SUICIDE PREVENTION AND POLICY
Suicide and the media
Jane Pirkis
Abstract
Around 100 studies have been conducted to examine the ‘Werther effect’
– the phenomenon whereby there is an increased rate of completed or
attempted suicide following the depiction of an individual’s suicide in
the media. These ‘media influence studies’ provide strong evidence for
the existence of the Werther effect in the news media, and equivocal evi-
dence for its existence in the entertainment media. Having established
this, there is now a need to complement these media influence studies
with inter-related studies that draw on approaches from a range of dis-
ciplines, particularly that of communication. The studies can be thought
of as investigating the full spectrum of news and entertainment media
processes and content, from how suicide stories are produced (news/
entertainment production studies), to what information they contain and
how this is framed (content analysis studies), to how this information is
received and perceived (audience reception studies). This will assist in
explicating the mechanisms by which the Werther effect might operate,
and in designing and evaluating interventions to improve the practices
of news and entertainment media professionals.
Keywords entertainment; media; news; suicide; Werther effect
Concern over the potential influence of the media on suicidal
behaviour first arose in 1774, when Goethe published The Sor-
rows of Young Werther, a novel in which the protagonist took his
own life because his love was unattainable. A spate of suicides
occurred across Europe shortly after the novel’s release, and a
number of those who died had clearly been influenced by its
content, as evidenced by their dressing like Werther, adopting
his method (gunshot), or being found with a copy of the book.
In 1974, Phillips coined the term ‘Werther effect’ to describe an
increase in suicidal behaviour following the depiction of an indi-
vidual’s suicide in the news or entertainment media.1
Evidence for the Werther effect
Evidence for the Werther effect remained largely anecdotal until the
1970s when Phillips published a seminal study that found greater
than expected rates of suicide in 26 of the 33 months in which a
Jane Pirkis BA(Hons) MPsych MAppEpid PhD is Associate Professor and Head
of the Centre for Health Policy, Programs and Economics at the
University of Melbourne, Australia. She has a particular interest in
the impact of media reporting of suicide on actual suicidal behaviour.
Conflicts of interest: none declared.
PSYCHIATRY 8:7
front-page suicide article was published in the United States press
over a 20-year period. Since Phillips’ study, around 100 investiga-
tions into the Werther effect have been conducted. Like Philips’,
the majority of these have been ecological ‘media influence stud-
ies’ in which completed or attempted suicide rates in a given area
have been compared for periods before and after the introduction
of a media stimulus. These studies have examined both news and
entertainment genres, and have expanded the range of media to
include not only newspapers but also television, films, books, and
music. Their methodologies have become increasingly sophisti-
cated, with more appropriate statistical techniques. They have also
tested the phenomenon in Asian and European countries and con-
sidered not only completed ­suicide but also attempted suicide.
Several reviews have concluded that these studies provide
solid evidence for the existence of the Werther effect in the news
media,2–4 and somewhat more equivocal evidence for its exis-
tence in the entertainment media.5 The effect varies with time,
usually peaking by about three days and levelling out by about
two weeks,6,7 but sometimes lasting longer.8 It is related to the
amount and prominence of coverage, with repeated and/or
‘high impact’ stories being most strongly associated with imita-
tive behaviours.9–11 The effect is accentuated when the person
described in the story and the reader/viewer share similar charac-
teristics,12 or when the person described in the story is a celebrity
and is revered by the reader/viewer.13–17 Explicit description of a
particular suicide method may lead to increases in actual suicidal
behaviour employing that method.9,10,18–20
Mechanisms by which the Werther effect might operate
The terms ‘Werther effect’, ‘suicide contagion’, ‘imitation’, and
‘suicide clustering’ have often been used synonymously. They
are certainly related, but thinking about the distinctions between
them may assist with explicating the mechanisms by which the
Werther effect might operate (Figure 1). The Werther effect can be
thought of as a form of suicide contagion that is similar to suicide
clustering, except that the index suicide is reported or portrayed
in the media rather than occurring in a given social network. The
term suicide contagion comes from the infectious diseases litera-
ture, and implies the transmission of a health state. In the case
of suicidality, more is required for transmission than the simple
contact required in the infectious diseases context, and there is a
reliance on the mechanism of imitation or copycat behaviours,
which involve some sort of modelling.21
Various explanations have been posited to explain how such
modelling might work, most of which are based on Bandura’s
social learning theory.22 The crux of social learning theory is that
behaviour can be shaped by an observer imitating a model with
whom he or she identifies in some way. Social learning theory
might explain why the Werther effect is more evident in the news
media than In the entertainment media (an observer might be
more likely to identify with a real person than a fictional one),
why there is a dose–response effect (greater exposure to the
model might maximally influence the observer), why the effect
is greater when the observer and model are similar or when the
model is a celebrity and regarded highly by the observer (both sce-
narios might promote strong identification with the model by the
observer), and why there are method-specific effects (the observer
might copy the behaviour as closely as possible).
269 © 2009 Elsevier Ltd. All rights reserved.
 SUICIDE PREVENTION AND POLICY
Diagrammatic representation of suicide contagion
occurring following an index suicide in the media or in
a given social network
Werther
In media
effect
Imitation
Index Subsequent
Contagion
suicide suicide(s)
Copycat
behaviour
In social
Clustering
network
Figure 1
A novel approach to addressing the Werther effect
Many countries have expressed concern about the Werther effect,
and a number have put in place strategies to address it. Australia
has arguably taken the most systematic approach, developing and
delivering an overarching strategy through its federally funded
Mindframe National Media Initiative (Mindframe).23 Mindframe
provides a comprehensive approach to dealing with the Werther
effect in both news and entertainment media.
With respect to the news media, a resource known as Report-
ing Suicide and Mental Illness was one of the early outputs of
Mindframe.24 In terms of content, this resource is similar to many
guidelines from around the world, including guidelines in the
UK.25 It draws on the evidence described above, and stresses that:
suicide should not be glamorized, sensationalized, or given undue
prominence; specific detail about the method or circumstances
of the suicide should be avoided; the importance of role mod-
els (particularly celebrities) should be recognized; myths about
suicide should not be perpetuated; and information about help
services should be provided.26 It differs from most of its overseas
counterparts, however, in terms of how it has been developed
and disseminated, and thus how much it has had ‘buy-in’ from
media professionals.26 Reporting Suicide and Mental Illness was
developed by the Australian Department of Health and Ageing,
with active input from a reference group that included represen-
tatives from media, mental health, and suicide prevention organi-
zations. It has been widely disseminated by the Hunter Institute
of Mental Health through face to face briefings, ad hoc advice,
distribution of printed and electronic copies of the resource and
supporting materials, and ongoing follow-up and promotion.27,28
In terms of the entertainment media, Mindframe has also
supported the Hunter Institute of Mental Health to assist writ-
ers involved in Australian film, television, and theatre to portray
suicide (and mental illness) in a responsible manner. The Hunter
Institute has developed a printed resource known as Mental Ill-
ness and Suicide: A Mindframe Resource for Stage and Screen29
and other web-based materials, and has run workshops with writ-
ers from a range of genres, including popular television series. At
all stages, it has worked closely with entertainment media pro-
fessionals, mental health care providers, consumers and carers,
PSYCHIATRY 8:7
in order to ensure accuracy and relevance. There are examples
of mental health professionals and entertainment media profes-
sionals collaborating to improve on-screen portrayals of mental
illness overseas,30 but to the author’s knowledge no other country
has put in place a systematic, comprehensive approach to dealing
with portrayals of suicide.
Gaps in knowledge about suicide and the media
The above ‘media influence studies’ on the Werther effect domi-
nate the literature on suicide and the media. Although they pro-
vide powerful support for the significance of the area, they leave
many questions unanswered.
First, they tend to be atheoretical. Although, as noted, social
learning theory has been offered as an explanation of the way in
which the Werther effect might operate, few studies have explic-
itly tested how elements of this theory (or, for that matter, other
behavioural theories) might apply.
Second, these media influence studies tend to be embedded
in disciplines such as psychology, sociology, psychiatry, and epi-
demiology, rather than communication, although there are some
exceptions. As a result, very few ‘news/entertainment production
studies’ have been conducted to examine the sociocultural news
values and other imperatives that operate on news and entertain-
ment media professionals to determine whether and how a particu-
lar suicide is reported or a suicide storyline is included in a fictional
piece. Similarly, media content is often inadequately analysed, sug-
gesting the need for ‘content analysis studies’ to examine the way
in which suicide is framed in news and entertainment media, and
to consider the accuracy and quality of the information provided.
In addition, relatively few ‘audience reception studies’ have been
conducted to assess how various audiences interpret, misinterpret,
seek out, ignore, or resist media messages about suicide.31
Finally, there is insufficient evaluation of the extent to which
given interventions might influence media professionals’ practices,
and still less evaluation of the impact that such interventions might
have on completed and attempted suicide rates. The Hunter Insti-
tute of Mental Health has conducted its own internal evaluations
of various elements of Mindframe, and has shown that it has been
positively received by journalists, scriptwriters, and playwrights.32
An independent pre- and post-evaluation of reporting of suicide
in Australia found that the quality of reporting improved after the
release of Reporting Suicide and Mental Illness under Mindframe,
with less use of sensationalist language and explicit reference to par-
ticular suicide methods, and greater provision of helpline informa-
tion.33 These findings are consistent with the small number of other
studies that have been conducted in the area,34–39 but further work
is required to establish whether these sorts of intervention have con-
sistent, sustainable impacts and whether particular elements (e.g.
active dissemination strategies) are associated with greater success.
Conclusion
We know that the Werther effect is real: depictions of suicide in
the news and entertainment media can undoubtedly lead to imita-
tive behaviours, as evidenced by statistically significant increases
in completed and attempted suicide rates (which cannot be
explained by suicidal behaviours that might have occurred any-
way being ‘brought forward’, because they are not followed by a
270 © 2009 Elsevier Ltd. All rights reserved.
 SUICIDE PREVENTION AND POLICY
c­ ommensurate decrease in rates). There is still a lot to learn, how-
ever. We do not know how the Werther effect operates, although
there are suggestions that it involves behavioural modelling.
We are not sure how best to address it, although multi-pronged
approaches involving active dissemination of resources and plenty
of support for media professionals show promise. Our current
knowledge is fairly ‘blunt’, and there is scope for further inves-
tigation of the full spectrum of news and entertainment media
processes and content, from how suicide stories are produced,
through what information they contain and how this is framed,
to how this information is received and perceived. There is a need
for mental health and suicide prevention professionals and media
professionals to collaborate to redress some of these knowledge
gaps. ◆ 24 Department of Health and Ageing. Reporting suicide and mental
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