Systematic comparison of recommendations for safe messaging about suicide in public communications

Background The diversity of guidelines for safe public messaging about suicide and the heterogeneous scientific research on the topic warrants comparisons of guidelines and analysis of the relevance of research findings to determine best practices. Methods We searched databases and websites for organizations’ guidelines concerning safe public messaging on suicide, and relevant research articles. Results We identified 24 public messaging guidelines, 11 terminology guidelines and 44 research papers. No recommendations were in all guidelines, with more agreement on what not to do than on what to do. Recommendations in over half of guidelines are: avoid glorifying suicide, do not describe suicide methods, don't say suicide in inexplicable or explain simplistically, do not state that suicide is frequent in specific circumstances, encourage help seeking. There were disagreements on including personal details about people who died by suicide, and agreement to avoid: “committed suicide,” “completed suicide,” “successful suicide,” “failed suicide/attempt” “unsuccessful suicide/attempt”. Only “died by suicide” was recommended by a majority. Some recommended and some said to avoid: “Suicide attempt,” “attempt to end his life,” “attempted suicide,” “non-fatal attempt at suicide,” “unintentional (death),” “intentional self-harm,” “suicidal ideation,” “completed suicide,” “survivor,” “suicide loss survivor.” Research papers had a wide range of objectives, methodologies, media studied and target populations. None provided empirical data that could help support or refute any recommendations. Limitations Lack of justifications for guidelines and scarce relevant research makes validation of recommendations challenging. Conclusions Research is needed to validate recommendations and terminology and develop consensus on guidelines for public messages, and determine if media guidelines for reporting on suicide are relevant for public messaging who's goal is to inform and educate rather than report news.