"Quite simply they don't communicate": a case study of a National Health Service response to staff suicide.

Workplace suicide can have significant knock-on effects within an organisation, yet research has shown within the healthcare profession, not all staff receive suicide prevention training, and few employers take the time to reflect on the need to change workplace policies or practices following the death of a staff member to suicide. How staff suicide is communicated across an organisation and to family members is important. Effective crisis communication is critical for effective management for a timely and sensitive response to a staff suicide within an organisation. By doing so, workplaces can help to reduce the significant emotional trauma suicide can have on an employee, and support good mental health across its workforce. This study aimed to explore and understand the communication processes around staff suicide across a National Health Service (NHS) Trust and to provide recommendations based on these findings. Semi-structured interviews were conducted with 29 participants, each lasting approximately 90 min. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were followed. Thematic analysis was used to analyse the data, resulting in seven themes being identified based on communication. Findings indicated that the Trust had no clear communication strategy in place for tackling staff suicide. Each suicide was handled differently, training across staff roles was lacking and operational procedures were deemed insensitive. This paper aimed to provide insight into the communication strategies used in the aftermath of a staff suicide. These findings highlight the inconsistency of the communication, lack of clear policy and guidance and the negative impact this had on staff. Further research is needed across NHS Trusts nationwide to gain insight into the current communication strategies in place to develop a national approach to clear communication following the death of an NHS worker to suicide. Tweetable abstract: Effective communication is critical in the aftermath of an NHS staff suicide. By doing so, NHS Trusts can help to reduce the trauma suicide can have on an employee and support good mental health across its workforce @stann2.

The perfect birth: a content analysis of midwives' posts about birth on Instagram.

BACKGROUND: There is limited research into how midwives use social media within their professional role. Small pilot studies have explored the introduction of social media into maternity practice and teaching but there is little evidence around how midwives use social media professionally. This is important as 89% of pregnant women turn to social media for advice during pregnancy, and how midwives use social media could be influencing women, their perception of birth and their decision making. METHODS: AIM: To analyse how popular midwives portray birth on the social media platform Instagram. This is an observational mixed methods study using content analysis. Five 'popular' midwives from each country (UK, New Zealand, USA and Australia) were identified and their posts about birth collated from a one-year period (2020-21). Images/videos were then coded. Descriptive statistics enabled comparison of the posts by country. Categorisation was used to analyse and understand the content. RESULTS: The study identified 917 posts from the 20 midwives' accounts, containing 1216 images/videos, with most coming from USA (n = 466), and UK (n = 239), Australia (n = 205) and New Zealand (n = 7) respectively. Images/videos were categorised into 'Birth Positivity', 'Humour', 'Education', 'Birth Story' and 'Advertisement'. Midwives' portrayals of birth represented a greater proportion of vaginal births, waterbirths and homebirths than known national birth statistics. The most popular midwives identified mainly had private businesses (n = 17). Both the midwives and women portrayed in images were primarily white, demonstrating a disproportionate representation. CONCLUSION: There is a small midwifery presence on Instagram that is not representative of the broader profession, or the current picture of midwifery care. This paper is the first study to explore how midwives are using the popular social media platform Instagram to portray birth. It provides insight into how midwives post an un-medicalised, low risk representation of birth. Further research is recommended to explore midwives' motivation behind their posts, and how pregnant and postnatal women engage with social media.

"Is it realistic?" the portrayal of pregnancy and childbirth in the media.

BACKGROUND: Considerable debate surrounds the influence media have on first-time pregnant women. Much of the academic literature discusses the influence of (reality) television, which often portrays birth as risky, dramatic and painful and there is evidence that this has a negative effect on childbirth in society, through the increasing anticipation of negative outcomes. It is suggested that women seek out such programmes to help understand what could happen during the birth because there is a cultural void. However the impact that has on normal birth has not been explored. METHODS: A scoping review relating to the representation of childbirth in the mass media, particularly on television. RESULTS: Three key themes emerged: (a) medicalisation of childbirth; (b) women using media to learn about childbirth; and (c) birth as a missing everyday life event. CONCLUSION: Media appear to influence how women engage with childbirth. The dramatic television portrayal of birth may perpetuate the medicalisation of childbirth, and last, but not least, portrayals of normal birth are often missing in the popular media. Hence midwives need to engage with television producers to improve the representation of midwifery and maternity in the media.

Newspaper Reporting on a Cluster of Suicides in the UK.

BACKGROUND: Media reporting may influence suicide clusters through imitation or contagion. In 2008 there was extensive national and international newspaper coverage of a cluster of suicides in young people in the Bridgend area of South Wales, UK. AIMS: To explore the quantity and quality of newspaper reporting during the identified cluster. METHOD: Searches were conducted for articles on suicide in Bridgend for 6 months before and after the defined cluster (June 26, 2007, to September 16, 2008). Frequency, quality (using the PRINTQUAL instrument), and sensationalism were examined. RESULTS: In all, 577 newspaper articles were identified. One in seven articles included the suicide method in the headline, 47.3% referred to earlier suicides, and 44% used phrases that guidelines suggest should be avoided. Only 13% included sources of information or advice. CONCLUSION: A high level of poor-quality and sensationalist reporting was found during an ongoing suicide cluster at the very time when good-quality reporting could be considered important. A broad awareness of media guidelines and expansion and adherence to press codes of practice are required by journalists to ensure ethical reporting.

PRINTQUAL - a measure for assessing the quality of newspaper reporting of suicide.

BACKGROUND: Many studies have demonstrated a relationship between newspaper reporting of actual or fictional suicides and subsequent suicidal behaviors. Previous measures of the quality of reporting lack consistency concerning which specific elements should be included and how they should be weighted. AIMS: To develop an instrument, PRINTQUAL, comprising two scales of the quality (poor and good) of newspaper reporting of suicide that can be used in future studies of reporting. METHOD: A first draft of the PRINTQUAL instrument was compiled, comprising items indicative of poor- and good-quality newspaper reporting based on guidelines and key sources of evidence. This was refined by team members and then circulated to a group of international experts in the field for further opinion and weighting of individual items. RESULTS: The final instrument comprised 19 items in the poor-quality scale and four in the good-quality scale. Following training, agreement between raters was acceptably high for most items (κ ≥ .75) except for three items for which agreement was still acceptable (κ ≥ .60). CONCLUSION: The PRINTQUAL instrument for assessing the quality of newspaper reporting of suicide appears appropriate for use in research and monitoring in future studies.