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Figure 1.
Reporting Guideline Adherence Scores for Select US Newspapers Covering the Deaths of Spade and Bourdain
Reporting Guideline Adherence Scores for Select US Newspapers Covering the Deaths of Spade and Bourdain

Scores could range from 0 to 14; a score of 12 or higher was set as the threshold for high fidelity. A paired t test for differences revealed significantly higher mean (SD) adherence scores for newspaper reporting on the suicide death of Anthony Bourdain compared with reporting on the suicide death of Kate Spade (8.0 [1.4] vs 6.8 [1.1]; mean difference = 1.2; 95% CI, 0.14-2.26; t9 = 2.57; P = .03).

aNational newspaper.

Figure 2.
Percentage of Select US Newspapers Adhering to Specific Suicide Reporting Guidelines
Percentage of Select US Newspapers Adhering to Specific Suicide Reporting Guidelines

Guideline adherence was assessed using 14 items derived from recommended reporting guidelines on suicide. Each guideline was coded 1 for yes or 0 for no for the presence of each guideline.

1.
Stack  S.  Suicide in the media: a quantitative review of studies based on non-fictional stories.  Suicide Life Threat Behav. 2005;35(2):121-133. doi:10.1521/suli.35.2.121.62877PubMedGoogle ScholarCrossref
2.
Reporting on Suicide. Recommendations for reporting on suicide. http://afsp.org/wp-content/uploads/2016/01/recommendations.pdf. Accessed November 1, 2018.
3.
Tatum  PT, Canetto  SS, Slater  MD.  Suicide coverage in U.S. newspapers following the publication of the media guidelines.  Suicide Life Threat Behav. 2010;40(5):524-534. doi:10.1521/suli.2010.40.5.524PubMedGoogle ScholarCrossref
4.
Life Voice Canada. Irresponsible media reporting of Kate Spade's suicide. https://www.lifevoice.ca/mental-health-consultation-services/irresponsible-media-reporting-of-kate-spades-suicide. Accessed May 5, 2019.
5.
Agility PR Solutions. Top 15 U.S. newspapers by circulation. https://www.agilitypr.com/resources/top-media-outlets/top-15-daily-american-newspapers/. Accessed March 5, 2019.
6.
Creed  M, Whitley  R.  Assessing fidelity to suicide reporting guidelines in Canadian news media: the death of Robin Williams.  Can J Psychiatry. 2017;62(5):313-317. doi:10.1177/0706743715621255PubMedGoogle ScholarCrossref
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    1 Comment for this article
    Reporting of tragedies
    Frederick Rivara, MD, MPH | University of Washington
    Suicides of celebrities are important because of the increase number of suicides that occur following their deaths. How the media reports these deaths is potentially important in influencing the risk of subsequent suicides. While reporters may disagree with the specific criteria examined in this article, no one can disagree that responsible reporting in the media is critical.
    CONFLICT OF INTEREST: Editor in Chief, JAMA Network Open
    Research Letter
    Public Health
    November 1, 2019

    Newspaper Adherence to Media Reporting Guidelines for the Suicide Deaths of Kate Spade and Anthony Bourdain

    Author Affiliations
    • 1Department of Pediatrics, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus
    • 2Center for Innovation in Pediatric Practice, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio
    • 3School of Social Work, Loyola University Chicago, Chicago, Illinois
    • 4E.W. Scripps School of Journalism, Ohio University, Athens
    • 5Center for Biobehavioral Health, Nationwide Children’s Hospital, Columbus, Ohio
    • 6Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus
    • 7Department of Behavioral Health, Nationwide Children’s Hospital, Columbus, Ohio
    JAMA Netw Open. 2019;2(11):e1914517. doi:10.1001/jamanetworkopen.2019.14517
    Introduction

    News media coverage of suicide is associated with an increased risk of subsequent suicides, with the strongest associations following newspaper reporting of celebrity suicides.1 To reduce these adverse effects, media guidelines were established for reporting on suicide in 20012; however, adherence varies, and research shows many media outlets are unaware that such guidelines exist.3

    On June 5, 2018, Kate Spade died by suicide, and on June 8, 2018, Anthony Bourdain died by suicide. These events provided an opportunity to examine newspaper adherence to reporting guidelines. Because much criticism followed the reporting on Spade’s death,4 we hypothesized that the reporting on Bourdain’s death would be more guideline adherent.

    Methods

    Newspapers were selected based on US geographic regions and daily circulation data.5 All 4 US regions (ie, Northeast, South, Midwest, and West) were represented, with no more than 2 newspapers from the same city. The 10 print newspapers included 3 national and 7 regional newspapers (Figure 1), all with a minimum circulation of 200 000.5 Articles about Spade and Bourdain were obtained for June 6, 2018, and June 9, 2018, respectively; June 11, 2018, was used for Bourdain’s death for USA Today because this newspaper publishes on weekdays only.

    Three of us (J.B.S., N.Y., and J.P.A.) evaluated each article to determine adherence to reporting guidelines. Newspaper names were removed to eliminate potential bias. However, headlines, pictures and captions, and location in the newspaper were provided. Each reviewer received articles in a randomized order to avoid order effects.

    Adherence was assessed using 14 variables derived from recommendations from Reporting on Suicide and the American Foundation for Suicide Prevention.2 Final consensus occurred via conference call. Interrater agreement averaged across the individual guidelines prior to consensus was deemed excellent (Cohen κ = 0.893; range, 0.705-1.000). Adherence was calculated for each article, with scores of at least 12 (indicating ≥80% adherence) set as the high-fidelity threshold, per the approach of Creed and Whitley.6

    A paired t test was conducted to compare adherence scores for reporting on both deaths. Statistical significance was set at P < .05, and all tests were 2-tailed. Statistical analysis was conducted with SPSS statistical software version 25 (IBM Corp). This study complied with Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline for cross-sectional studies. The study was not considered human subjects research according to the review policy of The Abigail Wexner Research Institute at Nationwide Children’s Hospital institutional review board.

    Results

    Figure 1 displays the guideline adherence scores of each newspaper. Overall, newspapers adhered to a mean (SD) of 7.4 (1.4) of 14 specific guidelines; none reached the threshold for high fidelity. A paired t test revealed a higher mean (SD) score for reporting on Bourdain’s death compared with Spade’s death (8.0 [1.4] vs 6.8 [1.1]; mean difference = 1.2; 95% CI, 0.14-2.26; t9 = 2.57; P = .03); this difference was associated with changes in scores for 5 of 10 newspapers.

    Regarding individual guidelines, Figure 2 shows only 2 of 14 guidelines were adhered to by all 10 newspapers for both deaths. Notably, 6 guidelines were followed by less than one-third of newspapers, and 2 were not adhered to by any newspaper.

    Discussion

    None of the 10 newspapers reviewed met the adherence threshold for high fidelity, highlighting widespread opportunities for improvement. As hypothesized, reporting on Bourdain’s suicide was more guideline adherent than reporting on Spade’s death. This suggests newspaper reporting on Bourdain’s suicide may have been influenced by the extensive criticism of the reporting on Spade’s suicide. Although most newspapers adhered to less than 50% of individual guidelines, our finding that 6 of 14 guidelines were followed rarely or never is concerning.

    This study has limitations, including a focus on print rather than online newspaper articles and the selection of newspapers from large markets only. Also, we were unable to test for differences in adherence between national and regional newspapers.

    In April 2014, Canadian journalists, the Mental Health Commission, and broadcasting corporations collaborated to establish reporting guidelines for suicide and create checklists for journalists to promote adherence.6 This resulted in increased adherence in the reporting on Robin Williams’s suicide in August 2014 (ie, 85% of articles had ≥70% adherence; 55% of articles had ≥80% adherence).6 A collaboration between US media staff, governmental agencies, and other stakeholders when updating and disseminating the recommended reporting guidelines for suicide may increase adherence, which in turn might reduce preventable harm.

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    Article Information

    Accepted for Publication: September 15, 2019.

    Published: November 1, 2019. doi:10.1001/jamanetworkopen.2019.14517

    Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2019 Sheftall AH et al. JAMA Network Open.

    Corresponding Author: Arielle H. Sheftall, PhD, Center for Innovation in Pediatric Practice, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, 700 Children’s Dr, Columbus, OH 43205 (arielle.sheftall@nationwidechildrens.org).

    Author Contributions: Dr Sheftall had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

    Concept and design: Sheftall, Young, Ackerman.

    Acquisition, analysis, or interpretation of data: All authors.

    Drafting of the manuscript: Sheftall, Tissue, Schlagbaum, Ackerman.

    Critical revision of the manuscript for important intellectual content: Sheftall, Singer, Young, Stevens, Ackerman.

    Statistical analysis: Sheftall, Schlagbaum.

    Obtained funding: Sheftall.

    Administrative, technical, or material support: Sheftall, Tissue, Schlagbaum, Young, Ackerman.

    Supervision: Sheftall, Ackerman.

    Conflict of Interest Disclosures: Ms Young reported receiving grants from Nationwide Children’s Hospital outside the submitted work, being an active member of the Society of Professional Journalists, using her association with the Society of Professional Journalists to find audiences to teach the curriculum about reporting on suicide developed with the Nationwide Children’s Hospital, and receiving travel compensation from sponsoring campus chapters of the Society of Professional Journalists. No other disclosures were reported.

    Additional Contributions: Jeffrey A. Bridge, PhD (The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio), contributed to the concept, design, and oversight of the study, supported with statistical analysis, and assisted with critical revision of the article. He did not receive compensation for his contribution.

    References
    1.
    Stack  S.  Suicide in the media: a quantitative review of studies based on non-fictional stories.  Suicide Life Threat Behav. 2005;35(2):121-133. doi:10.1521/suli.35.2.121.62877PubMedGoogle ScholarCrossref
    2.
    Reporting on Suicide. Recommendations for reporting on suicide. http://afsp.org/wp-content/uploads/2016/01/recommendations.pdf. Accessed November 1, 2018.
    3.
    Tatum  PT, Canetto  SS, Slater  MD.  Suicide coverage in U.S. newspapers following the publication of the media guidelines.  Suicide Life Threat Behav. 2010;40(5):524-534. doi:10.1521/suli.2010.40.5.524PubMedGoogle ScholarCrossref
    4.
    Life Voice Canada. Irresponsible media reporting of Kate Spade's suicide. https://www.lifevoice.ca/mental-health-consultation-services/irresponsible-media-reporting-of-kate-spades-suicide. Accessed May 5, 2019.
    5.
    Agility PR Solutions. Top 15 U.S. newspapers by circulation. https://www.agilitypr.com/resources/top-media-outlets/top-15-daily-american-newspapers/. Accessed March 5, 2019.
    6.
    Creed  M, Whitley  R.  Assessing fidelity to suicide reporting guidelines in Canadian news media: the death of Robin Williams.  Can J Psychiatry. 2017;62(5):313-317. doi:10.1177/0706743715621255PubMedGoogle ScholarCrossref
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