Stanford Initiative Aims to Educate Media About Responsible Suicide Reporting

In 2017, the popular Netflix drama “13 Reasons Why” became one of the most controversial series of the year because of its depiction of the fictional suicide of a 17-year-old girl. After its release, Google searches for “how to commit suicide” and “how to kill yourself” increased dramatically, and a 2020 study reported that the suicide rate among youth spiked 29% above historical trends in the month after the release of “13 Reasons Why.”

It is not surprising: An enormous body of research from American and international researchers—some of it dating back to the 1980s—has firmly established that certain kinds of media reporting on suicide deaths, and depictions of suicide in movies and television dramas, can influence suicide contagion, especially among young people.

To address that problem, the Media and Mental Health Initiative in the Department of Psychiatry at Stanford University aims to promote public education about mental health and suicide through proactive, sustained engagement with content producers in the news media, entertainment media, and social media.

“This collaborative project will systematically embed evidence-informed guidelines across all media platforms to advance narratives that promote hope, help seeking, and awareness about mental health and suicide while mitigating harmful ones,” said Steven Adelsheim, M.D., director of the Stanford Center for Youth Mental Health and Wellbeing and a member of the APA Council on Children, Adolescents, and Their Families.

The initiative is an outgrowth of a 2018 meeting of concerned psychiatrists and representatives from media outlets at the APA Annual Meeting in New York.

The World Health Organization, in collaboration with the International Association for Suicide Prevention, has formulated guidelines to promote responsible reporting about suicide. Some of those recommendations include avoiding prominent placement of stories about suicide and undue repetition of stories about suicide and never describing the method used or providing details about the site or location.

Victor Schwartz, M.D., a clinical associate professor of psychiatry at New York University School of Medicine who has partnered with Adelsheim in developing the new initiative, urges psychiatrists to visit the website of the Media and Mental Health Initiative and become involved. “It is an opportunity for psychiatrists to help educate journalists and the public about suicide risks and suicide contagion and about mental health and mental illness generally,” he said.

For more information about the initiative and a list of the media guidelines, see the Psychiatric News article “Psychiatrists Create Initiative to Educate Media About Suicide Contagion.”

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Calculator Shows Promise in Predicting Risk for Conversion to Psychosis

Although considerable progress has been made in determining risk factors for psychosis in recent decades, mental health professionals currently lack a widely available tool for calculating a precise estimate of risk for patients seeking help. Two studies published today in AJP in Advance suggest researchers have developed a risk calculator for the individualized prediction of a psychotic disorder over a two-year period.

In the first study, researchers led by Tyrone Cannon, Ph.D., a professor of psychology and psychiatry at Yale University, described how they examined eight criteria to evaluate the prediction of psychotic disorder in 596 participants (mean age 18.5 years) over a two-year period in the North American Prodrome Longitudinal Study (NAPLS-2).

“Higher levels of unusual thought content and suspiciousness, greater decline in social functioning, lower verbal learning and memory performance, slower speed of processing, and younger age at baseline each contributed to individual risk for psychosis,” Cannon and colleagues wrote. However, other variables—stressful life events, trauma, or a family history of schizophrenia—did not predict conversion to psychosis, they said. The overall model accuracy rate was 71%—which the authors noted is “in the range of values for established calculators currently in use for cardiovascular disease and cancer recurrence risk, which range from 0.58 to 0.81.”

“This prediction tool represents a potential breakthrough for early intervention in psychiatry. However, as with any predictive analytic model, its performance must be validated in samples of clinical high-risk patients collected independently of NAPLS-2,” Ricardo Carrión, Ph.D., an assistant professor of psychiatry at Hofstra Northwell School of Medicine in Hempstead, N.Y., and colleagues wrote in a companion article.

Carrión’s team evaluated the performance of the NAPLS-2 risk calculator in an external, independent sample of individuals (aged 12 to 25) at clinical high risk for psychosis collected as part of the Early Detection, Intervention, and Prevention of Psychosis Program (EDIPPP). The overall model accuracy rate was 79% in the EDIPPP sample. 

“Although further replication is needed, at present the risk calculator appears to have considerable potential for determining the probability that an individual will develop psychosis, and it may provide a foundation for the personalized treatment of clinical high-risk individuals,” Carrión and colleagues wrote.

For more in Psychiatric News about the Early Detection and Intervention for the Prevention of Psychosis Program, see “Early Intervention Trial in Youth at Risk for Psychosis Shows Improved Symptoms.”

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