Suicide on screen: Getting the message right can support better mental health outcomes
"13 Reasons Why" is just one of several widely successful shows to hit our screens in recent years that contains portrayals of suicide, sparking concerns from experts about the potential impact on vulnerable viewers.
In a new paper, University of South Australia researchers have confirmed that portrayals of suicide in moving-image fiction and non-fiction media, such as television and web series, films, and documentaries, has the potential to increase suicidal ideation and behavior.
But in the lead up to World Suicide Prevention Day on September 10, researchers Dr. Miriam Posselt and Heather McIntyre say their research—which analyzed the latest studies in suicide portrayal and screen media—also highlights the potential positive effects screen media can have.
"The research we reviewed shows there are many potential outcomes on viewers depending on how suicidal-related content is portrayed and engaged with but there is evidence that it can have a positive impact as well," Dr. Posselt says.
"Screen media can increase suicide awareness and help-seeking behavior, particularly if it includes support information or the character seeks help during their mental health challenges on screen and demonstrates managing or coping through a suicidal crisis.
"If used as an opportunity to educate, screen media could be a potentially powerful tool in suicide prevention, increasing awareness for mental health issues and reducing suicide shame and stigma.
"Television shows and movies can start conversations and share vital messages by helping to normalize the experience of having mental health difficulties and suicidal thoughts, as well normalizing the act of reaching out to ask for help."
According to UniSA Ph.D. candidate McIntyre, who has studied communications (film and media) and mental health, screen media has more potential to detrimentally affect viewers than other types of content.
"We live in a highly digitized world, where people have access to screens 24/7 and often 'binge-watch' through streaming services," McIntyre says.
"Film is a vehicle with far more immediacy than still images or the written word, which can create a far deeper sensory experience for the viewer, and therefore have a greater impact on them too.
"Filmmakers can push the boundaries of scintillation, possibly crossing over into an area that might not be helpful for a viewer's wellbeing.
"Research tells us that talking about suicide is not the problem—how it is portrayed is. Our review really demonstrates that the context and how images of suicide are presented, dictates whether it can have a negative or positive effect.
"At the same time, our review suggests a viewer's own past plays a part. Everyone engages with media differently. For individuals with higher levels (or history) of depression, suicidality, dissociation, thought suppression and identification with the protagonist, the potential harmful effects of viewing such media are often greater."
Given the potentially devastating impacts, clinical psychologist Dr. Posselt believes filmmakers have a significant responsibility for their viewers' wellbeing.
"Filmmakers need to think deeply about what they include in their films, especially if they use graphic, sensationalist or dramatic depictions of suicide or self-harming behavior, or depict these behaviors as solutions to problems," she says.
"Those involved in media production such as script-writers, producers and directors, should be aware of the potential harmful impacts that such portrayals can elicit, particularly because there are very rarely "trigger warnings" regarding this type of content in television and film.
"We know enough about how media portrayals of suicide can lead to suicide contagion and so called 'copy-cat suicides' that we should respect that and aim to prevent loss of life."
While traditional media guidelines on reporting on suicide have existed for many years—and last year the World Health Organization introduced specific resources for filmmakers—Dr. Posselt says all creators need to be more aware of how their products can affect mental health.