Putatively harmful and protective characteristics of articles focusing on suicide in major Toronto publications (2011–2014) and their association with increases or decreases in suicides after publication
| Characteristics of media items | Total (%) n = 6367 | No. of articles followed by increased suicides (%) | No. of articles followed by no change in suicides (%) | No. of articles followed by decreased suicides (%) | Harmful effect analysis* | Protective effect analysis† |
|---|---|---|---|---|---|---|
| Increased v. no change or decreased suicides, OR (95% CI) | No change or increased v. decreased suicides, OR (95% CI) | |||||
| Putatively harmful | ||||||
| Word “suicide” in the headline | 1736 (27.3) | 754 (43.4) | 234 (13.5) | 748 (43.1) | 0.98 (0.88–1.10) | 0.95 (0.85–1.06) |
| Suicide method (in headline) | 225 (3.5) | 115 (51.1) | 29 (12.9) | 81 (36) | 1.36 (1.04–1.77) | 1.31 (0.99–1.72) |
| Suicide method (in text) | 3153 (49.5) | 1420 (45.0) | 439 (13.9) | 1294 (41.0) | 1.11 (1.00–1.22) | 1.10 (0.99–1.21) |
| Hanging | 758 (11.9) | 328 (43.3) | 130 (17.2) | 300 (39.6) | 0.98 (0.84–1.14) | 1.13 (0.97–1.32) |
| Self-poisoning | 590 (9.3) | 265 (44.9) | 74 (12.5) | 251 (42.5) | 1.05 (0.89–1.25) | 0.98 (0.83–1.17) |
| Jumping (from building) | 219 (3.4) | 123 (56.2) | 28 (12.8) | 68 (31.1) | 1.68 (1.28–2.20) | 1.64 (1.23–2.20) |
| Jumping (from bridge) | 248 (3.9) | 110 (44.4) | 41 (16.5) | 97 (39.1) | 1.03 (0.79–1.32) | 1.14 (0.88–1.48) |
| Railway | 113 (1.8) | 39 (34.5) | 15 (13.3) | 59 (52.2) | 0.67 (0.46–0.99) | 0.66 (0.46–0.96) |
| Asphyxia by car exhaust | 30 (0.5) | 9 (30) | 9 (30) | 12 (40) | 0.55 (0.25–1.20) | 1.09 (0.53–2.27) |
| Asphyxia other than by car exhaust | 346 (5.4) | 183 (52.9) | 58 (16.8) | 105 (30.3) | 1.47 (1.19–1.83) | 1.72 (1.36–2.17) |
| Firearm | 824 (12.9) | 404 (49.0) | 99 (12.0) | 321 (39.0) | 1.28 (1.10–1.48) | 1.16 (1.00–1.35) |
| Cutting or stabbing | 201 (3.2) | 74 (36.8) | 23 (11.4) | 104 (51.7) | 0.74 (0.55–0.99) | 0.67 (0.51–0.89) |
| Drowning | 78 (1.2) | 26 (33.3) | 11 (14.1) | 41 (52.6) | 0.64 (0.40–1.03) | 0.65 (0.42–1.02) |
| Burning or electrocution | 126 (2.0) | 52 (41.3) | 23 (18.3) | 51 (40.5) | 0.90 (0.63–1.29) | 1.07 (0.75–1.54) |
| “Suicide by cop” | 27 (0.4) | 13 (48.1) | 6 (22.2) | 8 (29.6) | 1.19 (0.56–2.54) | 1.73 (0.76–3.97) |
| Assisted death | 132 (2.1) | 62 (47.0) | 10 (7.6) | 60 (45.5) | 1.14 (0.81–1.61) | 0.87 (0.62–1.23) |
| Other | 212 (3.3) | 100 (47.2) | 23 (10.8) | 89 (42.0) | 1.15 (0.88–1.52) | 1.01 (0.76–1.33) |
| Method described in detail | 812 (12.8) | 377 (46.4) | 100 (12.3) | 335 (41.3) | 1.13 (0.98–1.31) | 1.04 (0.90–1.21) |
| Photo (deceased) | 1220 (19.2) | 525 (43.0) | 162 (13.3) | 533 (43.7) | 0.96 (0.85–1.09) | 0.93 (0.82–1.05) |
| Photo (of someone looking sad) | 257 (4.0) | 118 (45.9) | 40 (15.6) | 99 (38.5) | 1.09 (0.85–1.41) | 1.17 (0.91–1.51) |
| Favourable characteristic (deceased)‡ | 669 (10.5) | 296 (44.2) | 95 (14.2) | 278 (41.6) | 1.02 (0.87–1.20) | 1.03 (0.87–1.21) |
| Identifies deceased as a celebrity | 747 (11.7) | 367 (49.1) | 102 (13.7) | 278 (37.2) | 1.28 (1.10–1.49) | 1.26 (1.08–1.48) |
| Statement that suicide is inevitable | 44 (0.7) | 26 (59.1) | 4 (9.1) | 14 (31.8) | 1.86 (1.02–3.41) | 1.57 (0.83–2.96) |
| Exciting reporting | 151 (2.4) | 60 (39.7) | 19 (12.6) | 72 (47.7) | 0.84 (0.61–1.17) | 0.79 (0.58–1.10) |
| Glorified or romanticized suicide | 47 (0.7) | 16 (34.0) | 6 (12.8) | 25 (53.2) | 0.66 (0.36–1.21) | 0.64 (0.36–1.14) |
| Monocausal explanation for suicide | 941 (14.8) | 386 (41.0) | 128 (13.6) | 427 (45.4) | 0.88 (0.76–1.01) | 0.86 (0.75–0.99) |
| Statement of approval of suicide | 164 (2.6) | 75 (45.7) | 23 (14.0) | 66 (40.2) | 1.09 (0.80–1.48) | 1.08 (0.79–1.49) |
| Interview with the bereaved | 1199 (18.8) | 499 (41.6) | 152 (12.7) | 548 (45.7) | 0.90 (0.79–1.02) | 0.84 (0.74–0.95) |
| Putatively protective | ||||||
| Unfavourable characteristic (deceased)‡ | 91 (1.4) | 32 (35.2) | 7 (7.7) | 52 (57.1) | 0.69 (0.45–1.07) | 0.54 (0.36–0.82) |
| Alternatives to suicide | 1194 (18.8) | 502 (42.0) | 196 (16.4) | 496 (41.5) | 0.92 (0.81–1.04) | 1.03 (0.91–1.17) |
| Community resources | 123 (1.9) | 48 (39.0) | 14 (11.4) | 61 (49.6) | 0.82 (0.57–1.18) | 0.74 (0.52–1.05) |
| Positive outcome of a suicide-related crisis | 85 (1.3) | 37 (43.5) | 11 (12.9) | 37 (43.5) | 0.99 (0.64–1.53) | 0.95 (0.61–1.46) |
| Warning signs of suicidal behaviour | 67 (1.1) | 32 (47.8) | 9 (13.4) | 26 (38.8) | 1.18 (0.73–1.91) | 1.15 (0.70–1.89) |
| How to approach someone | 13 (0.2) | 7 (53.8) | 1 (7.7) | 5 (38.5) | 1.50 (0.50–4.47) | 1.17 (0.38–3.57) |
| Message of hope | 282 (4.4) | 119 (42.2) | 46 (16.3) | 117 (41.5) | 0.94 (0.74–1.19) | 1.03 (0.81–1.31) |
Note: CI = confidence interval, OR = odds ratio.
↵* Harmful effect = comparisons of proportion of articles followed by increased suicides versus proportion of articles followed by no change or decreased suicides; ORs > 1 show a harmful effect.
↵† Protective effect = comparisons of proportion of articles followed by decreased suicides versus proportion of articles followed by no change or increased suicides; ORs < 1 show a protective effect.
↵‡ Favourable and unfavourable characteristics refer to statements in an article expressing positive or negative value judgments, respectively, about a person’s character, personality or behaviour.