MHM Magazine

2 | MENTAL HEALTH MATTERS | 2023 | Issue 1 MHM SADAG (The South African Depression and Anxiety Group) operated throughout the COVID-19 pandemic. Before COVID-19 the SADAG helpline call-centre received on average 600 calls per day. Within two months after South Africa went into total lock-down on 27 March 2020 the call volumes doubled to 1000 to 1400 calls per day. From January 2022 to September 2022 the SADAG call- centre received 562 176 calls, now averaging over 3000 calls per day. Analysis of the statistics further indicated that 1 in 4 calls were suicide related with the majority of calls coming from youth in line with the USA statistics. This statistic has also increased from 2021 when 1 in 5 calls were suicide related. The seminal article on the Werther Effect was published by David Phillips in 1974. The name was taken from Goethe's novel Die Leiden des Jungen Werthers (The Sorrows of Young Werther), published in 1774. In the novel, Werther shoots himself with a pistol after being rejected by the woman he loves. Shortly after its publication, there were reports of young men using the same method to kill themselves (shooting) in acts of hopelessness. Phillips noted that suicides increase immediately after a suicide story has been published in the newspapers in Britain and the USA, 1947 to 1968. The more publicity devoted to a suicide story, the larger the rise in suicides thereafter. The Werther effect is thus defined as an increase in suicide rates that follow media coverage of suicides or a suicide is inspired by reading about other’s suicide that are linked to a friend or family member who committed suicide. The Werther effect is a synonym for media-induced imitation effects of suicidal behaviour. This effect is also based on social learning theory. This is a theory of learning process and social behaviour which proposes that new behaviours can be acquired by observing and imitating others. Two case studies were discussed. The first was imitative suicide on the Viennese subway. It was noted that the number of subway suicides in Vienna increased dramatically between 1984 and mid-1987. A working group of the Austrian Association for Suicide Prevention developed media guidelines and initiated discussions with the media which culminated with an agreement to abstain from reporting on cases of suicide. The study indicated that in the second half of 1987 there was a decrease in suicides of 75% which was sustained for the next 5 years. The second case study was that of the suicide of Robin Williams, well-known comedian and actor who died by suicide (suffocation through hanging) on 12 August 2014. This study examined the monthly suicide count before and after his suicide and found a 10% increase in suicides in the two months following his death. A significant increase in the number of suicides by hanging/suffocation in men was also observed. In 2010 the Papageno effect was described in the British Journal of Psychiatry. The Papageno effect (protective effect) is in honour of the character in Mozart’s opera The Magic Flute (1791). In the opera Papageno fears that he has lost his love and prepares to kill himself. Three boys save him at the last minute by reminding him of other alternatives to dying. In their article the authors conclude that the impact of suicide reporting may not be restricted to harmful effects; rather, coverage of positive coping in adverse circumstances, as covered in media items about suicidal ideation, may have protective effects. Several countries throughout the world have now published media guidelines on suicide reporting. The World Health Organisation on their website published guidelines on ‘Preventing suicide: A resource for media professionals’. Their rrecommendations for proper reporting are : DO NOT: 1. Give precise details on the suicide method 2. Give personal information on the person who has committed suicide 3. Give some expressions such as "self-inflicted death". 4. Don't place stories about suicide prominently and don't unduly repeat such stories 5. Don't use language which sensationalises or normalises suicide, or presents it as a constructive solution to problems 6. Don't explicitly describe the method used 7. Don't provide details about the site/location 8. Don't use sensational headlines 9. Don't use photographs, video footage or social media links. DO’S: 1. Provide accurate information about where to seek help 2. Educate the public about the facts of suicide and suicide prevention, without spreading myths 3. Report stories of how to cope with life stressors or suicidal thoughts, and how to get help. 4. Apply particular caution when reporting celebrity suicides 5. Apply caution when interviewing bereaved family or friends 6. Recognise that media professionals themselves may be affected by stories about suicide. In conclusion more awareness needs to be created about the Werther and Papageno Effects. Numerous studies worldwide have found that the risk of contagion is real, and that responsible reporting can reduce the risk of additional suicides. Media covering of suicide can change perceptions, dispel common myths, and educate the public on the complexities of suicide. Although such media guidelines do not exist in South Africa every effort should be made to educate and continue to inform journalists about the effects of suicide reporting. Finally it's hoped that this paper would continue to stimulate discussion around the topic of suicide. Suicide helplines should continue to be promoted and supported nationally and regionally. References available on request.