Despite the news of pop icon Anita Mui Yim-fong's death taking up most of the front pages, a suicide story managed to make its way to the front of Apple Daily's second section during that week. It was a gruesome story - a man first throws his struggling wife out of the window of their high-rise apartment, then hurls himself after her. The story was accompanied by pictures of crying relatives huddled in a hospital corridor, a graphic reconstruction showing how the scene may have looked to a passing bird, and a photo of the apartment with a downward-pointing arrow to show that gravity was still doing its work in pulling the two to their death. As if to banish any doubt, there was also a photograph of the man's foot peeking out from under a blanket as the body lay skewered on balcony railings. But according to suicide experts, such graphic reporting of a suicide may mean that it is only a matter of time before it is repeated. 'Suicide tends to be copied because of the kind of behaviour it is,' said Dr Annette Beautrais, a leading suicide expert from New Zealand, who gave a public lecture at the University of Hong Kong earlier this month. 'It is something with which people have a morbid fascination, and a behaviour [whereby] vulnerable, mentally ill people may identify with others who have died in this way, seeing it as a solution for their own problems.' Although she said that it was nearly impossible to conduct research on whether media reports caused the rate of suicide to rise, Dr Beautrais said there was enough evidence linking the two to justify bringing in guidelines for journalists in Hong Kong. 'There is a media fascination with suicide, and so the public becomes more interested,' she said. 'The media may represent their interest in suicide as reflecting public interest, but there is a risk that media coverage of suicide also becomes gratuitous,' she said. At the lecture, Dr Beautrais suggested bringing in 'moral guidelines' for Hong Kong's media, based on those issued by the World Health Organisation in 1999. However, Hong Kong already has media guidelines. Five years ago, the Hong Kong Journalists Association (HKJA)introduced guidelines, and updated them six months ago when the number of suicide reports in the media continued to rise. 'We saw reports on charcoal suicide, which mentioned very detailed ways of committing suicide,' said Mak Yin-ting, chairperson of the HKJA's ethics committee. 'We thought the articles were not in the spirit of the guidelines, so we updated the guidelines.' Still, the suicide rate is at a 'historical high', according to Dr Paul Yip Siu-fai, director of the University of Hong Kong's Centre for Suicide Research and Prevention. He said that not only has the charcoal-burning method of suicide spread, but that media coverage of charcoal burning has fostered a new category of suicide victims. 'One of our main concerns is that [charcoal burning] is not simply a substitution. If it were a substitution of method, it would not affect the suicide rate,' Dr Yip said. 'Charcoal ... also draws in other people to commit suicide. According to our figures, the suicide rate in Hong Kong is now 16.4 per 100,000 - an all-time high. This is because of this new rise in charcoal burning, and we think that that could be due to newspaper reports. 'The rate in Hong Kong is two more than the international average - it was only 11 or 12 [per 100,000] before charcoal death was first reported in 1998.' There have also been reports that 'suicide contagion' through the media is spreading outside Hong Kong. Similar charcoal-burning suicides now occur in Macau, and Taiwan's first victim allegedly learned the method from reading Hong Kong newspapers over the internet. The idea of regulating the media to minimise suicide rates is nothing new. Dr Beautrais cites an example that goes back to the days of German playwright Johann Wolfgang von Goethe. In his 1774 work, The Sorrows of Young Werther, Goethe's main character shoots himself after a failed love affair. The wave of similar suicides by young men led to the book being banned in Denmark, Saxony and Milan. The imitation of suicidal behaviour is still known as the 'Werther effect'. So far, media guidelines - which are listed by the WHO as one of six key suicide prevention strategies, and were drawn up by a team of suicide research experts and journalists - have been adopted by several countries, including the US, Britain, Ireland, New Zealand and Australia. Deborah Kirkman, a spokeswoman for the Australian Press Council, said of Australian media: 'We do suggest that papers not use the word 'suicide' in the headlines, and that papers publish details of support groups. We strongly suggest not to give details of how a suicide was performed, for fear of copycat suicides, though the press is more inclined, from my observation anyway, to use the term, 'there were no suspicious circumstances' as opposed to 'a person committed suicide'. 'In a police report, if you're reporting on the suicide or exploring the issue of suicide itself, then yes, you may use the term suicide. Most people know precisely what 'sudden death' means.' Dr Beautrais said the extent to which media guidelines can be introduced 'is a reflection of the extent to which a society is prepared to endure some restrictions, which may have an impact on the entire population, but which are designed to benefit a minority of vulnerable individuals'. She said that about 90 per cent of people who die by suicide have at least one mental illness. Dr Beautrais gives numerous examples as evidence for the link between media coverage and suicide rates, but the one that hits closest to home in Hong Kong is suicide by charcoal burning and asphyxiation. In 1998, the first case of suicide by charcoal burning was given widespread and graphic coverage in the media, along with instructional diagrams. Within two months, charcoal burning had become the third most common method of suicide, and now accounts for one in four suicides. Other researchers agree with Dr Beautrais. '[The rise in the number of suicides by charcoal burning] would not just happen like this without the mass media advertising it,' said Dr Yip. 'We are trying to talk to news reporters and share our research findings, and hopefully they can do their own bit to try to reduce the number of suicides,' he said. Should concern for a vulnerable minority override public interest concerns such as press freedom, an uncomfortable topic since before the handover? Some journalists deny that guidelines would be justified. 'It's been a matter of concern for a lot of people for a long time, of course, but from a journalist's point of view, I would argue whether there is any proof to the theory,' said a former journalist with a Chinese-language newspaper, who asked not to be named. 'I don't condone dramatising a suicide. But it's all speculation. One day you report a school student jumping off the roof for whatever reason ... but if there's another incident similar to that two or three days afterwards, then people point their fingers at the newspapers. 'I would argue that people should get to the root of the problem of what causes students to jump off the roof instead of pinpointing the blame on the newspaper.' The HKJA's Ms Mak disagrees: 'When talking about press freedom, we are also responsible media. We cannot say that we can ignore all the side-effects. We know that there might be some side-effects on certain people with certain personalities, so we have to take care over that.' Dr Beautrais said that it was journalists' perceptions that they were mainly purveyors of information rather than agents in social conditioning that had led to a 'running battle' between clinicians and journalists in New Zealand. 'Clinicians are educated to 'first do no harm'. The credo of newspaper journalists, however, is to 'publish and be damned'. There would appear to be very little room for compromise in these two stances,' she said. 'Certainly newspapers do have a commercial reality, but it is to be hoped that they feel that they also have a responsibility to the more vulnerable members of their community,' she said. But how effective can such guidelines be if they rely on media self-regulation? 'Guidelines that allow a good degree of regulation within the profession would be more important than intervention from outside, because I do believe that there are voices within the profession that would be willing to advocate and compound the guidelines,' said Dr Dominic Lee of The Chinese University's of Hong Kong's Department of Psychiatry. Others disagree. 'In Chinese newspapers, the reporters have news guidelines, but no one follows them,' said Dr Yip, who organises seminars on suicide for journalists. 'I think it is not simply a matter of guidelines. There should be guidelines that reporters really take to heart. If they believe that whatever they do could have a harmful impact, then they will do something. If it's simply a guideline with no penalty, then I don't think it works,' he said. Dr Yip said the bottom line was money. 'Reporters tell me that when it goes back to the editor's room, that's where the decision is made,' he said. 'That's where they decide to make their front page headlines, their colour photos and so on. We were told: 'Don't preach to us. It's the editors, who are more concerned with financial considerations'.' The HKJA's Ms Mak said that, despite the number of unanswered questions, the risk alone of copycat suicides meant that the guidelines were justified. 'Life is so important that I think we should take every step to prevent another life being lost,' she said.