When it comes to reporting on suicide, words matter.

Media reports of suicide can influence the contagion of suicidal behavior, particularly in vulnerable populations—a phenomenon known as the Werther Effect.

In the three months following the suicide death of actor and comedian Robin Williams in 2014, for example, there were 16% more suicides than anticipated. The greatest increase was in males over 30 who died by asphyxiation—echoing the circumstances of the 63-year old Williams’ death.

In recognition of the potential for harm, the World Health Organization and other advocacy groups have developed recommendations for reporting on suicide. These recommendations include:

• Minimizing the inclusion of harmful information—i.e. the method of death involved

• Avoiding glamorizing or sensationalizing the person who died

• Portraying suicide as a preventable (not inevitable) outcome

• Providing readers with resources for suicide prevention

Adherence to these recommendations (among others) has been shown to reduce suicide rates, decrease the use of highly lethal suicide methods and increase the use of support resources.

Yet until now, there has been no standardized tool for assessing how well these recommendations are being followed.

TEMPOS, the Tool for Evaluating Media Portrayals of Suicide, is a user-friendly, standardized rating scale to assess adherence to these recommendations—and track how adherence changes over time.

TEMPOS was developed by Chloe Chang Sorensen (then a student at Stanford University) along with a team of researchers and health experts from the Country of Santa Clara’s Suicide Prevention Program and the Stanford Department of Psychiatry and Behavioral Sciences.

Sorensen, now a clinical research coordinator for the Depression Clinical & Research Program at Massachusetts General Hospital, was the lead author of a recent paper in the International Journal of Environmental Research and Public Health that examined how TEMPOS performed in assessing a set of articles written about two high profile celebrity suicides.

TEMPOS in Action

Sorensen applied the TEMPOS criteria to 220 articles that were written after the suicide deaths of American fashion designer Kate Spade on June 5, 2018, and celebrity chef and television personality Anthony Bourdain on June 8, 2018. Each article was also independently rated by one of five secondary raters.

TEMPOS employs a three-point rating system to assess adherence to ten criteria for reporting on suicide. For each criterion, an article is awarded two points for full adherence, one point for partial adherence and zero points for non-adherence.

In their analysis, the team found that adherence levels varied significantly by criterion.

The articles had the greatest adherence to the recommendation advising against the glamorization of suicide, which suggests that very few media outlets portray suicide in a positive manner. The lowest level of adherence was to the recommendation that articles provide resources for suicide prevention and mental health support—which backs up previous findings that few articles about suicide provide resources to help readers.

“Overall, there was a high rate of agreement among the coders, suggesting the scale’s reliability, validity, and its utility as a tool for researchers, journalists and public health professionals engaged in suicide prevention,” the researchers write.

Moving forward, the team hopes public health and suicide prevention professionals can use data generated by TEMPOS to develop more targeted interventions when working with media partners.

For example, the County of Santa Clara’s Suicide Prevention Program plans to use TEMPOS to identify which local media outlets are most in need of training, as well as which specific reporting recommendations are most in need of promotion.

TEMPOS can also be used by editors and publishers to determine if there are specific sections or reporters within their organization that need training—and to measure the impact of that training.

When working on a story about suicide, reporters can use TEMPOS as a ‘self-check’ tool to understand how harmful or helpful their coverage is.

Limitations and Future Directions

The researchers acknowledge some limitations to TEMPOS. For one, it is not designed to assess posts on social media, which is the most common source of news media for young people aged 18-29. Adapting TEMPOS to be suitable for social media will be important for future work, they write.

It was also challenging to apply TEMPOS to every type of news article, they note. The scale was easier to apply about individual suicide deaths, but more challenging for articles that were more general in nature.

The scale also assigns equal weight to each of the ten criteria, though some recommendations may be more impactful than others. More research is needed to identify which criteria have the largest impact on suicide contagion.

A Personal Connection

The TEMPOS project has been a personal one for Sorensen. As a student at Henry M. Gunn High School in Palo Alto, California, she lost five peers to suicide. Due to the school’s location in a very affluent community next to Stanford and in the middle of Silicon Valley, the cluster of suicides attracted a lot of media attention.

“As a 15 or 16-year-old, I was focused on processing these tragedies and trying to move through these horrible losses, and to have all these journalists come to town and write these stories was a difficult experience,” she says. “The stories never really focused on what could be done to help.”

As an undergraduate at Stanford, Sorensen received a research grant to travel the country and talk to different journalists about how they cover suicide—conversations that led to the development of TEMPOS.

“We realized they were receptive to writing more productive pieces, we just have to give them the tools to do just that.”

Sorensen hopes TEMPOS will be a valuable tool for media professionals, prevention experts, and researchers alike. She is working with the Stanford Media and Mental Health Initiative to disseminate the tool and develop trainings for media partners.

You can find more information about TEMPOS, as well as an interactive web-based version of the tool, at: https://med.stanford.edu/psychiatry/special-initiatives/mediamh/tempos.html.

Suicide Prevention Resources

National Suicide Prevention Lifeline | 1-800-273-8255
NSPL is available 24/7 via phone and chat and has a dial prompt for the Veterans Crisis Line as well as a Spanish line.
National Suicide Prevention Lifeline 1-800-273-TALK (8255) | chat
Trevor Lifeline for LGBTQ Youth 1-866-488-7386 | text 678-678 | chat

About the Mass General Research Institute
Research at Massachusetts General Hospital is interwoven through more than 30 different departments, centers and institutes. Our research includes fundamental, lab-based science; clinical trials to test new drugs, devices and diagnostic tools; and community and population-based research to improve health outcomes across populations and eliminate disparities in care.
Support our Research