Pushing past the stigma: Lessons from covering suicide and suicidal behaviors
(Photograph by Julien James/The New York Times)
Earlier this year, when I was reporting on the number of young children ending up in the emergency room because of a mental health crisis, I did not have much difficulty connecting with families. Interestingly, everyone who agreed to talk was white. They were either keen to reduce the stigma associated with mental illness or did not consider it a shameful subject.
When examining Black youth suicide for my National Fellowship project, however, the deep stigmas toward mental illness in the Black community not only became a reporting challenge but also a crucial part of the story.
“Black families don’t typically have literacy in discussing ‘feelings’ with each other,” said Dr. Kali D. Cyrus, a psychiatrist at Sibley Memorial Hospital in Washington, D.C., who is Black. “There is also the strong value of ‘keeping your business out of the street.’”
I felt driven to pursue this topic in part because of several unsettling statistics that had surfaced about racial disparities in suicide and suicidal behavior. Particularly concerning: Self-reported suicide attempts among Black teenagers had increased nearly 80% over nearly three decades — more than any other racial or ethnic group. In addition, the suicide rate among young Black children ages 5 to 12 was found to be nearly twice that of white children in the same age group.
What was going on?
My search for answers led me to more than a dozen experts across the country, and hours upon hours of interviews. But after speaking with researchers and leaders in the suicide prevention community, I became accustomed to being continually told that no, the families they knew would not speak with me, not even anonymously.
I could have stopped there and done what so many other journalists have done when covering this topic: included quotes from experts, discussed the statistics and left it at that. But I wanted the voices of Black youths to be represented. I wanted them to be part of the conversation, especially because some of the research suggested Black youths may have unique risk factors for self-harm. What were the specific problems they had faced? How did they seek help, if at all?
At one point I spoke with a parent and community advocate who knew a lot of families in the Boston area. She wanted to know: Would the people I interviewed be compensated financially? What was in it for them?
It was a great question. Why would anyone want to speak about this, much less with a reporter?
I explained that The New York Times does not pay its sources, but some people are motivated to speak about difficult issues for altruistic reasons — to help others feel less alone, for example. We also talked about why the story was important, and the care I was taking to get it right. Then I made time to answer every question she had. It felt at times as though I was the one being interviewed. She needed to know that I could be trusted.
After our conversation, I wasn’t sure if I would hear from her again. Then, 10 days later, I received a text message. “I have someone willing to speak to you. Is it too late?” Soon after she said she had found someone else as well. I texted both people, but only one responded. And this was how I came to speak with the young man we identified as Joe (a middle name), who I featured at the top of the article.
At the same time, I was contacting various people in Cleveland, where suicide attempts among high school students were almost two times higher than the national average. Eventually, I connected with the teenager who we refer to in the piece as Denise (also a middle name).
Finally, I spoke with people who regularly educate others about suicide prevention, like Jordan Burnham, who responded to me over Twitter, and Kathy Williams, who was introduced to me by someone I had interviewed in the past.
Just as it was important to include their stories, it was equally important to make sure that I did not write about them in a way that would result in any additional harm. I relied on the American Foundation for Suicide Prevention (AFSP), which has an excellent media toolkit, and guidance from the Department of Health and Human Services.
The AFSP warned against using the word “commit” as in “she committed suicide,” because the language might imply that a crime has been committed. It also assigns blame. Instead, the organization says, it’s best to say someone died by suicide or took their own life.
HHS points out that suicide is the result of many complex factors, “therefore media coverage should not report oversimplified explanations such as recent negative life events or acute stressors.” In other words, don’t suggest that someone’s divorce, or any single life event, “caused” them to end their life.
Other advice: Media reports should not share detailed descriptions of the method used or graphic details about how someone died. This has been shown to cause contagion, a phenomenon that occurs when exposure to suicide or suicidal behaviors through media reports (or within a family or peer group) can result in an increase in suicide and suicidal behaviors.
And always provide helpline information somewhere in your story, specifically the National Suicide Prevention Lifeline and the Crisis Text Line.
Finally, the A.F.S.P. urges reporters to convey that suicide is preventable.
This last one was a priority of mine. Because, although each of my subjects’ stories were heartbreaking, I recognized that they also offered hope. They showed that there was no shame in getting help or talking honestly about mental health. In fact, doing so only changed their lives for the better.