Effects of media stories featuring coping with suicidal crises on psychiatric patients: Randomized controlled trial

Abstract

Background Accumulating evidence suggests beneficial effects of media stories featuring individuals mastering their suicidal crises, but effects have not been assessed for psychiatric patients. Methods We randomized n = 172 adult psychiatric patients (n = 172, 97.1% inpatients) to read an educative article featuring a person mastering a suicidal crisis (n = 92) or an unrelated article (n = 80) in a single-blind randomized controlled trial. Questionnaire data were collected before (T1) and after exposure (T2) as well as 1 week later (study end-point, T3). The primary outcome was suicidal ideation as assessed with the Reasons for Living Inventory; secondary outcomes were help-seeking intentions, mood, hopelessness, and stigmatization. Differences between patients with affective versus other diagnoses were explored based on interaction tests. Results We found that patients with affective disorders (n = 99) experienced a small-sized reduction of suicidal ideation at 1-week follow up (mean difference to control group [MD] at T3 = −0.17 [95% CI −0.33, −0.03], d = −0.15), whereas patients with nonaffective diagnoses (n = 73) experienced a small-sized increase (T2: MD = 0.24 [95% CI 0.06, 0.42], d = 0.19). Intervention group participants further experienced a nonsustained increase of help-seeking intentions (T2: MD = 0.53 [95% CI 0.11, 0.95], d = 0.19) and a nonsustained deterioration of mood (T2: MD = −0.14 [95% CI −0.27, −0.02], d = −0.17). Conclusions This study suggests that patients with affective disorders appear to benefit from media materials featuring mastery of suicidal crises. More research is needed to better understand which patient groups are at possible risk of unintended effects.

Media coverage of Canadian Veterans, with a focus on post traumatic stress disorder and suicide

“…Again, this implies the need to diversify coverage of PTSD in the Canadian media so that it includes a greater proportion of stories containing themes of hope, recovery and successful mastery of challenging situations. Indeed, inclusion of such themes may foster a Papageno effect (discussed in the introduction) which has been shown in various studies to mitigate suicidality in susceptible individuals, including those with pre-existing mental health issues such as PTSD [ 34 , 39 , 47 , 48 ].…”

“…For example, the Mindset suicide guidelines do not include explicit bullet-points advising journalists to cover hopeful stories of resilience and mastery of crises. These are arguably the most important stories for suicide prevention and are instrumental in fostering a Papageno effect [ 34 , 39 , 47 , 48 ].…”

“…Conversely, the media can be a vector for increased awareness and education, such as pointing to available resources, highlighting stories of hope and recovery, and bringing attention to important social issues surrounding suicide [ 34 , 40 , 44 – 46 ]. Indeed, several research studies indicate a modest reduction in suicide mortality and suicidal ideation after suicide-related media reporting when the news focus has included content related to (i) mastery of crises; (ii) resilience in the face of adversity; and (iii) messages of hope and recovery [ 34 , 39 , 47 , 48 ] This has been labelled ‘the Papageno effect’.…”