Suicide on screen: getting the message right can support better mental health outcomes

Netflix-13-Reasons-Why13 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, The impact of screen media portrayals of suicide on viewers: A rapid review of the evidence, 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 behaviour.

Published to coincide with World Suicide Prevention Day (today – Thursday 10 September), researchers Dr Miriam Posselt and Heather McIntyre say their research – which analysed 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,” says Dr Posselt.

“Screen media can increase suicide awareness and help-seeking behaviour, 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 normalise the experience of having mental health difficulties and suicidal thoughts, as well normalising the act of reaching out to ask for help.”

According to UniSA PhD candidate Heather 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 digitised world, where people have access to screens 24/7 and often ‘binge-watch’ through streaming services,” she 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 has 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,” says McIntyre.

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 behaviour, or depict these behaviours 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,” says Dr Posselt.

While traditional media guidelines on reporting on suicide have existed for many years – and last year the World Health Organisation introduced specific resources for filmmakers – Dr Posselt says all creators need to be more aware of how their products can affect mental health.

The impact of screen media portrayals of suicide on viewers: A rapid review of the evidence is available to view online.

Image: 13 Reasons Why – courtesy of Netflix