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The Werther Effect: suicide reports in the media


August 23, 2019
By Peter Collins


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Since opening in Toronto on Oct. 18, 1918, the Prince Edward Viaduct (commonly referred to as the Bloor Viaduct) has been a suicide magnet. A barrier was erected in 2003 to prevent individuals from dying from suicide off the viaduct but someone occasionally manages to slip through and threaten to jump. That is why I found myself back on the viaduct on a cold and rainy day in mid-March, with the Emergency Task Force of the Toronto Police Service, to speak to a young man who wanted to jump to his death.

As a result of that incident, the busy north-south Don Valley Expressway that runs under a portion of the viaduct, and the east-west subway that runs under the length of the viaduct were closed for three hours, essentially paralyzing much of the city. Thankfully there was a successful resolution.

The Toronto Police Service media release stated officers were on the bridge in response to a “medical emergency.” This was the right statement to release. My colleague at the University of Toronto, Dr. Mark Sinyor, agreed. He has studied the influence of media accounts of suicide and his research supports that avoiding news stories focusing on suicide methods can prevent copy-cat behaviour—the Werther Effect.

The Werther Effect

In Goethe’s 1774 novel, The Sorrows of Young Werther, the main character, a young man named Werther, takes his own life because of unrequited love. Shortly after its publication the book was banned in a number of countries because of what was then described as “Werther Fever”—it was believed young individuals, who identified with Werther, were killing themselves.

Suicide is complex, influenced by many factors. Now, in the 21st century, it has become apparent that certain elements of media reports are associated with increased suicide deaths.

Suicide incidents are the most susceptible to copy-cat behaviours, followed by extensively-covered workplace violence and school shootings. If a well-known individual dies by suicide, and it is widely covered in the media, an increase in suicide rates has been reported.

Celebrity suicide effects led the World Health Organization to establish media guidelines for reporting a high-profile celebrity death, including sensitivity and the non-sensationalism in the reporting of the means of suicide, the precipitating factors, and the risk factors for suicide apparent or experienced by the celebrity.1

Suicide in the United States increased disproportionately after the suicide of Robin Williams in August 2014. Males over 30 had the greatest number of suicides, in response to William’s death, and suicides by the method he used were also higher in August 2014 and the following months.2

Representation of suicide on TV is also problematic. In April 2019, the U.S. National Institute of Mental Health reported a study by Bridge et al (still in press) that found the Netflix series 13 Reasons Why was “associated with a 28.9 per cent increase in suicide rates among American youth ages 10-17 in the month (April 2017) following the show’s release, after accounting for ongoing trends in suicide rates.”3

An association is not the same thing as causality. Suicide is a vastly complex phenomenon but media coverage and/or representation raises some real concerns.

Stephen Marche examined the Netflix show and its possible relationship with adolescent suicide in his New Yorker article. He stated, “Those who predicted the association between the show’s release and a rise in the suicide rate have met the fate of so much expert opinion in the twenty-first century: their predictions were ignored or cast into doubt by financially interested parties; the research, which came too late to matter, gave evidence that the predictions were true; and there were no consequences”.4

And what about physical barriers?

Sinyor et al (2017) 5 probed the impact of putting up the suicide barrier on jumping deaths in Toronto and the impact the media have on the suicide rates. They examined records from the Office of the Chief Coroner of Ontario covering 1993–2003 (11 years before the barrier) and 2004–2014 (11 years after the barrier was erected).

The purpose was to determine if there were changes in the yearly rates of suicide by jumping at Bloor Street Viaduct, other bridges (including the nearest comparison bridge, walking distance bridges), buildings and by other means. The finding was that suicide rates at the Bloor Viaduct declined from 9.0 deaths/year before the barrier to 0.1 deaths/year after the barrier.

That would make sense, however, negative media reports about erecting the barrier were associated with an increase in overall suicide-by-jumping from bridges in the four years after the barrier was erected. Over the long-term, however, the suicide-by-jumping declined in Toronto, with no associated increase in suicide by other means.

The barrier appears to have had its intended impact of preventing suicide despite a short-term rise in deaths at other bridges that seems, at least partially, to have been influenced by a media effect. Sinyor and his team warn research examining barriers placed at other locations should interpret the short-term results with caution.

In conclusion, the content of media reports—particularly those relating to celebrity suicide, certain methods of suicide, suicide pacts and suicide in older adults—may lead to suicide contagion.

Kudos to the Toronto Police Service for their responsible handling of a sensitive issue.

Meanwhile, the third season of 13 Reasons Why is scheduled for October 2019.

 

References

1. World Health Organisation (2008) Preventing Suicide: A Resource for Media Professionals (2008) www.whoint/mental—health/prevention/suicide/resource—mediapdf
2. Whitley, R., Fink, D., Santaella-Tenorio, J., & Keyes, K. (2019) Suicide Mortality in Canada after the Death of Robin Williams, in the Context of High-Fidelity to Suicide Reporting Guidelines in the Canadian Media. Canadian Journal of Psychiatry [ePub ahead of print].
3. NIMH (2019) www.nimh.nih.gov/news/science-news/2019/release-of-13-reasons-why-associated-with-increase-in-youth-suicide-rates.shtml
4. Marche, S. (2019) Netflix and Suicide: The Disturbing Example of “13 Reasons Why.”
The New Yorker. www.newyorker.com/culture/cultural-comment/netflix-and-suicide-the-disturbing-example-of-13-reasons-why
5. Sinyor, M. et al (2017) Did the suicide barrier work after all? Revisiting the Bloor Viaduct natural experiment and its impact on suicide rates in Toronto. British Medical Journal e015299. doi:10.1136/bmjopen-2016-015299

Dr. Peter Collins is the operational forensic psychiatrist with the Ontario Provincial Police’s Criminal Behaviour Analysis Unit. He has also been a member of the crisis/hostage negotiation team of the Toronto Police Service Emergency Task Force since 1992 and he consults to criminal justice agencies internationally. Peter’s clinical appointment is with the Centre for Addiction & Mental Health in Toronto, and he is an associate professor with the Division of Forensic Psychiatry at the University of Toronto. Contact him at pcollins.blueline@gmail.com.