OPINION: The Government has announced that New Zealand's 25-year-old censorship of suicide reporting is to be reviewed by the Law Commission. JAMES HOLLINGS talks to two leading experts who think the restrictions should go.
Vienna, capital of Austria, city of Mozart, Freud, and home to 1.8 million people, got an underground railway later than most cities in Europe.
When it was built, in the late 1970s, it quickly became hugely popular. But it soon started to attract publicity for all the wrong reasons. It became the method of choice for many suicides, and the city's newspapers reported them in often lurid detail.
What happened next has become a classic case study in the research on suicide prevention. Researchers at the University of Vienna persuaded most of the editors of Austria's news media to stop reporting on subway deaths. The result was an amazing 75 per cent decline in deaths by that method, and a reduction in suicides overall.
The conclusion, since confirmed in studies around the world, was clear: certain kinds of news media reporting of suicides lead to copycat deaths.
It was not the first such study, but it was one of the most conclusive to date.
Since that Viennese study, there has been a huge cultural shift in how the Austrian media report suicides, says Thomas Niederkrotenthaler, of the Medical University of Vienna.
He's one of the world's leading experts on the role of media reporting in suicide prevention.
He says Austrian news media still report suicides, as often as before, but mostly gone are lurid headlines, graphic photos, details of the method, prominent page one placement, language that tends to glorify the act, or suggest it is a solution, and rehashing of the same details in the period immediately afterwards - all factors shown to increase the risk of copycat suicides.
As a result, "the most common type of report [of a completed suicide] in the Austrian media is not associated with an increase in suicide", he says.
The Viennese approach, of working with the news media to tone down sensationalist coverage of suicides, has had a huge influence on suicide prevention strategies.
Authorities in dozens of countries now have guidelines that encourage the media to report suicide in a way which minimises the risk of copycats.
It's a starkly different approach to that taken in New Zealand. In 1988, the Labour government made it a criminal offence to report details of suspected suicides until the coroner ruled it was safe to publish details. That was despite an absence in New Zealand of the lurid tabloid reporting most associated with copycat suicides.
Since then, most suicides have either been unreported in the news media, or reported with the euphemism that there were "no suspicious circumstances".
Only in cases where the coroner decides to allow publicity, usually months afterwards, are further details given, and by then, the news interest is low.
In 2006, despite the trend overseas to a more voluntary approach, the Labour government tightened the law further, making it clear that the only ground on which coroners could disclose details was if they were sure public safety was not at risk.
It also banned relatives of a suicide from publishing details without the coroner's permission.
Such draconian legislation is unparalleled in the world and has caused widespread controversy. Coroners have voiced concerns about the role it thrusts upon them as public censors, and arbiters of safety in a highly complex area.
The news media and some bereaved relatives of suicides have complained about the restrictions it places on free speech and to voice concern about dangerous practices.
Others point out that the law applies only to suicides in New Zealand, and then only to mainstream news media. Suicides of people overseas are still reported, and social media sites such as Facebook are left free to spread rumour and sensational accounts unchecked.
The censorship also tended to stymie attempts to introduce guidelines in New Zealand. The Ministry of Health promulgated media guidelines in 1999, but research has found they have been largely ignored - probably because most journalists feel they cannot report the issue anyway.
On the other hand, some suicide researchers support the 2006 act. Annette Beautrais, who was principal investigator at the Christchurch School of Medicine's Canterbury Suicide Project, told the select committee considering the legislation that coverage of suicides should be "muted", and whenever possible limited to the name, address and occupation of the deceased and the fact that it was self-inflicted.
Some health boards also argued for a ban, on the grounds that publicity was damaging to the morale of health professionals and intruded on bereaved families.
The main news media companies agreed to voluntary guidelines on reporting of suicide in 2011. They are similar to those applied in Australia since 2004, and which suicide researchers there say have been widely taken up by news media.
But in a recent editorial in the New Zealand Medical Journal, Beautrais, now at Auckland University, and Professor David Fergusson, of Otago University, criticised the guidelines for including an "inadequate and biased" review of the risks of media reporting. They said the new guidelines diluted the 1999 guidelines formulated by the Ministry of Health.
They criticised calls by the chief coroner for more open reporting of suicide, saying it, and the resulting increased media coverage of suicide clusters, "set New Zealand on a path in breach of best practice internationally", and "cannot help but increase the risks of suicide faced by the New Zealand population".
Beautrais did not respond to a request for an interview for this article.
It is a situation that Niederkrotenthaler, and prominent Australian suicide expert Professor Jane Pirkis see as unfortunate. Both are in favour of a voluntary approach, where the media is encouraged to follow guidelines.
Niederkrotenthaler says: "From the perspective of suicide prevention, we need the journalists, we really need them because we want to reduce the stigma surrounding mental illness and suicidality.
"It's important to always point out, it's not about not reporting suicide, it's about reporting about it in a responsible way.
"Our experience is that there is a difference, that not all suicide articles have the same effect and many of them actually seem to have no harmful effect on suicides.
"But there are still sometimes harmful reports, and we screen the media for these articles, and send out recommendations if [such] articles come out.
"We also have symposia to discuss the recommendations and update them with journalists and editors. Actually it's working pretty well with the voluntary approach."
Isn't there a risk that lifting censorship in New Zealand might cause a wave of suicides?
"That is definitely a risk . . . It is important to be cautious of this risk, and to explain this risk to journalists and editors, because there are vulnerable individuals out there. Perhaps with time, the whole emotions need to settle a bit."
Pirkis, the director of the Centre for Health Policy, Programmes and Economics at the Melbourne School of Population and Global Health, has published widely on media reporting and suicide, including research on the effect of New Zealand's censorship regime on journalists.
She agrees there are times when suicide reporting is necessary.
She says New Zealand's legislative approach seems to inhibit the creation of a responsible culture of reporting based on the kind of guidelines used in Australia.
"When people start to think it's about censorship they rail against it . . . As an outsider, it does seem to me that it creates a lot of resentment among journalists - and this contrasts with the relative goodwill that we have seen here [in Australia] with respect to our [guidelines on how to report suicide]."
Opponents of the censorship have often argued that it inhibits discussion of warning signs, and promoting positive messages, in the way that stories about car accidents have raised awareness of the need for seatbelts.
Both Pirkis and Niederkrotenthaler are sceptical of that argument.
Niederkrotenthaler says it's a myth that more talk about suicides in the media will necessarily help reduce suicide. He points out that suicidal thoughts are very common in the general population. What's much less common is a level of "constriction", as it's called, where a vulnerable individual then decides to complete a suicide.
If anything, the research suggests that talking about completed suicides may help "normalise" it in the minds of vulnerable individuals. Therefore, providing detailed instructions about suicide methods should definitely be avoided.
But he says it's vital for societies to find a way to talk about suicide, in a way that doesn't encourage it. This includes talking about how to deal with suicidal thoughts and loss of someone to suicide.
He says a promising area is new research that shows that some kinds of publicity may have a protective effect.
In this study, Niederkrotenthaler and others found that reports about people who considered suicide, then rejected it - what's been called "mastery of crisis" stories - were associated with a decline in suicide rates.
"We also had some reporting about people who were bereaved by suicides and told their stories . . there is definitely some value in that reporting. It was really showing . . . how to cope with crisis and bereavement. There was always a small section below the article [saying], 'If you feel suicidal, call the crisis line'. So actually these articles have a lot of protective elements as well."
The Law Commission has now been tasked with reviewing the restrictions on media reporting in New Zealand, with a brief to report by March.
Among Minister for Courts Chester Borrows' reasons for the review were the difficulties in enforcing restrictions on social media.
Niederkrotenthaler is also cautious about calls for regulating online media, such as Facebook, and pro-suicide chat sites.
"There's still very little research [on online media]. There may be a contagion effect. But on the other hand we have to figure out how we can intervene and what the impact of this interactive component really is . . . Because talking about the suicide method may have a different effect on people when it's interactive."
He says although there's been much discussion of the negative stories, such as cyber bullying, online media also offers great opportunities for suicide prevention, through reporting about mastery of the crisis, and offering help.
"Even with the pro-suicide chat forums, we have to see what the effect really is. We have to understand that we have here a group that is our main target group, and that this provides a rare opportunity for suicide prevention.
"But it is just difficult to intervene effectively in these forums. We really have to learn more to understand how to do that."
Dr James Hollings is a senior lecturer at Massey University, where he supervises the master of journalism programme and teaches papers for the bachelor of communication.
HOW TO GET HELP
Suicide Prevention Helpline 0508 828 865 Youthline 0800 376 633 Depression Helpline 0800 111 757 Lifeline 0800 543 354 Samaritans 0800 726 666
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