NEW YORK — Not only does the suicide rate in the general population increase following a celebrity suicide, but victims copy the method, new research shows.
Investigators found that in the weeks following the death of actor and comedian Robin Williams on August 11, 2014, which was widely reported as a suicide by hanging, there was a surge in suicides by hanging.
Similarly, in the wake of the gunshot suicide of American football Hall of Famer Tiaina Baul Seau Jr (Junior Seau) on May 2, 2012, there was a jump in suicides by firearms.
“Our study showed not only that the rate of suicides increases following a celebrity suicide, but the method is copied as well,” Patrick Ying, MD, Department of Psychiatry, New York University (NYU) School of Medicine, New York City, told Medscape Medical News.
The findings were presented here at the American Psychiatric Association (APA) 2018 annual meeting.
Media to Blame?
From the Underlying Causes of Death database at the Centers for Disease Control and Prevention, Ying and his colleague Ari Jaffe, MD, also in the NYU Department of Psychiatry, downloaded data for completed suicides that occurred from January 1999 to December 2015. The information was derived from death certificates filed in the United States.
The investigators extracted cases in which suicide was the “injury intent,” and then sorted these cases by month and mechanism of injury, which included firearm, suffocation (including hanging), and poisoning.
They developed a model that enabled them to identify all suicides, as well as suicide by firearm and suffocation. They controlled for seasonal variations in suicide rates, and included a 2-month lagging variable to control for secular trends in suicide rates and increases in population over time.
The model, said Jaffe, not only identifies suicides but is “quite accurate” for predicting the number of suicides and determining deviations from this pattern.
The investigators found that in the case of Robin Williams, there was a clear spike in total suicides and in suicides by suffocation (for both, P < .001) during the month of his death and immediately afterward.
Compared to the number of suicides as predicted by the model, Williams’ death was associated with a 12.8% increase in suicides in August and September 2014 and a 25.5% increase in suicides attributable to suffocation during those months.
When examining the results generated by the model, “those are the months that pop out” as clear increases, said Jaffe. “But you don’t see the same increase in, for example, firearm suicides,” he added.
As for Junior Seau, in the period following his suicide with a gun, “we see a spike in firearm suicides but not in suffocation suicides,” said Jaffe.
Firearm-related suicides jumped 10.3% in the month following Seau’s death.
Jaffe said he would have liked to have tracked firearm suicides following the death by gunshot in April 1994 of musician Kurt Cobain, of the band Nirvana, but the database does not go back that far.
The phenomenon of increased suicides in the wake a celebrity taking his or her own life is referred to as a “contagion” or “copycat” effect, said Jaffe.
But it is perhaps not the celebrity status but widespread media coverage of the death that is the driving force.
“It’s not necessarily celebrities — it’s when suicides are reported, when there’s a publicized suicide,” said Ying.
This new study carries a message for the media about how suicides might best be covered, said Ying.
He noted that the American Foundation for Suicide Prevention has developed recommendations regarding best practices for the reporting of suicide.
For example, sensationalistic headlines and pictures of the location, the method of death, and of grieving loved ones should be avoided, and “warning signs” and “what to do” sidebars should be included in the reporting.
Major Concern
Commenting on the findings for Medscape Medical News, immediate former APA President Anita Everett, MD, chief medical officer, the Substance Abuse and Mental Health Services Administration, said copycat suicide is “a big concern” for mental health professionals.
Adolescents who may be “on the edge or in a zone where they are thinking of suicide” may be especially vulnerable when someone they know and admire, or a beloved celebrity, dies by suicide.
That event might make suicide seem more acceptable, she said.
The method of suicide is an important factor. Some methods are easier to access and could pose more of a risk for suicide, she said. Gunshot is the most lethal, followed closely by hanging.
Everett stressed that no suicide occurs in a vacuum and that with every suicide, loved ones are left behind.
Everett spent years working in hospital settings where she observed people being treated for overdoses.
“After a suicide attempt, they’re in the hospital, in a place where people care about them, and they tend to come around and are almost always glad that the suicide didn’t happen,” she said.
The study investigators and Dr Everett have disclosed no relevant financial relationships.
American Psychiatric Association (APA) 2018. Abstract 6-86, presented May 7, 2018.
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