“Breaking the silence” suicide prevention media campaign in Oregon: Evaluation of impact on help-seeking and suicide mortality

Introduction
Research has established that suicide-related media can impact suicide rates both positively and negatively, supporting efforts to engage the media in the service of suicide prevention. The goal of the current study is to evaluate the impact of a suicide prevention media campaign implemented April 7–14, 2019 in Oregon.
Methods
Several indices of help-seeking behavior and suicide risk were employed: suicide-related Google Health API searches, National Suicide Prevention Lifeline (Lifeline) (currently known as the 988 Suicide and Crisis Lifeline) call volume, and state suicide mortality data from April 7, 2016—May 6, 2019. Eight states with similar 2016–2018 average suicide rates were compared with Oregon. Bayesian structural time-series modeling in R was used to test intervention effects.
Results
During the 30 days following the start of the campaign, there was a significant increase in Lifeline calls from Oregon area codes (2488 observed vs. 2283 expected calls, p = 0.03). There were no significant changes in suicide mortality or suicide-related Google searches in Oregon.
Conclusions
The campaign appeared to increase help-seeking behavior in the form of Lifeline calls, without any indication of an iatrogenic suicide contagion effect. However, the campaign’s potential to reduce suicide mortality was unmet.