Nationally renowned youth suicide researcher Madelyn Gould traveled to Palo Alto this week to give a talk on the implications of community messaging around suicide contagion.
Gould, a professor of clinical epidemiology in psychiatry at Columbia University and the New York Psychiatric Institute, spoke Thursday morning to an audience of school district and city representatives, law enforcement, mental health professionals, high school students, parent leaders and members of the local faith and business communities gathered at the Palo Alto Medical Foundation, which hosted the event in partnership with youth well-being coalition Project Safety Net and the Palo Alto Police Department.
Gould's talk touched on many questions that have plagued the Palo Alto community over the last several years in the wake of two teenage suicide clusters. Are there suicide cluster-prone towns? Does the media play a role in triggering a cluster? What are the implications of community messaging during a contagion? How can a community shift its narratives around mental health?
Gould stressed that while the media plays a critical role and must provide both sensitive and educational coverage around suicide, changing the narrative in a community "requires everybody."
Community messaging, she said, will often "focus the implications for media reporting, but I think people often don't appreciate or forget or we don't think about that the messaging that everybody makes from students to suicide-prevention programs to parents … all our messaging needs to take into account the concerns that we have. It's not just the responsibility of the media. It really is everybody's responsibility."
Gould's research on the subject has included "psychological autopsies" of adolescent suicide clusters, during which she and other researchers compared communities where there was a death by suicide but not an ensuing cluster and communities where there was a cluster; the effect of a peer's suicide on fellow students; suicide postvention programs in schools; the effect of youth suicide screening programs; the effectiveness telephone crisis services; risk factors for teen suicide; and the effect of newspaper coverage on teen suicide, among other areas of study.
She has also consulted with Project Safety Net members "from afar" over the last few years to advise on suicide prevention efforts, she said.
On Thursday, Gould offered examples of the impact, both positive and negative, that community messaging from various sources can have. She cited a Facebook experiment in 2012 during which the social media site altered the number of positive and negative posts in the news feeds of 689,003 randomly selected users for one week. People who saw more positive posts, in turn, wrote more positive posts themselves and those who read more negative posts were more negative in their own posts, Gould said.
Gould also pointed to research around the role the media plays in youth suicide clusters. She cited studies that have found there is a greater increase in suicide when the frequency of news stories increase, when there's a higher proportion of the population exposed, when headlines are dramatic and when the prominence of a story increases, such as appearing on the front page of a newspaper. A 2014 study she co-authored analyzed newspaper coverage between 1988 and 1996 and found that "several story characteristics, including front-page placement, headlines containing the word suicide or a description of the method used, and detailed descriptions of the suicidal individual and act, appeared more often in stories published after the index cluster suicides than after non-cluster suicides," the study reads.
But a "converse effect exists also," Gould said Thursday. News stories that highlight positive stories, for example, of people who experienced suicidal ideation but found coping strategies or emphasize seeking help for mental health issues, have brought suicide rates down, she said. This is known as the "Papageno effect" media content that is associated with a decrease in suicide rates, so is viewed as "protective."
"We want to increase stories, definitely, that educate and shape attitudes and avoid misinformation," Gould said. "We want to decrease stories that promote contagion."
Gould also investigated the question, "Are there suicide cluster-prone communities?" With regard to demographic factors like ethnicity, population size, socioeconomic levels or levels of education, there are not, she said.
"The problem with suicide is it's so stigmatizing because if it was an earthquake or a flood then there's an outpouring of 'we have to support this community,'" Gould said. "It's suicide and all of a sudden it's like, 'Well, what's wrong with the community? It must be the schools.'
"There are lots of high-achieving schools all over this country," she added. "Blame the school and you're just going to reinforce the wrong … narrative."
Gould also urged the adults in the audience to harness students' frequent desire in the wake of a peer death by suicide to "do something" to work collaboratively on suicide prevention efforts.
Gunn High School senior Ridhaa Sachidanandan put a familiar question to Gould: How can Palo Alto dispel the stigmatized perception that mental illness is a "character flaw" to be hidden rather than talked about?
In response, Gould herself admitted that she struggled with postpartum depression after the birth of her first children.
"I think we have to start getting out of the closet when it comes to mental health issues," she said.