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Calvo S, Carrasco JP, Conde-Pumpido C, Esteve J, Aguilar EJ. Does suicide contagion (Werther effect) take place in response to social media? A systematic review. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2024:S2950-2853(24)00032-2. [PMID: 38848950 DOI: 10.1016/j.sjpmh.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/10/2024] [Accepted: 05/27/2024] [Indexed: 06/09/2024]
Abstract
INTRODUCTION The Werther, Copycat or contagion effect of suicidal behaviour is a complex phenomenon that can arise due to exposure to media stories in which identifiable people take their lives. On the contrary, the Papageno effect prevents people from suicide by promoting positives examples of suicidal crisis management. Impact of both effects has been widely studied in different types of situations, but its existence in social media is a source of much debate. METHODS A systematic search following the PRISMA guidelines of PubMed, Scopus, Embase, PsycInfo, Web of Science and the references of prior reviews yielded 25 eligible studies. RESULTS Most of the studies found were observational, with very different methodologies and generally with low risk of bias. In these, the results suggest the existence of the Werther effect in response to social media stories about suicide. This is mediated by multiple factors, including the characteristic of the users, the type of interaction and the content of the publications. At the same time, the Papageno effect is also described. Evidence found by type of social media and future implications are discussed. CONCLUSION Suicidal content on social media can be both contagious and protective. It is confirmed that the Werther and Papageno effects may occur in response to social media, so they could be an interesting target for preventive interventions.
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Affiliation(s)
- Serena Calvo
- Pediatrics Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Juan Pablo Carrasco
- Psychiatry Deparment, Consorcio Hospitalario Provincial de Castellón, Castellón, Spain.
| | - Celia Conde-Pumpido
- Psychiatry Deparment, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Jose Esteve
- Psychiatry Deparment, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Eduardo Jesús Aguilar
- Psychiatry Deparment, Hospital Clínico Universitario de Valencia, Valencia, Spain; INCLIVA Instituto de Investigación Sanitaria, Valencia, Spain; CIBERSAM Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain; University of Valencia, Department of Medicine, Valencia, Spain
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2
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Asharani PV, Koh YS, Tan RHS, Tan YB, Gunasekaran S, Lim B, Tudor Car L, Subramaniam M. The impact of media reporting of suicides on subsequent suicides in Asia: A systematic review. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2024; 53:152-169. [PMID: 38920243 DOI: 10.47102/annals-acadmedsg.2023237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Introduction This systematic review is aimed at (1) evaluating the association between media portrayals of suicides and subsequent copycat suicides or attempts among the general public in Asia, (2) understanding the factors associated with copycat suicides and (3) determining the positive impacts of the media reporting of suicides (e.g. increased help-seeking, coping). Method A systematic review and narrative synthesis of English and Chinese articles from 8 electronic databases (i.e. PsycINFO, MEDLINE, Embase, CINAHL, Web of Science, Ariti, China National Knowledge Infrastructure and OpenGrey) from January 2000 to May 2023 was conducted. Observational studies were included, and the data were analysed through narrative synthesis. The protocol was registered with PROSPERO (CRD42021281535). Results Among the 32 studies included (n=29 for evidence synthesis) in the review, there is good-quality evidence to show that copycat suicides and suicide attempts increase after media reports of a suicide, regardless of country, celebrity status, study design, type of media, mode of suicide or follow-up period. Females, younger age groups and those sharing similar characteristics as the deceased in publicised suicides (age, gender) were more susceptible to negative impact. Reporting of the mode of death of the deceased increased suicides by the same method among the public. Conclusion Media portrayals of suicide appear to have a negative impact on copycat suicides at the population level in Asia. Thus, in addition to tighter media control, healthcare systems, professional medical bodies and community outreach services should work collaboratively to promote early help-seeking in those with psychological distress.
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Affiliation(s)
- P V Asharani
- Research Division, Institute of Mental Health, Singapore
| | - Yen Sin Koh
- Research Division, Institute of Mental Health, Singapore
| | | | - Yoke Boon Tan
- Research Division, Institute of Mental Health, Singapore
| | | | - Benedict Lim
- Research Division, Institute of Mental Health, Singapore
| | - Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Sinyor M, Fraser L, Reidenberg D, Yip PSF, Niederkrotenthaler T. The Kenneth Law Media Event - A Dangerous Natural Experiment. CRISIS 2024; 45:1-7. [PMID: 38252508 DOI: 10.1027/0227-5910/a000942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Affiliation(s)
- Mark Sinyor
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, ON, Canada
| | | | - Dan Reidenberg
- National Council for Suicide Prevention, Burnsville, MN, USA
| | - Paul S F Yip
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, PR China
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, PR China
| | - Thomas Niederkrotenthaler
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
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Niederkrotenthaler T, Tran US, Baginski H, Sinyor M, Strauss MJ, Sumner SA, Voracek M, Till B, Murphy S, Gonzalez F, Gould M, Garcia D, Draper J, Metzler H. Association of 7 million+ tweets featuring suicide-related content with daily calls to the Suicide Prevention Lifeline and with suicides, United States, 2016-2018. Aust N Z J Psychiatry 2023; 57:994-1003. [PMID: 36239594 PMCID: PMC10947496 DOI: 10.1177/00048674221126649] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to assess associations of various content areas of Twitter posts with help-seeking from the US National Suicide Prevention Lifeline (Lifeline) and with suicides. METHODS We retrieved 7,150,610 suicide-related tweets geolocated to the United States and posted between 1 January 2016 and 31 December 2018. Using a specially devised machine-learning approach, we categorized posts into content about prevention, suicide awareness, personal suicidal ideation without coping, personal coping and recovery, suicide cases and other. We then applied seasonal autoregressive integrated moving average analyses to assess associations of tweet categories with daily calls to the US National Suicide Prevention Lifeline (Lifeline) and suicides on the same day. We hypothesized that coping-related and prevention-related tweets are associated with greater help-seeking and potentially fewer suicides. RESULTS The percentage of posts per category was 15.4% (standard deviation: 7.6%) for awareness, 13.8% (standard deviation: 9.4%) for prevention, 12.3% (standard deviation: 9.1%) for suicide cases, 2.4% (standard deviation: 2.1%) for suicidal ideation without coping and 0.8% (standard deviation: 1.7%) for coping posts. Tweets about prevention were positively associated with Lifeline calls (B = 1.94, SE = 0.73, p = 0.008) and negatively associated with suicides (B = -0.11, standard error = 0.05, p = 0.038). Total number of tweets were negatively associated with calls (B = -0.01, standard error = 0.0003, p = 0.007) and positively associated with suicide, (B = 6.4 × 10-5, standard error = 2.6 × 10-5, p = 0.015). CONCLUSION This is the first large-scale study to suggest that daily volume of specific suicide-prevention-related social media content on Twitter corresponds to higher daily levels of help-seeking behaviour and lower daily number of suicide deaths. PREREGISTRATION As Predicted, #66922, 26 May 2021.
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Affiliation(s)
- Thomas Niederkrotenthaler
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Ulrich S Tran
- Wiener Werkstaette for Suicide Research, Vienna, Austria
- Department of Cognition, Emotion, and Methods in Psychology, School of Psychology, University of Vienna, Vienna, Austria
| | - Hubert Baginski
- Complexity Science Hub Vienna, Vienna, Austria
- Institute of Information Systems Engineering, Vienna University of Technology, Vienna, Austria
| | - Mark Sinyor
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Markus J Strauss
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Steven A Sumner
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control, Atlanta, GA, USA
| | - Martin Voracek
- Wiener Werkstaette for Suicide Research, Vienna, Austria
- Department of Cognition, Emotion, and Methods in Psychology, School of Psychology, University of Vienna, Vienna, Austria
| | - Benedikt Till
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Sean Murphy
- Vibrant Emotional Health, National Suicide Prevention Lifeline, New York, NY, USA
| | - Frances Gonzalez
- Vibrant Emotional Health, National Suicide Prevention Lifeline, New York, NY, USA
| | - Madelyn Gould
- Departments of Psychiatry and Epidemiology, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, USA
| | - David Garcia
- Complexity Science Hub Vienna, Vienna, Austria
- Institute of Interactive Systems and Data Science, Faculty of Computer Science and Biomedical Engineering, Graz University of Technology, Graz, Austria
| | - John Draper
- Vibrant Emotional Health, National Suicide Prevention Lifeline, New York, NY, USA
| | - Hannah Metzler
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Complexity Science Hub Vienna, Vienna, Austria
- Institute of Interactive Systems and Data Science, Faculty of Computer Science and Biomedical Engineering, Graz University of Technology, Graz, Austria
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5
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Hawley LL, Niederkrotenthaler T, Zaheer R, Schaffer A, Redelmeier DA, Levitt AJ, Sareen J, Pirkis J, Sinyor M. Is the narrative the message? The relationship between suicide-related narratives in media reports and subsequent suicides. Aust N Z J Psychiatry 2023; 57:758-766. [PMID: 35999688 PMCID: PMC10126449 DOI: 10.1177/00048674221117072] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES When journalists report on the details of a suicide, the way that they contextualize the meaning of the event (i.e. the 'narrative') can have significant consequences for readers. The 'Werther' and 'Papageno' narrative effects refer to increases and decreases in suicides across populations following media reports on suicidal acts or mastery of crises, respectively. The goal of this study was to investigate the impact of these different narrative constructs on subsequent suicides. METHODS This study examined the change in suicide counts over time in Toronto, Canada. It used latent difference score analysis, examining suicide-related print media reports in the Toronto media market (2011-2014). Articles (N = 6367) were coded as having a potentially harmful narrative if they described suicide in a celebrity or described a suicide death in a non-celebrity and included the suicide method. Articles were coded as having potentially protective narratives if they included at least one element of protective content (e.g. alternatives to suicide) without including any information about suicidal behaviour (i.e. suicide attempts or death). RESULTS Latent difference score longitudinal multigroup analyses identified a dose-response relationship in which the trajectory of suicides following harmful 'Werther' narrative reports increased over time, while protective 'Papageno' narrative reports declined. The latent difference score model demonstrated significant goodness of fit and parameter estimates, with each group demonstrating different trajectories of change in reported suicides over time: (χ2[6], N = 6367) = 13.16; χ2/df = 2.19; Akaike information criterion = 97.16, comparative fit index = 0.96, root mean square error of approximation = 0.03. CONCLUSION Our findings support the notion that the 'narrative' matters when reporting on suicide. Specifically, 'Werther' narratives of suicides in celebrities and suicides in non-celebrities where the methods were described were associated with more subsequent suicides while 'Papageno' narratives of survival and crisis mastery without depictions of suicidal behaviours were associated with fewer subsequent suicides. These results may inform efforts to prevent imitation suicides.
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Affiliation(s)
- Lance L Hawley
- Frederick W. Thompson Anxiety Disorders
Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Psychiatry, Sunnybrook Health
Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Thomas Niederkrotenthaler
- Unit Suicide Research and Mental Health
Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical
University of Vienna, Vienna, Austria
| | - Rabia Zaheer
- Department of Psychiatry, Sunnybrook Health
Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Ayal Schaffer
- Department of Psychiatry, Sunnybrook Health
Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Donald A Redelmeier
- Department of Medicine, University of
Toronto, Toronto, ON, Canada
- Evaluative Clinical Sciences, Sunnybrook
Research Institute, Toronto, ON, Canada
- Division of General Internal Medicine,
Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Institute for Clinical Evaluative Sciences,
Toronto, ON, Canada
| | - Anthony J Levitt
- Department of Psychiatry, Sunnybrook Health
Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Jitender Sareen
- Departments of Psychiatry, Psychology and
Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of
Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Mark Sinyor
- Department of Psychiatry, Sunnybrook Health
Sciences Centre, University of Toronto, Toronto, ON, Canada
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6
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Amsalem D, Jankowski SE, Pagdon S, Valeri L, Yang LH, Markowitz JC, Neria Y, Pescosolido BA, Dixon LB, Martin A. Selfie Videos to Reduce Stigma and Increase Treatment Seeking Among Youths: Two Noninferiority Randomized Controlled Trials. Psychiatr Serv 2023; 74:229-236. [PMID: 36254455 DOI: 10.1176/appi.ps.20220168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Confronting stigma early in life could enhance treatment seeking. In two randomized controlled trials (RCTs), one focused on psychosis and the other on adolescent depression, the efficacy and equivalence of brief social contact-based videos were evaluated and compared with a control condition. The outcomes of interest were changes in illness-related stigma and treatment-seeking intention. The hypotheses were that the intervention videos would show greater efficacy than control conditions and that traditional and selfie videos would demonstrate similar efficacy. METHODS Young adults (study 1, N=895) and adolescents (study 2, N=637) were randomly assigned to view intervention videos (in traditional or selfie styles) or to a control condition. In short videos (58-102 seconds), young presenters humanized their illness by emotionally describing their struggles and discussing themes of recovery and hope. RESULTS Repeated-measures analyses of variance and paired t tests showed significant differences in stigma and treatment seeking between the intervention and control groups and similar efficacy of the traditional and selfie videos. Cohen's d effect sizes ranged from 0.31 to 0.76 for changes in stigma from baseline to 30-day follow-up in study 1 and from 0.13 to 0.47 for changes from baseline to postintervention in study 2. CONCLUSIONS The RCTs demonstrated the efficacy of brief videos, both traditional and selfie, in reducing illness-related stigma among young adults and adolescents and in increasing treatment-seeking intention among adolescents. Future studies should explore the effects of brief videos presented by social media influencers on mental health stigma and treatment engagement.
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Affiliation(s)
- Doron Amsalem
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Samantha E Jankowski
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Shannon Pagdon
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Linda Valeri
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Lawrence H Yang
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - John C Markowitz
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Yuval Neria
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Bernice A Pescosolido
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Lisa B Dixon
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Andrés Martin
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
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7
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Niederkrotenthaler T, Laido Z, Gould M, Lake AM, Sinyor M, Kirchner S, Braun M, Chowdhury S, Gonzalez F, Draper J, Murphy S, Till B. Associations of suicide-related media reporting characteristics with help-seeking and suicide in Oregon and Washington. Aust N Z J Psychiatry 2022:48674221146474. [PMID: 36579678 DOI: 10.1177/00048674221146474] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Specific content characteristics of suicide media reporting might differentially impact suicides in the population, but studies have not considered the overarching theme of the respective media stories and other relevant outcomes besides suicide, such as help-seeking behaviours. METHODS We obtained 5652 media reports related to suicide from 6 print, 44 broadcast and 251 online sources in Oregon and Washington states, published between April 2019 and March 2020. We conducted a content analysis of stories regarding their overarching focus and specific content characteristics based on media recommendations for suicide reporting. We applied logistic regression analyses to assess how focus and content characteristics were associated with subsequent calls to the US National Suicide Prevention Lifeline (Lifeline) and suicides in these two states in the week after publication compared to a control time period. RESULTS Compared to a focus on suicide death, a focus on suicidal ideation, suicide prevention, healing stories, community suicide crises/suicide clusters and homicide suicide was associated with more calls. As compared to a focus on suicide death, stories on suicide prevention and stories on community suicide crises/suicide clusters were also associated with no increase in suicides. Regarding specific content characteristics, there were associations that were largely consistent with previous work in the area, for example, an association of celebrity suicide reporting with increases in suicide. CONCLUSION The overall focus of a media story may influence help-seeking and suicides, and several story characteristics appear to be related to both outcomes. More research is needed to investigate possible causal effects and pathways.
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Affiliation(s)
- Thomas Niederkrotenthaler
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.,Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Zrinka Laido
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.,Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Madelyn Gould
- Division of Child and Adolescent Psychiatry, College of Physicians & Surgeons, Columbia University, New York, USA.,Department of Epidemiology, School of Public Health, New York, USA.,New York State Psychiatric Institute, New York, NY, USA
| | - Alison M Lake
- New York State Psychiatric Institute, New York, NY, USA
| | - Mark Sinyor
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Stefanie Kirchner
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.,Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Marlies Braun
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.,Wiener Werkstaette for Suicide Research, Vienna, Austria
| | | | - Frances Gonzalez
- Vibrant Emotional Health, National Suicide Prevention Lifeline, New York, NY, USA
| | - John Draper
- Vibrant Emotional Health, National Suicide Prevention Lifeline, New York, NY, USA
| | - Sean Murphy
- Vibrant Emotional Health, National Suicide Prevention Lifeline, New York, NY, USA
| | - Benedikt Till
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.,Wiener Werkstaette for Suicide Research, Vienna, Austria
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8
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Metzler H, Baginski H, Niederkrotenthaler T, Garcia D. Detecting Potentially Harmful and Protective Suicide-Related Content on Twitter: Machine Learning Approach. J Med Internet Res 2022; 24:e34705. [PMID: 35976193 PMCID: PMC9434391 DOI: 10.2196/34705] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 06/02/2022] [Accepted: 06/08/2022] [Indexed: 01/11/2023] Open
Abstract
Background Research has repeatedly shown that exposure to suicide-related news media content is associated with suicide rates, with some content characteristics likely having harmful and others potentially protective effects. Although good evidence exists for a few selected characteristics, systematic and large-scale investigations are lacking. Moreover, the growing importance of social media, particularly among young adults, calls for studies on the effects of the content posted on these platforms. Objective This study applies natural language processing and machine learning methods to classify large quantities of social media data according to characteristics identified as potentially harmful or beneficial in media effects research on suicide and prevention. Methods We manually labeled 3202 English tweets using a novel annotation scheme that classifies suicide-related tweets into 12 categories. Based on these categories, we trained a benchmark of machine learning models for a multiclass and a binary classification task. As models, we included a majority classifier, an approach based on word frequency (term frequency-inverse document frequency with a linear support vector machine) and 2 state-of-the-art deep learning models (Bidirectional Encoder Representations from Transformers [BERT] and XLNet). The first task classified posts into 6 main content categories, which are particularly relevant for suicide prevention based on previous evidence. These included personal stories of either suicidal ideation and attempts or coping and recovery, calls for action intending to spread either problem awareness or prevention-related information, reporting of suicide cases, and other tweets irrelevant to these 5 categories. The second classification task was binary and separated posts in the 11 categories referring to actual suicide from posts in the off-topic category, which use suicide-related terms in another meaning or context. Results In both tasks, the performance of the 2 deep learning models was very similar and better than that of the majority or the word frequency classifier. BERT and XLNet reached accuracy scores above 73% on average across the 6 main categories in the test set and F1-scores between 0.69 and 0.85 for all but the suicidal ideation and attempts category (F1=0.55). In the binary classification task, they correctly labeled around 88% of the tweets as about suicide versus off-topic, with BERT achieving F1-scores of 0.93 and 0.74, respectively. These classification performances were similar to human performance in most cases and were comparable with state-of-the-art models on similar tasks. Conclusions The achieved performance scores highlight machine learning as a useful tool for media effects research on suicide. The clear advantage of BERT and XLNet suggests that there is crucial information about meaning in the context of words beyond mere word frequencies in tweets about suicide. By making data labeling more efficient, this work has enabled large-scale investigations on harmful and protective associations of social media content with suicide rates and help-seeking behavior.
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Affiliation(s)
- Hannah Metzler
- Section for the Science of Complex Systems, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.,Unit Suicide Research and Mental Health Promotion, Center for Public Health, Medical University of Vienna, Vienna, Austria.,Complexity Science Hub Vienna, Vienna, Austria.,Computational Social Science Lab, Institute of Interactive Systems and Data Science, Graz University of Technology, Graz, Austria.,Institute for Globally Distributed Open Research and Education, Vienna, Austria
| | - Hubert Baginski
- Complexity Science Hub Vienna, Vienna, Austria.,Institute of Information Systems Engineering, Vienna University of Technology, Vienna, Austria
| | - Thomas Niederkrotenthaler
- Unit Suicide Research and Mental Health Promotion, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - David Garcia
- Section for the Science of Complex Systems, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.,Complexity Science Hub Vienna, Vienna, Austria.,Computational Social Science Lab, Institute of Interactive Systems and Data Science, Graz University of Technology, Graz, Austria
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9
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Sinyor M, Hartman M, Zaheer R, Williams M, Pirkis J, Heisel MJ, Schaffer A, Redelmeier DA, Cheung AH, Kiss A, Niederkrotenthaler T. Differences in Suicide-Related Twitter Content According to User Influence. CRISIS 2022. [PMID: 35656646 DOI: 10.1027/0227-5910/a000865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: The content of suicide-specific social media posts may impact suicide rates, and putatively harmful and/or protective content may vary by the author's influence. Aims: This study sought to characterize how suicide-related Twitter content differs according to user influence. Method: Suicide-related tweets from July 1, 2015, to June 1, 2016, geolocated to Toronto, Canada, were collected and randomly selected for coding (n = 2,250) across low, medium, or high user influence levels (based on the number of followers, tweets, retweets, and posting frequency). Logistic regression was used to identify differences by user influence for various content variables. Results: Low- and medium-influence users typically tweeted about personal experiences with suicide and associations with mental health and shared morbid humor/flippant tweets. High-influence users tended to tweet about suicide clusters, suicide in youth, older adults, indigenous people, suicide attempts, and specific methods. Tweets across influence levels predominantly focused on suicide deaths, and few described suicidal ideation or included helpful content. Limitations: Social media data were from a single location and epoch. Conclusion: This study demonstrated more problematic content vis-à-vis safe suicide messaging in tweets by high-influence users and a paucity of protective content across all users. These results highlight the need for further research and potential intervention.
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Affiliation(s)
- Mark Sinyor
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Maya Hartman
- Michael G. DeGroote School of Medicine, McMaster University, Waterloo Regional Campus, Kitchener, ON, Canada
| | - Rabia Zaheer
- Department of Education Services, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Marissa Williams
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Athabasca University, Athabasca, AB, Canada
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Marnin J Heisel
- Departments of Psychiatry and of Epidemiology & Biostatistics, The University of Western Ontario, London, ON, Canada
| | - Ayal Schaffer
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Donald A Redelmeier
- Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Amy H Cheung
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Alex Kiss
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Thomas Niederkrotenthaler
- Medical University of Vienna, Center for Public Health, Department of Social and Preventive Medicine, Unit Suicide Research & Mental Health Promotion, Vienna, Austria
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10
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Media coverage of Canadian Veterans, with a focus on post traumatic stress disorder and suicide. BMC Psychiatry 2022; 22:339. [PMID: 35578212 PMCID: PMC9109435 DOI: 10.1186/s12888-022-03954-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A large corpus of research indicates that the media plays a key role in shaping public beliefs, opinions and attitudes towards social groups. Some research from the United States indicates that military Veterans are sometimes framed in a stereotypical and stigmatizing manner, however there is a lack of research on Canadian media coverage of Veterans. As such, the overarching aim of this study is to assess the tone and content of Canadian media coverage of military Veterans, with a focus on PTSD and suicide. The first objective is to document and analyze common themes, content and temporal patterns in Canadian media coverage of Veterans per se. The second objective is to examine common themes and content in the sub-set of articles having PTSD as a theme. The third objective is to assess adherence to responsible reporting of suicide guidelines in the sub-set of articles having suicide as a theme. METHODS We used validated and systematic methods including use of key words, retrieval software and inter-rater reliability tests to collect and code news articles (N = 915) about Veterans from over 50 media sources during a 12-month period, with specific coding of articles about PTSD (N = 93) and suicide (N = 61). RESULTS Analysis revealed that the most common theme is 'honour or commemoration of Veterans' which occurred in over half of the articles. In contrast 14% of articles focused on danger, violence or criminality. In the sub-set of articles with PTSD as a theme, over 60% focused on danger, violence or criminality, while only around 1 in 3 focused on recovery, rehabilitation, or health/social service intervention. In the sub-set of articles about suicide, there was generally strong adherence to responsible reporting guidelines, though less than 5% gave help-seeking information. Moreover, most reporting on PTSD and suicide focused on a single anomalous murder-suicide incident, with few articles about suicide prevention, helpful resources and modifiable risk factors. CONCLUSIONS The results reveal some encouraging findings as well as a need to diversify media coverage of Canadian Veterans. This could be achieved through targeted educational outreach to help Canadian journalists responsibly report on Veterans and their mental health issues.
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11
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Niederkrotenthaler T, Till B, Kirchner S, Sinyor M, Braun M, Pirkis J, Tran US, Voracek M, Arendt F, Ftanou M, Kovacs R, King K, Schlichthorst M, Stack S, Spittal MJ. Effects of media stories of hope and recovery on suicidal ideation and help-seeking attitudes and intentions: systematic review and meta-analysis. THE LANCET PUBLIC HEALTH 2022; 7:e156-e168. [DOI: 10.1016/s2468-2667(21)00274-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/11/2021] [Accepted: 11/16/2021] [Indexed: 12/15/2022] Open
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12
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Law PCF, Too LS, Hill NTM, Robinson J, Gould M, Occhipinti JA, Spittal MJ, Witt K, Sinyor M, Till B, Osgood N, Prodan A, Zahan R, Pirkis J. A Pilot Case-Control Study of the Social Media Activity Following Cluster and Non-Cluster Suicides in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:343. [PMID: 35010601 PMCID: PMC8751152 DOI: 10.3390/ijerph19010343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/21/2021] [Accepted: 12/25/2021] [Indexed: 06/14/2023]
Abstract
Social media may play a role in the "contagion" mechanism thought to underpin suicide clusters. Our pilot case-control study presented a novel methodological approach to examining whether Facebook activity following cluster and non-cluster suicides differed. We used a scan statistic to identify suicide cluster cases occurring in spatiotemporal clusters and matched each case to 10 non-cluster control suicides. We identified the Facebook accounts of 3/48 cluster cases and 20/480 non-cluster controls and their respective friends-lists and retrieved 48 posthumous posts and replies (text segments) referring to the deceased for the former and 606 for the latter. We examined text segments for "putatively harmful" and "putatively protective" content (e.g., discussion of the suicide method vs. messages discouraging suicidal acts). We also used concept mapping, word-emotion association, and sentiment analysis and gauged user reactions to posts using the reactions-to-posts ratio. We found no "putatively harmful" or "putatively protective" content following any suicides. However, "family" and "son" concepts were more common for cluster cases and "xx", "sorry" and "loss" concepts were more common for non-cluster controls, and there were twice as many surprise- and disgust-associated words for cluster cases. Posts pertaining to non-cluster controls were four times as receptive as those about cluster cases. We hope that the approach we have presented may help to guide future research to explain suicide clusters and social-media contagion.
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Affiliation(s)
- Phillip Cheuk Fung Law
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3053, Australia; (L.S.T.); (M.J.S.); (J.P.)
| | - Lay San Too
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3053, Australia; (L.S.T.); (M.J.S.); (J.P.)
| | - Nicole T. M. Hill
- Telethon Kids Institute, Nedlands 6009, Australia;
- School of Population and Global Health, The University of Western Australia, Nedlands 6009, Australia
| | - Jo Robinson
- Orygen, Parkville 3052, Australia; (J.R.); (K.W.)
- Centre for Youth Mental Health, The University of Melbourne, Parkville 3053, Australia
| | - Madelyn Gould
- Departments of Epidemiology and Psychiatry, Columbia University, New York, NY 10032, USA;
| | - Jo-An Occhipinti
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney 2050, Australia; (J.-A.O.); (A.P.)
- Computer Simulation and Advanced Research Technologies (CSART), Sydney 2021, Australia
| | - Matthew J. Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3053, Australia; (L.S.T.); (M.J.S.); (J.P.)
| | - Katrina Witt
- Orygen, Parkville 3052, Australia; (J.R.); (K.W.)
- Centre for Youth Mental Health, The University of Melbourne, Parkville 3053, Australia
| | - Mark Sinyor
- Sunnybrook Health Sciences Centre, Department of Psychiatry, University of Toronto, Toronto, ON M4N 3M5, Canada;
| | - Benedikt Till
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria;
| | - Nathaniel Osgood
- Department of Computer Science, University of Saskatchewan, Saskatoon, SK S7N 5C9, Canada; (N.O.); (R.Z.)
| | - Ante Prodan
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney 2050, Australia; (J.-A.O.); (A.P.)
- Translational Health Research Institute, Western Sydney University, Penrith 2751, Australia
| | - Rifat Zahan
- Department of Computer Science, University of Saskatchewan, Saskatoon, SK S7N 5C9, Canada; (N.O.); (R.Z.)
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3053, Australia; (L.S.T.); (M.J.S.); (J.P.)
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13
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Côté D, Williams M, Zaheer R, Niederkrotenthaler T, Schaffer A, Sinyor M. Suicide-related Twitter Content in Response to a National Mental Health Awareness Campaign and the Association between the Campaign and Suicide Rates in Ontario. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2021; 66:460-467. [PMID: 33563028 PMCID: PMC8107951 DOI: 10.1177/0706743720982428] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Mental health awareness (MHA) campaigns have been shown to be successful in improving mental health literacy, decreasing stigma, and generating public discussion. However, there is a dearth of evidence regarding the effects of these campaigns on behavioral outcomes such as suicides. Therefore, the objective of this article is to characterize the association between the event and suicide in Canada's most populous province and the content of suicide-related tweets referencing a Canadian MHA campaign (Bell Let's Talk Day [BLTD]). METHODS Suicide counts during the week of BTLD were compared to a control window (2011 to 2016) to test for associations between the BLTD event and suicide. Suicide tweets geolocated to Ontario, posted in 2016 with the BLTD hashtag were coded for specific putatively harmful and protective content. RESULTS There was no associated change in suicide counts. Tweets (n = 3,763) mainly included content related to general comments about suicide death (68%) and suicide being a problem (42.8%) with little putatively helpful content such as stories of resilience (0.6%) and messages of hope (2.2%). CONCLUSIONS In Ontario, this national mental health media campaign was associated with a high volume of suicide-related tweets but not necessarily including content expected to diminish suicide rates. Campaigns like BLTD should strongly consider greater attention to suicide-related messaging that promotes help-seeking and resilience. This may help to further decrease stigmatization, and potentially, reduce suicide rates.
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Affiliation(s)
- David Côté
- Department of Psychiatry, 71545Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,University of Toronto, Ontario, Canada
| | - Marissa Williams
- Department of Psychiatry, 71545Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Athabasca University, Alberta, Canada
| | - Rabia Zaheer
- Department of Psychiatry, 71545Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,University of Waterloo, Ontario, Canada
| | - Thomas Niederkrotenthaler
- Center for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Unit Suicide Research & Mental Health Promotion, Vienna, Austria
| | - Ayal Schaffer
- Department of Psychiatry, 71545Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Ontario Canada
| | - Mark Sinyor
- Department of Psychiatry, 71545Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Ontario Canada
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