- Suicide rates on the rise
- Suicide rates in the United States have risen over the last decade.
- Mental health conditions affect suicide risk
- The majority of people who die by suicide were experiencing a mental health condition like depression or bipolar disorder, though only around half were diagnosed at the time of their death.
- Raise awareness of risk factors
- The causes of suicide are complex, but driving awareness of risk factors, including pre-existing mental health conditions, history of previous attempts, and substance misuse, as well as protective factors, including a strong support network, access to mental health care, and good problem-solving skills around suicide can help with prevention.
- Avoid details that increase contagion risk
- When depicting suicide, limit details that could lead to contagion (copying the harmful behavior), such as footage of a suicide, details about method, memorials for people who died by suicide, and suicide notes that oversimplify the cause.
- Impact of language around suicide
- Avoid language like “committed suicide” or “killed himself,” and instead use language like “died by suicide” and “took his own life,” to prevent suicide from being equated with acts of violence or criminal behavior.
Storytelling Tips
Portray a Range of Mental Health Experiences
- Highlight stories of people who wanted to end their life but found ways to live with the right support and treatment plan, to offer a hopeful vision to viewers who might be struggling.
- We sometimes see characters and cast members traveling down the mental health continuum to the point of distress, but then we don’t see the journey back.
- The reality is that individuals who have dealt with thoughts of suicide can learn to manage their mental health and go on to thrive by finding the right treatment plan (such as therapy and/or medication), a healthy support network, and coping skills. Depict this scenario whenever possible.
Diversify Representation
- Portray underrepresented groups who are at risk for suicide so people who are struggling can see their experiences reflected.
- Groups like Indigenous People, Black Americans, and Asian Americans may have had previous negative experiences with mental healthcare, or have cultural barriers that make it less likely they will talk about mental health and suicide, or reach out for help. It’s important to let viewers know that while barriers may exist, help is always available.
Show Conversations About Mental Health and Help-Seeking
- Depict open conversations about suicide, warning signs, and how to prevent it.
- Many families and communities don’t have open conversations about mental health or suicide in the same way they would about physical health. Depicting these real conversations, in a way that feels authentic to your characters, can encourage those discussions and lead to support.
Spotlight Support from Friends and Family Members
- Show how loved ones can play a role in prevention.
- Storytelling can help friends or family member recognize the warning signs of suicide and show how to start a conversation and offer (or ask for) support. Look for opportunities to integrate these messages around prevention into your projects.
Highlight the Power of Coping Skills and Self-Care
- Highlight healthy coping skills in your stories.
- In addition to support from a mental health professional, coping skills can play a powerful role in protecting people dealing with feelings of hopelessness and distress.
- Look for ways to show everyday characters, as well as those with mental health conditions, using healthy coping strategies to show viewers who are struggling how they, too, can protect their mental health.
Depict Effective, Realistic Help-Seeking and Treatment
- Avoid the misunderstanding that medication will change or erase someone’s personality.
- While the reality is that it may take some time and effort to arrive at the right medication(s) or dosage for someone who needs it – just as it would with medication for a physical illness – for some people, medication (and/or therapy) is a key part of getting help.
- Portraying this inaccurate notion about medication can discourage viewers from getting much-needed help. In many cases, people report that being on the right medication has enabled them to be more creative and productive, by being less hampered by their distress.
Represent the Causes of Mental Health Challenges Accurately
- Ensure your narrative reflects the complex causes of distress and suicide.
- Oversimplifying the causes of suicide can muddy messages about prevention, and mistakenly lead viewers to believe they can fix one problem or stressor for a struggling loved one and end the risk of suicide. In reality, suicide is never the result of one simple cause or event.
- People who attempt suicide are often dealing with mental health challenges that can impact their perceptions, reasoning, and decision-making process. Though it may seem as though choice is involved, or even appear to be the result of a rational decision-making process, research shows that judgment is compromised for someone in a state of suicidal distress.
Consider the Impact of Language
- Avoid the phrase “committed suicide.” While not all characters or cast members in a story may realize it, the phrase “committed suicide” is advised against and used less and less frequently, as it outdatedly equates suicide with criminal behavior, rather than being the outcome of a very real health condition.
- Instead, use language like “died by suicide” and “took their own life” to prevent mental health struggles and suicide from being equated with acts of violence or criminal behavior.
- Avoid referring to suicide as “successful,” “unsuccessful,” or a “failed attempt.” Instead use, “died by suicide” or “completed.”
Move Past Stereotypes
- Ensure your storylines aren’t inadvertently romanticizing the stories of real or fictional people who attempt or die by suicide in ways that make them seem larger than life.
- The stereotype that associates suicidal tendencies with genius and creativity can contribute to contagion or copycat behaviors, especially among young people or individuals whose thought process might be compromised by mental health challenges.
Avoid Sharing Potentially Harmful Details
- Certain details about suicide attempts or suicides can lead to contagion or copycat behaviors. Avoid the following details in storytelling when possible:
- Specific details about the way a character attempted or died by suicide. Avoid real or scripted footage of suicides or suicide attempts. If necessary to the storyline, consider having these actions take place off camera. In dialogue, any details necessary to the plot regarding the method used in a suicide attempt or death should be kept to a minimum.
- The names of drugs that characters use to attempt suicide, or other details about means of suicide. Struggling viewers may use this information to plan their own suicide attempt. Avoid the conversation among characters about “how they would do it,” and which ways of taking one’s own life are most lethal.
- Content of suicide notes. Sometimes in entertainment media, suicide notes are presented as a way for the deceased character or cast member to deliver a manifesto, call out people who wronged them, or to have the last word. Viewers shouldn’t be left with the impression that someone’s suicide death can be blamed on a specific individual or incident, or that killing oneself is an effective way to make a statement. In reality, the majority of people who take their own lives do not leave a note.
- Language or situations that make people’s story or work more important or memorable because they died by suicide or overdose. It is also advised to avoid overly romanticizing the individual or their suicide death in scenes showing overly elaborate memorials following the death. Keep in mind that suicide is never a foregone conclusion, or someone’s fate. Viewers should not come away with a sense of hopelessness, themselves, or think that help is not available to them.
Provide Resources and Calls to Action
- Integrate information about free resources available to people who are suicidal, or those worried about a loved one.
- The National Suicide Prevention Lifeline can be reached 24/7 by calling 988. The Trevor Project also offers a crisis hotline for LGBTQ+ individuals at 1-866-488-7386. Find more resources here.
For more tips on representing suicide in entertainment media, click here.
Snapshot
Suicide is the worst-case outcome for emotional distress and mental health challenges. Here is some info on the who, why, how and when of suicide that can help in thinking about suicide storylines.
Who
Suicide doesn’t disciminate and can impact any individual, family, or community.
- The highest rates of suicide are among middle-aged white men.
- Women attempt suicide more often, but more men die by suicide because they typically choose a deadlier means (like shooting or hanging), which offer a much lower chance of survival.
- White people in general have the highest rates of suicide, followed by Indigenous and Native Peoples. The next most prevalent ethnicities — but with much lower rates — are Black Americans, and Asian and Pacific Islanders. Recent data has shown significant increases in suicide deaths among Black youth.
It is difficult to predict who is at risk for suicide, but some common factors to be aware of include:
- The majority of people who die by suicide are experiencing a mental health condition like depression or bipolar disorder (though only around half are diagnosed at the time of their death).
- Substance misuse can increase the risk of suicide.
- Groups who face discrimination and rejection by family members and their community — like people who identify as LGBTQ+ — are also at increased risk for suicide attempts.
Why
Entertainment media sometimes depicts characters thinking about or attempting suicide after a specific situation like bullying, a breakup, or a significant financial loss. While these factors can contribute to feelings of distress and hopelessness, they don’t cause suicide directly. Our mental health is impacted by a range of factors including genetics, upbringing, our perspective on mental health and help-seeking, coping skills, support networks, and the stressors and difficult situations in our lives.
While there is no specific or single cause for suicide, here are the most common situations or stressors people often face before dying by suicide, in order of prevalence:
- Relationship problems/breakups
- Substance misuse
- Physical health problems
- Job/financial loss
- Legal problems
- Homelessness
How
Firearms are the most common method of death by suicide, accounting for a little more than half of all suicide deaths. The next most prevalent methods are suffocation (including hanging) and poisoning (including drug overdoses).
When
While individuals who are suicidal may think about and even plan their suicide over a period of months or years, suicide can be an impulsive action taken when a person might be in distress, or under the influence of substances and not thinking clearly. That’s why restriction to means — the ways in which people attempt to take their lives — is so important. Sometimes these impulses pass and suicide attempt survivors realize that they want to live shortly after their attempt.
Facts & Stats
Some key statistics from the latest CDC Fatal Injury Report, with data from 2018:
Other Statistics
Risk & Protective Factors
Risk factors that can put individuals at increased risk for suicide:
- Family history of suicide
- Previous suicide attempt(s)
- History of mental disorders, particularly clinical depression
- History of alcohol and substance misuse
- Feelings of hopelessness
- Impulsive or aggressive tendencies
- Other suicides in same community
- Isolation, a feeling of being cut off from other people
- Barriers to accessing mental health treatment
- Loss (relationships, social, work, or financial)
- Physical illness
- Easy access to lethal methods
Protective factors that can put individuals at a lower risk for suicide:
- Access to effective for mental, physical, and substance misuse disorders
- Family and community support, and feelings of connectedness
- Coping and life skills
- A sense of purpose
- Cultural and religious beliefs that discourage suicide
- Restricted access to means
Symptoms & Warning Signs
- Hopelessness
- Rage, uncontrolled anger, or seeking revenge
- Acting reckless or engaging in risky activities, seemingly without thinking
- Feeling trapped or like there’s no way out
- Increased alcohol or drug use
- Withdrawing from friends, family, and society
- Anxiety, agitation, inability to sleep, or sleeping all the time
- Dramatic mood changes
- Expressing no reason for living or no sense of purpose in life
- Prior suicide attempts
Treatment Options
- Talk therapy focused on finding and treating underlying mental health conditions, resolving feelings of hopelessness, and developing coping skills.
- Inpatient treatment to keep someone seriously at risk for suicide safe and in a controlled environment until the suicidal ideation can be stabilitized.
- Medication to treat underlying mental health conditions like depression, anxiety disorders, bipolar disorder, or schizophrenia.
- Support networks for managing any mental health challenge, especially people who have expressed thoughts of suicide or who have had a previous suicide attempt. It can be helpful for both the person who is struggling and friends or family members to come up with a plan of how they will be supportive and take action if the suicidal ideation returns or worsens.
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