[1] 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.

[2] 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.

[3] 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.

[4] 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.

[5] Marzano L, Spence R, Marsh I, Barbin A, Kruger I. (2025). How does news coverage of suicide affect suicidal behaviour at a high-frequency location? A 7-year time series analysis. BMJ Public Health, 3(1).

Abstract: Introduction News reporting of suicide can have a significant influence on suicidal behaviour in the general population, especially following the death of a well-known individual. By comparison, the impact of reporting on suicides at well-known, ‘high-frequency’ locations is less well understood. We investigated the relationship between news coverage of suicide and incidents at a high-frequency coastal location in the UK over a 7-year period.

Methods We analysed bidirectional associations (with daily and weekly lags) and Granger causality between suicide-related news in the UK (n=38 595, of which 789 focused on cliff locations) and suspected suicides (n=278) and crisis interventions (n=3050) at the site between 1 January 2017 and 31 December 2023. Separate subanalyses explored associations with repeat coverage and with headlines featuring explicit location/method details.

Results While coverage of incidents at the study site and other coastal locations represents a small and decreasing proportion of all UK news of suicide, 51% of all cliff-related news focused on the study site, often explicitly identified in the story’s headline (81%). There were significant but small (r<0.3) correlations between the volume of news coverage (particularly when method-specific and location-specific) and suicidal behaviour at the site, with fatalities increasing in the immediate aftermath of reporting. This effect was strongest in 2018–2019 (which had the greatest volume of reporting and repeat coverage) but failed to reach significance in 2020–2023, when there were fewer reports, less repeat coverage and no headlines referring to multiple deaths at the site.

Conclusions Findings underscore the importance of continued efforts to monitor and improve the quality of news and other media portrayals of suicide. Follow-up studies, including qualitative research with people with lived/living experiences of suicide, could further explore how different types of news stories and wider narratives might contribute to increases—and potentially decreases—in suicides at high-frequency locations.

[6] Mackenzie, J. M., Marsh, I., Fields, B., Kruger, I., Katsampa, D., Crivatu, I., & Marzano, L. (2025). Preventing suicides on the railways: Learning from lived and living experiences. BMC Public Health, 25(1), 1625.

Background: Despite increasing recognition of the crucial role of lived/ing experience in shaping suicide prevention policy and practice, the perspectives of people who have considered or attempted suicide by train are seldom captured in analyses of what could reduce suicides on the railways. The aim of this study was to explore lived/ing experience perceptions of what types of approaches are effective or ineffective in this context, and why.

Methods: We carried out 1) in-depth qualitative interviews with 34 individuals who had attempted or contemplated suicide on the railways; 2) an online survey investigating lived/ing experiences of suicidality at rail locations (N = 269); 3) an online ethnography of content relating to train/rail suicide from different online spaces including 'pro-choice' forums and reddit (254 posts and 1228 associated comments).

Results: Several measures to prevent suicide on the railways were identified-and critiqued-in lived/ing experience accounts. These included strategies to challenge dominant cultural narratives around railway suicide (e.g. by shifting the focus from the lethality of this method to its impact on train drivers and others); environmental measures to restrict access to means and/or create a safer and more positive atmosphere; and increasing opportunities for help-seeking and 'helpful' third-party interventions. However, considering what works for whom, and when, emerged as crucial. The challenges of preventing rail suicides against a backdrop of severely stretched mental health services were also repeatedly highlighted.

Conclusions: The perspectives of people with lived/ing experiences, whilst far from homogenous, provide crucial insights into the potential value and unintended consequences of different measures to prevent suicides on the railways. Our findings reiterate the need for comprehensive suicide prevention strategies, targeting different stages of the suicidal process.

 [7] 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.