What we already know about the online environment: an updated review of research (January 2015)

The growth of the internet and the ever increasing pace at which our lives are becoming digitised is undeniable. In 2014, 38 million adults (76%) in Great Britain accessed the Internet every day; 21 million more than in 2006 (ONS, 2014). The ways in which we access the net are also changing - the number of people who use smart phones more than doubled between 2010 and 2014 from 24% to 58% (ONS, 2014); we are no longer tethered to desktop computers - internet access on the move is the norm. However, our understanding about what the internet means for suicide and vulnerable people online is limited. Although it is largely accepted that the online environment poses both challenges and opportunities for suicide prevention, research into suicide and the online environment remains in its infancy (Daine et al, 2013), and researchers, the media and practitioners are currently still grappling with how best to understand and engage in this environment (Boyce, 2010).

There have been increasing reports of internet-related suicides both in the media and academic research (e.g. Corkery et al 2010, Becker et al 2004, Alao 2006 & 1999, Prior 2004, Beatson 2000 & Baume 1997). The definition of internet-related suicide encompasses a range of content including: information about suicide methods - for example, unusual and high-lethality methods (Gunnel et al, 2012), unregulated pharmacies and websites procuring access to drugs and mail order ‘suicide kits’, ‘support’ websites and forums (some of which involve pro-suicide streams) and the making of suicide pacts (Rajagopal, 2004 & Hitosugi, 2005). What makes this incredibly challenging is the alarming ease at which harmful content can now be instantly generated, posted, accessed,  replicated and shared globally via social media platforms, chat rooms, forums and networking sites (Bell, 2007; Durkee, 2011; Luxton, 2012). Unlike traditional media, content is diverse, disparate and perhaps most significantly, user generated by anonymous uncensored voices (Biddle, 2013) who have a platform from which to contribute to suicide dialogue.

Furthermore, the so-called ’suicide contagion’ has become a particular area of concern and speculation. Contagion is a real risk following media reporting of a suicide and numerous studies have shown the existence of this phenomenon in traditional media for both real and fictional suicides (Gould 1990, Philips, 1974). Research on suicide contagion online (including chat rooms, social networks, video-sharing websites, blogs and micro blogs) is very minimal (Maloney et al, 2014) and direct associations with the internet are unclear (Daine et al, 2013). There is a real need to better understand this phenomenon and the ways in which the online environment can provide opportunities to counter contagion. We know that key factors in reducing contagion offline include encouraging individuals at risk to seek help, debunking suicide myths and highlighting the link between mental health and suicide (Mann et al, 2005); we now need to ensure these factors are considered in online environments.   

 A common theme throughout research in this area is that we need to do more. There is currently a well-documented gap in online service provision-especially in the UK (Jacob et al, 2014). Evidence suggests that suicide prevention via the web has the potential to be effective and that social media especially has the potential to identify (and support) those at risk of suicide (Christensen et al, 2014, Sueki, 2015, Jashinsky, 2014). As well as this potential there is a need to counterbalance the proliferation of suicide and self-harm communities (commonly via internet forums) that currently dominate the suicidal content online.

Finally, Jacob et al (2014) highlighted the need to better understand how healthcare professionals could work with distressed people online, with other researchers  calling for an increase in effectively trained online practitioners who are able to provide text-based support (Bell, 2014). The nature of the internet brings with it risks and challenges for suicide prevention but it also has incredible potential to provide support. Samaritans are committed to better understanding the online environment and through continued research and consultation findings ways to support vulnerable people online.

Jen Russell - Policy, Research and Development

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