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Postvention Strategies



    
    

    "Postvention" is the term used to refer to intervention after a suicide has occurred. Family and friends of the suicide victim may be at increased risk of suicide themselves. Postvention strategies are designed to help prevent further suicides and suicide "clusters" of friends and relatives. "Suicide clusters are groups of suicides occurring closer in space and time than would normally be expected. Such clusters occur predominately among adolescents and young adults." (CDC, 1992) These programs are implemented "to help youth effectively cope with feelings of loss that come with the sudden death or suicide of a peer." (CDC, 1992)



    School Crisis Response Team. The program aimed at postvention used by the Edina (Minnesota) Public Schools recommends that the school district take several steps regarding the death of any student. The procedure calls for the "notification of superintendent, all building principals, Crisis Intervention Steering Committee, Crisis Teams, and school staff in building." (Peterson, et al., 1993) The school principal decides on the media procedure. An early morning meeting and an afternoon follow-up meeting are held with the staff on the first day following the suicide. At these meetings the principal reviews the facts of the suicide to dispel any rumors. Possible student reactions, the role of the team, availability for support, and referral processes are all discussed. A room is made available for students to come to talk and outside experts may be called to counsel students and staff.



    Follow-up procedures include monitoring of high-risk students. "Teachers are informed of funeral arrangements [and] memorial requests are reviewed for appropriateness." (Peterson, et al., 1993) Crisis teams meet regularly following a crisis to consult and reassess actions that have been taken.



    Suicide Postvention Project. The Piscataway, New Jersey, postvention program provides crisis intervention to survivors of the suicide (close friends, students, teachers, and other school personnel), social service agency staff who work with youth, family members, and media personnel in the aftermath of a suicide. These services are a series of interventions designed to help all involved, including the community at large, to effectively cope with suicide. Human service agency personnel work with school staff in identifying suicidal youth and the risk for contagion. "Media personnel receive consultation on how to report the suicide story in a responsible fashion, thereby reducing the risk for copycat or cluster suicides." (CDC, 1992)



    Media Reporting. In November 1989, a national workshop "was held to address general concerns about, and specific recommendations for, reducing the possibility of media-related suicide contagion." (MMWR, 1994) One risk factor identified from research is suicide contagion, which is a process by which exposure to suicide or suicidal behavior influences other to commit suicide. The effect of contagion seems to be strongest among adolescents. These findings have caused suicide-prevention specialists to limit the reporting of suicide, especially youth suicide.



    Suicidologists, public health officials, researchers, psychiatrists, and psychologists worked with news media professionals at the 1989 workshop to share their concerns about the ways in which suicide could be responsibly reported. They explored "ways in which suicide, especially suicide among persons 15-24 years of age, could be reported with minimal potential for suicide contagion and without compromising the independence or professional integrity of news media professionals." (MMWR, 1994)



    A set of general concerns about and recommendations for reducing the possibility of media-related suicide contagion, developed by the national workshop, includes the following:

    Some characteristics of news coverage of suicide may contribute to contagion, and other characteristics may help prevent suicide. Clinicians and researchers acknowledge that it is not news coverage of suicide per se, but certain types of news coverage, that promote contagion. Persons concerned with preventing suicide contagion should be aware that certain characteristics of news coverage, rather than news coverage itself, should be avoided. (MMWR, 1994)


    Those participating in the workshop agreed that to reduce the likelihood of suicide contagion, reporting should be concise and factual.



    Workshop participants believed that certain actions in the reporting of suicide may increase the likelihood of contagion. Among characteristics of reports that may increase the likelihood is the presenting of simplistic explanations for suicide. The media should explain that the final precipitating event was not the only cause of a suicide. Enumerating all the problems that may have played a role in a suicide is not necessary, but acknowledgment of possible causative problems is recommended.



    A preoccupation with suicide may be promoted by repetitive or prominent coverage, especially among persons 15-24 years of age. (MMWR, 1994) The media should be made aware of the association between excessive coverage and the potential for suicide contagion. Public officials should discuss with media representatives alternative approaches for coverage of suicide stories.



    Sensational coverage of suicide should be avoided and the prominence of the news report should be minimized. Sensationalism can be minimized by not discussing the morbid details of a suicide. Also, providing details of the procedures used to complete the suicide may facilitate imitation of the behavior by at risk persons. "News media professionals should . . . avoid the use of dramatic photographs related to the suicide (e.g., photographs of the funeral, the deceased person's bedroom, and the site of the suicide)." (MMWR, 1994)



    News reporters should abstain from glorifying suicide and from focusing on the victim's positive characteristics. "News coverage is less likely to contribute to suicide contagion when reports of community expressions of grief (e.g., public eulogies, flying flags at half-mast, and erecting permanent public memorials) are minimized." (MMWR, 1994) Such actions suggest that society is honoring the suicidal behavior, rather than mourning the person's death. Empathy often leads to a focus on reporting the positive aspects of the victim's life. "If the suicide completer's problems are not acknowledged in the presence of these laudatory statements, suicidal behavior may appear attractive to other at-risk persons-especially those who rarely receive positive reinforcement for desirable behaviors." (MMWR, 1994)



    Workshop participants agreed that reporting of suicide can have several direct benefits. Among the benefits is the fact that community efforts to address the problem of youth suicide can be strengthened. Media coverage can help increase awareness in the community by describing the help and support available and by explaining how to identify persons at high risk for suicide. "An ongoing dialogue between news media professionals and health and other public officials is the key to facilitating the reporting of this information." (MMWR, 1994)



    Media reporting of suicide can have positive or negative effects on the suicide rate. There is a need to establish a policy for the reporting of suicide that would minimize the negative influences. Responsible reporting of suicide should exclude any detailed description of the method used. Reports that glamorize the suicidal event mask its reality as the end result of a series of experiences that are far from glamorous.



    Postvention efforts must focus on the needs of high-risk persons, such as relatives, friends, and past suicide attempters. These people should be identified and referred for counseling. The crisis response must not glorify the victim or sensationalize the suicide. "Elements in the environment that might increase the likelihood of further suicide should be identified and changed. Immediate access to the means of suicide, especially those used by the victim, should be restricted." (CDC, 1992)



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