Viewport width =
silent killer
July 15, 2013 | by  | in Features |
Share on FacebookShare on Google+Pin on PinterestTweet about this on Twitter

Silent Killer

[Content note: The following article concerns suicide.]

In September 2011, Lydia Yurenko booked a one-way flight to Russia. She was living in London at the time, in a basement flat with my brother—her husband. She flew back to the city of her birth, St Petersburg, where her family lived. During the Soviet years, Lydia’s parents were doctors and had been justly rewarded with a fine home; however, post-Soviet Russia had been cruel. Lydia’s mother now lived alone in a small apartment. September is autumn-time in St Petersburg, and for a few days Lydia stayed with her mother as the leaves fell from the trees, welcoming the coming winter.

On September 23, Lydia’s mother left her apartment after an argument with her daughter. She arrived home later that day to find Lydia hanging in the doorway.

The last sentence of that paragraph may have come as a shock; something out of the ordinary, a strange tragedy perhaps. You could be forgiven for thinking such a scenario was rare—suicide is rarely talked about, and almost never mentioned in the media. The reality is that it is not. In New Zealand, someone commits suicide every 16 hours, on average. 11 people have died by their own hand since this time last week. By this time next week, another 11 will be dead. That’s a lecture theatre every nine months. For every two people who die in a car crash, three commit suicide. The media are open about the former; holiday road tolls are broadcast like sport scores, and new police initiatives are given airtime along with safe-driving advertising campaigns. Not suicide, though.

While not all deaths are investigated by the Coroner, every suicide is subject to a coroner’s inquiry. Coroners are lawyers or former judges, and are charged with establishing when, where, how and why a death happened. They also investigate whether action can be taken to prevent similar deaths, and make recommendations. When the Coroner releases their findings on a suicide, the media is heavily restricted in what they can publish by section 71 of the Coroners Act 2006. Generally, this is restricted to the person’s name, address, occupation, and the fact that the death was suicide. To publish anything else—the means, the motive, the outlines of the life left behind—is to break the law. Such restrictions serve as a safety mechanism, to isolate and minimise the coverage of such incidents so that negative outcomes—further suicides—are minimised. By international standards, our overall suicide rate is about average for OECD rates. It is also steady, at around 550 deaths per year, meaning that though things aren’t getting any worse, they’re not getting any better.

•••

Suicide does not exist in a vacuum. In early 2012 I flew to London and lived with my brother for a time, in the flat he and Lydia had shared. We travelled to Paris to speak to their friends, and to Berlin, where they had first met. It was a sort of post-mortem reconnaissance mission, aimed at understanding what had led to her death. Possibilities were discussed in the Soviet-era housing blocks of eastern Berlin where she had once lived and worked, stories were told over dinners in Paris where she’d holidayed, and her presence in the London museums she had worked at was as much an artifact as anything else on display. We talked, shared, cried, hurt, and healed. The subject was out in the open, part of a common consciousness which we didn’t shy or run from.

When reporting on suicide, the media follow a ‘code’, the terminology of which you are likely to have encountered: ‘no suspicious circumstances’, ‘no suspects’, ‘died suddenly’. These euphemisms tiptoe around reality, little white lies which are designed to minimise possible harms caused by careless suicide reporting. Fairfax Media, which owns The Dominion Post, The Press, and Stuff.co.nz, asks its reporters to “exercise care” when reporting suicide. This is in order that “journalists do not unwittingly encourage others to take their own lives”. In 1999, the Ministry of Health published guidelines for media in a two-page document entitled ‘Reporting Suicide: At a Glance Card’. These guidelines include representing suicide as “a poor choice”, avoiding romanticising suicide, minimising tributes, and acknowledging the person’s mental-health issues. The Ministry also recommended not placing suicide stories on the front page, avoiding repetitive coverage, and never reporting on the method used by the person. In 2011, the Ministry published a revised set of guidelines, entitled ‘Reporting Suicide: A resource for the media’. The 2011 iteration was developed by the Media Freedom Committee, Fairfax, TVNZ and Radio NZ, in conjunction with mental-health professionals. The new guidelines were seven times as long, but covered essentially the same material: the status quo was reinforced.

Media guidelines are important: the reporting and portrayal of suicide are factors which have the potential to increase rates of suicidal behaviour. As such, the media can help to prevent suicide by reporting in ways which decrease the risk of suicide for vulnerable people. This is supported by evidence-based research: in a 2003 paper, ‘Suicide and the Media’, author Madelyn Gould states it is “crucial for mental- and public-health professionals and the media to develop a partnership to enhance the effectiveness of the reporting of suicide, while minimizing the risk of imitative suicides.” Gould, an expert on the evaluation of suicide-prevention interventions, takes care to emphasise that the media has the ability to educate and change the attitudes of the public. The 11 years of relatively stagnant annual suicide rates between the 1999 media resource and its 2011 equivalent indicate that the attitudes and behaviours of the public can’t have changed enough. Upholding the status quo hasn’t changed anything for the worse, but equally, hasn’t changed anything for the better. Chief Coroner Judge Neil MacLean, speaking on suicide in 2012, stated that rates weren’t dropping despite resources like the Ministry of Health’s being provided and used. “I’m concerned we don’t seem to be making any impact, there’s no downward trend at all,” MacLean said.

Part of the problem here is the adherence to what the guidelines declare as best practice. Former Associate Minister of Health Peter Dunne told media in 2011 that guidelines on suicide reporting had to be media-owned, or risk redundancy: “There is no point having guidelines imposed from the outside that the media do not agree with, accept or use.” The guidelines were developed, agreed on, and accepted by the media, but this does not mean they are implemented uniformly—different media outlets’ own in-house guidelines differ, resulting in inconsistencies which devalue the guidelines themselves.

Media aren’t totally to blame for being at a loss about how to implement the guidelines, as even experts can’t agree on what constitutes ‘best-practice reporting’. Bay of Plenty Regional Coroner Wallace Bain, who favours a more liberal approach to reporting, blasted the guidelines after his inquiry into a cluster of five suicides in Kawerau in 2010 and 2011. When ruling on the Kawerau case in 2012, Bain stressed that the issues surrounding suicide reporting need to be urgently resolved: “coroners, the media, and communities of New Zealand [need] a clearer direction based on international best practice in suicide prevention as to publication and openness and the effects of suicidal behaviour.” In agreement are University of Otago academics Colin Gavaghan and Mike King, who explored the ethics of suicide reporting in a paper released in March. Gavaghan and King, like Bain, came to a liberal-leaning conclusion; that “when a suicide seems likely to cast light on a serious social or legal problem, or to inform an important policy debate, a coroner should be able to take that into consideration when deciding whether to allow reporting.” A counter to the liberal view is offered by the Prime Minister’s Chief Science Advisor Sir Peter Gluckman, who told a 2012 conference on Suicide Prevention that media reporting and coronial enquiries has the potential to make things worse.

What is clear is that the grey area in which New Zealand media currently operates (between expert’s opinions, and within the guidelines) isn’t making anything better, let alone more clear. Allowing the reporting of certain facts can, in some cases, paint half the picture. In a coroner’s decision released in 2009, the media were allowed to report on a suicide which took place at Christchurch Men’s Prison in 2005. Widely reported was the fact the man had access to razor blades, but media outlets could not report on what he did with them. The “clearer direction” Bain wishes for certainly didn’t point here.

•••

A Russian gravestone typically has a photo or engraving of the dead person’s face, on the stone. Before a gravestone is prepared, a temporary photo is placed at the grave. It’s a way of attaching an identity; of supplanting a person’s absence with their memory and paying respect. New Zealand’s protocols around suicide do close to the opposite: according to international research, sweeping suicide under the rug limits opportunities for prevention. If a death is not worth reporting, it can give the impression no one cares. This sends a dangerous message—a potentially deadly message—to those with suicidal tendencies.The less we utilise opportunities to talk about suicide constructively, the fewer opportunities we have to reach out to the vulnerable. If a tree falls in a forest and nobody hears it, how are the other trees going to cope when faced with a strong wind and weak roots?

One of Bain’s recommendations in his findings on the Kawerau suicides was for the Government to evaluate how recent changes to media guidelines have affected suicidal behaviours. Later that year, MacLean said New Zealand needed to “gently bring the issue of suicide from out of the shadows”. “Coroners have a responsibility to encourage the informed public discussion about how best to reduce the rate of suicide. To have that discussion we need up-to-date and complete information,” MacLean said. At the time these remarks were made, the Coroner had been releasing detailed statistics on suicide to the media for three years, a positive first step to greater information provision. Associate Minister of Health Peter Dunne, while supportive of the figures’ release, cautioned there were no “quick or easy fixes”.

In May this year, eight months on from MacLean’s statements, Dunne released the ‘New Zealand Suicide Prevention Action Plan 2013–2016’. It contained 30 points for suicide prevention across many spheres of society, and was the closest thing to a quick and easy fix to New Zealand’s suicide problem seen in some time. (To be fair, the plan built on previous initiatives and falls under the long-term fix, the ‘NZ Suicide Prevention Strategy 2006-2016’.) At the plan’s release, Dunne described the suicide rate as “unacceptably high” and as something that “must change”. Prime Minister John Key agreed: “it’s critically important that we pour more resources [into suicide prevention],” he said of the $25 million in spending to be delivered through the plan.

The ‘New Zealand Suicide Prevention Action Plan 2013–2016’ mentions the media only once. It aims to “provide good information to the media” by December 2014, by reorienting the current suicide-information service. Also covered by this directive are “whānau, families and friends of people at risk or people who have died”. If the media can shape and change attitudes and behaviour, it stands to reason that they are a more important part of suicide prevention than this plan would indicate. Squandering the ability to change attitudes and behaviours of the populace is as much a threat to suicide prevention as anything else.

•••

Three weeks ago, I was having coffee with a friend when she received a phone call from her mother informing her that her aunt had just committed suicide. As I offered my sympathies and put her in a taxi home, I reflected on the nearly two years that had passed since Lydia’s death. My brother still lives in their same London flat, visits the same friends they shared, and every so often returns to St Petersburg. I still think of Lydia often. Her mother still opens the front door to her apartment the same way she did on September 23, 2011. Life goes on; the status quo continues.

It’s often said that the status quo is not working, and when calls to this effect come from our chief coroner, there is only so long they can be ignored. Settling for a suicide rate that has stagnated is not good enough; we need to try something that will effect meaningful change to New Zealand’s silent killer—something that will make a difference to those 11 people each week. “Not talking about it, treating it as a taboo topic,” says MacLean, “hasn’t made any difference at all.”

——

Where to get help:

• If it’s an emergency and you feel you or someone else is at risk, call 111.

• Youthline: 0800 376 633

• Lifeline: 0800 543 354

• Depression Helpline: 0800 111 757

• What’s Up: 0800 942 8787 (noon to midnight)

Share on FacebookShare on Google+Pin on PinterestTweet about this on Twitter

About the Author ()

Comments are closed.

Recent posts

  1. An (im)possible dream: Living Wage for Vic Books
  2. Salient and VUW tussle over Official Information Act requests
  3. One Ocean
  4. Orphanage voluntourism a harmful exercise
  5. Interview with Grayson Gilmour
  6. Political Round Up
  7. A Town Like Alice — Nevil Shute
  8. Presidential Address
  9. Do You Ever Feel Like a Plastic Bag?
  10. Sport
1

Editor's Pick

In Which a Boy Leaves

: - SPONSORED - I’ve always been a fairly lucky kid. I essentially lucked out at birth, being born white, male, heterosexual, to a well off family. My life was never going to be particularly hard. And so my tale begins, with another stroke of sheer luck. After my girlfriend sugge