Tech + Health

05.01.14

Teen Copycat Suicides Are A Real Phenomenon

A new study provides the strongest evidence yet that sensational media reporting of a teen suicide plays into the tendency of other kids to imitate the tragic act.

There’s a scene in the 1988 cult classic Heathers where Veronica, the only non-Heather in her clique, returns home to find her parents glued to the TV set. A surreal local news segment is covering Westerberg High’s reaction to a spate of recent (thought-to-be) suicides: students hold hands in an orchestrated outpouring of counterfeit emotion as the cameras circle. “Can’t you see?” Veronica yells as she rips the power cord from the socket, “These little programs are eating suicide up with a spoon. They’re making it sound like it’s a cool thing to do.”

Indeed, at that very moment in the film, the unfortunate secondary heroine Martha “Dumptruck” is walking out into traffic in a suicide attempt of her own, described by Heather No. 2 as “just another case of a geek trying to imitate the popular people of the school and failing miserably.”

Are suicides imitative? Though media-fueled teen suicide outbreaks sound more like the stuff of Hollywood films than real life, research published today in The Lancet Psychiatry journal confirms their existence.

“It just seems so frightening, but a lot of behaviors are modeled,” says Dr. Madelyn Gould of the New York State Psychiatric Institute and lead author of the study.

Heightened newspaper coverage following a young adult’s suicide is significantly linked to subsequent self-inflicted deaths, according to Gould’s research. Her study finds that the more sensational the reporting, the more details provided, and the more prominent the story’s placement, the more likely it was that additional suicides would follow. What’s more, the study reinforces the opinion that irresponsible reporting on suicide overwhelmingly impacts the young. According to another study by the same author, the prevalence of copycat suicide is up to four times higher in young adults than any other age group.

The theory of copycat suicides—fueled by media coverage—has long been studied in academic circles. Most of this research leans on social learning theory, the idea that when a vulnerable teen identifies with a suicide victim, he might choose the same fate, thinking, “’Well, maybe that’s a way out for me. I’m experiencing that same pain, those same problems,’” Gould explains. And it might not even be a conscious decision, she says: “It may just activate a suicidal thought in someone that has it in the back of their heads. You don’t want this thought to become a behavior.”

The more sensational the reporting, the more details provided, and the more prominent the story’s placement, the more likely it was that additional suicides would follow.

In the most advanced study of its kind, Gould and her colleagues used state records from 1988 to 1996 to identify “clustered” suicides of young adults—that is, between three and 11 suicides of people 13 to 20 years of age that occurred in the same city or town within three months of each other.

She and her colleagues used a control group—theirs is the first study to do so—pooling the data of young suicide victims from non-neighboring counties within the same state whose death occurred after the three-month window had closed. The researchers examined stories in 469 local papers following suicides in both the clustered and the control group.

Looking at 48 suicide clusters, Gould found that significantly more newspaper articles on the deaths were published following the initial cluster suicide (7.5 on average) than after non-clustered suicides in the control group (5.1).  And in 25 percent of the cases for the clustered suicides, at least one news story about the original victim had been published, compared with 14 percent for the control group.

It’s not just that the suicides in a cluster were written about more often—the type of coverage was significant. The first suicide in a cluster was more likely to be printed on the front page of a newspaper and more likely to include photos, while the headlines more often contained the word ‘suicide’. The coverage was also more likely to detail the specific suicide method, and was classified as “sensational” or tabloid-like. Suicide notes were also mentioned more frequently.

Gould’s findings support existing research on the subject. In 1974, sociologist David Phillips coined the tendency of teenagers to imitate these suicides as “The Werther Effect”—named for the lovelorn protagonist of Goethe sturm und drang novel, The Sorrows of Young Werther, which featured a maudlin fictional suicide that, according to legend, was copied so many times by real people that the book was banned in several countries.

‘Teenagers are highly imitative, influenced by fads and fashions in general,” Phillips explained years later to The New York Times.

Phillips’ groundbreaking work was the first to show an increase in the number of suicides after an initial suicide had been reported by the media, and he found that this increase ballooned the longer the initial suicide stayed on the front pages. The quintessential example, for Phillips, was Marilyn Monroe’s death—her suicide, which swamped media coverage at the time, was correlated with over 300 “copycat” suicides above and beyond the expected average for years between 1948-1967.

Gould is quick to offer the statistician’s routine warning about mistaking correlation for causation; still, she writes, the results are strong enough to suggest that the press should be more responsible in its coverage of suicide and emphasized “the importance of adherence to media guidelines that discourage reporters from using too much detailed or graphic representations of suicides.”

Suicide is the third-leading cause of death for people between the ages of 15 and 24—claiming about 4,600 young lives each year, according to the Centers for Disease Control and Prevention. Nationally, the overall trend is relatively stable at about 10 per 100,000 in the population. But for every suicide in this age group, there are hundreds of other unsuccesful attempts. For many young people, suicide rates were actually on the decline until a 2011 uptick (the most recent year for which data is available) rolled back the gains made since 2001, according to a nationwide survey that tracks risky behavior in high school students. About eight percent of kids in grades 9-12 reported trying to kill themselves at some point in 2011.

Journalists have wrestled with the question of how to cover teen suicides before. In March of 1987, as part of a suicide pact, four New Jersey teenagers drove into a garage together and left the motor running. At least seven suicides by carbon monoxide poisoning quickly followed—including one boy who had saved clippings about the other deaths—leading police and the media alike to question whether reporting on suicide was in the public interest or just served as an advertisement to other troubled teens.

Reporting a suicide—especially a child’s—meaningfully and responsibly is, as Gould’s research shows, a difficult task. Many news organizations make decisions about coverage on a case-by-case basis. The Society of Professional Journalists hasn’t codified any national standards, though several groups like the Suicide Prevention Resource Center (SPRC) provide guidelines (PDF). SPRC’s “what to avoid” section (details, prominent placement, pictures, sensationalism) dovetails with the list of practices that Gould’s study highlighted in cases where reporters made preventing copycat suicides a newsroom priority.

Gould’s study clearly adds to our knowledge of suicide contagion, but it comes with limitations. Most notably, it examines a time period ending in 1998. That’s two years before the launch of Google, which has made millions of graphic teen suicide stories a simple click away—not to mention the sprouting of social networks that erase the geographical limitations that once bounded print news.

Related research suggests that Internet use is linked with an increase in self-harm and suicide. In one of the largest reviews on the subject last year, an Oxford team found that the Internet can both prevent and contribute to teenage suicide, acting as a gateway to support networks while at the same time providing kids with instant access to veritable how-to manuals and echo chambers that normalize unhealthy behaviors.

And then there’s the infamous 4chan debacle last December. That’s when “Stephen,” a user of the online message board, posted “This is it. Tonight I will be ending my own life.” Two hundred viewers egged Stephen on while he downed handfuls of unidentified pills and vodka, then lit himself and his dorm room on fire.

In an accompanying comment in the The Lancet journal, suicide experts Jane Pirkis and Jo Robinson speak to the shifting media landscape and its potential perils. “Less regulated, more volatile, and more interactive media might have an even greater effect, particularly because young people are not only major consumers of these forms of media, but also the creators of their content.”

While this study focuses on traditional newspapers (still, by the way, the sources where most young people learn about the suicides of others, according to a 2011 study), Gould says it has implications for non-journalists as well—and especially for young people. “With social media, they are the ones who create the stories now.”

Gould doesn’t propose that media coverage is the only factor to cause suicide clusters. Still, she says, we have to take account of its undeniable role. This report was part of a larger, not-yet-released study that seeks to explain why suicide clusters happen in one community and not another. Her group has interviewed parents, friends, siblings, as well as consulting news reports and medical, death and police records to ultimately try to find out what makes a particular young person’s death a probable model for imitation.

“Suicidal behavior is complex,” Gould says. “We have to examine the many puzzle pieces that contribute to suicide, without discounting any specific piece. The costs are too great.”