Understanding Suicide its Prevention and Detection in Reality Tv Shows
A Brief Guide for Tv Producers
Produced by Dr Arthur Cassidy B.Sc, B.Sc. Ph.D C.Psychol, AFBPsS
Associate Fellow of the British Psychological Society
Director of Yellow Ribbon Suicide Prevention Programme ( NI)
www.tvmediapsychologist.com
Why People die by Suicide
As a Tv psychologist who has fifteen years and more of academic and health research experience in the study and prevention of suicides and especially celebrity and reality Tv suicides, the time is right to help the world of TV production , MP’s and the general public to understand the complexity of suicides.
This week press reports in the tabloids and broadsheets have highlighted the needless and tragic death of a man who had appeared on the Jeremy Kyle Show. Last year the same press reports covered the suicides of a pseudo celebrity Sophie Graydon from Love Island and her boyfriend Aaron a few days later. In the past few years we had the suicidal death of my own Hollywood icon Robin Williams .Most weeks now I’m reading invariable accounts in press of the rise in teenage suicides associated with Instagram and the abuse of narcotics .We live in a world where not only do we have a mental health epidemic, but in Northern Ireland constitutionally part of the United Kingdom, the highest suicide rate in the entire UK. AS an ex University academic and researcher, I now work in television helping viewers understand the broad range of psychological illnesses , latest research, and various problems associated with teenagers social media addictions alcohol abuse and personality disorders. In addition,ten years ago I set up a Suicide Prevention Charity in Northern Ireland Yellow Ribbon Suicide Prevention Progamme , an American based health initiative based in Westminster, Colorado. Founded in the early 1990s’ after their teenage son Michael Emme took his own life after buying and restoring Ford Mustang yellow in colour, his parents Dale and Dar set up a Suicide Prevention campaign. I received their licence to set up a branch in Portadown in Northern Ireland.
Suicide is a very highly complex behaviour or phenomenon as every single one is highly complex and unique. We do know also from established clinical and psychological research that for every completed suicide in UK there are a constellation of factors, these normally involve an array of pychosocial factors associated with environment, such as redundancy bereavement, various forms of loss , relationship breakdown, divorce financial hardship. and so on. Other factors in many cases are biological by nature, and involve various brain chemicals such as serotonin dopamine noradrenaline and many more. In my own suicide prevention unit, I see suicidally depressed individuals regularly from young teenagers through the late adolescents to young twenty somethings and males in their early forties to mid fifties. Statistically in NI and in England we see a gender difference in that emotionally vulnerable young males early twenties to mid thirties , and older vulnerable men between mid forties to mid fifties are at high risk of suicide. As females have a tendency to talk through their emotional issues with a confidente, males do not.
When I see GP referrals at my weekly sessions, or if involved in Tv reality shows pre production, I am searching for an activating agent that could put that individual at risk, some of which are noted above. Those at a high risk are those with a history of suicidal depression in the family tree, and those who have symptoms of BPD , Borderline personality disorder. There may be a previous psychiatric history or specific personality traits that may surface and so could trigger off the remaining factors. I’m asking a series of questions to assess the degree or suicidal risk and then with my team to plan a course of recovery from the person making attempts to end their life. People die by suicide because of a plethora of problems. Cuts to the NHS, overcrowded wards and lack of resources in psychiatric hospitals for proper care of the mentally ill. Staff shortages are a significant contributor where many patients might be asked remain at home as no hospital beds available.
That family have not have the skill base to deal with and exercise caution preventative measures that could save the persons life. Others take their own lives due to a lack of hope about the future and the ambiguities surrounding Brexit do not help. The general breakdown of family life and dynamics are another contributory factor in many suicides where there is no hope of reconciliation, or where massive debts have been incurred. Over the past five to ten years I’ve worked with the farming community tough men who have lost their lives or made near completion attempts to end their life due to loss of autonomy. Farmers can have very large debts with large bank loans to purchase necessary agricultural equipment such as a new tractor at on average £80,000 and more. Low returns on milk production with rising veterinary costs increase the suicidal risk in farmers. Farmers have no time to see a GP so will listen to my mental health podcasts whilst sitting on a tractor ploughing few fields.
The definition of suicide is far from easy “ the act of killing oneself”. This is not helpful as it ignores whether there was a motive to end one’s life and was it a conscious decision besides a moral right. If we cast our minds back to the World Trade Centre at 9/11 where many people jumped out the windows to escape the flames and ultimately died, how do we define that scenario?At least fifty people died like this and the real figure is closer to two hundred. Did they die by suicide?
Many years ago we discovered evidence in studies of suicide known as “ Assortative relating” where individuals for associations with those with similar faith beliefs and practices They were what we call “suicide clusters” where agreements are formed t among highly vulnerable people to end their lives together. The internet now in the millenium with sophisticated social media platforms have facilitated assortative relationships in various countries . These can be seen in pro -suicide websites that abound in today’s freely available social media platforms such as You Tube.
Psycheache
I am often asked by patients or clients who suffer from chronic anger depression anxiety or who present with alcohol related issues and family dysfunction if I can explain their “inner pain”, before I explain it to them I am deeply concerned that they have the potential to kill themselves by overdosing on paracetamol or prescribed painkillers, and I want to prevent that scenario. the majority of suicidally depressed clients, though not all have what’s called psycheache. It’s a kind of intense emotional pain or a psychological pain that never goes away. It’s claimed in our profession that psycheache comes from distorted psychological needs. These include the persons individual needs that may not have been met for example, lack of love from one’s partner husband wife or family. The psycheache is of such unbearable and intolerable intensity that the individual is motivated to terminate his or her own life. However lethality is a key ingredient in some reality tv contestants thinking or cognitive patterns following a reality tv show Their mental functioning is thwarted by the fact that their highly unrealistic expectations of Tv agents ringing them for a high profile reality contract simply does not happen. If class A or B drugs and alcohol are consumed these can interact with the intense emotional pan and specific personality traits such as impulsivity and would cause asphyxiation and death.
Suicide & Reality Tv shows
It’s imperative and should be mandatory that any Individuals who enter any format of high profile reality tv shows disclose any history of anxiety, depression, self harming, previous traumas etc. Individuals who have had any or all of those ought not to be auditioned as it could be potentially dangerous with legal implications for the Tv production company and Broadcaster.
Reality tv show contestants may and do experience post show post traumatic stress disorder, and a profound threat to their self worth as a person ,and to their self esteem.The meltdown they cannot cope with due to the false expectations of where participation in the show might have led, and accentuated their career perhaps bringing them a nice little fortune. For most emotionally vulnerable contestants who get through the assessment loopholes, they may have the desire to kill themselves if their psychological needs are not met by the show and its producers. There is a lust for fame wealth and all it might bring them in the delusional world of reality television. On completion of the show ending all contestants go back home with one exception, the one who is the winner and collects all the photocalls the glossy magazine interviews , modelling cotracts holidays or maybe even be a pseudo celebrity tv presenter.
Contestants make their own decision to enter a reality tv show, but they do not enter knowing that should it not go their way, then suicide is a way out from the huge embarrassment and public disgrace and massive exposure to over 2.5 million viewers. But the reality is that producers and tv presenters are never immune from being also in a vulnerable position. by virtue of their role in abnormally increasing viewers ratings and massively increasing revenue. The ethics of studio performance raises serious questions when the balance is totally wrong and where the shows contestants mental health is compromised.
Tv producers and broadcasters I’ve advised over the years and worked with, invariably listened to my psychological callout for the properly controlled and systematic monitoring of the psychological welfare of participants especially after the show . The stigma surrounding suicide is still here and is taboo to many tv producers and executives. It’s not until we have these tragic and uneeded” reality tv suicides” that it opens up a hornets nest when the viewers are out to point the finger of blame on the presenters onscreen confrontational and threatening interviews.
Based on a plethora of psychological research into threats to personal identities, I suggest to the DCMS Committee that existing reality TV formats including interview techniques during the show itself, are regulated and controlled by specialist television Psychologists who are BPS qualified and Chartered, and have years of experience in dealing with self harmers and those with suicidal tendencies and ideation . Counsellors, psychotherapists clinical psychologists psychiatrists involved in screening and selection of potential contestants before or during pre production would have to be trained specifically in the detection and identification of suicidal precursors and suicidal ideation past or present in reality Tv show contestants.
Recent press reports Daily Mail 15th May 2019, have claimed that the suicide victim Steve Dymond had a history of mental health problems including depression. He had been through life’s up and downs. And when in a personal crisis in February this year, due to an innocuous event of his fiancee seeing an intimate photograph of him with his ex girlfriend, Steve was plunged into another crises. Why on earth did the assessors of contestants mental health functioning not detect vulnerability to suicide? Did the Director of Welfare at ITV know who was carrying out the psychological assessment and was he aware of Mr. Dymond’s personal mental health issues, and if not why not? How or why did the Compliance officer for the Kyle show permit any contestants to be subjected to intense questioning on stage by the presenter? What psychometric tests were utilized in pre screening as it is very possible for any show contestant with suicidal thoughts to navigate the screening process and get through the pre assessment undetected? In fact Steve should not ever have been allowed to go onscreen , nor any other reality tv contestants, who might have had suicidal ideation or suicidal thoughts and depression. I’m raising questions here about the balance of the moral right of anyone to apply to be on the show and if diligent checks have been made with their GP etc before auditions. It seems highly unlikely. It also raises serious questions about the presenters interrogative questioning for the purpose of “entertainment” when he or any presenter would be aware of the contestants mental health state. Did Jeremy know all the facts and if not who actually did in the production team? How fortunate we are that Dame Carolyn McCall CE0 of ITV has decided to end this out of date show which could easlly have perpetuated the anguish and mental health of the few million viewers who were addicted to it.
Many colleagues in my profession including myself, researching and treating the suicidally depressed or using alternative methodologies, have explored various individuals basic psychological needs not being met. The basic need for love and to be accepted and also the need to belong to a stable family, are core ingredients in the preservation of human life. When individuals do not have a satisfying job, or a satisfying relationship they become devoid of these necessary ingredients and this state of emotional dysregulation may become a trigger or activating agent in the decision to end one’s life. The heightened emotional context of studio audiences the highly combustible psychological atmosphere with no way of escape can become life threatening in the hours or days to follow as we have seen recently.
When a contestant (or any individual ) in a high profile Tv reality show feels invariably that their autonomy, nurturance, understanding, dominance and achievement are thwarted, this becomes an intense trigger and precursor to psycheache and suicidal thinking. I see many in my charity clinic with a strong faith but so deeply in despair, when their faith becomes shattered,or under threat by the darkness of suicidal depression, then it’s time to take stock of where the individual has been in the past and how his or her current self perceptions have become irrational and out of focus.
Thwarted Effectiveness
Any professional psychologist or more so, Tv reality producers must recognize that contestants for reality shows who have had a past history of depression, or anxiety have the potential to relapse once they attend auditions. Early suicidal assessment needs to be given to prevent such individuals being finally selected for the show. There is a deep sense in some cases that one is a burden. If you let your group down to experience all the negative aspects of letting yourself down to.This is rarely influenced by one psychological processes but in an intense collaboration of subsidiary psychosocial factors. On stage in particular reality tv shows, any contestants who have bottled up their emotions anger jealously and such like, begin to realize that their ineffectiveness can also influence other contestants effectiveness an heighten the combustion. This is a highly volatile context rarely if ever recognized by the show host or presenter, unwittingly knowing that a potential suicide is around the corner. There is the escalating feelings of shame and of being a burden to others, to ex wives or partners, to the immediate or estranged family.
The contestant has now to consider in this darkness, subjected to the millions of “addicted “viewers whether to take on the immense burden of shame and guilt, devoid of any form or logic or reasoning, and perhaps consumed with guilt,- or to consider self destruction by their own hand.
I have had several ex contestants over the past few years from Love Island and other reality shows in touch with me where they have described in depth their low self esteem, stress reaction and inability to cope with life after the exhilaration and high profile exposure to social media. One was Rosie Williams a young Welsh Solicitor who was severely trolled for many months following her time on the show and has suffered psychologically. Following the untimely death of Sophie Graydon from Love Island a few years ago, her boyfriend Aaron’s friends contacted me for help just as he passed away a few days after Sophies passing. Since then I have had some calls from ex reality Tv Show Love Island contestants asking for my professional help due to no agent calling them and having low self esteem and low self worth with anhedonia ( lacking pleasure and happiness ).
With regard to the Jeremy Kyle show my professional view is that this format must not ever be allowed to be broadcast again. These very high risk Tv reality shows are in fact not “Light entertainment” or might present as such under disguise. Mr Kyle assumes the role and function on camera as some form of “therapist”, which is morally unacceptable unwise and psychologically destructive to the emotionally vulnerable contestants. In the case where any contestant concedes and agrees to the contract pre show, do they fully understand the small print? There ought to be informed consent and the contestant must fully understand to what are they consenting to and under what circumstances. One could go on stage in a healthy psychological condition, and within ten minutes or less experience profound psychological threats to their identity and emotional health status. This occurs as a result of the interrogative nature of the presenters questioning technique. Where is the role of compliance in all of this? I still have many questions to ask in the context of the entire aims function and consequences of these show formats which puts the lives of contestants at very high risk.
There is in addition to the aforementioned, a point where the legal provision by ITV of a contestants psychological aftercare programme terminates. Within reason this ought to be set at five to six years following high profile exposure, the onus should never be on an ex contestant to contact the therapeutic team but for very rigorous monitoring of the frequency and nature of their intervention over the five yeas period. I argue that Government bring in legislation and guidelines to enact the rules and format of all Tv reality tv shows so that monetarization is not the priority but complete psychological protection of every contestant. There is another aspect in that any ex show contestant might well develop an array of mental health problems based on their personality and attitudes and other psychosocial variables that could act as a suicidal trigger. This would in most cases be attributed not to ITV or Channel 4 or any other broadcaster, but to one’s personal moral choices.
June 2019