Media coverage of suicide can play a pivotal role in raising public awareness of an important public health issue. But research suggests that reporting on suicide can potentially trigger suicidal behavior in vulnerable individuals. To encourage the responsible reporting of suicide as a public health issue, media recommendations have been developed. Based on interviews with 50 US journalists, this study explores journalists’ awareness of and attitudes toward suicide reporting risks and US media recommendations. Through the lens of suicide news reporting, this is a study examining how journalists view their professional roles and sense of social responsibility when reporting on issues, like suicide, with potential public health consequences. We find that while the journalists interviewed want to cover suicide responsibly, and as a public health issue, they often deviate from recommendations. In many cases, professional conventions and routines conflict with or hinder guideline compliance. Moreover, many journalists deliberately disregard suicide reporting guidelines because they clash with their professional values and perceived responsibility of serving the public via truth-telling and full disclosure of information.