Suicide reporting guidelines for media save 139 Australian lives over five years
A new study from the Health Economics Group within the Monash School of Public Health and Preventive Medicine has highlighted the success of Australia’s suicide reporting guidelines for media, showing they avert on average 139 suicides over a five-year period, and deliver a 94 to 1 return on investment ratio.
Over 3,000 people are lost to suicide each year in Australia. Each death profoundly impacts families, friends, and communities.
The human and social impacts of suicide are accompanied by substantial economic costs, through medical and productivity costs, but also the broader costs of pain and suffering experienced by those who have lost a loved one. Recent economic appraisal put the cost of death and disability from suicide and self- harm in Australia at A$30.5 billion per year, supporting the urgent need for effective and cost-effective suicide prevention efforts.
Guidelines that enable responsible media reporting of suicide are typically incorporated in national suicide prevention strategies. Here in Australia, the Department of Health has funded Everymind© to develop and implement the Mindframe initiative, providing media professionals and stakeholders with evidence-based guidelines for the responsible reporting of suicide, the safe portrayal of mental illness, and communication around drug and alcohol use.
Dr Long Le was senior author on a review of the guidelines, published recently in Suicide and Life-threatening Behavior. He says, “Australia has been very proactive and progressive in this space. We’ve had some form of these guidelines for more than two decades now, that encourage reporters to reduce the prominence of reports of suicide, avoid sensationalist language, refrain from providing specific detail about methods used, and encourage sign-posting to support services.
“There is considerable evidence for copy-cat suicide attempts. Suicide reporting guidelines are borne from a desire to reduce this, and there is now good evidence for improvement in Australia’s quality of reporting around the topic, and some evidence – albeit limited and from overseas – that such reporting is linked with a reduction in similar suicides.”
In addition to understanding the effectiveness of suicide prevention interventions, evidence-based public health is also focused on the cost-effectiveness of such interventions. Scarcity of resource and funding is a common theme considered by policymakers who must understand the overall value of such initiatives. Economic evaluation involves a comparative analysis of both costs and consequences of alternative courses of action to generate evidence-based information and support resource allocation decisions.
The Australian Government therefore funded this current investigation through the National Suicide Prevention Leadership and Support Program.
Until now, a single investigation from 2011 remained the only cost-analysis to have been undertaken in Australia on this subject. Led by the current Head of the Health Economics Group, Professor Cathy Mihalopoulos, the study concluded that very few suicides would need to be averted to make Mindframe cost-effective. At the time of her evaluation, very limited data was available to be incorporated, so more detailed conclusions weren’t possible. Over the intervening decade, mental health and suicide prevention have enjoyed greater focus from researchers and policy-makers.
Dr Long says, “The increased interest in this area, and more readily accessible data makes it a great time to re-visit, and see what more we can find.
“Only a few studies have evaluated reductions in suicide following the implementation of guidelines; therefore, we extrapolated from studies of increases in suicides following the kind of reporting that Mindframe is designed to avert. Given the prominent media coverage they elicit, we used suicides by well-known celebrities as datapoints in our analysis.”
To establish the effectiveness of Mindframe in reducing copy-cat suicides, the researchers incorporated 20 studies that investigated the association between media reporting of celebrity suicides and subsequent suicides in the general population. The pooled estimate from this meta- analysis suggested a 13 per cent relative increase in suicide risk in the 28-day period after media coverage. The researchers developed their economic model based on a conservative assumption of one celebrity suicide per year (based on unpublished data).
To estimate the financial costs of suicides, the researchers used two methods: the value of a statistical life - an estimate of the value society places on reducing the risk of dying, worth around A$4.5 million for a healthy person living for another 40 years – and the average total cost caused by a single suicide, A$806,545 for males and A$421,123 for females as estimated in a KPMG report from 2018.
Finally, they estimated the costs of delivering the Mindframe program, including staffing costs, and costs associated with guideline reviews, training content updates and delivery of guidelines. Over a five-year period, these were estimated at A$6.3M
The team’s economic modelling showed a corresponding monetary cost savings from suicide reduction of A$596M over the same timeframe, yielding a return on investment ratio of 94:1. Their secondary analysis revealed that the guidelines were associated with a reduction of 139 suicides and a gain of 107 quality-adjusted life years over a five-year period.
“I think this really shows that these guidelines deliver huge value to Australian society, and should continue to play an important role in our national suicide prevention strategy. 139 lives saved across five years is an incredible achievement for the individuals and families involved, and to society more broadly, as we benefit from the contributions that those 139 people can now make to their communities, throughout their lives.”
If you need help in a crisis, call Lifeline on 13 11 14. For further information about depression contact Beyond Blue on 1300 224 636 or talk to your GP, local health professional or someone you trust.
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