Media reportage of suicide among police officers in Ghana: A mixed method analysis

Abstract Rates of suicide have been recorded among the police in some parts of the world. Despite the attention that this topic has received, it appears that not much is being researched on it in Africa. Besides, research on suicide in Ghana has been skewed towards the public, to the neglect of the police. The sparse literature on suicide among the police both in Africa and in Ghana inspired this study. Our objectives were to examine the state of suicide among the police in Ghana as reported in the media, the differences between private and public news outlets with respect to their reportage of police suicide, and reasons that account for suicide among the police in Ghana. Using a mixed method approach and with purposive sampling technique, contents of news items from seven popular news portals on suicide among police officers in Ghana between the years 2015 and 2021 were reviewed. Sixty-nine (69) news items were analysed using both quantitative and qualitative content analysis. It was observed that there were more reports of suicide on male officers compared with their female counterparts, with the rifle, pistol, and hanging being the modes for carrying out the act of suicide. Almost an equal number of superior and subordinate officers were reported to have committed suicide. To ensure that they completed their act, officers resorted to the use of lethal means, such as shooting themselves through the eye, head, throat, chin, and jaw. The reasons for committing suicide clustered around the themes of psychosocial precipitants, too high expectations, expected to man up, failed marriage, education of children, institutional lapses, failed paternity test, proposal, lack of public support, fed up with this life, can’t take the disgrace, and access to deadly weapon. Generally, media outlets failed to comply with the acceptable guidelines for reporting suicide. The use of a mixed method afforded us the opportunity to glean some reasons that account for suicide among the police in Ghana, showing how the psychological state of the officer, the society, and faulty institutional structures within the service could lead to officer suicide. Also, there is a need for media outlets to be educated on the need to adhere to the standard guidelines for reporting suicide.


Introduction
In view of the number of different roles in the police service, individuals in those different roles are likely to experience different events, and consequently different risks or threats (Sheard et al., 2019). For instance, officers of emergency call-handling are detached from the incident and different compared with the day-to-day responsibilities of a public-facing 24/7 police officer (Ramey et al., 2017). Thus, officers in different roles are also likely to experience different types of traumas (Sheard et al., 2019).
Police officers suffer both fractures and lacerations (Jayakrishnan et al., 2013), physical and verbal abuse (Ellis et al., 1993), depression and suicidality (Njiro et al., 2021), and death (Hipple et al., 2017) in the course of their duties. Moreover, Barnett et al. (2021) noted that officers of the Ghana Police Service are exposed to several work-related potential traumatic events: assault, road accidents, exposure to dead bodies, flood, and fire. They observed that although most officers were exposed to some form of potential traumatic events, such experiences did not necessarily translate into expressed trauma. Nevertheless, more than half of the respondents in their study experienced at least a traumatic symptom with many of them affirming the traumatic indices of re-experiencing the trauma and consciously avoiding the traumatic triggers and/or the trauma (Barnett et al., 2021). Also, it has been suggested that role overload and ambiguity, lack of supervisor and coworker support, and physical environment were work-environment factors affecting the stress levels of police officers in Ghana (Gyamfi, 2014).
Additionally, police work is deemed to be highly stressful considering one's exposure to trauma, unpredictable events, extended periods of boredom, tension with respect to organisational issues, and the inconsistent nature of its shift work (Violanti et al., 2011). Acquadro Maran et al. (2015) have suggested that stress has a serious impact on both the psychological and physical health of police officers, with problematic consequences: depression, post-traumatic disorder, and suicide (McCanlies et al., 2014), as well as reduced quality of work and absenteeism (Verhage et al., 2018).
A theory that has currently proved helpful in explaining job stress across occupations, such as the police service (Raper et al., 2020), is the job demands-resources (JD-R) theory (Bakker & Demerouti, 2017). The JD-R theory postulates that all work features could be categorised as demands or resources, with demands being "those physical, psychological, social, or organisational aspects of the job that require sustained physical and/or psychological effort" (Bakker & Demerouti, 2017, p. 274). Continuous exposure to job demands activates health impairment processes producing negative consequences for people (e.g., mental ill-health) and their establishments (e.g., absence) (Houdmont et al., 2020). High job demands have also been shown to contribute to significant clinical levels of anxiety (Acquadro Maran et al., 2015), with anxiety being associated with burnout (Zhou et al., 2016).

Suicide reportage in Ghana's media
According to the Mental Health Authority (2022), there were frequent media reportage on suicide in Ghana almost every day in 2021. They revealed that there were 797 attempted suicide cases in 2018, rose to 880 in 2019 before dropping to 777 in 2020. The year 2021 saw the rise of attempted suicide cases to 902. Completed suicide rose from 69 in 2020 to 86 in 2021. Some cases were not reported due to stigma (Mental Health Authority, 2022). Some guidelines have been outlined for responsible media reportage on suicide to aid in its prevention (WHO, 2000;WHO & IASP 2017). Studies show the lack of compliance with the WHO's recommendations with respect to standard reporting guidelines among media outlets and journalists in low-and middle-income countries (LAMICs) (Arafat et al., 2019;Armstrong et al., 2018;Chang & Freedman, 2018;Chu et al., 2018;Chun et al., 2018). The breaches of the recommended reporting practices are associated with increased probability of imitative suicidal behaviour and copycat suicide among vulnerable groups (Niederkrotenthaler et al., 2010). Quarshie et al. (2020) showed the lack of compliance with WHO reporting guidelines among media outlets and journalists in Ghana. Studies on suicide in Ghana have been mostly skewed towards the general population to the neglect of police officers. Despite the plethora of research on mental health among the police in other parts of the world, few studies have been conducted in Africa in this regard (e.g., Adebayo et al., 2008). So far, the paucity of research within the African context makes it difficult to draw firm conclusions based on the associations observed. It is our position that more studies are required to ascertain the general state of suicide among police officers in Ghana as reported in the media. We sought to investigate the state of suicide among the police in Ghana as reported in the media, and to ascertain the differences between private and public news outlets with regard to their reportage of police suicide.  concluded that mixed results have been found in studies examining suicide rates among police officers. Whereas some studies showed low rates of suicide among police officers, others indicated higher rates, with some indicating no difference in rates between police officers and comparison populations . Further, traumatic events, lack of support from the service, stigma associated with requesting for assistance, shift work, and problem associated with adopting to police culture were stressors that were associated with police suicide .

Suicide among the police
A psychological autopsy approach has been proposed and found that pre-hired factors were the key factors contributing to suicide among police officers (Rouse et al., 2015). As well, a psychological model of police suicide has been proposed by Violanti and Samuels (2007). This framework especially conceptualises suicide within the vocational context of the police service. Violanti and Samuels (2007) postulated that police officers have from the period of recruitment probably gained a diminished ability to utilise diverse social roles. Such officers then probably increasingly lose their ability to contemplate the depth of their emergency-driven and non-workrelated contexts. It is argued that in effect the police officers cope through overutilisation of the police vocational role (in contrast to their pre-hired identity).

Suicide within the African context
It has been established that suicide rates among individuals within Africa and other parts of the world are on the high side (Mars et al., 2014, World Health Organisation, 2014. Oyetunji et al. (2021) noted that more men die by suicide as compared with women in Nigeria. Some individuals commit suicide due to relationship difficulties, and sometimes it takes place at the person's residence (Olibamoyo et al., 2021). Victims sometimes leave behind a note, spelling out the reason for committing suicide (Olibamoyo et al., 2021). In Ghana, suicide is considered as a "bad death" and is viewed by Ghanaians as an extraordinary moral evil, which attracts dishonor and shame to one's family and the society in general. On the religious front, suicide is classified as a sin by all religious groups in Ghana (Osafo et al., 2011). There is the belief that "a man does not fear death", "a man does not cry", and "it is a real man who takes bitter medicine" thus requiring that men become daring, showing invincibility and mental fortitude (Adinkrah, 2013).
Suicidal behaviour in Ghana is socially barred and attempted suicide is considered a criminal offense: "whoever attempts to commit suicide shall be guilty of misdemeanor" (Criminal code 1960, Act 29 Section 57). Adinkrah (2013) pointed out that there have been reports of criminal prosecutions of individuals who attempt suicide in Ghana. Such a punitive posture and stigmatisation of attempted suicide in Ghana leads to poor recording and under reporting of suicide attempts becoming a serious challenge to Ghana's healthcare system (Adinkrah, 2013). Reasons that account for attempted suicide in Ghana, cluster around shame, lack of support, existential struggles, abandonment, and supernatural reasons (Akotia et al., 2018). However, there is little knowledge on the reasons that account for suicide among the police in Ghana. In essence, we sought to explore the reasons that account for suicide among the police in Ghana as reported in the media. In effect, we asked the following questions: (1) What is the state of suicide among the police in Ghana as reported in the media?
(2) What are the differences between private and public news outlets with regard to their reportage of police suicide?
(3) What reasons account for suicide among the police in Ghana?

Suicide among the police in Ghana
Anecdotal evidence reveal that members of the Ghana police service must deal with threats from the people within the community and frequent transfers (normally as a form of punishment), maltreatment from superiors, intimidation, threat of dismissal and reduction in rank. Often, the police in Ghana are required to respond to calls that potentially expose them to traumatic events, such as rape, child abuse, car crashes, domestic violence, homicides, and emotionally charged incidences. Such repeated exposure to traumatic events leads to secondary trauma, with its attendant psychological effects on the police officer. Recently, it was reported that a police officer had committed suicide after he was forced to resume from his leave and go on guard duties (MyJoyOnline, 2021).

Research design
A mixed method was used in the study. The use of a mixed method guarantees that the weakness inherent in a quantitative method are addressed by the qualitative method and vice versa (Brown et al., 2015). The use of the mixed method afforded us the opportunity to provide a more robust analysis. We quantified the number of suicidal behaviours published in online media outlets in Ghana between 2015 and 2021. In addition, qualitative content analysis was used to explore the content, patterns, and trends of the reported news items. Besides, the mixed method was suitable in helping us answer our research questions.

Data source and sample
Contents of news items report on mental health including suicide and suicidal behaviour among police officers in Ghana between 2015 and 2021 were reviewed. The news portals of some major local media outlets, such as Daily Guide, Daily Graphic, Ghanaian Times, GhanaWeb, Adom FM, Starr FM, and MyJoyOnline, were accessed by the second author. These news portals by the various media houses have been noted to have a wider readership (Quarshie et al., 2018). Newspaper outlets such as Daily Guide, Ghanaian Times, and Daily Graphic are not only the major outlets with wide readership but their online presence made it possible to access news items published online. The study employed a purposive sampling method by choosing only issues that covered suicide and suicidal behaviour among police officers.

Search strategy and data cleaning
Search phrases used were "Ghana police", "police suicide", "police assault", and "police shooting" in a bid to retrieve relevant news items. Initially, two hundred and nineteen (219) news items were copied based on their titles. Thereafter, hundred (100) news items were screened out for eligibility. Thereafter, a hundred and nineteen (119) total suicide reports were identified after eligibility screening. Following this, fifty (50) items were dropped based on duplication within the same news portal. Although a particular news item could be captured in two or more portals, they were maintained owing to the different angles from which they were reported. Thus, some news portals provided more information on a particular item compared with others. In all, sixty-nine (69) news items were retained for further analysis ( Figure 1).

Qualitative
Guided by the research questions of the study, the authors read through the news items to code information relevant to answering the research questions. The coding was done to ascertain the reasons that account for suicide among the police. Following the initial coding process was the grouping of the codes into categories with reference to their similarity. These categories were labelled as themes and subthemes as deemed appropriate. The themes were discussed among the authors and agreement reached as to which ones should be presented. The final themes and subthemes with comments are presented in Table 2.

Quantitative
Quantitative content analysis was used in analysing the data. Content analysis has been used for all types of written text (Bengtsson, 2016). Quantitative content analysis originates from media research (Bengtsson, 2016). Initially, we quantified the text data by reducing the text information into numeric values. The quantified text was grouped into categories and inputted into SPSS version 22. Thereafter, the categorical variables were summarized with frequencies. Further, inferential statistics was performed on some of the categorical variables. Using SPSS version 22, Chi-square test was used to compare private and public media outlets on their compliance with suicide reporting standards.

Results
Most of the officers who committed suicide were within the ranks of superintendent (27) and constable (26) and were more likely to be male (73) ( Table 1). Police officers were more likely to commit suicide using a rifle (21), and to commit the act in their room (34). As well, officers were more likely to shoot themselves through the throat (6) ( Table 1).
The reasons that account for police suicide generally clustered around psychosocial precipitants (subthemes: stress, depression, psychological problem, stigma, and exposure to trauma), too high expectations, expected to man up, education of children, lack of public support, institutional lapses (subthemes: issues of promotion, meagre salary, internal victimization, feeling ignored by Total reports using suicide related search words from seven (7) online news portals from 2015-2021 (n=219) Total suicide reports identified after eligibility screening (n=119) Total suicide reports for the study (n=69) Screened for eligibility: Reports excluded (n=100) Screened for duplication within the same news portal (n=50) superiors, and lack of through background check), failed paternity test, failed marriage proposal, fed up with this life, can't take the disgrace, and access to deadly weapon (Table 2).
No significant association was found between report of the reason for suicide, and the type of media outlet; report of the setting of suicide and type of media outlet; mode of suicide and type of media outlet; age of victim and type of media outlet; sex of victim and type of media outlet; rank of victim and type of media outlet. Nevertheless, it was observed that private media outlets were more likely to report on the weapon used for committing suicide, compared with public media outlets, χ 2 (1) = 3.28, p < .05 (Table 3).

Discussion
The study sought to answer three research questions: (1) What is the state of suicide among the police in Ghana as reported in the media?; (2) What are the differences between private and public news outlets with regard to their reportage of police suicide? (3) What reasons account for suicide among the police in Ghana? Most of the reports on suicide were on men. The use of rifle, pistol, and hanging were the modes for carrying out the act of suicide. Moreover, the room and washroom were settings for police suicide. As well, news outlets reported almost an equal number of superior and subordinate officers committing suicide. In terms of the lethality of the suicide process, police officers shot themselves through the head, throat, eye, jaw, and the chin. Also, we found psychosocial precipitants, too high expectations, expected to man up, education of children, lack of public support, institutional lapses, failed paternity test, failed marriage proposal, fed up with this life, But the deceased allegedly left a short note that read "I can't take this disgrace, something I don't know about." • It appears this officer considered himself to be innocent of an accusation and to save himself from disgrace, suicide was the option he deemed fit.
Access to deadly weapons • He said these officers also commit suicide just to end their problems because they have access to deadly weapons which are meant for their work.
• This report seems to suggest that officers resort to suicide because they have access to weapons that could easily aid them carry out the act.
can't take the disgrace, and access to deadly weapon to be the reasons that account for suicide among the police in Ghana as reported in the media.
News reports indicated that too high expectations and the idea that police officers are supposed to man-up accounted for suicide among the police. Thus, probably accounting for the most reports on male police suicide. This corroborates the Samaritan's (2012) position that masculinity and social expectations instigate men towards suicidal behaviour. In the same vein, Oyetunji et al. (2021) showed that more men die by suicide compared to women in Nigeria.  explained that the stigma associated with requesting for assistance is associated with police suicide.
A lot of details on police suicide were given with regard to age, sex, rank of officers, setting of the suicide (i.e., mostly in the room), mode of suicide (i.e., using firearm, hanging), and reason for the suicide. Similar mode and setting for committing suicide have been recorded in Olibamoyo et al. (2021). In their study, it was found that hanging, use of firearm, and self-inflicted injury were some of the modes of committing suicide (Olibamoyo et al., 2021).
Reports captured the lethality of the suicide process: officers shooting themselves through the head, throat, eye, jaw, and chin. With their experience, it is comprehensible that they knew how to carry out the act successfully. Ghana's law criminalises suicide, with punishment for attempted or failed suicide. The knowledge that one will be punished if s/he fails to carry out the act successfully makes it imperative for police officers to carry out the act in the way that gives the highest probability of obtaining success, hence the parts of the body damaged.
Stress, depression, stigma, psychological problems, issues of promotion, meagre salary, internal victimization, exposure to trauma, feeling ignored by superiors were some of the causes of suicide. There were reports indicating the stressful and depressive nature of the police service in Ghana, which leads them to commit suicide. This is in consonance with Barnett et al. (2021) who found that police work in Ghana is traumatic, with officers most likely to be exposed to at least a dead body. In the same vein, Gyamfi (2014) indicated that the physical environment, lack of supervisor and work support were factors impacting stress levels among police officers in Ghana. Such exposure could account for the stressful and depressive nature of the police service in Ghana, corroborating Sheard et al. (2019) who noted that police officers have poor psychological well-being. The depressive nature of the police service has also been evidenced by Njiro et al. (2021) who found that police officers in Tanzania screened positive for depression. McCanlies et al. (2014) showed the detrimental impact of stress on the psychological health of police officers manifest in suicide. According to the JD-R theory, demands in the form of social, psychological, physical, or organisational aspects of a job that demands continuous psychological and/or physical effort (Bakker & Demerouti, 2017), activates health damaging processes that result in negative outcomes for individuals (e.g., mental ill-health) (Houdmont et al., 2020). This explains the job stress among police officers (Raper et al., 2020). In view of the stressful and depressive nature of the police service, officers are likely to resort to suicide as a response to their psychological suffering (Zhang, 2005).
It was found that some police officers committed suicide because society expected them not to reveal their weakness. The idea that "a man does not cry", "a man does not fear death", and "it is a real man who takes bitter medicine" places a demand on men to show mental fortitude, invincibility, and a daring disposition (Adinkrah, 2013). Such a prevailing cultural notion breeds certain expectations about the police, requiring that they man-up, to avoid stigmatisation. In effect, the discrepancy between societal expectations and the inner disposition of the officer to admit his weakness may push him or her into suicide to avoid stigma. This supports Akotia et al. (2018) who showed that some people within the Ghanaian context resort to suicide to avoid shame. In the reports, "can't take this disgrace" was a reason given by an officer for committing suicide, mirroring the findings of Akotia et al. (2018).
A comparable number of both senior and subordinate officers were reported to have committed suicide. In Ghana, most subordinate officers enter the police service without knowing the full implications of being in the service. They often join due to economic hardships and are normally not qualified or in the right frame of mind to adjust to the demands of the profession. In essence, they often lack the psychological readiness for success in the police profession. This is in consonance with Rouse et al. (2015), who noted that some pre-hired factors are vital factors leading to police suicide. Per the psychological model of police suicide (which conceptualizes suicide within the context of the police profession), police officers' ability to use different social roles continues to diminish after the period of recruitment (Violanti & Samuels, 2007). In that way, their ability to contemplate the weight of their emergency-driven and non-work-related settings increasingly diminishes, thereby forcing them to cope through overutilization of their police vocational role in contrast to their identity before enlistment into the service. Further, the "do before complain" relationship that exist between superior officers and subordinate officers in the Ghana police service makes it difficult for subordinates to obtain fair hearings with respect to their grievances. As such, there are very little outlets for them to vent their frustrations, probably accounting for police perceived suicide in Ghana.
Rising in the ranks in the Ghana police service is perceived to be political especially at the superior officer rank zone. A superior officer who feels s/he is due for promotion but has been denied or delayed, is likely to be frustrated thereby leading to suicidal tendencies. At the superior level, it is safe to reason that an officer would have been exposed to a number of traumatic events in the course of his or her career. Such traumatic experiences could resurface late on in life. Up until late 2021, the Ghana police service did not have a well-structured psychological or counseling unit to help address the psychological needs of officers. The lack of such structures limited officers' chances of obtaining some form of psychological intervention for the emotional and psychological trauma they face in the course of duty.
Although there was no significant difference between both private and public media outlets with respect to the details of information on police suicide, private media outlets were more likely to provide details on the weapon used for committing suicide compared to public media outlets. The findings confirm Quarshie et al. (2020) who found that journalists and media outlets in Ghana generally do not comply with the WHO's guidelines for reporting suicide cases. Also, the findings buttress other studies that have shown the lack of compliance with the WHO's recommendations for standard reporting of suicide in LAMICs (Arafat et al., 2019;Armstrong et al., 2018;Chang & Freedman, 2018;Chu et al., 2018;Chun et al., 2018).

Limitation of the study
Although the mixed method used provided some merits, our inability to include other media outlets and to expand the period for the search might have impacted the amount of evidence gleaned. Also, we were unable to map out the number of news items on suicide in every year, but will suggest that future studies map out the number of suicide cases in a year to study patterns of suicide reportage and draw (if possible) correlates with prevailing conditions within the country. Some quantitative and qualitative designs such as cross-sectional surveys, interviews and focus group discussions could be employed in future studies. For a qualitative study, future studies could consider interviewing colleagues and family members of police officers who committed suicide.

Conclusion and recommendations
It was observed that a large percentage of the reports on suicide were on men, with rifle, pistol, and hanging being the main modes for committing suicide. Officers often chose their rooms and washroom as settings for committing suicide. Moreover, news outlets reported almost an equal number of senior officer and junior officer suicides. To ensure success in committing suicide, officers chose more lethal methods: shot themselves through the head, throat, eye, jaw, and the chin. With respect to the reasons for committing suicide, psychosocial precipitants, too high expectations, expected to man up, education of children, lack of public support, institutional lapses, failed paternity test, failed marriage proposal, fed up with this life, can't take the disgrace, and access to deadly weapon were the themes that summarized officers' reasons for committing suicide. Detailed reports were also given on the cases of suicide, contrary to the WHO's recommended standards. We recommend that adequate education and training on acceptable standards for reporting suicide be made available to media practitioners. In training police officers, the curriculum of the Ghana Police Training School should include how to manage expectations. Proper recruitment practices are encouraged to ensure that the right individuals are enlisted into the service. This should include adequate background checks and psychological assessments to guarantee that only persons without a history of psychological problems are enlisted into the service. The Ghana Police Service should collaborate with the Ghana Psychological Association (GPA) in that regard. Moreover, continuous, and periodic training and psychological assessment of police officers is recommended to ensure that they are psychologically fit. Psychological assessments of all police officers should be conducted bi-annually. Thus, the human resource management arm of the Ghana Police Service needs a thorough review. A well-resourced Human Resource Directorate is required in this regard. Counseling services within the police service should also be improved.