What is the role of social media in suicide related behaviour?
Summary: Is social media a risk to the public? What are the major considerations? Is it all bad? This article explores the tensions between problems that have been identified in real time access to information versus real time support and interventions delivered through social media. Challenges that continue to emerge relate to legal responsibility and accountability for content posted on social media platforms.
Whether it’s general discussion, the reporting of a death or the responses to someone expressing suicidal thoughts, believe it or not, there are serious risks involved. The Internet allows for instant access to information and engagement with other users. Recent research has asked the question of whether this instantaneous access is threatening to public health, and if there is an association between Internet/social media usage and suicidal behaviour. Due to the large population accessing the Internet, researchers are interested in whether social media “helps or hinders” suicide prevention. Over the last 10 years alone, there has been a dramatic increase in access to and acceptance of social media in our lives, across multiple platforms.
Let’s consider the potential risks and benefits associated with social media when it comes to suicide. What constitutes as “social media” has been debated, but according to Robinson and colleagues (2016) it may include networking sites such as Facebook, LinkedIn and Twitter, virtual social worlds and game worlds, Instagram and Snapchat and video sharing sites including YouTube (Robinson et al 2016) with the list always growing.
The negative effect
You can probably guess what some of the risks are when it comes to social media and suicide. Access to information on the topic of pro-suicide and suicidal methods is easy and extensive across the internet (Luxton, June & Fairall, 2012). But what is a “pro-suicide” message? Generally we could consider it some communication that endorses or normalises suicide as an acceptable behaviour. Robinson and colleagues (2016) described “legitimising” suicide as a solution as one key concern. People who may not have understood mechanisms or were seeking explicit details have quickly learned or been informed of methods to die through social media (Luxton et al 2012; Robinson et al 2016). Luxton and colleagues (2012) reported a marked increase in one mechanism of death (a cluster) previously unknown until it was described through social media. Contagion and suicide “pacts” were also flagged as significant concerns through the Young and Well report (Robinson et al 2014).
Of major concern identified by Luxton and colleagues (2012) are online chat rooms and forums. Through the exchange of emotions and thoughts, individuals may emphasise hopelessness and isolation in the absence of reflecting on the available supports (of which there are many, such as the Suicide Call Back service or Lifeline). The concern seen relates to a lack of a moderator or regulator to intervene in these groups.
There is also no regulation to consider whether such online forums may include peer pressure or cyber bullying. There have been ongoing efforts to stop bullying in schools and workplaces where it is more visible, with the introduction of anti-bullying laws introduced in Australia in recent years. However cyberbullying is behind closed doors and may not be shut down until it is too late.
The Children’s Rights Report (Nicolson, Ball & Ross 2014) outlined strong concerns at the negative impact of social media on increasing risk, including the age at which children may be access suicide specific information. A disturbing account included in this report, outlined how details of suicide could be distributed across a network and community via social media before family members could even be notified of the death, let alone Police complete their investigation (or Coroners’ inquiry) (Nicolson et al 2014). Indeed, one criticism made by a Coroner investigating six suicide deaths in Tasmania, noted that the family of a girl whom died by suicide, had created a website commenting on causal factors in her death without all the evidence (Magistrates Court Tasmania 2015).
It was reported by the South Australian Child Death and Serious Injury Review Committee that information about social media use was not routinely gathered in the course of a coronial investigation (Nicolson et al 2014) – so clearly there is information missing that must be considered when trying to understand the breadth and depth of involvement of social media in suicide.
Even well-meaning people can inadvertently contribute to increasing risk of suicide and self injury, through glorifying the community response (Magistrates Court Tasmania 2015). Most people wanting to express their distress and shock at suicide deaths of loved ones and are unlikely to recognise the risk of such accounts, yet this has been consistently identified in the strong responses following suicide deaths portrayed in the media.
Mindframe http://www.mindframe-media.info/ provide a critical point of referral for the reporting of suicide and mental illness within the media – but no such service regulates or informs the information shared across social media. If you would like to know more, I strongly encourage you to reflect on these guidelines.
Can social media have a positive effect?
Although there are many negative associations between social media use and suicide identified, there are various networking sites that attempt to prevent such behaviours and where opportunities for intervention can be maximised. Numerous networking sites such as Facebook have established help pages and services that allow for communal support (Luxton et al 2012) although they need to be specifically sought out and reviewed. These preventative strategies allow for the establishment of connections between individuals, promoting social support and broadening access to help.
Key benefits is the 24/7 access to up to date information on mental health, distress tolerance strategies and online counselling. Robinson and colleagues (2014) highlighted the ability to promote help seeking behaviour and services equipped to provide appropriate services, online assessments and intervention. It was also confirmed that suicide prevention sites were often moderated by trained volunteers (Robinson et al 2016). Australia currently has many significant organisations at the forefront of online delivery of interventions. Melvin, Gresham and Beaton (2016) highlighted the value of online and smartphone ready access to Safety Plans and support when a person is isolated or trying to manage distress alone, with BeyondNow one such app.
Of value is also the capacity to intervene in instances where someone may have otherwise been hard to engage, around overt expressions of risk. Furthermore, Robinson and colleagues (2016) explained that people accessing suicide prevention sites were generally seeking support, rather than methods for death.
Considering the overwhelming evidence that social support and connectedness are not only protective factors against suicide but can support a person’s return to complete mental health (see the previous article Achieving complete mental health after suicidality) it seems that harnessing the strengths of social media is a bold way forward. Robinson and colleagues (2016) however explained that allowing the access to information via social media may enable marginalised and isolated people to remain that way.
In order to further understand the potential influences of social media around suicidal behaviour, further research is warranted particularly on the effectiveness of social media based suicidal preventative measures.
Given the profound potential risks identified in social media content, including the age of access to same, it would appear that there needs to be serious consideration for social media sites having information available upon entering the site, that guides contributors in how to talk about and reflect on suicide without glorifying the death or offering details on mechanism. There should also be a tool that flags high risk content to redirect them back to information pages. Of course, some content requires people to take some personal responsibility which could be rejected or ignored, whereby a regulatory body should also be appointed to monitor and close sites considered inappropriate or dangerous. Controlling user behaviour in this instantaneous environment will remain incredibly difficult.
We require greater insight into the legal complexities of social media sites and the internet, whereby we can enhance protective efforts and offer greater control over negative content. In the first instance, all practitioners discussing suicide in a public forum (whether that is social media or otherwise) should reflect on the guidelines set out under Mindframe while the research has an opportunity to catch up.
Nicolson, S., Ball, L. & Ross, J. (2014) The Children’s Rights Report, Australian Human Rights Commission, http://www.humanrights.gov.au/about/publications/
Luxton, D. D., June, J. D., & Fairall, J. M. (2012). Social Media and Suicide: A Public Health Perspective. American Journal of Public Health, 102(2), 195–200. doi:10.2105/AJPH.2011.300608
Melvin, G., Gresham, D. & Beaton, S. (2016). Safety first – not last! Suicide Safety Planning Intervention (SPI), Inpsych, 38(1), 14-15.
Robinson, J., Cox, G., Bailey, E., Hetrick, S., Rodrigues, M., Fisher, S. & Herrman, H. (2016). Social media and suicide prevention: A systematic review. Early Intervention in Psychiatry, 10, 103-121
Robinson, J., Rodrigues, M., Fisher, S. & Herman, H. (2014). Suicide and Social Media: findings from the literature review, Young and Well Cooperative Research Centre, Melbourne.
Magistrates Court Tasmania (2015) Youth suicide 2015 TASCD 298, 299, 300, 301, 302, 303, retrieved 30 March 2016, http://www.magistratescourt.tas.gov.au/divisions/coronial
First published 29 April 2016
By Carmen Betterridge