worth the potential harms. “Given the youth mental health crisis, the steadily rising rates in youth suicide combined with what was so clearly a dangerous website where you could see people dying every week, even though this involved complicated decisions, we felt that we had an obligation to report on this,” Twohey says. “We felt we couldn’t look away.”
Perhaps wanting to preempt critics, the Times’ package included a note about its decision-making process, which was undertaken in consultation with Reidenberg and other experts. “Editors decided to identify the site and the preservative used in many of the suicides — as some other news outlets have done — in order to fully inform readers about the dangers they pose, particularly to the young and vulnerable.”
Rod Hicks, the director of Ethics and Diversity at the Society of Professional Journalists, says journalists have a duty to minimize harm, and points to his organization’s Code of Ethics. “Reporting on something … just because some other news organization has, is not a good reason to do it,” he says. “It’s not all about what you write; it’s sometimes about what you don’t write.”
The way in which the story was handled, and the inclusion of the most potentially harmful details, raised ethical questions for journalists with no easy answers.
For Andrew Solomon, who has written extensively about depression and suicide, the decision to name the preservative, instead of just referring to it generally, was a mistake. “I thought it was startling, and it felt irresponsible to me,” he says. “I don’t think the Times piece was written by evil people setting out to make a name for themselves. They were careful. But what degree does writing about [a little-known method] make it more accessible to more people, make [suicide] happen more? I think that’s a very difficult line.”
Cherkis, who is currently writing a book about suicide for Random House, wasn’t sure he would have made the same choices but believed the revelations in the story ultimately provided a valuable public service. “If I was a parent and I was reading that New York Times story, I would be grateful that they wrote what they wrote,” he says.
Several prominent suicidologists responded to the story by writing a guest essay for the Times, which the paper declined to publish. Arguing that the article “likely contributed to additional suicide deaths,” the group took to Medium, urging the paper to “empirically examine whether traffic to the site increased after the publication of this article (compared to the year before publication),” and to “investigate whether suicides by the particular lethal means mentioned in the article (which again, was in direct violation of responsible media guidelines) increased as well.”
Twohey and Dance acknowledge the potential danger in their decisions, but also feel it was urgent to provide that information to authorities, who were largely in the dark. “So many people who should know about the method and website were not aware of it, from parents to vulnerable kids to mental health professionals to police officers who were showing up to suicide deaths and did not know what they were looking at,” Twohey says. “So we also felt there was a public service in informing people who should know about these dangers with the hope there could be greater accountability.”
That part of their bet paid off. As a result of the story, the House Committee on Energy and Commerce sought an investigation into the site. The reporters say they have been contacted by appreciative EMTs and emergency room doctors and school officials who have blocked access to the dangerous website on their school computer systems.
Pattani, who created the training video for Coursera, declined to offer an opinion on the Times story specifically but said she believes a cautious approach makes sense. “Sometimes I think as journalists we think, ‘Well, if I don’t put it out there, someone else will have it,’ or ‘It’s easy to look up.’” But one of the things we know about suicide is that it can be impulsive.
“So the same way that if you have a gun inside the safe, a few extra minutes for someone to access that gun might be enough to change their minds,” Pattani continues. “I think we, as journalists, can apply a similar approach to our stories. Yes, the information still exists in the world but maybe I’m adding an extra five seconds. Maybe by the time someone gets to the information they have changed their mind, or they are not in a state where the information will lead to harming them in some way.”
If withholding information seems anathema to the American press, it is an idea that has gained more acceptance with the rise of mass shootings and political disinformation campaigns. After 149 criminologists, sociologists and psychologists signed a letter in 2017 calling on journalists to stop naming or showing photos of shooters after two sociologists examined how assailants are often motivated by a desire for fame and attention, more newsrooms are accepting the idea of strategic silence.
Now, journalists nationwide again face choices about whether and how to cover the suicide death of a celebrity, and their decisions — combined with the power of social media — will have real-world implications, and could change the trajectory of some people’s lives.
On the same night that a teenager massacred 19 students and two teachers at an elementary school in Uvalde, Texas, my oldest son, now 17, learned from an Instagram post that a friend and former teammate had killed himself. It was the second suicide of a friend he learned about on social media, and the second suicide at the boy’s school that year. Hayden was 16. ,
Julie Scelfo is a longtime journalist (The New York Times, Newsweek), a media ecologist, co-author of “The Women Who Made New York” and the founder of Get Media Savvy, a nonprofit working to establish a healthy media environment and protect humanity.