In the past year there have been clusters of student deaths and suicides at several US colleges including, MIT, University of Pennsylvania, Tulane University, Appalachian State College and George Washington University. These clusters have received quite a bit of media attention, and have precipitated discussions about campus mood, college stress, student vulnerability, leave of absence policies and access to care on campus.
How are we to understand and respond to these clusters of student deaths? How far does the media influence our view of the events? And, importantly, what impact does media have on the incidence of suicide itself?
I came to experience the impact of a “cluster” of student deaths during the 2003-2004 academic year, when I served as medical director at NYU’s student counseling service. I also came to see the impact of media reporting on campus suicide.
For several years prior to the 2003-2004 cluster of deaths, there had not been a single death on NYU’s campus. Then many followed within a brief span of time. This pattern has also occurred at schools like University of Pennsylvania and Cornell University. As rates of school suicides are not available in any research setting, I say this, based on anecdotal reporting and my experience.
Media can influence interpretation of suicide rates
In fact, when we look at the rates of suicide and other deaths at NYU over a span of several years, the rates are similar to other schools. The same appears to be true of the other schools that have experienced recent clusters of suicides and other deaths.
Media can impact our interpretation of events. It can frame events in a way that make them feel like a cluster.
Consider if three suicides were to occur among young adults in a town of 40,000-50,000 people over six months. It is likely that local newspapers (if there is one) would not report these deaths and if they were reported, it is not very likely they would be presented as a cluster of suicides unless they happened within an unusually brief time or possibly occurred among a group of friends.
If this same series of deaths occurred among college students at a school of 40,000 students, it may very likely be reported as a cluster of deaths, particularly if the school has had few suicides in prior years.
Media could also lead to ‘suicide contagion’
But the interaction of suicide and media is, in fact, more complicated. Reporting can not only create the perception of suicide clusters but can actually in subtle ways impact the suicide rate in a community or school. In other words, media reporting can also increase the risk of suicide contagion.
We know that at any given time in any population there are people at risk for suicide. We know, for example, that six to eight percent of college students report having experienced serious thoughts of suicide in the prior year. People with psychotic illnesses, especially in early stage of illness, are also at significant risk for suicide. Thus, students who may be in early stages of a psychotic illness also may experience greater risk of suicide contagion.
We know that reporting can, at times, suggest suicide as a typical response to stress. Or, in providing rich biographical data, might make the person who died seem heroic. Media could also provide graphic details about the mode of death – all of which are thought to increase the risk for those who read the articles.
It seems that the more someone is able to identify or feel connected to the person or people who have died by suicide, the greater the increase in risk.
In fact, I’ve wondered whether the high-profile reporting and attention given to the suicide of Robin Williams, has impacted or contributed to the recent seeming upsurge of campus deaths. Williams was a much loved and admired figure; someone who many young people could “connect” with.
What can college do to prevent suicides
So, what can colleges do when faced with a series of suicides?
How do they know whether this is a cluster that is an artifact of perception or whether it reflects an actual trend or increase in suicide deaths? It may not be possible to know right away and it may not matter.
When faced with any suicide death, a school needs to institute a postvention plan – that is, a series of activities undertaken by a community to respond to a death, suicide or other public crisis.
This plan includes developing a protocol for identifying, tracking and when needed, intervening with those at risk as well as providing emotional and clinical support to the campus as a whole.
The school needs to broadly examine current services and support programs to identify any gaps. But of great importance to the community, the school counseling leadership needs to manage and educate campus and local media about safe and healthy reporting.
The way we convey information will matter. Too little information might lead to community anxiety and suspicion while too much of the wrong kind of information may increase risk for contagion.
So here is the complexity and the challenge. Media needs to report events, but the manner in which these events are presented will impact how we understand the events and even the way the events might unfold.
In the context of suicide reporting, prevention and postvention, media has the responsibility to not only share information, but also, arguably, to protect the community at whom reporting is directed.
Dart Center’s reporting guide for journalists urges journalists to be careful so they are not “inadvertently ‘selling’ suicide as a meaningful way out.” Journalists need to ensure their reporting on suicide is accurate, as well as safe.