# Media Discourse, Influence, and Reflection: Content Analysis and Text-Mining Study of Suicides and Homicides in Long-Term Care

## TL;DR

This study examines how media coverage of suicides and homicides in long-term care in Taiwan changed after a new care policy was introduced, showing shifts in language and the potential for media to influence public health outcomes.

## Contribution

The study introduces a content and text-mining analysis of media discourse on caregiving tragedies in long-term care, linking policy changes to shifts in language and suicide prevention efforts.

## Key findings

- The term 'family moral tragedy' decreased by 32.4% in headlines and 24% in content after 2017.
- The term 'care burden' increased significantly in frequency post-2017.
- Media coverage provided more suicide prevention information (e.g., hotlines) than long-term care services.

## Abstract

As populations age, the demand for long-term care services steadily increases. The effectiveness of government-promoted long-term care policies and the public’s access to relevant service information are demonstrably influenced by media representation. In addition, prior research has suggested that news framing can mitigate the negative influence (the Werther effect) with a more hopeful framing (the Papageno effect), thereby reducing the public’s susceptibility to negative news.

This study investigates the phenomenon of suicides and homicides in long-term care reported in the news, in which family caregivers or care receivers died by suicide or homicide. We examined changes in the media’s reporting framework before and after the implementation of Taiwan’s Long-Term Care Plan 2.0 in 2017. We further examined the consistency between the content of news reports and the information provided by the media on long-term care services and suicide prevention (eg, hotlines).

Content analysis and text-mining techniques were used to analyze 433 news reports covering 95 cases of suicides and homicides in long-term care in Taiwan from 2009 to 2021. A random-effects model was applied to examine term frequency transition post implementation.

The majority (>60%) of the cases involved family caregivers’ homicide-suicide. The term “family moral tragedy” has been replaced by “long-term care tragedy” in recent discourse. This shift is evident in a decline in the frequency of “family moral tragedy” since 2017, with usage decreasing by 32.4% in headlines and by 24% in news content. The term frequency of “care burden” has significantly increased from 0.0006 (SD 0.0008) to 0.017 (SD 0.0461; t337=3.006; P=.003). While linguistic characteristics of the content have remained consistent, there were statistically significant differences in medical and ethics-related terms. The media tends to provide more suicide prevention information (eg, hotlines; >50%), offering relatively limited coverage on long-term care services (<25%).

The news media have the potential to change the public’s response to specific issues. Our findings suggest that government efforts to encourage media coverage of positive experiences with long-term care services can be a preventative measure against caregiving suicides and homicides. Moreover, government initiatives should focus on strengthening media publicity and enhancing media literacy within the long-term care sector. By empowering the media to provide readers with clear channels for seeking help, such as hotlines, the media will contribute positively to the mental health of family caregivers. Finally, an annual database on family caregiver homicide-suicide should be established. In that case, the government could identify potential risk factors and inform the formulation and revision of relevant policies and services via this database, ultimately contributing to preventing suicides and homicides in long-term care and achieving public health goals.