Suicidal patients need better online support from clinicians and help groups

Improve clinicians' understanding of the online world, review web-based support services for vulnerable people and safeguard the public against pro-suicide content. Those are some of the recommendations being put to the internet industry, health providers and suicide prevention services after researchers mapped how people with suicidal feelings use the internet.

The report, produced by the University of Bristol, Samaritans and Papyrus, is today presented to representatives from the internet industry, health providers and suicide prevention services in a bid to minimise the potential for harm and improve accessibility to services for those in need.

The study drew on data from the Bristol-based Children of the 90s cohort.  Examining the experiences of more than 4,000 people, researchers found that of those who did report having had suicidal thoughts, a high proportion had looked for information about suicide online, some of which involved researching methods.  And an abundance of material that was likely to cause harm was easily accessible. 

Researchers did find evidence regarding the preventative influence of the internet but while some individuals were found to derive peer support from online groups, considerable dissatisfaction was expressed with formal online help.

"We urgently need to find the better ways of supporting people online and understanding the way they use the internet, so that we can try and protect them," said lead investigator Dr Lucy Biddle, Senior Lecturer in Medical Sociology from Bristol's School of Social and Community Medicine. 

"What we haven't known until now is precisely how many people use the internet when they are feeling suicidal, who they are, why they do this and how they interpret the material that they view.  This information is vital if we are to minimise harm but also to work out how we can capitalise on the potential to use the internet as a vehicle for reaching out to those in need."

In a sub-study of 21-year-old participants who had made suicide attempts (248 out of the overall 4,000, or 6 per cent of the overall sample) almost three quarters reported some kind of suicide-related internet use at some point in their lives.

One in five had accessed sites giving information on how to hurt or kill yourself, though most of these had also visited help-sites. Nearly 1 in 10 (9.1 per cent) had used the internet to discuss suicidal feelings and 7.5 per cent had searched for information on suicide using a search engine. 8.2 per cent had visited help sites.

Popular sites and search engines like Google, Facebook, YouTube and Twitter could do more to reduce risks, say the researchers as part of their recommendations. YouTube and Wikipedia are advised to take down harmful content and search engines could help by ensuring supportive rather than harmful content comes up when searching. 

Samaritans has been working with social media and online providers since 2010 to try and improve the ways they deal with suicide content online and provide help for vulnerable people.  The organisation cautions that sites with dangerous content are often based abroad and material about suicide is spread widely around the internet, making censorship an unrealistic option.

"We should encourage organisations which operate popular sites, such as social networks, search engine providers and news media outlets, to develop responsible practices relating to suicide which reduce the availability of harmful content and promote sources of support," said Samaritans CEO Ruth Sutherland.

Ged Flynn, chief executive of PAPYRUS Prevention of Young Suicide noted that many families discovered only after a death that the internet had played a significant part in the suicide of the young person who had taken his or her own life: "This study shows how suicidal young people still seek help online but also find information on how to end their lives. Whilst it is good to see fewer pro-suicide sites these days, we must never be complacent. PAPYRUS still asks internet providers to take their responsibilities seriously when providing platforms for information that can kill young people. We can all play our part in making the online environment suicide safer for young people and those who care for them."