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There is no doubt that fighting stigma is both central and essential to successful suicide prevention activities.
Stigma feeds ignorance, false beliefs and misinformation; it counteracts help-seeking, and negatively affects those who are suicidal and those who are bereaved from suicide.
Stigma also influences those who have attempted suicide, especially males. The cultural script imposes that men should be “successful” even in self-destructive behaviours.
Frequently, after a suicide attempt, males have to relocate, look for a new job, lose their friends and network of relationships; in short, run away.
This chain of events nourishes further self-isolation, depression and eventually, more determination to not “fail” the next attempt.
For the last 25 years the World Health Organization has repeatedly stimulated initiatives aimed at increasing awareness of the impact of stigma on suicide deaths.
Virtually all national strategies contain recommendations for fighting stigma and encouraging responsible media reporting on suicide.
Despite this commitment I am not sure about the concreteness of Australian efforts in combating the stigma of suicide.
It seems to me that some mild reduction in the stigma associated with mental disorders might have been achieved, but suicide stigma remains.
A recent paper has outlined significant improvements in the way suicide cases are presented by the media. (1)
I have heard journalists, locally and nationally, saying the best option is to keep silent about suicide themes. The decline in suicide rates has reinforced this opinion among media managers.
However, it is dubious that the decrease in suicide rates has actually happened in Australia.
The Australian Bureau of Statistics has formally recognised under-enumeration in its suicide mortality data, and, in an unprecedented move, has initiated a revision of their published figures.
Conclusions from a Senate inquiry in June this year clearly underline the existence of serious problems with the official dimension of suicide in the country.
Six of the 42 recommendations included in the Senate committee report, The Hidden Toll: Suicide in Australia, concern improvements in data quality. (2)
In addition, particularly in the last decade, the impressive immigration into Australia of Asian people (now exceeding 1.5 million people) has effectively diluted suicide rates among Australian-born individuals (my institute is publishing two papers on this topic soon).
I share the invitation made public by the South Australian State Coroner, Mark Johns, to publish statistics on suicide.
There is no one single piece of scientific evidence indicating that discussing themes relating to suicide in a serious, concerned and non-sensational way elicits further suicidal behaviour.
On the contrary; I believe it would help to reduce suicide mortality. Perpetuating the “code of silence” only helps suicide behaviour to increase; it certainly does not help reduce it.
Professor Diego De Leo, DSc, is the Director of the Australian Institute for Suicide Research and Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Griffith University.
References
(1) Pirkis J, Dare A, Blood W, et al. The Media Monitoring Project: Changes in media Reporting of suicide in Australia between 2000/01 and 2006/07. Crisis: The Journal of Crisis Intervention and Suicide Prevention 2009; 30: 25-33.
(2) Australian Senate Community Affairs References Committee. The hidden toll: suicide in Australia. Canberra; Commonwealth of Australia, June 2010.