As this month commemorates the 20th anniversary of the Kurt Cobain’s death, I am reminded of the iconic headlines that alerted the world to the tragedy. Dramatic, sensationalized headlines like the Seattle Post-Intelligencer‘s “Kurt Cobain’s Suicide Note Ends With ‘I Love You'” and Newsweek’s “Suicide: Why Do People Kill Themselves?” romanticized Cobain, risking contagion (or “copycat suicide”) among the artist’s vulnerable young fans. Though no actual rise in the suicide rate was attributed to Cobain’s death, over 50 studies have concluded that pervasive and  graphic coverage of suicide deaths pose a serious danger.

Today, mental health advocacy and policy organizations, including National Alliance on Mental Illness, the Suicide Prevention Resource Center, and the National Institute of Mental Health, have provided the media with carefully-researched guidance on how to report safely on suicide. Appropriate language, including “died by suicide” in place of the outdated “committed suicide,” which connotes guilt, as well as preventative messaging, such as emphasizing the warning signs of suicide and encouraging help-seeking, are among the recommendations that have been implemented by mindful news sources.

However, not everyone has taken note. On April 13, Benedict Carey, writing for the New York Times, covered a decision by the American Association of Suicidology to recognize suicide attempt survivors as a key constituency group. (The AAS had previously acknowledged the voices of mental health professionals and the surviving family members of people lost to suicide, but fears about the effects of recounting their trauma had left attempt survivors out of the conversation).

In his piece, Carey referred to “successful” and “failed” suicide attempts: harmful language with dangerous connotations. He also described suicide as an “unpredictable act,” completely ignoring the existence of warning signs and risk factors. To his credit, his use of interview quotes allowed for a discussion of stigma to successfully take place within the piece, but the article was still a missed opportunity for important and necessary education about the way that we discuss suicide on the cultural level.

The Times piece is hardly alone. The next day, USA Today revisited a story that had shocked many with the dramatic headline “11-year-old boy’s suicide attempt part of epidemic.” The piece does many things right: listing warning signs and resources, citing the role of mental illness in suicide (90% of people who die by suicide had a mental health disorder or addiction at the time of death), and an important interview with a prevention expert, but it also does many things very wrong. Not only did the article begin with a graphic description of the young boy’s attempt method (a serious factor in contagion risk), but it maintains a focus on bullying as the cause of hundreds of suicides, contributing to misinformed cultural notions of the causes of suicide, which can tend to fixate on finger-pointing rather than mental health education.

Serious progress has been made in the coverage of suicide and mental-health-related issues in the news media, including an entry in the revered AP Style Handbook. However, a deeper understanding of the need for a careful and guided approach to coverage of these topics seems to still be lacking. The media have an opportunity, and a responsibility, to be a powerful force for good. Their partners in advocacy are here to provide the necessary guidance to bring this change and save lives.

via American Foundation for Suicide Prevention:

Most of the time, people who kill themselves show one or more of these warning signs before they take action:

• Talking about wanting to kill themselves, or saying they wish they were dead
• Looking for a way to kill themselves, such as hoarding medicine or buying a gun
• Talking about a specific suicide plan
• Feeling hopeless or having no reason to live
• Feeling trapped, desperate, or needing to escape from an intolerable situation
• Having the feeling of being a burden to others
• Feeling humiliated
• Having intense anxiety and/or panic attacks
• Losing interest in things, or losing the ability to experience pleasure
• Insomnia
• Becoming socially isolated and withdrawn from friends, family, and others
• Acting irritable or agitated
• Showing rage, or talking about seeking revenge for being victimized or rejected, whether or not the situations the person describes seem real

Individuals who show such behaviors should be evaluated for possible suicide risk by a medical doctor or mental health professional.

What To Do When You Suspect Someone May Be at Risk for Suicide

Take it Seriously

• 50% to 75% of all people who attempt suicide tell someone about their intention.
• If someone you know shows the warning signs above, the time to act is now.

Ask Questions

• Begin by telling the suicidal person you are concerned about them.
• Tell them specifically what they have said or done that makes you feel concerned about suicide.
• Don’t be afraid to ask whether the person is considering suicide, and whether they have a particular plan or method in mind. These questions will not push them toward suicide if they were not considering it.
• Ask if they are seeing a clinician or are taking medication so the treating person can be contacted.
• Do not try to argue someone out of suicide. Instead, let them know that you care, that they are not alone and that they can get help. Avoid pleading and preaching to them with statements such as, “You have so much to live for,” or “Your suicide will hurt your family.”

Encourage Professional Help

• Actively encourage the person to see a physician or mental health professional immediately.
• People considering suicide often believe they cannot be helped. If you can, assist them to identify a professional and schedule an appointment. If they will let you, go to the appointment with them.

Take Action

• If the person is threatening, talking about, or making specific plans for suicide, this is a crisis requiring immediate attention. Do not leave the person alone.
• Remove any firearms, drugs, or sharp objects that could be used for suicide from the area.
• Take the person to a walk-in clinic at a psychiatric hospital or a hospital emergency room.
• If these options are not available, call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) for assistance.

Follow-Up on Treatment

• Still skeptical that they can be helped, the suicidal person may need your support to continue with treatment after the first session.
• If medication is prescribed, support the person to take it exactly as prescribed. Be aware of possible side effects, and notify the person who prescribed the medicine if the suicidal person seems to be getting worse, or resists taking the medicine. The doctor can often adjust the medications or dosage to work better for them.
• Help the person understand that it may take time and persistence to find the right medication and the right therapist. Offer your encouragement and support throughout the process, until the suicidal crisis has passed.