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Flowers are seen on the late Robin Williams' star on the Hollywood Walk of Fame in Los Angeles, California August 12, 2014. Comedians, politicians and several generations of fans collectively mourned on Tuesday the death of Robin Williams, the actor famous for his frenetic and freewheeling comedy whose apparent suicide at age 63 prompted an outpouring of tributes. (LUCY NICHOLSON/REUTERS)
Flowers are seen on the late Robin Williams' star on the Hollywood Walk of Fame in Los Angeles, California August 12, 2014. Comedians, politicians and several generations of fans collectively mourned on Tuesday the death of Robin Williams, the actor famous for his frenetic and freewheeling comedy whose apparent suicide at age 63 prompted an outpouring of tributes. (LUCY NICHOLSON/REUTERS)

Robin Williams gives voice to a silent killer Add to ...

The media world has changed dramatically in the 20 years between the suicides of Kurt Cobain and Robin Williams but there is no question the coverage of mental health issues, and suicide in particular, is infinitely better.

When Kurt Cobain died of a self-inflicted shotgun blast to the head, in April, 1994, he was dubbed a “casualty of success.” The Nirvana singer was described, alternately, as a rock star who died living on the edge, and as charter member of “the stupid club,” the infamous series of musicians who died at 27, at the height of their success.

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There were snide references to Mr. Cobain’s drug use and abuse, but little mention of the severe depression he suffered and of his struggles with addiction. In fact, most media reported that he used heroin to treat “chronic stomach pain.”

Contrast that to the reporting on the death of Robin Williams, who died by asphyxiation due to hanging earlier this week. Much of the reporting – even in the early hours after the news broke – focused on the actor’s diagnosis of bipolar disorder, his history of depression, and how he self-medicated with alcohol and drugs such as cocaine.

Aside from some predictable gibberish from trolls, there was little talk of weakness and ungratefulness for success. Rather, the emphasis had been on how depression can afflict anyone, even the rich, the famous and the funny. Social media such as Facebook and Twitter overflowed not only with tributes to Mr. Williams, but with links to resources for those suffering from depression and suicidal thoughts.

Already, there are in-depth articles being published about the underfunding of mental-health research, the long waits for care, and how some specific demographic groups are at much greater risk of suicide – in particular, men of Mr. Williams’s age, in their 60s. (Men are four times as likely to die by suicide as women, largely because of their reluctance to seek treatment.)

The breadth and the sophistication of the media coverage is heartwarming. You can virtually feel the knowledge of depression growing, and the stigma surrounding mental illness evaporating, and that may well be Mr. Williams’s most lasting legacy.

But the suicide of a well-known public figure, combined with the ubiquity of social media, poses some real ethical challenges, chief among them: How much information is enough – or too much?

For a long time, the media did not cover suicide, or wrote about self-inflicted deaths euphemistically, i.e. “died suddenly.” This was due to a strange mix of puritanism, respect and shame. Many of those self-imposed barriers crumbled with Mr. Cobain’s death and, subsequently, as loved ones of those who died by suicide (especially parents of teens) challenged media silence as a barrier to getting help.

Journalists have also long operated under the belief that writing about suicide will lead to more suicide, the so-called contagion effect. But, in recent years, editors and reporters have pulled their heads out of the sand and decided to focus on reporting factually and respectfully on suicide. Groups such as Associated Press editors and the Canadian Journalism Forum on Violence and Trauma have developed their own guidelines. (Full disclosure: I am a contributor to the latter.)

This guidance is necessary because we live in what is essentially the postprivacy age, as demonstrated by Marin County Sheriff Lieutenant Keith Boyd, who described Mr. Williams’s death in painful detail at a live-broadcast press conference. (And let’s not forget police also released gruesome photos after Mr. Cobain’s death.)

The challenge for the media is not to linger on those details but, rather, to use them as a springboard to discuss the underlying causes of suicide, and the improvements that are needed in prevention and treatment.

About 38,000 Americans (and another 3,500 Canadians) die by suicide annually, making it one of the leading causes of death. About 90 per cent of people who die by suicide are suffering from untreated or undertreated mental illness. (Mr. Williams was suffering from severe depression but it is not clear yet what treatment he was undergoing.)

In recent days, the “tears of a clown” metaphor has been used often, to underscore how sufferers of depression, like Mr. Williams, often wear an outward mask of joy to hide their inner pain.

As a society, we have also been hiding behind a mask, failing to acknowledge that mental illness – and untreated mental illness in particular – is public health crisis that rivals physical diseases like cancer and heart disease.

Suicide is, by and large, a silent killer. It has been given a voice – at least temporarily – by the man of many voices, Robin Williams.

Are we listening?

Follow on Twitter: @picardonhealth

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