How to Speak Suicide

Introduction

Suicide is a sensitive topic for many people. Suicide is the end of a person’s life by their own choosing. Commonly, people will ask why a person has committed suicide. That question goes unanswered all too often. The leading cause of suicide is clinical depression—unsurmountable sorrow and despair that leads to loss of hope and thoughts of ending your existence to escape the pain. When a suicide happens, many factors need to be considered before communicating the details to an organization. There exists many guidelines for media reporting of suicides, but little is said about how to talk about suicide at the organization level. This paper aims to answer the question: What is the appropriate method for an organization to communicate a suicide of one of its community members?

Annotated Bibliography

Collings, S.C., & Kemp, C.G., (2010). Death knocks, professional practice, and the public good: The media experience of suicide reporting in New Zealand. Social Science and Medicine, 71(2), 244-248.

Collings and Kemp sought to examine the perceptions of suicide of those who report the news in New Zealand (2010). A series of interviews of 15 reporters were digitally recorded, de-identified, transcribed verbatim, and analyzed line by line to identify common themes and ideas held by the journalists. Some common themes included public responsibility to protect the good of the community, suicide is “taboo,” and the public’s right to know for news transparency. Additionally, some media personnel reported that they felt like teachers, having a role in the way children and young adults learn social norms. Mental health awareness was linked to suicide discussions. Awareness of drug and alcohol abuse can also be tied to suicide awareness (Collings & Kemp, 2010).

The commercial nature of news dictates that suicide is newsworthy by disclosing the nature of the act, and the identity of the deceased. As Collings and Kemp stated, “interesting stories sell, so celebrity suicides receive special attention (p. 246).” This was particularly true in the death of Robin Williams, whose widow reported he suffered from a debilitating mental illness that would have greatly affected his quality of life.

Reporting suicide is “part of the job,” but each story leaves the reporter with memories. Reporters were left distressed, shocked, or saddened (Collings & Kemp, 2010). Participants noted the death knock, which is approaching the family soon after the death for a statement, which was cited as the most difficult part of the job. Some noted that the emotional turmoil was just too great to pursue the topic.

The Ministry of Health in New Zealand has guidelines about what can be reported, and on the most part, coroners were cooperative, except in cases of celebrity death. While none of the participants reported using the MoH guidelines, they felt the legal guidelines conflated them. Many felt that their responsibility as a reporter would remain, whether or not the MoH guidelines were in place.

This article found that reporters framed suicide in the effort to protect and educate the public. It found that the effort of reporting a suicide leaves the journalist with personal effects, be them empathy or sadness in having to approach a family which recently suffered a loss, or if it’s to push the boundaries of ethical reporting just to get the big news story. This is the important take away: reporting a suicide to others changes you. Some reported that there should be one rule for all deaths, yet suicide seems to stand out as deserving special attention. Needless to say, informing others of a suicide is a difficult task that can leave you choked up when it’s time to identify the event. This puts in place the notion that it takes courage and confidence to make that announcement with respect to the deceased.

Davis, J.M., & Bates, C. (1990). Faculty suicide: Guidelines for effective coping with a suicide in a counselor-training program. Counselor Education & Supervision, 29(3), 197.

“It can’t happen to us.” That is what a counselor education program thought before a faculty member in the department completed suicide. As anticipated, members of the department (students and colleagues) responded with anger and sadness, but they were not able to find a logical explanation for what happened (Davis & Bates, 1990). This is not a common occurrence. Researchers could find no literature on the topic. Suicide prevention material for high schools, colleges, and families were plentiful, but only one article was found about the effects of a faculty suicide. The researchers sought to: explore the presuicide and postsuicide departmental dynamics to better understand [their] own situation (Davis & Bates, 1990, p. 197). This comparison is important, because it is human nature to react and respond to the emotional and mental toll a suicide will have on those around the deceased.

Through their findings, the researchers put together a set of policy recommendations for other departments. These important recommendations include not glamorizing or dramatizing the event, emphasizing that doing nothing can be dangerous, and serving the faculty needs so they can provide support for the students. They recommend and outside consulting agency for faculty to openly and succinctly address their most personal needs and concerns. The family and a representative of the organization should work together to formulate a brief statement for the media and other departments (Davis & Bates, 1990). A university liaison for the family may be appropriate. Students should be notified within 24 to 48 hours, so they find out appropriate and accurate facts before they find out on their own. Students should be treated as survivors of suicide as well. Memorializing the deceased without dramatizing the suicide may be appropriate, but should be coordinated with the family.

Davis and Bates (1990) emphasize, “After a crisis is not the time to plan for it” (p. 197). There could even be hope that discussing these events, when stress and discouragement are high, and people are pushed to their limit, could lead to relief for afflicted individuals, avoiding a tragic suicide event. Would knowing that a response plan is in effect prevent a person from suicide? How can we ever really know. It is clear that organizations, especially those with public relations and human resources, need to be prepared to talk about a suicide when it happens. Therefore, it’s important to review pre- and postsuicide responses to practical cases.

Hsiung, Robert C. (2007). A suicide in an online mental health support group: reactions of the group members, administrative responses, and recommendations. CyberPsychology & Behavior, 10(4), 495-500.

Suicide in a support setting for mental illnesses is inevitable. Such is the case in an online discussion board that was under study from October 2001 to April 2003. Participants gave informed consent for their messages to be used in research. This community used information and communication technologies (ICTs) to form a group dedicated to support for psychiatric conditions. As a discussion board, it maintained a significant history of text and discussion. When a person—Z—committed suicide, the response of community members was recorded and evaluated. Z had talked openly about suicide ideology, and it was encouraged to vent about your life’s discouragements (Hsiung, 2007).

As with many online communities, people don’t know each other in person. This lack of real-life encounters makes it difficult to grieve and find closure on the event. Even after a year, on a memorial post made by the group moderator, members posted anger and sadness in response to their emotional memories of Z (Hsiung, 2007). Regardless if it was suicide or cancer, the moderator felt it was appropriate to create a memorial page, outside of the general community conversation, that people could go to when they wanted to pay their respects.

As may be true in other cases where ICTs are used, such as a work place, some workers may not actually meet their colleagues. They may have only worked together in virtual relationships (email, phone calls, and video conferences). Yet, they remain affected by the suicide completion, and face confusion when a new employee comes to replace the deceased. Human Resources may have a role in training and informing new members of the organization of the past history of the position. Out of respect for the deceased, you would not dramatize the event, but the fact remains that the team suffered a loss, and others will continue to be afflicted by their memories.

There always exists a concern about suicide contagion. Suicide contagion is an increased likelihood that reporting or talking about a suicide will influence or encourage a person contemplating the action to do so. In the research study conducted by Hsiung (2007), no evidence of postsuicide effect, called “Werther effect” in online posts. This was a real group. Posters created meaningful relationships and mourned a deceased member (Hsiung, 2007).

When communicating a suicide completion to an organization, provide resources to counseling and grieving services. This provides a means for those most affected by the news to seek relief. This, in turn, will hopefully reduce the “Werther effect” and minimize any post-news situations.

Niederkrotenthaler, T., Sonneck, G., Niederkrotenthaler, T., Till, B., Kapusta, N. D., Voracek, M., Dervic, K., Dervic, K., & Sonneck, G. (2009). Copycat effects after media reports on suicide: A population-based ecologic study. Social Science and Medicine, 69(7), 1085-1090.

Suicide contagion is the effect of copycat or imitated suicide based on the report or notification of such an event. The influence of media based reports required research and observation to learn the effects of media reports on potential suicide victims. Whether or not reporting on suicide influences suicide prevention efforts is a topic of much debate. Suicide reporting may educate the public, or it may trigger an individual to suicide (Niederkrotenthaler, Sonneck, Till, Kapusta, Voracek, & Dervic, 2009). However, few studies have found evidence of postsuicde increase in events. Several reasons for this were cited by Niederkrotenthaler et al. such as variations in methodologies, and lack of theoretical guidance (2009). The researchers wanted to identify evidence that supports assumptions that imitation follows reports of celebrity suicides.

Two views of identification were examined: vertical and horizontal. Vertical identification exists when the reported deceased is a celebrity or public figure. Horizontal identification is a set of one or more similar characteristics (Niederkrotenthaler et al., 2009). The researchers had two hypotheses: celebrity status would indicate an increase in copycat suicide reporting, and criminality status would see a lesser frequency of copycat suicide. Thirdly, they hypothesized that the frequency of suicide reporting would influence post-report imitation suicides. They also estimated that a definitive label (versus a speculative label) would increase post-item imitation, and that post-report suicides would resemble the celebrity in age, sex, and method.

Researchers obtained statistic data covering 1996 to 2006 from Statistics Austria. They also obtained Austrian newspapers that contained “self-murder” or “suicide” from the Austrian Press Agency. They only examined suicides where the name of the deceased was disclosed. Overall, 197 suicides were identified, which included internationally known Austrians and foreign celebrities alike (Niederkrotenthaler et al., 2009).

The findings were that celebrity status, middle aged men did predict a post-report increase of suicide. Furthermore, celebrity status was the primary factor in predicting copycat effects on suicide reporting. Overall, the authors’ hypotheses were found to be supported by evidence gathered.

There always exists the threat of a copycat or imitated suicide. In other research, I’ve found that it is imperative to provide resources and referrals to professional counseling and grieving services so that those affected most by the news of a completed suicide can seek appropriate counseling and care.

Pirkis, J., Blood, R.W., Skehan, J., & Dare, A. (2010). Suicide in the news: informing strategies to improve the reporting of suicide. Health Communication, 25(6-7), 576-577.

The media has great influence on the public’s actions, including in terms of behaviours related to suicide. Pirkis, Blood, Skehan, and Dare sought to examine media reports of suicide in New Zealand, and their results were explicitly included in the Commonwealth of New Zealand’s publication, Reporting Suicide and Mental Illness (2010). The method of their Media Monitoring Project was a quantitative content analysis and qualitative textual analyses to identify whether news values like status, conflict, unusualness of death, involvement of children, or “public interest” played a role in the reporting of a suicide.

From the Media Monitoring Project, the following guidelines were announced: be moderate in coverage, without details about the way the person died, and provide information about resources and helplines. Reporting Suicide and Mental Illness does not aim to censor media, but rather, is a means to ensure ethical reporting of individual cases, while empowering journalists to educate and inform the public (Pirkis et al., 2010). To evaluate whether the work has had an impact, the researchers did another year of analysis on suicide reporting, and found significant improvements in the manner suicides were conveyed.

Perkis and others’ (2010) findings support my research question in that there are specific considerations that need to be made when communicating to a large population. Information needs to be provided that focuses on the grieving process rather than dramatizing the event. Again, resources and counseling referrals should be provided.

Stern, S. R. (2003). Encountering distressing information in online research: a consideration of legal and ethical responsibilities. new media & society, 5(2), 249-266.

Sterns (2003) starts his article with a hypothetical situation. Hypothetically, researchers looking at WWW home pages discovered a page of two young boys who talked about how awful their lives were, and included, in detail, plans to terrorize their high school. These researchers analyzed the Webpage as they did all the others they discovered and moved in. Weeks later, the writers of the terrorizing home page attacked their school. How did the researchers react? They found themselves questioning their actions, wondering what would happen if fellow Americans learned they discovered this plan weeks before it was carried out.

Although a hypothetical situation, the above scenario echoes the question researchers should be asking themselves: what should I do if I encounter distressing information in online research? Unlike an offline counselor or mandated reporters, online researchers don’t have a special relationship with their research subjects. This limits the legal requirement to report. However, ethical and moral judgements need to be considered (Sterns, 2003). Sterns talks through this situation, not through research, but through a series of what-ifs.

Sterns quoted a 1976 California Supreme Court finding:

Under the common law, as a general rule, one person owes no duty to control the conduct of another, nor to warn those endangered by such conduct . . . except when the defendant stands in some special relationship to either the person whose conduct needs to be controlled or in a relationship to the foreseeable victim . . .

One important caveat is that reporting an act does violate confidentiality by disclosing information to a third party (Sterns, 2003). Therapists have specialized training in psychological situations to identify potentially harmful behavior. Online researchers lack this insight.

However, beyond legal requirements, there may be ethical and moral obligations that online researchers need to pay respect to. These include: respect for persons, beneficience, affirmative duty, and freedom of speech (Sterns, 2003).

Sterns comments that it is best to consult with other researchers in times of uncertainty. He contents that all researchers should contemplate their online relationship to research subjects, and make a plan about what to do about distressing information before they encounter it. Having a plan makes a discover all the much less scary.

Sterns’ article is important to my research question. Although I’m asking about how to talk about a suicide, it is inevitable that research may discover an act before it happens. As a researcher myself, I don’t know how I would react if I found some information that later could have been used to defuse a deadly situation.

Conclusion

Considerations of communicating a suicide to an organization include many facets that need to be considered before a statement can be made. The risk of imitation suicides, grief, sadness, anger, respect, and due process influence the messages that must be said. From a department that suffered a completed suicide, Davis and Bates (1990) indicated that a message should be sent out within 24 to 48 hours to avoid gossip and incorrect reports. Care should be taken when communicating about a suicide, however. While it is important to inform the organization of the correct details, there needs to be concern given to the mental well-being of the organization members. Much like the professional aspect of journalism finds that the public’s good is served by proper suicide reporting, the members of the organization have a right to know, and it is important to use the opportunity to educate and empower members (Collings and Kemp, 2010). This includes providing support to everyone who may request it in a time of distress and grieving.

People will want to mourn and memorialize the deceased (Hsiung, 2007). Careful planning and open discussion with respect to privacy and family wishes should be maintained. In planning an announcement to an organization, after confirmation of death and identity, respect for the deceased should be a top priority. Family wishes should trump organizational requests for memorializing the dead.

If the deceased held a position of power, or was a public figure of celebrity status, there may be a risk of imitation behavior (Niederkrotenthaler, Sonneck, Till, Kapusta, Voracek, & Dervic, 2009). This is especially true of male, middle-aged men. When providing information about a suicide, as we have seen, the method of death should be emphasized less, and resources to counseling services should be provided.

Online researchers are not likely to have a legal obligation to report distressing information they find online (Sterns, 2003). However, ethical and moral considerations should be considered. If a research finds information that could stop a deadly attack, how should they respond? Sterns (2003) recommends that all researchers plan ahead and have a strategy in place should they encounter information that they may have to reveal at a later time. I find it would be easier to report a distressing situation, rather than inform the public after a horrific event of the prior knowledge that was obtained. In terms of communicating with an organization, I would find it most prudent to prevent a loss rather than disseminate an apology for failing to act.

Overall, I think it’s clear that communicating a suicide is a difficult task that no one wants to take on. However, suicides are inevitable, and an organization can plan ahead to mitigate the disruption a death in the community will make. Considerations to minimize the Werther effect and improve griefing services should be made. Moral and ethical requirements about how to disseminate suicide details need to be considered.

On Saturday, December 5, 2015, a body was found on the side of Interstate 94 in Minneapolis. The body was identified as a doctor from Hennepin County Medical Center. Police have no clues as to the cause of death, but early reports indicated suicide. On the following Monday, the HCMC CEO sent an email to all HCMC staff. Part of this message stated:

Today the Hennepin County Medical Examiner confirmed that Dr. Christopher Robert, Chief of Anesthesiology, died this past weekend. While we have been providing support since Sunday to staff who worked with Dr. Robert, we needed to wait for this official confirmation before sending a broader message.

We know that his body was discovered near I-94 and Groveland Avenue, but at this time not many other details of the incident have been released. While there are probably stories out there, it is best that we not add to the speculation and instead let the investigation determine what happened. This is respectful to Dr. Robert and his family and best for all of us as we work through this difficult time.

If you or your department/unit needs support today or in the future, the Critical Incident Support (CIS) team will be available today until 4pm in the library on R2 for walk-in requests. If you need resources/support after this walk-in time, please email your request to MS.CIS. CIS includes chaplains and mental health professionals.

As you can see, this message reflects what my writing has found. Confirmation of death and identify was made before the announcement was sent. Few details about the manner of death have been released or reported, and counseling support services were provided. This real-world example demonstrates that care and concern for those who remain should be just as powerful as the respect for the deceased.

References

Collings, S.C., & Kemp, C.G., (2010). Death knocks, professional practice, and the public good: The media experience of suicide reporting in New Zealand. Social Science and Medicine, 71(2), 244-248.

Davis, J.M., & Bates, C. (1990). Faculty suicide: Guidelines for effective coping with a suicide in a counselor-training program. Counselor Education & Supervision, 29(3), 197.

Hsiung, Robert C. (2007). A suicide in an online mental health support group: reactions of the group members, administrative responses, and recommendations. CyberPsychology & Behavior, 10(4), 495-500.

Niederkrotenthaler, T., Sonneck, G., Niederkrotenthaler, T., Till, B., Kapusta, N. D., Voracek, M., Dervic, K., Dervic, K., & Sonneck, G. (2009). Copycat effects after media reports on suicide: A population-based ecologic study. Social Science and Medicine, 69(7), 1085-1090.

Pirkis, J., Blood, R.W., Skehan, J., & Dare, A. (2010). Suicide in the news: informing strategies to improve the reporting of suicide. Health Communication, 25(6-7), 576-577.

Stern, S. R. (2003). Encountering distressing information in online research: a consideration of legal and ethical responsibilities. new media & society, 5(2), 249-266.