1. Introduction and literature review

Pandemics, because they are complex events that usually push human beings to the limit, exacerbate the crises of health systems and tend to strongly impact the psyche of citizens. In the case of the COVID-19 pandemic that began in 2020, various sources warned about a possible increase in suicide rates (^{Sher, 2020}; ^{Tandon, 2021}). Although international organizations provided guidelines to help health systems (^{Wasserman et al., 2020}) and constructively guide citizens on these possible problems, the media have played a dual role in the information that has been circulated on the subject.

The porous nature of the current information ecosystem (^{Carlson & Lewis 2015}), where traditional media compete with digital media and social networks for the same audience, and the explosion of online news media added to the crisis of traditional media with the corresponding precariousness of journalistic work (^{Barredo-Ibáñez, 2021}), have definitively affected the quality of information to which the common citizen is exposed. The infodemic-the over-information of spurious content on certain topics, in this case, COVID-19 (^{World Health Organization, 2022})-is related, from a media point of view to capturing attention as a broad process around which social media and traditional media are articulated. This attention-grabbing or seeking tends to generate negative effects on the emotions of the recipients (^{Twenge et al., 2018}).

These effects lead to the treatment of people as users, who are overloaded with content, attraction and loyalty strategies, leading in many cases to psychological disorders such as anxiety, lack of sleep, and irritability (^{Rodrigues et al., 2022}). The outcome of this attention-grabbing is visibly seen in the slot machine effect, where it is proposed that people become addicted through the constant and diverse symbolic gratifications from media and social platform narratives (^{Patino, 2019}); the sentinel effect, according to which individuals sleep less and less, waiting to receive notifications from the various devices they have (^{Eisenstein & Estefanon, 2011}); the FOMO effect fear of missing out which alludes to the anxiety of missing some type of important news, or the solitary consumption effect, which drives individuals to insistently show their daily life to obtain social endorsement (^{Costa & Capoano, 2020}), to name a few.

The intervention of effects such as those that have been listed leads to numerous public health problems, among which the suicidal act stands out, which is a complex problem that depends on psychological, personal, cultural, and economical factors, among others (^{Castro et al., 2014}). Furthermore, within this multicausal phenomenon, many authors conclude that there is also a relationship between media consumption and suicidal ideation (^{Herrera et al., 2015}; ^{Acosta et al., 2017}; ^{Lois et al., 2018}; ^{Durán & Fernández, 2020}; ^{Niederkrotenthaler et al., 2020}). The increase in screen time from 2010 onward can help us understand the increase in depressive symptoms and suicidal acts in American adolescents (^{Twenge et al., 2018}). Phenomena such as cyber victimization (^{Sedgwick et al., 2019}) or cyberbullying underpin the link between suicide and the media that has been transferred from the analogue to the digital.

This aforementioned link usually occurs through a contagion effect which is also called the Werther effect or copycat effect and tends to be incentivized according to aspects such as the celebrity status of the person (^{Stack, 2005}; ^{Herrera et al., 2015}; ^{Carmichael &. Whitley, 2019}).That is, the more famous the celebrity, the greater the possibility of copying by those receiving that content, particularly when the medium in which it is shared does not follow the technical guidelines to address suicide proposed by the ^{World Health Organization (2017)}. The guidelines suggested by this source range from narrative aspects such as not using sensationalist language or editorials such as advising not to highlight suicide stories spectacularly in the head. Similarly, personal circumstances also influence the contagion effect, since the content will have a greater impact among vulnerable groups than in those other groups with greater media literacy (^{Muñoz & Sánchez, 2013}).

In contrast to the Werther effect is the Papageno effect, which is the influence that media can have on defusing suicidal ideation by individuals (^{Sinyor et al., 2018}; ^{Herrera et al., 2015}). These authors explain that, sometimes, the media will silence suicide as a way to avoid the contagion effect. Addressing this topic has the ambivalent role of news taboos; hence, suicide has been proposed as one of the taboo topics of journalists (^{Barredo-Ibáñez, 2011}). As such, suicide has the ambivalent role of the taboos described by ^{Gantz (1978}) in an already classic work, as it is a topic that can protect societies by presenting options for greater support but also as a destroyer of those same societies when it is treated in a normalized and/or sensationalist manner.

This study examines the relationship between the levels of suicidal ideation and the reception of news -non-fictional broadcastsand audiovisual entertainment programs -realistic or hyperrealistic broadcastsin the first year of the pandemic in Colombia. This communicative approach to this mental health problem is novel, considering that research related to suicide has frequently focused on studying the influence of psychological factors (^{Barzilay & Apter, 2014}), social (^{Perceval et al., 2018}), political, cultural and also economic factors (^{Stack, 2021}). Suicidal ideation are thoughts related to the desire to end one’s own life and is considered being a major risk factor of suicidal act (^{Nobile et al., 2021}). Reception in this context has to do with media consumption and specifically with the type of commitment or involvement that the audience assumes with what they receive from the media (^{Pathak & Biswal, 2021}).

Suicide, as we see it, is a controversial issue, especially in a country such as Colombia, whose media coverage of mental health problems has been described as lacking (^{Gutiérrez-Coba et al., 2017}). Added to this is the fact that it is a country that has experienced the oldest internal armed conflict in Latin America, which has left more than 250,000 dead and 9 million victims. A decade ago, the prevalence of suicide in the country was one every 4 hours, mainly due to intoxication, firearms and hanging (^{Muñoz & Sánchez, 2013}). Far from decreasing, the suicide rate from 2005 to 2019 before the pandemic increased from 5.1 cases per 100,000 inhabitants to 5.9 (DANE, 2021a, p. 8). In this context, the work of the media has been essential to face this global health crisis (^{Wasserman et al., 2020}).

However, the study by Garcés et al. (2021) shows that the media can contribute to the improvement of mental health and, especially, to the reduction of stress in this COVID-19 pandemic, when families gather to watch entertainment programs to be together and reduce the tension generated by the confinements and uncertainties of the pandemic. Suicidal ideation is considered an important factor in predicting suicidal action (^{Sedgwick et al., 2019}). This is the first imaginary step that, as explained by ^{Castro et al. (2014}), may continue with the attempt and, later, with the consummation of suicide.

Authors such as ^{Moscardini et al. (2021}) emphasize that there are protective factors such as the social environment or reasons for living that can help mitigate suicidal ideation. On the other hand, the absence of these factors can increase this ideation. Likewise, there is empirical evidence indicating that video games are also used as psychotherapeutic entertainment resources for mental health care (^{Ceranoglu, 2010}). Other studies point out how the negative impact of the media and the lack of practices that strengthen personal well-being or spiritual life are identified as factors linked to suicidal ideation (^{Martínez & Robles, 2016}). From this portion of the literature review, the following hypothesis emerges:

H1. The reception of audiovisual programs is associated with a decrease in the levels of suicidal ideation in Colombia during the period studied, when they promote entertainment and psychological or spiritual well-being.

The previous hypothesis is based on the approaches outlined in the previous literature that, as has been described, emphasize the media’s influence-by action or omission-on the behaviour of the users. Thus, it seems logical to assume that not all media content has the same capacity to influence people.

Although organizations such as the ^{World Health Organization (2017)} have been publishing guidelines on addressing suicide for more than two decades, which have been replicated at different national and subnational levels (^{Ministerio de Sanidad, Política Social e Igualdad, 2020}), some authors point out that the media continue to publish content on this topic, ignoring these recommendations (^{Niederkrotenthaler et al., 2020}).

Likewise, the COVID-19 pandemic accentuated the effects on the mental health of citizens because, as ^{Da Silva & de Lucas (2020}) explain, there was a predominance of negative emotions that deepened social vulnerability, such as “fear, anxiety, stress, irritability and confusion” (p. 164). With the following hypotheses, we will verify to what extent these negative contents published by the media in the context of the COVID-19 pandemic intensified those emotions, generating a greater impact on the levels of suicidal ideation. From this portion of the literature review, H2 emerges:

H2. The reception of news about the negative impact of the pandemic on human life is significantly associated with the increase in suicidal ideation in Colombia during the first year of the COVID-19 pandemic.

2. Methodology

This correlational study of predictive level is based on a non-experimental cross-sectional design. The sampling was performed by quota with the voluntary participation of 660 Colombians residing in capital cities (Cartagena, Bogotá, Armenia, Cali, Barranquilla, Ibagué, Medellín, Valledupar, San Andrés Islands, Riohacha, Monteria, Bucaramanga, Buenaventura, Sincelejo and Tumaco) and the main rural areas of the three most populated regions: Andean, Pacific and Caribbean. The sample was selected in a non-probabilistic approach starting from a population with an age range between 18 and 59 years, which according to the official Colombian census is approximately 32,957,031 inhabitants (Z = 1.96; variance = .25; error = 4%).

The age variable was the sample quota, given that the empirical evidence indicates that suicide in Colombia presents significant age-associated differences and hits young people and the working adult population harder (^{Cendales et al., 2007}). Therefore, the participating sample was structured based on two age ranges: young people between 18 and 26 years (50%) and adults between 27 and 59 years (50%). Regarding the gender of the participants, women (62.8%) were more interested in participating in this study than men (37.2%). It is important to mention at a sociodemographic level that 72.8% of the sample is studying technological or professional careers in higher education institutions in Colombia, and the remaining 27.2% are professionals. Likewise, 49.7% of the respondents declare themselves unemployed and the remaining 50.3% work in the capital cities. In terms of family composition, 78% of the sample lives in nuclear households or extended families, and 22% lives in single-parent families.

To collect the information, students who are pursuing professional careers in the universities where members of the research team work were trained. These students emailed the questionnaire between November 1 and 30, 2020, with prior informed consent and institutional endorsement, to family members, acquaintances, and friends who met the sample requirements in terms of age and region. Regarding the ethical and institutional procedures, this is study is registered with the code NV03PS2201 in a Caribbean coast university in Colombia. This study also complied with the ethical guidelines of the Declaration of Helsinki on Research Involving Human Subjects; therefore, the data collected with minors under 18 years of age were not taken into account in the analysis, since the parents, in most cases, were reluctant to sign the informed consent. This made it difficult to analyze how the variables under study operate in the adolescent population, which is a high suicide risk group.

The questionnaire was made up according to an information and media reception scale (EMI) designed by Garcés et al. (2021) and the Suicide Ideation Inventory (PANSI) created by ^{Osman et al. (2002}). A item-by-item conceptual explanation was not provided, in order to enhance efficient readability, as has been done previously in the aforementioned studies. The EMI presents a good consistency and evaluates through 16 items the frequent reception of series or programs, which has an acceptable Cronbach’s alpha (α =.73), as well as the reception of news about the pandemic and cases of suicide (α =0.86). Both the items presented in the reception of series or programs or the reception of news about the pandemic and suicide cases were measured in a range of 1 (never) to 4 (very frequently). These types of reception show a satisfactory factorial validity that explains 67.27% of the frequent consumption of media in this context of a health crisis (KMO =.872; Chi2 = 6023; df = 210; p-value =.000).

To evaluate suicidal ideation, the PANSI scale was used, which analyzes this problem from 8 items that investigate, in a range from 1 (never) to 5 (always), the presence of frequent negative thoughts (α =.95) associated with the desire to take one’s own life for various reasons, such as not being able to meet the expectations of others, hopelessness about the future, the crisis in relationships, inability to solve problems, feelings of failure and despair to end suffering. These items explain 68.5% of the total variance of negative suicidal ideation (KMO =0.938; Chi2 = 5408; df = 36; p-value =.000).

The levels of suicidal ideation (low, moderate and high) were obtained through a scale by percentiles, taking as reference the minimum and maximum values of the general score and the 30th and 70th percentiles. For media reception, a nonparametric correlation test and a binary logistic regression analysis were applied because the data of these variables do not have a normal distribution.

3. Analysis of results

4. Discussion and conclusions

The literature consulted warns of the negative effects on emotions caused by attention-grabbing strategies as a result of hypercompetitiveness and competition between social media and news outlets (^{Eisenstein & Estefanon, 2011}; ^{Patino, 2019}; ^{Costa & Capoano, 2020}; ^{Rodrigues et al., 2022}). In that sense, before the COVID-19 pandemic, international studies such as that of ^{Carmichael & Whitley (2019}), or in the case of Colombia, that of ^{Gutiérrez-Coba et al. (2017}), noted an irregular quality of information when addressing issues related to mental health. Therefore, at a time of great global confusion, in a broad framework of social vulnerability (^{Da Silva & de Lucas, 2020}; ^{Manzar et al., 2020}) and infodemic, it seems difficult to assume that media content will be effectively anchored to the same advice characterized by the ^{World Health Organization (2017)}.

Faced with a subject as complex as that of the suicidal act, the results presented in this study on the high levels of suicidal ideation found, alert the concern that these levels may continue to grow during and after this health crisis. For this reason, mental health is an issue that should be given greater attention at this time in Colombia and in the world, even more so because suicidal ideation is one of the risk factors for the consummation of the act, as stated by ^{Nobile et al., (2021}). Likewise, the relationship found between suicidal ideation and media reception support what was emphasized by ^{Lois et al. (2018}) and ^{Wasserman et al. (2020}), the narrative of the media can help to transform the perceptions of people, even more so in times of a generalized crisis such as that of COVID-19.

Regarding media reception, online platforms can be constituted as interactive spaces to build support communities and provide more information, as highlighted by institutional sources (^{Ministerio de Sanidad, Política Social e Igualdad, 2020}). Offering healthy advice, promoting sports practices, communicating the help offered by the mental health system, or family support networks are usually some recommendations that help protect people from suicidal ideation (^{Martínez & Robles, 2016}). It is also very important to regulate social networks to involve them more in these public health issues (^{Ministerio de Sanidad, Política Social e Igualdad, 2020}), as they can also be part of a complex solution. In this way, the problem of the lack of intermediation that occurs on these platforms can be solved (^{Rodrigues & Araújo, 2022}). This situation differs in traditional media due to the active intervention of journalists.

At this point, as the first contribution of this study, we found an interesting conclusion based on confirming the nuances related to H1, where exposure to audiovisual entertainment programs contributed to lowering suicidal ideation in respondents in Colombia in the COVID-19 pandemic context. These nuances allude to the type of entertainment program that the respondents acknowledged having consumed frequently or very frequently, watching programs that promoted or strengthened the spiritual life - within this episode of large-scale public health crisis - helped to diffuse suicidal ideation by establishing, probably, a fundamental accompaniment and by giving reasons to live when facing a moment of high uncertainty. In this sense, programs with content that emphasized psychological and spiritual well-being are considered a protective factor, following the reasoning of ^{Moscardini et al. (2021}) and ^{Martínez & Robles (2016}). But, of course, these programs are not isolated from other protective factors. Likewise, some studies such as ^{Twenge et al. (2018}) have shown a positive relationship between non-screen-mediated activities such as physical exercise or cultivating spiritual lifeand the absence of disorders such as depression.

On the other hand, previous literature assures that there is a close relationship between suicide news and the increase in suicides among the population (^{Sinyor et al., 2018}; ^{Niederkrotenthaler et al., 2020}), except in those cases where a negative construction of suicide is shown (^{Stack, 2005}). Therefore, this narrative can effectively serve as a deterrent, provided it is accompanied by other protective factors, such as institutional or psychological help. Similarly, authors such as ^{Twenge et al. (2018}) point out the link between screen time and depressive symptoms. Our results, following this line, confirm that both exposure to negative news about the pandemic and intentional access to news about suicide positively reinforced the suicidal ideation of the respondents, which is the first indicator of a potentially suicidal act (^{Castro et al., 2014}; ^{Sedgwick et al., 2019}). Thus, H2 is confirmed, showing the link between the impact of negative news regarding the pandemic and the increase in suicidal ideation in the time frame and with the type of respondents chosen.

The findings obtained at the journalistic level, suggest that this COVID-19 pandemic possibly contributed to exacerbating the mood, hopelessness and risk of death that has been present in this violent context in Colombia. The reason for this can be supported by the copycat effect (^{Carmichael & Whitley, 2019}), motivated by the lack of reasons or will to live (^{Moscardini et al., 2021}) in a moment of generalized isolation and anxiety. Although it is important to point out that although psychological factors or problems, such as depression, are involved in suicidal ideation, as suggested by ^{Barzilay & Apter (2014}) and ^{Nobile et al. (2021}), in our study age and physical and mental health did not influence the relationship between suicidal ideation and the receipt of information about human losses by suicide or as a consequence of the coronavirus. This indicates that the effect of the media on this problem does not depend so much on health conditions, but also on how the participants assumed or gave meaning to the content and information received.

In conclusion, the way in which a pandemic and suicide cases are journalistically covered influences suicidal ideation. Both reception of negative news about the number of deaths from coronavirus, as well as the intentional search for or access to information in the media about suicide cases, acted as risk predictors of suicidal ideation. Conversely, the reception of programs that promoted or strengthened spiritual life was a protective factor against suicidal ideation. Exposure to audiovisual entertainment programs could help lower the levels of suicidal ideation in contexts of a health crisis, as long they emphasize the support networks and the reasons for living that are present in the programs that promote spiritual life.

The results obtained at a general level urge journalists and audiovisual companies not to lose sight of the social responsibility of the media and more so in the context of a health crisis such as the one suffered by COVID-19. In this sense, it is important to reflect on the type of information that is produced in this context and how it can contribute to public health and help citizens make better decisions regarding the care measures that must be adopted to face this crisis. Although this pandemic has indeed been a school of learning for everyone, including journalists, this does not exempt them from training in public health issues to learn how to cover this type of crisis with greater social responsibility. Likewise, knowledge of the basic terminology at the epidemiological level is required to understand the pandemic (^{Garcés-Prettel et al., 2021}). Journalists and communicators in general should take more into account the recommendations of the ^{World Health Organization (2005)}, which has been offering guidelines to the media on how to avoid panic, without generating false security or transparency, when reporting on security measures and precautions to take during a pandemic.

This study is not without limitations. The first limitation refers to the extraction of the data: it would be interesting to be able to compare the result with a longitudinal perspective. Almost a decade ago, ^{Muñoz & Sánchez (2013}) urged the need to initiate studies that explore the influence of the media on the so-called “autolytic behaviours” in Colombia. Since then, the truth is that very few studies on this phenomenon have been published in the Andean Republic. Another limitation of the study has to do with not having been able to extract a balanced proportion in the participation of men and women in the sample, which justifies that future studies analyze the relationship between suicide and media reception from a gender perspective.

Therefore, this study, although it does not allow us to draw a comparative exercise with the situation before COVID-19, does help to understand and explain some predictive factors of suicidal ideation as a function of media reception. In the future, it would be convenient to analyze the phenomenon taking into account specific variables, such as gender, social ties, interpersonal communication and intrafamily relationships, which may intervene in the relationship between suicidal ideation and media reception, especially in children and adolescents.