[1] Ladwig, K. H., Kunrath, S., Lukaschek, K., & Baumert, J. (2012). The railway suicide death of a famous German football player: impact on the subsequent frequency of railway suicide acts in Germany. Journal of Affective Disorders, 136(1-2), 194-198. [PubMed Link]

Abstract: Background: The railway suicide of Robert Enke, an internationally respected German football goal keeper, sent shockwaves throughout the world of football. We analyzed its impact on the frequency of subsequent railway suicide acts (RS).  

Methods: Two analytic approaches were performed applying German Railway Event database Safety (EDS) data: first, an inter-year approach comparing the incidence of RS during a predefined “index period” with identical time windows in 2006 to 2008; second, an intra-year approach comparing the number of RS 28 days before and after the incidence. To analyze a possible “compensatory deficit”, the number of RS in the subsequent first quarter of 2010 was compared with the identical time windows in the preceding three years. Incidence ratios with 95% confidence intervals were estimated by Poisson regression. Findings were controlled for temperature. 

Findings: Compared to the preceding three years, the incidence ratio (IR) of the number of RS in the index period increased by 1.81 (1.48–2.21; p < 0.001), leading to an overall percentage change of 81% (48–121%; p < 0.001). Comparing the number of suicides 28 days before and after the incidence revealed an even more pronounced increase of IR (2.2; 1.6–3.0). No modifications of these associations were observed by daytime, by location of the suicide and fatality. No compensatory deficit occurred in the post-acute period. 

[2] Niederkrotenthaler, T., & Sonneck, G. (2007). Assessing the impact of media guidelines for reporting on suicides in Austria: interrupted time series analysis. Australian & New Zealand Journal of Psychiatry, 41(5), 419-428. [PubMed Link]

Abstract: Objective: Media guidelines for reporting on suicides are a widely used means of preventing imitative suicides, but scientific accounts of their impact on suicide numbers are sparse. This report provides an evaluation of the Austrian guidelines that were introduced in 1987 as a natural experiment. 

Methods: The impact of the guidelines was tested by applying an autoregressive integrated moving average (ARIMA) model and a linear regression model. In addition to a nationwide evaluation, Austria was divided into three areas according to regional differences in coverage rates of the collaborating newspapers and the impact of the intervention was tested for each area separately. Main outcome measures were the overall annual suicide numbers, and the numbers of Viennese subway suicides that were exceptionally newsworthy for the mass media. In order to test intermediate impacts, also quantitative and qualitative changes in media reporting after the introduction of the guidelines were analysed. 

Results: There was some evidence of a nationwide impact of the guidelines, calculated as a significant reduction of 81 suicides (95% confidence interval: −149 to −13; t = −2.32, df = 54, p <0.024) annually. This effect was particularly due to a significant reduction in the area with the highest coverage rates of the collaborating newspapers. Viennese subway suicides showed a highly significant level shift (t = −4.44, df = 19, p <0.001) and a highly significant trend change (t = −4.20, df = 19, p <0.001) after the introduction of the guidelines. These effects corresponded to significant changes in the quality and quantity of media reporting. 

Conclusions: The present results clearly support the hypothesis that the media guidelines have had an impact on the quality of reporting as well as on suicidal behaviour in Austria, and stress the importance of collaborating with nationwide, but also with regional media to achieve efficacy. Further research is needed to provide an international insight into this public health issue. 

[3] Chow, S., Men, V. Y., Zaheer, R., Schaffer, A., Triggs, C., Spittal, M. J., ... & Sinyor, M. (2024). Suicide on the Toronto Transit Commission subway system in Canada (1998–2021): a time-series analysis. The Lancet Regional Health–Americas, 34.

Background: The Toronto Transit Commission (TTC) operates the public transit system in Toronto, Canada. From 1954 to 1980, there were 430 suicide deaths/attempts on the TTC subway system. In 2011, TTC implemented Crisis Link, a suicide helpline to connect subway passengers with counsellors. Upstream factors such as media reporting about suicide incidents may also influence suicidal behaviour. Our objectives were to investigate how Crisis Link and media reports about TTC suicide incidents influenced suicide rates.

Methods: Suicide data were obtained from the TTC and Coroner, with Crisis Link data provided by Distress Centres of Greater Toronto (1998–2021). Media articles were identified through a database search of Toronto media publications. Interrupted time-series analysis investigated the association between Crisis Link calls, media articles, and quarterly suicide rates on the subway system.

Findings: There were 302 suicides on TTC’s subway system from 1998 to 2021. The introduction of Crisis Link was associated with a large but non-significant decrease in TTC-related suicide rate in the same quarter (IRR = 0.64, 95% CI = 0.36–1.12). Each subsequent post-Crisis-Link quarter experienced an average 2% increase in suicide rate (IRR = 1.02, 95% CI = 1.004–1.04). Furthermore, for each TTC-related media article in the previous quarter, the suicide rate on the TTC increased by 2% (IRR = 1.02, 95% CI = 1.004–1.04).

Interpretation: The Crisis Link helpline was associated with a large but non-significant short-term decrease in suicide rates. However, this outcome was not sustained; this may, in part, be attributable to media reporting which was associated with increased suicides. This should inform suicide prevention policies in Canada and worldwide.

[4] Niederkrotenthaler, T., Voracek, M., Herberth, A., Till, B., Strauss, M., Etzersdorfer, E., & Sonneck, G. (2010). Role of media reports in completed and prevented suicide: Werther v. Papageno effects. The British Journal of Psychiatry, 197(3), 234-243. 

Abstract: Background: Media reporting of suicide has repeatedly been shown to trigger suicidal behaviour. Few studies have investigated the associations between specific media content and suicide rates. Even less is known about the possible preventive effects of suicide-related media content. 

Aims: To test the hypotheses that certain media content is associated with an increase in suicide, suggesting a so-called Werther effect, and that other content is associated with a decrease in suicide, conceptualised as a Papageno effect. Further, to identify classes of media articles with similar reporting profiles and to test for associations between these classes and suicide. 

Method: Content analysis and latent class analysis (LCA) of 497 suicide-related print media reports published in Austria between 1 January and 30 June 2005. Ecological study to identify associations between media item content and short-term changes in suicide rates. 

Results: Repetitive reporting of the same suicide and the reporting of suicide myths were positively associated with suicide rates. Coverage of individual suicidal ideation not accompanied by suicidal behaviour was negatively associated with suicide rates. The LCA yielded four classes of media reports, of which the mastery of crisis class (articles on individuals who adopted coping strategies other than suicidal behaviour in adverse circumstances) was negatively associated with suicide, whereas the expert opinion class and the epidemiological facts class were positively associated with suicide. 

Conclusions: 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. 

[5] Action Alliance for Suicide Prevention. (2024) Framework for Successful Messaging.

Description: The Framework for Successful Messaging is a resource to help people messaging about suicide to develop messages that are strategic, safe, positive, and make use of relevant guidelines and best practices. Certain types of public messaging about suicide can increase risk among vulnerable individuals. Conversely, communications can be a powerful tool to promote resiliency, encourage help-seeking, publicize prevention successes, and encourage actions that help prevent suicide. It addresses “public messaging”: any communications released into the public domain. From posters, PSAs, and social media to websites, newsletters, fundraising appeals, event publicity, press interactions, public talks, and advocacy efforts, each contributes to the public’s perceptions about suicide and suicide prevention.

[6] American Association of Suicidology. (2018). Suicide Reporting Recommendations.  

Document Excerpt: These guidelines provide updates from previously published national and international suicide reporting guidelines, along with updated recommendations for reporting on suicide using social media. They are not intended to limit press freedom but rather serve as an evidence-based resource for effective reporting on suicide. They are grounded in the principles of journalism ethics (3,4) and suicide prevention. (2) The goals of these guidelines are to support journalists in creating effective news stories that inform the public and increase awareness about suicide and its complexities, while reducing risk of additional suicides. Ideally, these stories will also provide resources and a sense of hope to those experiencing suicidal thoughts and behaviors. Adoption of these guidelines will reduce the risk of suicide for those vulnerable to suicide contagion and allow journalists the freedom to tell stories that make a difference. (5,6,7) Suicide reporting guidelines should be provided to all journalists, news editors, website providers, bloggers, virtual communities, and users of social media to ensure widespread adoption. People reporting on suicide have the power to change public perspectives, reduce prejudice and discrimination around suicide, and save lives with the implementation of these guidelines. 

[7] American Foundation for Suicide Prevention (n.d.). For Journalists. 

Description: Website describing suicide contagion that includes guidance for talking about suicide in the media. 

[8] Reportingonsuicide.org. (n.d.) Recommendations for Reporting on Suicide. 

Document Excerpt: The Recommendations for Reporting on Suicide were developed by leading experts in suicide prevention and in collaboration with several international suicide prevention and public health organizations, schools of journalism, media organizations and key journalists as well as Internet safety experts. The recommendations are based on more than 50 international studies on suicide contagion. 

[9] World Health Organization. (2008). Preventing Suicide A Resource for Media Professionals. 

Document Excerpt: reporting of suicide, and, using this evidence, provides a resource for media professionals about how to report on suicide. It encourages caution in reporting suicide. It recognizes that there are times when a suicide will need to be reported on the grounds of its newsworthiness. It makes suggestions about how best to ensure that such reporting is accurate, responsible and ethical. The resource acknowledges that reporting of suicide differs within and across countries. There are cultural differences in terms of what is appropriate to report and how information about a given suicide is accessed. This resource is designed to provide general guidance, but media professionals are encouraged to work with their own suicide prevention community and to draw on local guidelines wherever possible. 

[10] Operation Lifesaver, Inc. (n.d.) Safe and Effective Messaging on Rail Incidents: Useful Tips for Effective Reporting on Rail Suicide. 

Description: Recommendations for reporting specifically on rail incidents developed by the FRA, Volpe Center and OLI. 

Additional Resources

Gabree, S. & Mejia, B. (2017). The Reporting of Suicide and Trespass Incidents by Online Media in the United States. Technical Report No. DOT/FRA/ORD-17/09. Washington, DC: U.S. Department of Transportation, Federal Railroad Administration. 

Abstract: The reporting of a suicide death in the media has the potential to increase imitative suicide attempts for vulnerable individuals who read the article, a phenomenon known as suicide contagion or the “Werther effect.” Organizations around the world have developed recommendations for how to responsibly report on suicide incidents in a way less likely to result in contagion. For this research, 1,173 articles on FRA-reported suicide and trespass incidents were collected and analyzed for content. While media outlets often followed many of the suicide reporting recommendations, none were consistently followed in every article analyzed and a few key   recommendations were often never applied. For example, the term “suicide” was often included in the title of articles, details about the location where the suicide took place and the actions preceding impact were often provided, while help-seeking information was   only rarely included. In general, railway suicide incidents tended to be reported in a similar way to trespass incidents, rather than as a suicide by another means. The development of railway-specific recommendations could help to encourage responsible reporting practices regarding railway trespass and suicide incidents. 

Greenstein, L. (2018, June 15). Why Suicide Reporting Guidelines Matter. National Alliance on Mental Illness. 

Description: Website describing suicide contagion that includes guidance for talking about suicide in the media.