The Impact of Social Media and the Internet on Suicidal Experiences

by | Oct 20, 2021 | Uncategorised | 0 comments

Trigger warning: this blog post contains information on topics related to suicidal thoughts and behaviours, and suicide deaths.

Written by Olivia Sale (CARMS Volunteer)

Background

In our digital world, an estimated 50.6% of the people worldwide use social media1, and 59.5% use the internet2. People use the internet for a variety of reasons, including networking (e.g., using social media), entertainment, and staying up to date with news and current affairs3. Some individuals may use the internet to obtain information for issues relating to mental health, such as suicidal experiences (e.g., suicidal thoughts, self-harm, suicide attempts). This can include accessing supportive online communities4, or adversely, seeking information about suicide methods and accessing groups that encourage suicidal behaviours5.

In this blog post, we will look at two ways in which people use social media and the internet for issues relating to suicidality. The first is seeking help and support for suicidal thoughts and behaviours (i.e., help seeking). The second relates to identifying people in crisis by tracking posts on social media platforms, such as Twitter, Facebook, and Instagram. We conclude with a discussion about the implications of online interventions for people at risk of death by suicide.

Help seeking

Individuals may use social media and the internet to seek help and support for suicidal thoughts and behaviours. In their review of 52 studies, Mok (2015)7 found that online communities that discuss suicide are generally helpful. Websites offering support for people experiencing suicidal thoughts are more prevalent than websites encouraging suicidal behaviours6. Online communities can offer empathetic understanding, a sense of community, and can play an integral part in coping with suicidal thoughts7,8. Although these communities can be a useful source of support for individuals, it is important to note that this support is not a substitute for professional mental health services.

Although some social media users find posting about suicide online to be helpful, there is a risk of a possible contagion effect of suicidal acts for individuals who access these posts9. The suicide contagion effect has been described as an increased likelihood of death by suicide in those who have been exposed to suicide (e.g., through the media, peers, family)10. When examining the Twitter accounts of individuals whose posts refer to suicide, these posts can reach both social media users who tweet about suicide and those who do not9. Although studies should examine the impact of posts referring to suicide online, the availability of suicide-related tweets could lead to emulation by those who read them.

Furthermore, internet websites detailing the use of specific suicide methods have increased by 12.7% between 2007 and 201411. There have been indications that explicit descriptions of suicide methods have led to an increase in death by suicide through the same methods12. Limiting access to the most lethal methods of suicide can reduce the overall number of suicides13. Understanding suicide methods detailed in media outlets can aid in fewer suicide deaths through these methods by reducing their lethality13. Despite these patterns, there have been concerns about implying a direct link between these events, highlighting the need for more research on the contagion effect phenomenon12.

Photo by Sergey Zolkin on Unsplash

Using social media to identify people in crisis

Social media offers a unique platform for users to communicate their thoughts and feelings and share experiences of mental health issues14. Due to the nature of social media, the provided support can be anonymous and easily accessible15. Lexicon-based approaches are becoming increasingly used to detect suicidal ideation in Twitter posts16. The language that social media users communicate with can be utilised to identify people who may be in crisis and in need of support. Posts associated strongly with the emotion of sadness can be acknowledged by computer programmes to help identify people who may be in crisis and at an increased risk of suicide death16. For example, in a study by Sarsam (2021), specific tweets were identified as being potentially related to suicide, whereas ‘I will not come and kill myself at this time’, for example, was not identified as a suicide-related tweet16.

Social media can be used to identify people who are currently in crisis and may need help from emergency services17. In a real-life case study, a Facebook user sent a post announcing their suicide attempt and their friends contacted the emergency services. Police were able to respond promptly and effectively by taking the individual in question to hospital17. Although posts relating to suicide on social media sites may be useful for potentially identifying people who may be at risk of suicide death, researchers and clinicians alike must be cautious about how they interpret and view posts on social media. Sinyor (2021)18 explored the prevalence of tweets that referred to suicide and compared them to figures for suicide deaths. No significant relationship was found between the two, indicating that some tweets may not be harmful and may not necessarily indicate imminent risk of suicide death18.

An important factor to consider is the ethical issue of viewing social media profiles, particularly of individuals who are under the care of mental health services19. For example, there are concerns around the privacy, confidentiality, and informed consent of the individual who is accessing services19. Ethical issues pose an important dilemma, as exploring a public social media account of a patient under the care of mental health services is entirely legal19. However, it may negatively impact or compromise an existing therapeutic relationship if information available online is discussed19. There are currently no clear guidelines regarding mental health practitioners accessing patient social media accounts.

 Photo by Adem AY on Unsplash

Implications of online interventions for people at risk of suicide death

Although there are many studies exploring the impact of the internet and social media use on people who feel suicidal, there appear to be very few studies outlining online interventions for such experiences. In their review of 30 studies, Robinson (2016)15 found no studies that described potential online interventions for people who experience suicidal thoughts and behaviours. Despite the lack of clearly outlined interventions, we will discuss alternative avenues for online support for individuals in crisis who may be experiencing suicidal thoughts and/or behaviours.

It is important to consider the role of the internet and social media sites and the ways in which they relay information about suicide. For example, after the suicide death of a celebrity, there was an increase in Google searches of both helpful (e.g., ‘helpline’) and harmful (e.g., ‘hanging’) search terms related to suicide20. Increasing accessibility of mental health support telephone numbers when people search for suicide-related terms on Google could be helpful 21. Furthermore, prominent social media sites, including Instagram, have utilised technologies that suppress self-harm and suicide-related content22. This technology identifies images and words that are related to self-harm and suicide and either removes or reduces the visibility of the content from Instagram. However, this approach may not be helpful for all users who search for self-harm and suicide-related content, as some people find these posts to be helpful. For example, people may feel less isolated if they come across other social media users who have similar experiences14.

In addition to monitoring suicide-related content, social media and internet websites should aim to provide mental health education and information about mental health support services. Where Instagram have restricted access to potentially harmful content, they have replaced that content with prompts to contact a friend, tips for coping with mental health crisis, and direct links to helplines23. Facebook have introduced a dedicated ‘emotional health resource centre’ which includes mental wellbeing guides and a helpline24. Furthermore, education programmes provided in secondary schools have been successfully conducted with the aim of informing students how to communicate safely and sensitively about suicide online25. As a result of the programme, 80% of students felt more confident when providing emotional support to others25.

Shout is an example of an organisation that offers mental health support via text messages. The anonymous and confidential modality of accessing help is a promising means for providing mental health support for people. In their first 18 months, Shoutsupported texters through 500,000 conversations, with 38% of texters revealing that the conversation was the first time they reached out for support with their mental health26.  Even though long-term follow up data are unavailable for this service, 83% of texters who talked about suicide in a conversation through Shout found the conversation to be helpful, and 70% felt calmer after their conversation27.

Conclusion

It is important to recognise that individuals use social media and the internet in various ways and will be impacted differently by their unique online experiences14. As discussed in this blog post, individuals using the internet and social media for suicide-related experiences (e.g., suicidal thoughts, self-harm, suicide attempts) may access informal supportive communities, communicate their experiences through social media sites, and access charitable organisations (e.g., Shout, Mind, Samaritans). Whilst using social media and the internet in this way can increase emotional support, reduce isolation, and enable access to helpful information, potential problems have been identified. Individuals can also access information detailing suicide methods and potentially harmful content. Internet websites, social media platforms, and individuals themselves can mitigate risks by encouraging safe use of the internet, reducing the accessibility of potentially harmful content, and ensuring that mental health support services are readily available via internet searches for suicide-related content. Overall, individuals using the internet and social media for mental health and suicide-related issues have unique experiences and differ in relation to the content that they find helpful or harmful. Even so, reducing the overall risk and making supportive services accessible can make the internet and social media platforms safer for all users.

 

A bit about Olivia Sale:

“I completed my undergraduate Psychology degree in July, and I am currently working as a volunteer Research Assistant on the CARMS project. During my undergraduate degree, I completed a professional placement year as an Honorary Art Psychotherapy Service Assistant, where I co-facilitated an Art Psychotherapy group in an early intervention psychosis service. I have recently started a master’s degree in Clinical Psychology and am looking forward to where this will take me.”

References
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  2. Johnson, J. (2021, September 10). Global digital population as of January 2021. https://www.statista.com/statistics/617136/digital-population-worldwide/
  3. Valentine, O. (2018, January 11). Top 10 reasons for using social media. Global Web Index. https://blog.gwi.com/chart-of-the-day/social-media/
  4. Sadagheyani, H. E., & Tatari, F. (2020). Investigating the role of social media on mental health. Mental Health and Social Inclusion, 25(1), 41–51. doi:10.1108/mhsi-06-2020-0039
  5. Harris, K., McLean, J., & Sheffield, J. (2009). Examining suicide-risk individuals who go online for suicide-related purposes. Archives of Suicide Research, 13(3), 264–276. doi:10.1080/13811110903044419
  6. Westerlund, M., Hadlaczky, G., & Wasserman, D. (2012). The representation of suicide on the internet: Implications for clinicians. Journal of Medical Internet Research, 14(5), e122. doi:10.2196/jmir.1979
  7. Mok, K., Jorm, A. F. & Pirkis, J. (2015). Suicide-related Internet use: A review. Australian and New Zealand Journal of Psychiatry, 49 (8), pp.697-705. https://doi.org/10.1177/0004867415569797
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Mental health support resources, additional to the NHS
  • The Sanctuary: The Sanctuary provides 24-hour support to adults experiencing mental health issues or who are in crisis. During the day from 6am to 8pm it offers a crisis support line. From 8pm to 6am it offers a physical space where you can talk things through. Web: selfhelpservices.org.uk/the-sanctuary. Helpline: 0300 003 7029 (local call rates and mobile phone charges apply).
  • Self Help & The Big Life Group: Self Help provide a range of resources across the Northwest of England for people experiencing mental health problems. They offer talking therapies, eTherapy, peer support and groups. You can search the Self Help site to find services that are closest to you. Web: selfhelpservices.org.uk. Helpline: 0300 003 7029 (local call rates and mobile phone charges apply). Email: each branch has its own email address. Phone lines are open every day, 24 hours a day.
  • The Samaritans: Samaritans is a confidential emotional support service if you are feeling troubled or upset. Samaritans can be contacted by phone or by email 24 hours a day. During the day you are very much welcome to drop in and speak to someone face to face in some branches. The website allows you to put in your postcode to find the nearest drop-in centre to you. Often, these drop-in centres are open in the evenings also. Web: www.samaritans.org. Helpline: 116 123 – this number is free to call. Email: jo@samaritans.org. Phones and email operate 24 hours a day.
  • Mind: Mind helps people experiencing mental distress to better their mental health. They offer numerous resources and sources of advice, for instance, about housing, legal issues, benefits, or debt issues. They also offer courses which many people have found helpful. For example, they run classes on how to be more resilient. There are regional offices, so search on-line to find a branch close to you. Web: www.mind.org.uk. Helpline: 0300 123 3393 (local call rates and mobile phone charges apply). Text: 86463. Email: info@mind.org.uk. Helplines operate 9.00 to 18:00.

 

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