"Hanged." The front page of the New York Daily News said it all in one word on August 13, 2014. Above the capital letters, which filled nearly a third of the page, was a photo of comedian Robin Williams with a somber expression, dead at age 63.
The headline, unfortunately, contravened the most basic recommendations of the World Health Organization and suicide prevention experts for how the media should cover suicide, including "toning down" accounts, to avoid inspiring similar deaths.
News of Williams' death appears to be associated with a nearly 10 percent rise in the number of suicides in the United States in the five months that followed, according to a study published Wednesday in the journal PLOS ONE. That increase was especially large among men ages 30 to 44, whose suicide rate rose almost 13 percent. Even more significant was a 32.3 percent spike in the number of suicides by suffocation, which is how Williams died.
"The effect you see . . . is so dramatic, you don't even need statistics to see it," said lead author David S. Fink, referring to a graph comparing suicides in the five months after Williams' death with the same five months the previous year. "That's very rare to see an effect so big you just need the statistics to confirm it. You can see it with the naked eye."
Analyzing monthly mortality statistics from the Centers for Disease Control and Prevention, researchers at Columbia University estimated that the number of suicides from August to December 2014 should have been 16 849. Instead, the number was 18 690, representing an additional 1 841 cases. Fink and his colleagues based their figures not on averages, but on long-term trends, which they said was a more accurate method of measurement.
Few studies of the effects of celebrity suicides on the U.S. population have been undertaken over the years, Fink said. The most recent case was musician Kurt Cobain, who died in 1994, and before that, Marilyn Monroe in 1962. Although Cobain's death was not marked by an increase in suicide, at least in the Seattle area where the rock star made his home, Monroe's death, which was widely reported at the time as a suicide, was followed by a 10 percent to 12 percent increase in suicides in the general public. The difference, Fink said, probably is a result of the media being more circumspect in holding back the details of Cobain's death.
Lahrs Mehlum, the director of Norway's Centre for Suicide Prevention, told The Washington Post by email that the authors of the study "used reasonably good methods," and that there was "every reason to believe that the reported increase is a real one."
"Sadly, there were all too many examples of unfortunate presentations of the case of Robin Williams' suicide," Mehlum said. "Many journalists failed to mention the huge health problems Williams struggled with (both mentally and physically), but rather portrayed a glorified version of the event. This is not according to international guidelines for media reporting of suicide.
"Another breach of these guidelines was the explicit reporting of the suicide method. The problem of these ways of reporting a suicide in the case of a celebrity is, of course, the real danger of copycat suicides, and this seems to be confirmed through this study."
The phenomenon of "suicide contagion" or "copycat" suicides, is not new. Scientists often refer to it as the "Werther effect," referring to the 1774 novel "The Sorrows of Young Werther" by German author Johann Wolfgang von Goethe. After publication of the book, whose lovelorn protagonist takes his own life, there occurred an extraordinary outbreak of similar suicides all over Europe. This was especially true of young men about the same age as Werther, and whose bodies were often found dressed in the same clothes the fictional Werther was wearing at the time of his death.
Fink knows there is no easy solution to the problem, especially in the wake of a celebrity suicide.
"In curbing this phenomenon, the most difficult part is the confluence of factors," Fink said. "There are so many little pieces. [For instance] we know there's an environmental component that's going to affect them. So how to create a healthy environment is important. And right now the media reporting guidelines are rarely followed in the United States."
For more information on suicide prevention, or to seek help:
Please contact the South African Depression and Anxiety Group (Sadag) on 0800 567 567.