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If you are having thoughts of suicide, please know that you are not alone. If you are in danger of acting on suicidal thoughts, call 911. For support and resources, call the National Suicide Prevention Lifeline at 1-800-273-8255 or text 741-741 for the Crisis Text Line.

“Suicide is on the rise in the United States, but people still don’t know quite how to talk about it,” wrote Atlantic health editor Julie Beck after the deaths of Kate Spade and Anthony Bourdain last week. Conversations on suicide often have disparities: News stories on celebrity deaths don’t always follow reporting guidelines, and demographic data on suicides don’t always tell the full story. Today’s stories look into how and why.


“Less Need to Be Told”

By Karen Yuan

In the months following reports of Robin Williams’s suicide in 2014, epidemiologists at Columbia University observed that suicides in America increased by 10 percent, with a 32 percent increase in deaths that resembled Williams’s own. According to their research, sensationalist media coverage may correlate with the celebrity-suicide effect, in which “copycat” suicides follow that of a celebrity. Though the World Health Organization offers guidelines on how to report on suicide, the researchers state in a paper, published earlier this year, that “the extent to which these guidelines were followed after the death of Mr. Williams is questionable.” Several news headlines had reported, for example, against WHO guidelines, the method Williams used to commit suicide.

David Fink was one of the Columbia researchers. “Suicide is a social phenomenon,” he told me. “When we see someone that we can relate to,” such as a celebrity, take the action, that can be a trigger to take a similar action. The research found that the highest increases in suicide following Williams’s death were among men of similar age to the actor. I asked Fink for his thoughts on the recent coverage of celebrity suicides. Here’s an edited transcript of his answers to my questions.

The story of the suicide itself still needs to be conveyed, and that's something that we can't get around. But there's very clear guidelines that the World Health Organization has put forward: Focus on the death of this person, focus on who they left behind, provide the suicide hotline number. What we're seeing instead is that the goriest of details are coming out, and people are telling you exactly how this person died. We saw an increase in [the same method of] suicide following Robin Williams’s death, which makes us think that the method comes into play.

I think the key would be to inform the audience that Anthony Bourdain died at 61, and provide a photo, not of the scene, but of the individual, with the hotline number. I don't think there's any other stories that need to be written. It's not that there's a story that's missing. It's that less need to be told. It's that certain things need to be kept private. I don't think we need anything more.

I think either people don't know about the guidelines, or that there's a willful choice to run a story for bigger headlines. So we need to educate the people that don't know about the guidelines, and to the people that do know, we have to keep saying, this has consequences.

There are people in media who are turning a mirror on themselves for a second and contemplating [their coverage]. The thing is, we change because the group changes. If one outlet puts out that sensationalist story, everybody else can jump onto it. This is another social interaction.


What We Don’t Know About Suicide Demographics

By Abdallah Fayyad

According to a new report from the Centers for Disease Control and Prevention, suicides are on the rise in the United States. The study found that suicide rates have spiked across the board in all racial groups. But one demographic seems to be particularly plagued with high suicide rates: middle-aged white men.

The new CDC report is consistent with years of studies showing suicide rates that are strikingly higher in the white community than almost all minority groups. Only one other racial or ethnic group has comparable—and at times higher—rates of suicide than whites: Native Americans. In 2016, according to the Suicide Prevention Resource Center, the rate was highest among Native Americans and whites, at 21.4 and 18.5 deaths per 100,000, respectively. The rate among other groups, however, was much lower. For African Americans and Hispanics, there were 6.4 deaths by suicide per 100,000. Given that risk factors in minority communities are likely to be just as high as they are among whites—if not higher—these findings are surprising. As Atlantic writer Olga Khazan wrote, “African Americans face a greater risk of death at practically every stage of life.”

But according to Ian Rockett, a professor of epidemiology at West Virginia University, the data don’t tell the whole story. “We hear a lot of talk about health disparities,” he said, “but what we don’t hear much about at all is what I would call health data disparities.” Suicides are generally likely to be undercounted because of the difficulty of correctly classifying causes of death, especially in cases where there’s no history of mental health diagnoses. In one of his studies, Rockett and his coauthors found that suicides in minority communities are even more likely to be misclassified. “If the data is more deficient for minorities, then the gaps between whites and blacks might actually be much smaller,” he said.

One reason the data may not reflect the reality of suicides in minority communities, Rockett said, is limited access to health care. “Minorities have less access to the health-care system, therefore they’re less likely to have mental health problems diagnosed,” he said. That may make it harder for experts to ascertain whether the cause of death was suicide. This poses extra difficulty in cases involving drug overdoses or alcohol poisoning.

Kimya Dennis, a professor of sociology and criminal studies at Salem College, said that some deaths attributed to violence may also have suicidal factors at play. “There are lots of people who put themselves in dangerous environments because they have suicidal thoughts,” she said. “Some people might not say ‘I want to kill myself’ outright, but some people might say, ‘I don’t care.’” Dennis said that our understanding of mental health and suicide should take note of these types of cases, which are disproportionately prevalent in minority groups.

As the CDC study shows, suicides are not just ravaging white communities, but the United States as a whole. And Rockett’s findings suggest that the toll of suicide in minority communities might be even greater than researchers realize. “I don’t know that data disparities would explain the whole gap, but I think it’s important to consider,” Rockett said. “I think the big danger with health data disparities is that problems get more underestimated amongst the people with the more deficient data. And that has implications for targeting at-risk populations or designing interventions. It’s harmful for prevention.”


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