Hip-Hop Track’s Suicide Prevention Message Strikes the Right Chord— What does Logic’s song mean for mental health interventions?

The time hip-hop song “1-800-273-8255” spent in the spotlight was associated with more calls to the U.S. suicide prevention hotline and fewer suicides, researchers found.

In the song, released in April 2017, rapper Logic expresses suicidal ideation but after an in-song conversation with a National Suicide Prevention Lifeline hotline representative (played by singer Alessia Cara), he sings, “I finally wanna be alive… I don’t want to die today.”

Upon the song’s release, the National Suicide Prevention Lifeline saw a 5% uptick in calls. Subsequently, after the song was performed at the 2017 MTV Music Awards and at the 2018 Grammy Awards, the hotline saw 8.46% and 6.45% spikes in calls, respectively, suicide researcher Thomas Niederkrotenthaler, PhD, MSc, of the University of Vienna, and collaborators reported in The BMJ.

During such promotion of “1-800-273-8255,” the Lifeline received a cumulative excess of 9,915 calls, an increase of 6.9% (P<0.001) over the expected number. Additionally, over the same period, there were 245 fewer suicides than expected, Niederkrotenthaler and colleagues reported.

“1-800-273-8255” peaked at Number 3 on the Billboard Hot 100 and was nominated for Song of the Year at the 2018 Grammy Awards. Now, researchers cited it as an example of how popular media can influence population-wide mental health outcomes.

“Media campaigns for suicide prevention have received a groundswell of support internationally, but evaluations are scarce and often limited in terms of scope,” the research team wrote. “Our finding of a substantial increase in actual help seeking and a possible decrease in suicides during the period of high public attention to Logic’s song support the real world effectiveness of this intervention,” they continued.

As of 2019, suicide is the tenth leading cause of death in the U.S., and the second leading cause of death among individuals age 10-34 years, according to the National Institute of Mental Health.

“The Logic song was one of the very few examples of such stories which received a truly large audience that can indeed make an impact on behavioral outcomes in the population such as Lifeline calls and suicide counts,” Niederkrotenthaler said to MedPage Today.

“The findings are clearly encouraging — stories of hope and recovery that feature individuals coping with suicidal ideation and crisis can have a beneficial effect,” he said.

Niederkrotenthaler cited the “Papageno Effect” that describes how media stories of people overcoming suicidal thoughts may prevent suicides. Papageno is a character from Mozart’s opera “The Magic Flute” who considers suicide but is stopped by spirits

On the other hand, media coverage of celebrity deaths is often associated with increased suicide rates. This phenomenon has been termed the “Werther Effect.” One meta-analysis, also conducted by a team led by Niederkrotenthaler, found that risk of suicide increased by 13% after the media reported a celebrity suicide.

A major dilemma for research in this area has been that stories of hope and recovery receive much less media coverage than stories of suicide death,” study investigators wrote. Logic’s song is likely the biggest suicide prevention message related to recovery to date, they noted.

“Logic has shown the potential of creative arts to communicate constructive coping strategies for people in mental distress. Future plans for similar interventions should attempt to measure attitudes to suicide in the target audience to help us understand the mechanisms of action,” psychiatrist Alexandra Pitman, PhD, MSc, of University College of London, wrote in an accompanying editorial.

The study group retrieved all original tweets geolocated to the U.S. that contained the search terms “Logic” and “1-800-273-8255” to determine the time span of public attention to media events related to Logic’s song. They developed a model using call data to the Lifeline hotline and suicide statistics from the National Center for Health Statistics from 2010-2018.

The study group adjusted for possible confounding events — including the Netflix show “13 Reasons Why,” which was associated with an increase in suicides after its release — and also included variables for notable celebrity deaths during their study period.

“Given the study design, ecological fallacy is possible, whereby the reported associations might have arisen from a fall in suicide rates among people not exposed to the song,” Pitman said. More information on the demographics of the song’s audience is needed to see if they match the groups in which suicide rates dropped, she added.

Study authors acknowledged that the observational nature of their study means that causality cannot be established.

Those in need of professional mental health support should call the National Suicide Prevention Lifeline at 800-273-8255 (TALK) or go to suicidepreventionlifeline.org.

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