Research shows that the majority of those who jumped off the Golden Gate bridge in the US and survived changed their mind and wanted to live as they fell.

Most of the professionals working in the media report suicides in a professional manner. Suicide is a delicate and serious public health concern which leaves a trans-generational legacy of pain and suffering in the relatives who are tormented daily by many unanswered questions for several years.

A suicide places the loved ones at risk of mental health illness and suicide itself. Unethical reporting, blogging or speculation accentuates this torture. Good quality research indicates that the media can play a crucial role in soothing this pain and help save lives through responsible reporting (Hawton, Wasserman, Phillips).

About one million suicides occur worldwide every year, or one every 42 seconds (WHO). About six people are affected by each death.

Raw data of the local National Statistics Office indicates that about 24 males and 12 females take their lives every year. This surely is an underestimate given the fact that suicide cases tend to be under-reported due to stigmatisation issues or deaths being reported as inconclusive.

The weekly raw data from Malta’s crisis resolution team suggest that about 6-10 people are brought in for help after having self harmed. The demographics vary but the typical person is female, in her 20s and has psycho-social issues.

The causes for self harm are rarely one but usually multiple. Teenagers are increasingly self harming worldwide. Statistically, the most worrying cases are older, lonely males who have no hope, are severely mentally ill and who abuse alcohol or drugs. When faced with a crisis, they feel helpless and entrapped and cannot look at pro-life alternatives.

People, however, are not statistics: every attempt must not be trivialised.

Modifying the way suicide is reported can lead to a significant reduction in imitative behaviour

Over 50 studies clearly demonstrate a link between insensitive, repetitive and detailed reporting and imitative suicide behaviour.

The peak of this behaviour occurs within the first three days of reporting and levels within one month.

Furthermore, this behaviour is related to the amount of coverage and prominence given. It is also accentuated when the victim and the reader/viewer are similar in some way or when the person described in the story is a celebrity and is held in high regard by the reader/viewer.

In contrast, there is no published evidence to show that suicide reporting puts people off attempting suicide.

Highlighting specific suicide locations or methods likewise draws vulnerable people to such places or behaviours.

Malta and Gozo are no exception to this: my workload increases significantly due to inappropriate reporting.

Besides, research suggests that suicide reports are not simply the result of bringing forward in time an inevitable, future suicide. Often, the mental health problems of people who died by suicide are overlooked in the report.

The causes of suicidal behaviour are portrayed too simply: suicide tends to be attributed to single factors (for example, a relationship break-up) in contrast to the complex explanation found in reality.

Modifying the way suicide is reported can lead to a significant reduction in imitative behaviour. This is a challenge for the professional journalist who works under pressure for media platforms that must sell to provide wages.

Online guidelines are available (BBC, Samaritans etc.). The evidence-based consensus is to inform the audience without sensationalising the suicide (or the headlines), to include local crisis phone numbers, a suicide-prevention logo and emphasising where the public can get support. The guidelines stress that comments from suicide prevention experts should be included in the reports.

Common media-fuelled myths include the idea that one has to be mentally ill to think about suicide or that people who talk about suicide are not really serious about killing themselves.

Other myths harbour the belief that if a person is serious about killing himself then nothing can be done. These people in reality do not want to die but want to get out of the painful crisis they are in.

One further colossal myth is that talking about suicide in a sensitive manner is a bad idea because it may give someone the idea to try it.

Furthermore, those who have attempted suicide are 100 times more likely than the general population to do it again. About four in 10 people who die by suicide have attempted suicide previously. The majority of those who try to kill themselves have mental health problems at the time of death and would have sought help in the past. These psychological problems are typically serious and are in themselves risk factors for suicide.

The feelings of helplessness and hopelessness are scientifically more predictive for suicide.

Every attempted suicide should be taken seriously, including the so called ‘cries for help’.

A seminal study, carried out on survivors who jumped off the Golden Gate bridge in the US shows that the majority of survivors changed their mind and wanted to live as they fell. This research paper resonates with the work of poet Mario Azzopardi who prophetically wrote about a man in an identical situation in the book Qawsalla.

Malta needs a national suicide prevention plan as part of a greater mental health strategy document to help the hopeless and helpless. Installing conspicuous, fixed telephone booths in vulnerable suicide spots will minimize unnecessary deaths, as happens abroad. Trained personnel should be available 24/7 to take these calls and offer support.

Annual training and seminars for professionals, the policeetc. should be incorporated in the strategy.

Regular research and scrutiny of the local characteristics of suicidal behaviour will hone our management. To date, there is only one excellent study of the demographics of suicide locally but this is over a decade old and needs replicating (Scicluna).

Liaison with foreign teams and centres of excellence will bolster our services, foster research and provide a milieu to share experiences.

Malta has dedicated crisis teams who work behind the scenes everyday with other health professionals to save lives. There are crisis lines available (112, 9933 9966) as well as a Facebook page dedicated to crisis resolution.

More needs to be done, especially in spring and summer when the suicide rates escalate worldwide. Community teams need enhancing to provide satellite surveillance out of hospitals and nip crises in the bud.

Mark Xuereb is a psychiatrist and university lecturer.