Mental health Sunnybrook Magazine - Spring 2018

The media could have a role to play in suicide prevention. Here’s how

Mother and daughter talking

For Dr. Mark Sinyor, a crucial part of suicide prevention has to do with communication.

“We are trying to find ways of getting the truth out,” he says, “rather than the many misconceptions about suicide that have been perpetuated for a very long time. People want to understand suicide and what is to ‘blame,’ but we need to resist simplistic answers like the historical notion that suicide is the result of a single life stressor. Unfortunately, suicide is sometimes depicted as an inevitable outcome, with a de-emphasis on the role of treatable mental disorders. But none of this is the case at all.”

A staff psychiatrist with Sunnybrook’s Department of Psychiatry, Dr. Sinyor points out that people with mood disorders – depression and bipolar disorder – account for more than 50 per cent of all suicide deaths.

“There is no reason that anyone needs to die from suicide,” he says. “Suicidal crises are often fleeting and there are many ways in which we can intervene to help people through them. In virtually all cases, they are accompanied by a treatable mental disorder. Every suicide death is a tragic missed opportunity for someone to have gotten help.”

Timely care for the underlying disorder can be the key to preventing most of these tragedies.

“There is no reason that anyone needs to die from suicide.”

– Dr. Mark Sinyor, psychiatrist

Colin is one of Dr. Sinyor’s patients – and a case in point. For years, Colin’s bipolar condition remained undiagnosed. To all outward appearances, he appeared to be doing fine.

“Life is not only what happens on the outside,” says Colin, 29. “I was in pain all the time. I didn’t tell anyone at first that I was suicidal. I put on a good face, but I was crying when I was alone.”

After several suicide attempts, visits to multiple psychiatrists and a variety of medications, a friend’s intervention led Colin to Sunnybrook and a course of treatment under Dr. Sinyor’s supervision.

“I owe Sunnybrook my life,” says Colin.

That was over two years ago. Colin has since gotten married and now works at a job that he finds satisfying. He wants nothing more than to “stay like this – stable,” he says. “I know it’s going to be a struggle, but I’m surrounded by good people. I’m a lucky guy.”

His message to others like himself? “Reach out for help. Just do it.”

The stigma of mental illness continues to hinder treatment, which motivated philanthropists Glenn and Stacey Murphy of Toronto to donate $10-million to create the Murphy Family Centre for Mental Health at Sunnybrook. This new state-of-the-art inpatient facility will treat those with severe mental illness, including patients like Colin with mood and anxiety disorders. It will use a collaborative approach that frames mental illness as a disease like any other to reduce stigma and encourage treatment.

Colin’s case is the type of positive story Dr. Sinyor would like to see highlighted more often in the press. A scientist with the Hurvitz Brain Sciences Program at Sunnybrook, Dr. Sinyor cites research showing that the way the news media reports on the topic may significantly affect rates of suicide – and attempted suicide – in wider society.

“Suicide contagion” is a very real phenomenon. “When news reports are published emphasizing suicide methods or the inevitability of suicide, sadly, we see more suicide deaths,” Dr. Sinyor explains. “But the opposite is also true – resilience is also contagious. Research from Europe shows that when the media broadcasts stories like Colin’s, you see fewer suicide deaths afterwards.”

He notes that people are apt to identify with people depicted in the media they consume. “It is a fact that too many people still do die by suicide, but far more find ways to overcome it, and if you only publish stories about deaths, you’re sending a skewed picture to everybody – and a potentially dangerous picture. Our goal is to help shift things in a positive direction.”

Dr. Sinyor is currently creating a structure for collaboration between mental health professionals and journalists to better “inform the public in a way that sends accurate messages,” he says. “We’re not trying to censor journalists or tell them how to do their job,” notes Dr. Sinyor, who is the lead author on the Canadian Psychiatric Association’s updated media guidelines on suicide reporting. “Journalists need to be independent.”

Still, he believes more effort could be made to “create context” when reporting on suicide and to convey the key truths on the issue – that suicide is preventable, that there are other means of coping with life’s stresses, and that the vast majority of people who have suicidal thoughts never follow through. In short, suicide is not inevitable even when life appears hopeless.

“Journalists have a lot of power to influence the way people think and, to an extent, behave,” he says. “They need to exert that power in a way that’s safe and helpful. We are just trying to be a resource that they can call on for guidance.”

Ultimately, Dr. Sinyor would like his message to be a positive one. He points out that suicide rates in Toronto and in most westernized countries – the U.S. is the exception – have declined significantly in recent years.

“People are more willing to seek help,” he says, “and resources are increasing. It’s not all doom and gloom and people need to understand that. We’re making a dent. We need to decrease the stigma of these disorders, increase people’s ability to seek help, and send the message that there is hope.”

Preventing tragedies with better access to care

Often with young suicides, there is a rush in the media to identify a “cause,” such as bullying. Sunnybrook researchers, however, are confirming that the narrative is much more complex.

According to Dr. Mark Sinyor – lead author of a 2014 study of bullying as a contributing factor in youth suicide in Toronto – it’s a “myth” that youth suicides are caused by one specific event or setback in a young person’s life.

“Bullying by itself does not kill teens – full stop,” he says. The study found that mental illness is “a significant contributor” to youth suicide, often in combination with psychosocial stressors like bullying or substance abuse. Bullying was in fact relatively low (6.4 per cent) on the scale of stressors identified as affecting the 94 youth suicides included in the study, compared to depression in 40 per cent of the cases, or conflict with parents (21.3 per cent).

Noting the crucial importance of social contagion in impressionable young people, Dr. Sinyor cites another study, conducted at the University of Ottawa and published in 2013. In examining the association between exposure to suicide in a classmate and suicidality outcomes in youth, the study showed that if a teenager learned of another teen’s suicide, the risk of thinking about or even attempting to take one’s own life was two to six times higher, even if the teen did not personally know the victim. Simply knowing that someone else in their peer group had died conferred a risk.

However, the factors leading to these tragic events should not be oversimplified, Dr. Sinyor advises.

“Suicide is complicated and the stressors that often contribute in youth – such as romantic breakups, problems at school, problems with the law and bullying – all have in common that they can cause youth to feel a deep sense of shame and a disconnect from others,” Dr. Sinyor says. “All youth will experience some of these problems at some point and will have to cope with the distress that they cause. So, the focus shouldn’t be on eliminating distress but on teaching resilience. We need to message resilience rather than hopelessness.

“We need to send a message to youth that they can overcome stress with the appropriate tools, and we need to provide resources – including timely access to mental health care – to those who are struggling.”

About the author


Donna Yawching