Quality of online news reporting of suicidal behavior in Myanmar: Adherence to the World Health Organization reporting guidelines.

BACKGROUND: Media reporting of suicide has an essential role in the suicidal behavior of the general population. AIMS: The aim of this study is to assess the quality of online news reports of suicidal behavior in Myanmar against the World Health Organization (WHO) reporting guidelines.
METHODS: We performed a content analysis of all available suicide-related news reports published in vernacular online newspapers of Myanmar.
RESULTS: A total of 285 reports were analyzed, consisting of 87.4% suicides and 12.6% nonfatal suicidal attempts. Potentially, harmful information reported in the text includes the methods of suicide (100%), the word or term in Burmese related to suicide (89.5%), the name of the person (56.5%), life event (50.5%), and photo or suicidal person (17.9%). Meanwhile, helpful information such as prevention programs and the contact information for suicide services to the readers have been infrequently reported.
CONCLUSION: The study found that the newspaper reporting of suicide in Myanmar is grossly nonadherent to the WHO media guidelines. Copyright:

INTRODUCTION

Suicide is a global preventable public health problem. However, prevention is challenging due to the complexity of causal factors and the lack of specific risk factors.[1] Multiple strategies have been shown promising results while they are not universal. Among the prevention strategies, responsible media reporting has been recommended as a population-level prevention strategy.[12] Available evidence suggests that insensible media reporting increases suicidal behavior among the general population, especially vulnerable persons.[3] Several bodies such as the World Health Organization (WHO) and Samaritans formulated the media reporting guidelines, and the WHO recommends following specific guidelines while reporting suicide news.[24] The WHO specifically recommend the media to avoid language that normalizes suicide, or consider suicide as the solution to the problem, to prevent providing detailed information about the participant, the setting, the method of suicide or displaying any photo or video of the suicidal participant, to avoid excessive repetition stories about suicide, to choose the headline deliberately, to educate the readers on suicide, and provide information about help-seeking.[2]

The prevalence of mental distress is high,[5] and suicide is a public health problem in Myanmar.[6] The WHO reported that the age-standardized suicide rate in Myanmar was 8.1/100,000 population in 2016.[7] However, stigmatization on mental health problems,[89] low public awareness, and limitation of mental healthcare facilities and resources[9] might hamper to disclose the suicidal behavior, and to seek for mental health support. According to Myanmar's Penal Code (Section 309), suicidal attempts are considered offenses affecting life and punishable that further hinder the disclosure. Suicide-related news is reported in the newspapers and online news media in Myanmar. However, no study has been conducted to assess Myanmar's newspaper reporting quality to the best of our knowledge. Evaluations of media reporting of suicide are a critical step to understand the current situation and to find out the ways of improvement. Therefore, this study was aimed to assess the quality of online news reporting of suicide-related news in Myanmar against the WHO media reporting guidelines.

MATERIALS AND METHODS

This study was conducted by collecting suicide-related reports from the seven online newspapers of Myanmar. We choose the newspapers based on the readership of the paper, availability of suicidal news, and accessibility to search. The suicidal reports were searched using the keywords of suicide (that-thay), jump (khone-cha), hanging (kyoe-swe-cha), self-burning (mee-shoe-that-thay), and take poison (a-sate-thaut). The reports were published in Burmese from December 2012 to August 2020. The reports of suicidal cases of all Myanmar citizens were included in this study. Meanwhile, the suicidal reports about foreign citizens living in Myanmar or Myanmar citizens living abroad were excluded from this study. The data collection was carried out by the researcher, who is a Myanmar citizen and speak the Burmese language. There were some cases reported in more than one media. The reported news from the different media, duplicated cases, were included because different media presented in other formats needed to be assessed with the WHO guidelines.

The content of each report was read and extracted the following information; (1) the descriptive information about the report; including date of publication, name of news media, the focus of report (attempt, death), number of people in the report, report about the pact, public figure, (2) details of the suicidal person, method, location, life event, suicidal notes, photographs, diagrams, and (3) potentially helpful characteristics and (4) potentially harmful characteristics in the reports. Potentially, helpful characteristics mean the (i) causes of suicidality such as describing the link between the alcohol or mental disorders, (ii) the health expert opinion or research findings related to suicide or population-level statistics to inform the public, and (iii) information and contact on suicidal prevention and support services. Potentially, harmful characteristics are reporting (i) the location of the suicidal scene, (ii) the details of the suicidal methods, (iii) underlying cause and suicidal notes, (iv) including the word “suicide” or similar terms or methods in the title, (v) effect or interviews with bereaved person and (vi) photo of the suicidal person. Descriptive statistics reporting the frequency and percentages of the variables were used in this report.

The authors followed the methods followed in previous studies to identify the information.[410] As all the reports were publicly available, no formal ethical clearance was sought.

RESULTS

A total of 285 reports were analyzed, consisting of 249 (87.4%) suicides and 36 (12.6%) nonfatal suicidal attempts. Among the seven newspapers, two were international or global newspapers based in Western countries (British Broadcasting Corporation – UK and Voice of America – the USA), and run the news in Burmese. The detail of newspapers included in this study can be found in Table 1.

Table 1

The frequency of reporting suicide in each online newspaper (n=285)

Name of newspaper	Frequency (%)
Myanmar times	123 (43.2)
Eleven media	59 (20.7)
The Irrawaddy	39 (13.7)
7 day news	29 (10.2)
DVB	27 (9.5)
BBC Burmese	5 (1.7)
VOA Burmese	3 (1)
Total	285 (100)

DVB – Democratic Voice of Burma; BBC – British Broadcasting Corporation; VOA – Voice Of America

Approximately, 85.6% reported methods of suicide in the title or subtitle, while 73.3% of the news included the word “suicide” or similar words, such as “suicidal” in the title. Life events were also reported in 22.5% of the title or the subtitle of the news.

Potentially, harmful information was reported in the text includes the methods of suicide (100%), the word or term in Burmese related to suicide (89.5%), the name of the victim (56.5%), detailed methods of suicide (52.1%), life event (50.5%), and photo or suicidal person (17.9%). Meanwhile, preventive or helpful information to the readers has been rarely reported. Among the helpful information includes the statistical data (7.4%), prevention program (2.5%), and expert opinion regarding suicide (1.75%). Lastly, none of the news reported the contact information for suicide services (0%). The detail of the number and frequency of potentially harmful and potentially helpful news information can be found in Table 2.

Table 2

Myanmar online media compliance with the World Health Organization suicide reporting guidelines (n=285)

Variable	Frequency (%)
Harmful information
Mentioned in title of subtitle
Methods of suicide	244 (85.6)
The word “suicide”	209 (73.3)
Life event	64 (22.5)
Anywhere in text
Methods of suicide	285 (100)
Term “commit suicide”	255 (89.5)
Name	161 (56.5)
Detailed method	148 (52.1)
Life event	144 (50.5)
Monocausality	140 (49.1)
Photo or figure	118 (41.4)
Occupation	86 (30.2)
Related to mental illness	74 (25.9)
Characteristics	57 (20)
Photo of suicidal person	51 (17.9)
Alcohol consumption – drunk	46 (16.1)
Interview with bereaved	45 (15.8)
Accessible public site	26 (9.1)
Citation from suicide note	17 (5.9)
Effects on bereaved	9 (3.2)
Helpful information
Statistical data	21 (7.4)
Prevention program	7 (2.5)
Expert opinion	5 (1.7)
Research finding	1 (0.3)
Contact information	0

DISCUSSION

Responsible media reporting has been considered one of the promising population-level suicide prevention strategies.[12] We aimed to assess the quality of media reporting of suicide-related news reports in Myanmar against the WHO media reporting guidelines. A content analysis of 285 vernacular online reports of Myanmar was performed, and quality was assessed comparing with the WHO media guidelines.

The study revealed that the vast majority of online newspapers and journals in Myanmar are not adherent to the WHO guideline while reporting suicide. They reported potentially harmful information about the suicide, such as unnecessary details of the events, places, and persons in abundance while paying little attention to preventive information such as suicide-related statistics, suicide prevention services, hotline numbers, and expert opinion. The finding is consistent with studies conducted in several countries of the WHO South-East Asian region,[11] specifically, Bangladesh,[412] India,[1314] Pakistan,[15] Sri Lanka,[16] Thailand,[17] and Indonesia.[10] However, wide variations have also been reported among studies based on both inter- and intra-country.[18]

The study revealed a wide variation in the presence of suicide reports in different newspapers [Table 1] which can be explained by the variations in readership,[13] perceived newsworthiness of the suicide,[19] and reporting domain of suicide such as crime journalist or health journalist.[20]

The countries in Asia, such as Malaysia and the Republic of Korea, have developed the guidelines for media reporting on suicide with the collaboration of various stakeholders, the ministry of health, Psychiatric association, NGOs, suicide prevention association, and media persons. Similarly, In Australia, a collaborative effort was made to prepare the media reporting guidelines, distributing the resources to the media, conducting training and briefings, offering advice, and follow up on media reporting. This practice was found to be well received and followed by the reporters and media.[21]

We recommend the following initiatives to change the media reporting status in Myanmar. Media reporting guidelines is an essential aspect of the suicide prevention strategy. The national guidelines for reporting suicide in media should be developed based on the WHO guidelines while including the discussion and contributions by reporters and editors to be applicable in the local setting. The journalism institutes in Myanmar should emphasize media reporting guidelines in their program. Periodic training and courses should be offered to the reporters and editors to improve the awareness of the guidelines and the impact of media reporting. Decriminalization could benefit by shifting the suicide reporting from crime reporters to health reporters.[11] Therefore, the editors should recommend the health reporters prepare the news related to suicide rather than the crime reporters. Enduring collaboration between mental health professionals and media personnel is necessary. Although there are limitations in human resources, funding, and suicide prevention program, cooperation between the ministry of information, ministry of health, and nongovernmental organizations could enhance the implementation.

To the best of our knowledge, this is the first conducted study assessing the quality of media reports in Myanmar. However, the study has several limitations. First, only seven newspapers were scrutinized. Second, we analyzed the reports retrospectively. Third, we did a cross-sectional analysis. Fourth, we assessed only vernacular newspapers, and English papers were left un-scrutinized.

The study found that the newspaper reports of suicide in Myanmar are grossly nonadherent to the WHO media guidelines. Newspapers of Myanmar explicitly mentioned the harmful characteristics and had little attention to inform the preventive measures while reporting suicide. Immediate initiatives are warranted to improve the quality of media reporting to find out the barriers for responsible media reporting and holistic multisectoral collaboration between the stakeholders at both national and international levels.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.