title: Newspaper reporting and the emergence of charcoal burning suicide in Taiwan: A mixed methods approach.
abstract: BACKGROUND
  It has been suggested that extensive media reporting of charcoal burning suicide was a key factor in the rapid spread of this novel method in many East Asian countries. But very few empirical studies have explored the relationship between media reporting and the emergence of this new method of suicide.
  
  
  OBJECTIVE
  We investigated the changing pattern of media reporting of charcoal burning suicides in Taiwan during 1998-2002 when this method of suicide increased most rapidly, assessing whether the characteristics of media reporting were associated with the changing incidence of suicide using this method.
  
  
  METHODS
  A mixed method approach, combining quantitative and qualitative analysis of newspaper content during 1998-2002 was used. We compared differences in reporting characteristics before and after the rapid increase in charcoal burning suicide. Point-biserial and Pearson correlation coefficients were calculated to quantify the associations between the media item content and changes in suicide rates.
  
  
  RESULTS
  During the period when charcoal burning suicide increased rapidly, the number of reports per suicide was considerably higher than during the early stage (0.31 vs. 0.10). Detailed reporting of this new method was associated with a post-reporting increase in suicides using the method. Qualitative analysis of news items revealed that the content of reports of suicide by charcoal burning changed gradually; in the early stages of the epidemic (1999-2000) there was convergence in the terminology used to report charcoal burning deaths, later reports gave detailed descriptions of the setting in which the death occurred (2001) and finally the method was glamourized and widely publicized (2001-2002).
  
  
  CONCLUSIONS
  Our analysis was restricted to newspaper reports and did not include TV or the Internet.
  
  
  CONCLUSIONS
  Newspaper reporting was associated with the evolution and establishment of charcoal burning suicide. Working with media and close monitoring of changes in the incidence of suicide using a new method might help prevent a suicide epidemic such as charcoal burning suicide seen in Taiwan.
authors.affiliation: Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan; Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Ying-Yeh
authors.initials: YY
authors.lastname: Chen
authors.affiliation: Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan; Department of Public Health, National Cheng Kung University College of Medicine, Tainan, Taiwan.
authors.forename: Chi-Wei
authors.initials: CW
authors.lastname: Tsai
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Lucy
authors.initials: L
authors.lastname: Biddle
authors.affiliation: Suicide Research Unit, Institute of Social Medicine Center for Public Health, Medical University of Vienna, Vienna, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Niederkrotenthaler
authors.affiliation: Department and Graduate Institute of Medical Education and Bioethics, National Taiwan University College of Medicine, School of Medicine, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: ccwu88@ntu.edu.tw.
authors.forename: Kevin Chien-Chang
authors.initials: KC
authors.lastname: Wu
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: David
authors.initials: D
authors.lastname: Gunnell
mesh_terms: D002606:Charcoal / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D020452:Journalism / Q000706:statistics & numerical data*; D009524:Newspapers as Topic; D013405:Suicide / Q000706:statistics & numerical data*; D013624:Taiwan / Q000453:epidemiology; D000092864:Suicide Prevention
chemical_list: D002606:Charcoal
keywords: Acculturation; Charcoal burning suicide; Media; Mixed methods; Newspaper; Taiwan