title: Assessing the impact of media guidelines for reporting on suicides in Austria: interrupted time series analysis.
abstract: OBJECTIVE
  Media guidelines for reporting on suicides are a widely used means of preventing imitative suicides, but scientific accounts of their impact on suicide numbers are sparse. This report provides an evaluation of the Austrian guidelines that were introduced in 1987 as a natural experiment.
  
  
  METHODS
  The impact of the guidelines was tested by applying an autoregressive integrated moving average (ARIMA) model and a linear regression model. In addition to a nationwide evaluation, Austria was divided into three areas according to regional differences in coverage rates of the collaborating newspapers and the impact of the intervention was tested for each area separately. Main outcome measures were the overall annual suicide numbers, and the numbers of Viennese subway suicides that were exceptionally newsworthy for the mass media. In order to test intermediate impacts, also quantitative and qualitative changes in media reporting after the introduction of the guidelines were analysed.
  
  
  RESULTS
  There was some evidence of a nationwide impact of the guidelines, calculated as a significant reduction of 81 suicides (95% confidence interval: -149 to -13; t = -2.32, df = 54, p <0.024) annually. This effect was particularly due to a significant reduction in the area with the highest coverage rates of the collaborating newspapers. Viennese subway suicides showed a highly significant level shift (t = -4.44, df = 19, p <0.001) and a highly significant trend change (t = -4.20, df = 19, p <0.001) after the introduction of the guidelines. These effects corresponded to significant changes in the quality and quantity of media reporting.
  
  
  CONCLUSIONS
  The present results clearly support the hypothesis that the media guidelines have had an impact on the quality of reporting as well as on suicidal behaviour in Austria, and stress the importance of collaborating with nationwide, but also with regional media to achieve efficacy. Further research is needed to provide an international insight into this public health issue.
authors.affiliation: Medical University of Vienna, Center for Public Health, Institute for Medical Psychology, Severingasse 9, A-1090 Vienna, Austria. thomas.niederkrotenthaler@meduniwien.ac.at
authors.forename: Thomas
authors.initials: T
authors.lastname: Niederkrotenthaler
authors.forename: Gernot
authors.initials: G
authors.lastname: Sonneck
mesh_terms: D001317:Austria; D002423:Cause of Death; D003430:Cross-Sectional Studies; D030881:Disclosure / Q000706:statistics & numerical data*; D017408:Guidelines as Topic; D006801:Humans; D007100:Imitative Behavior; D008402:Mass Media; D015233:Models, Statistical; D009524:Newspapers as Topic; D011786:Quality Control; D011890:Railroads / Q000706:statistics & numerical data; D013405:Suicide / Q000706:statistics & numerical data*; D000092864:Suicide Prevention