Prevention of the Werther effect: compliance of the Italian newspapers to the ‘reporting on suicide’ recommendations

Objectives: Suicide media coverage could lead to imitation, the so-called ‘Werther effect’. The World Health Organization (WHO) published specific recommendations for reporting suicide news. This study aimed to quantify the compliance of Italian newspapers with the WHO suicide reporting guidelines. Study design: This was a quantitative content analysis study. Methods: All articles published by the three main Italian newspapers from June 2019 to May 2020 describing suicides or attempted suicides were included. The articles were analyzed using a checklist based on the WHO recommendations, which included 18 ‘negative’ items (e.g. ‘presence of the word ‘suicide’ in the title’) and nine ‘positive’ items (e.g. ‘the article reports the contacts of a suicide prevention hotline’). Each negative item was scored −1, and each positive item was scored +1. Multivariate linear regressions were performed to identify factors associated with lower adherence to WHO recommendations and higher social media engagement with the articles. Results: A total of 3483 articles were screened, and 110 articles were included in the final analysis. The suicidal was male in 73.6% of cases. The median checklist score was −6 (interquartile range 3). Five percent of the articles had at least one positive item. The word ‘suicide’ was found in 90% of the titles. Female suicides were associated with a higher checklist score (coefficient 0.81, P = 0.039). No correlation was found between the checklist score and the social media engagement of the articles. Conclusions: Italian newspapers do not adhere completely to the WHO recommendations on reporting suicide, leading to a potential imitation effect. Public health professionals should make decision-makers and journalists aware of the importance of these recommendations.