1
|
Haime Z, Kennedy L, Grace L, Cohen R, Derges J, Biddle L. The Journey of Engaging With Web-Based Self-Harm and Suicide Content: Longitudinal Qualitative Study. JMIR INFODEMIOLOGY 2024; 4:e47699. [PMID: 38546718 PMCID: PMC11009851 DOI: 10.2196/47699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 10/10/2023] [Accepted: 02/15/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Self-harm and suicide are major public health concerns worldwide, with attention focused on the web environment as a helpful or harmful influence. Longitudinal research on self-harm and suicide-related internet use is limited, highlighting a paucity of evidence on long-term patterns and effects of engaging with such content. OBJECTIVE This study explores the experiences of people engaging with self-harm or suicide content over a 6-month period. METHODS This study used qualitative and digital ethnographic methods longitudinally, including one-to-one interviews at 3 time points to explore individual narratives. A trajectory analysis approach involving 4 steps was used to interpret the data. RESULTS The findings from 14 participants established the web-based journey of people who engage with self-harm or suicide content. In total, 5 themes were identified: initial interactions with self-harm or suicide content, changes in what self-harm or suicide content people engage with and where, changes in experiences of self-harm or suicide behaviors associated with web-based self-harm or suicide content engagement, the disengagement-reengagement cycle, and future perspectives on web-based self-harm or suicide content engagement. Initial engagements were driven by participants seeking help, often when offline support had been unavailable. Some participants' exposure to self-harm and suicide content led to their own self-harm and suicide behaviors, with varying patterns of change over time. Notably, disengagement from web-based self-harm and suicide spaces served as a protective measure for all participants, but the pull of familiar content resulted in only brief periods of disconnection. Participants also expressed future intentions to continue returning to these self-harm and suicide web-based spaces, acknowledging the nonlinear nature of their own recovery journey and aiming to support others in the community. Within the themes identified in this study, narratives revealed that participants' behavior was shaped by cognitive flexibility and rigidity, metacognitive abilities, and digital expertise. Opportunities for behavior change arose during periods of cognitive flexibility prompted by life events, stressors, and shifts in mental health. Participants sought diverse and potentially harmful content during challenging times but moved toward recovery-oriented engagements in positive circumstances. Metacognitive and digital efficacy skills also played a pivotal role in participants' control of web-based interactions, enabling more effective management of content or platforms or sites that posed potential harms. CONCLUSIONS This study demonstrated the complexity of web-based interactions, with beneficial and harmful content intertwined. Participants who demonstrated metacognition and digital efficacy had better control over web-based engagements. Some attributed these skills to study processes, including taking part in reflective diaries, showing the potential of upskilling users. This study also highlighted how participants remained vulnerable by engaging with familiar web-based spaces, emphasizing the responsibility of web-based industry leaders to develop tools that empower users to enhance their web-based safety.
Collapse
Affiliation(s)
- Zoë Haime
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Laura Kennedy
- Centre for Society and Mental Health, Kings College, London, United Kingdom
- Samaritans, Surrey, United Kingdom
- Department of Health Service and Population Research, King's College London, London, United Kingdom
| | | | - Rachel Cohen
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Health and Social Services Group, Welsh Government, Cardiff, United Kingdom
| | - Jane Derges
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Lucy Biddle
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| |
Collapse
|
2
|
Primbs R, Feldmann L, Iglhaut L, Allgaier AK, Schulte-Körne G, Greimel E. Evaluation of an information booklet for adolescents on depression: evidence from a randomized controlled study. Child Adolesc Psychiatry Ment Health 2023; 17:65. [PMID: 37245045 DOI: 10.1186/s13034-023-00614-x] [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] [Received: 03/17/2023] [Accepted: 05/15/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Adolescents with depression often show barriers to seek treatment offers due to various reasons, including limited knowledge about the manifestation of the disorder, its treatment options, or fear of stigmatization. Psychoeducational approaches might reduce these barriers by increasing depression literacy. The aim of the present randomized controlled study was to evaluate whether an innovative and age-appropriate evidence-based information booklet about youth depression increases depression-specific knowledge in adolescents with depression and is also appealing to the target group. METHODS 50 adolescents with a history of depression (current/remitted) aged 12-18 years participated in the study including a pre-, post- and follow-up assessment. Participants were randomly assigned to one of two groups. The experimental group received a target group-specific information booklet about youth depression including seven subdomains. The active control group received an information booklet about asthma in youth that was highly comparable to the depression booklet in terms of format and length. Before and after reading, and at a four-week follow-up, we assessed knowledge about youth depression based on a questionnaire. Furthermore, participants evaluated the acceptability of the information booklets. RESULTS Unlike the active control group, the experimental group showed a significant increase in depression-specific knowledge from pre to post and from pre to follow-up across all subdomains. This increase was evident in four subdomains ("symptoms", "treatment", "antidepressants", and "causes"). The overall reception of the information booklet about depression was positive and participants stated that they would recommend the information booklet about depression to their peers. CONCLUSION This is the first randomized controlled study to demonstrate that an information booklet about youth depression effectively imparts depression-specific knowledge to participants with a history of depression and shows high acceptance. Information booklets that are appealing and increase depression-specific knowledge might be a promising low-threshold and cost-effective approach to reduce barriers to treatment and raise awareness.
Collapse
Affiliation(s)
- Regine Primbs
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Hospital of the Ludwig- Maximilians-University (LMU) Munich, Nussbaumstrasse 5, D-80336, Munich, Germany.
| | - Lisa Feldmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Hospital of the Ludwig- Maximilians-University (LMU) Munich, Nussbaumstrasse 5, D-80336, Munich, Germany
| | - Lucia Iglhaut
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Hospital of the Ludwig- Maximilians-University (LMU) Munich, Nussbaumstrasse 5, D-80336, Munich, Germany
| | | | - Gerd Schulte-Körne
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Hospital of the Ludwig- Maximilians-University (LMU) Munich, Nussbaumstrasse 5, D-80336, Munich, Germany
| | - Ellen Greimel
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Hospital of the Ludwig- Maximilians-University (LMU) Munich, Nussbaumstrasse 5, D-80336, Munich, Germany
| |
Collapse
|
3
|
Mann JJ, Michel CA, Auerbach RP. Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2023; 21:182-196. [PMID: 37201140 PMCID: PMC10172556 DOI: 10.1176/appi.focus.23021004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Objective The authors sought to identify scalable evidence-based suicide prevention strategies. Methods A search of PubMed and Google Scholar identi- fied 20,234 articles published between September 2005 and December 2019, of which 97 were randomized controlled trials with suicidal behavior or ideation as primary outcomes or epidemiological studies of limiting access to lethal means, using educational approaches, and the impact of antidepressant treatment. Results Training primary care physicians in depression rec- ognition and treatment prevents suicide. Educating youths on depression and suicidal behavior, as well as active out- reach to psychiatric patients after discharge or a suicidal crisis, prevents suicidal behavior. Meta-analyses find that antidepressants prevent suicide attempts, but individual randomized controlled trials appear to be underpowered. Ketamine reduces suicidal ideation in hours but is untested for suicidal behavior prevention. Cognitive-behavioral therapy and dialectical behavior therapy prevent suicidal behavior. Active screening for suicidal ideation or behavior is not proven to be better than just screening for depression. Education of gatekeepers about youth suicidal behavior lacks effectiveness. No randomized trials have been reported for gatekeeper training for prevention of adult suicidal behavior. Algorithm-driven electronic health record screening, Internet-based screening, and smartphone passive monitoring to identify high-risk patients are under-studied. Means restriction, including of firearms, prevents suicide but is sporadically employed in the United States, even though firearms are used in half of all U.S. suicides. Conclusions Training general practitioners warrants wider implementation and testing in other nonpsychiatrist physi- cian settings. Active follow-up of patients after discharge or a suicide-related crisis should be routine, and restricting firearm access by at-risk individuals warrants wider use. Combination approaches in health care systems show promise in reducing suicide in several countries, but evaluating the benefit attributable to each component is essential. Further suicide rate reduction requires evaluating newer approaches, such as electronic health record-derived algorithms, Internet-based screening methods, ketamine's potential benefit for preventing attempts, and passive monitoring of acute suicide risk change.Reprinted from Am J Psychiatry 2021; 178:611-624, with permission from American Psychiatric Association Publishing. Copyright © 2021.
Collapse
Affiliation(s)
- J John Mann
- Division of Molecular Imaging and Neuropathology (Mann, Michel) and Division of Child and Adolescent Psychiatry (Auerbach), New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York (Mann, Auerbach); Division of Clinical Developmental Neuro- science, Sackler Institute for Developmental Psychobiology, Columbia University, New York (Auerbach)
| | - Christina A Michel
- Division of Molecular Imaging and Neuropathology (Mann, Michel) and Division of Child and Adolescent Psychiatry (Auerbach), New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York (Mann, Auerbach); Division of Clinical Developmental Neuro- science, Sackler Institute for Developmental Psychobiology, Columbia University, New York (Auerbach)
| | - Randy P Auerbach
- Division of Molecular Imaging and Neuropathology (Mann, Michel) and Division of Child and Adolescent Psychiatry (Auerbach), New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York (Mann, Auerbach); Division of Clinical Developmental Neuro- science, Sackler Institute for Developmental Psychobiology, Columbia University, New York (Auerbach)
| |
Collapse
|
4
|
Tepe ÇŞ, Eker F. Content analysis of suicide prevention web pages from perspective of preventive psychiatric approaches. CURRENT PSYCHOLOGY 2023:1-8. [PMID: 37359652 PMCID: PMC10008009 DOI: 10.1007/s12144-023-04496-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 03/13/2023]
Abstract
Suicide is a serious public health problem; however, suicides are preventable with evidence-based and often low-cost interventions. This study analyzes the online content of suicide prevention and helps websites in the context of preventive psychiatry. The universe and sample of the research consisted of 147 web pages whose links can be found on the most widely used international social media platforms and websites dedicated to suicide prevention. To conduct the content analysis, the crisis hotline guide prepared by the World Health Organization for suicide prevention and the guide prepared for media professionals were used in the data collection form created by the researchers. The majority of the websites were of European origin and were prepared by mental health and suicide prevention associations for suicide prevention and crisis intervention. Telephone helplines were the most common means of communicating with consultants via the web page. On the basis of the research findings, suggestions were generated regarding the scope, content, and sustainability of web pages for crisis intervention and suicide prevention prepared at the national and international levels.
Collapse
Affiliation(s)
- Çiğdem Şen Tepe
- Faculty of Health Sciences, Department of Psychiatric Nursing, Sakarya University, Sakarya, Turkey
| | - Fatma Eker
- Faculty of Health Sciences, Department of Nursing, Cyprus International University, Nicosia, North Cyprus
| |
Collapse
|
5
|
Blattert L, Armbruster C, Buehler E, Heiberger A, Augstein P, Kaufmann S, Reime B. Health Needs for Suicide Prevention and Acceptance of e-Mental Health Interventions in Adolescents and Young Adults: Qualitative Study. JMIR Ment Health 2022; 9:e39079. [PMID: 36416884 PMCID: PMC9730201 DOI: 10.2196/39079] [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] [Received: 04/27/2022] [Revised: 07/31/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Adolescence is a phase of higher vulnerability for suicidal behavior. In Germany, almost 500 adolescents and young adults aged 15-25 years commit suicide each year. Youths in rural areas are characterized by a higher likelihood of poorer mental health. In rural areas, appropriate support for adolescents and young adults in mental health crises is difficult to access. The general acceptability of digital communication in youths can make the provision of an eHealth tool a promising strategy. OBJECTIVE The aim of this study was to explore the health needs regarding suicide prevention for adolescents and young adults in rural areas of Germany and Switzerland and to identify characteristics of suitable e-mental health interventions. METHODS This study reports on a qualitative secondary analysis of archived data, which had been collected through formative participatory research. Using 32 semistructured interviews (individually or in groups of 2) with 13 adolescents and young adults (aged 18-25 years) and 23 experts from relevant fields, we applied a deductive-inductive methodological approach and used qualitative content analyses according to Kuckartz (2016). RESULTS Experts as well as adolescents and young adults have reported health needs in digital suicide prevention. The health needs for rural adolescents and young adults in crises were characterized by several categories. First, the need for suicide prevention in general was highlighted. Additionally, the need for a peer concept and web-based suicide prevention were stressed. The factors influencing the acceptability of a peer-driven, web-based support were related to low-threshold access, lifelike intervention, anonymity, and trustworthiness. CONCLUSIONS The results suggest a need for suicide prevention services for adolescents and young adults in this rural setting. Peer-driven and web-based suicide prevention services may add an important element of support during crises. By establishing such a service, an improvement in mental health support and well-being could be enabled. These services should be developed with the participation of the target group, taking anonymity, trustworthiness, and low-threshold access into account.
Collapse
Affiliation(s)
- Lisa Blattert
- Scientific Institute of Office-Based Haematologists and Oncologists (WINHO), Köln, Germany
| | - Christoph Armbruster
- Section of Health Care Research and Rehabilitation Research (SEVERA), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Eva Buehler
- Department of Chemistry and Didactics, University of Education Heidelberg, Heidelberg, Germany
| | - Andrea Heiberger
- Research Methods in Health Sciences, Faculty of Mathematics, Natural Sciences and Technology, Freiburg University of Education, Freiburg, Germany
| | | | - Sarina Kaufmann
- Case Management, Clinical Centre Schwarzwald-Baar, Villingen-Schwenningen, Germany
| | - Birgit Reime
- Department of Applied Health Sciences, Furtwangen University of Applied Sciences, Furtwangen, Germany
| | -
- Department of Applied Health Sciences, Furtwangen University of Applied Sciences, Furtwangen, Germany
| |
Collapse
|
6
|
Voros V, Fekete S, Szabo Z, Torma E, Nagy A, Fekete J, Tenyi T, Osvath P. High prevalence of suicide-related internet use among patients with depressive disorders - a cross-sectional study with psychiatric in-patients. Psychiatry Res 2022; 317:114815. [PMID: 36063749 DOI: 10.1016/j.psychres.2022.114815] [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] [Received: 01/10/2022] [Revised: 08/26/2022] [Accepted: 08/28/2022] [Indexed: 10/31/2022]
Abstract
The association between Internet use and suicidal behavior is a subject of intense research. Internet use patterns of patients with depressive disorders were assessed to determine the prevalence and aim of browsing for suicide-related contents and its impact on help-seeking. Self-administered questionnaire among psychiatric in-patients treated for depression was used to assess suicidal behavior, characteristics of Internet use and help-seeking preferences. 113 psychiatric in-patients with depressive disorders participated in the study. One-third had a history of life-time suicide attempt and the majority had already encountered suicide-related contents while browsing the Internet. 27.4% reported intentional and specific search for suicidal contents. This suicide-related Internet user (SRIU) group was characterized by younger age, single status, more frequent suicidal ideations, and they more likely considered that they would attempt suicide in the future. Among patients with depressive disorders, a sub-group was identified with a potential higher suicide risk. The frequent use of the Internet and online help-seeking preference may provide an opportunity to prevent suicidal behavior in this high-risk sub-group. Further research is needed into the possibilities of using the Internet more effectively for suicide prevention.
Collapse
Affiliation(s)
- Viktor Voros
- Department of Psychiatry and Psychotherapy, Medical School, University of Pecs, Pecs, Hungary.
| | - Sandor Fekete
- Department of Psychiatry and Psychotherapy, Medical School, University of Pecs, Pecs, Hungary
| | - Zsuzsanna Szabo
- Department of Psychiatry and Psychotherapy, Medical School, University of Pecs, Pecs, Hungary
| | - Eszter Torma
- Department of Psychiatry and Psychotherapy, Medical School, University of Pecs, Pecs, Hungary
| | - Agnes Nagy
- Department of Psychiatry and Psychotherapy, Medical School, University of Pecs, Pecs, Hungary
| | - Judit Fekete
- Department of Psychiatry and Psychotherapy, Medical School, University of Pecs, Pecs, Hungary
| | - Tamas Tenyi
- Department of Psychiatry and Psychotherapy, Medical School, University of Pecs, Pecs, Hungary
| | - Peter Osvath
- Department of Psychiatry and Psychotherapy, Medical School, University of Pecs, Pecs, Hungary
| |
Collapse
|
7
|
Cohen R, Rifkin‐Zybutz R, Moran P, Biddle L. Web-based support services to help prevent suicide in young people and students: A mixed-methods, user-informed review of characteristics and effective elements. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:2404-2413. [PMID: 35514202 PMCID: PMC10084127 DOI: 10.1111/hsc.13819] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/11/2022] [Accepted: 04/12/2022] [Indexed: 06/14/2023]
Abstract
The online world may provide an alternative means to engage young people and students with suicidal feelings, who are typically reluctant to seek help. We aimed to map, characterise and obtain user evaluation of current online suicide support for this group in order to assess the usefulness of current provision and how it may be improved. We conducted a mixed-methods study, comprised of an internet search, content analysis of site features and qualitative interviews with site users: 9 young people and 4 general practitioners. Data collection took place in 2019 and 2020 in the UK. Young people participants were recruited through the well-being networks of a large University in South-West England and via a national young person's mental health app. General practitioners were recruited locally through professional networks. We identified a wide range of easily accessible online support, including examples of interactive services, such as live chat and text messaging, but a lack of support that is both suicide-specific and young adult-specific, and an absence of online suicide or mental health crisis support services tailored specifically for students. Qualitative data showed that clarity, brevity and immediacy are the most important facets of engaging crisis help for young people, and that young people may prefer to use text-based rather than verbal forms of communication when seeking help. Few services provided access to active peer support, outside of lived-experience stories, which were evaluated as both valuable and potentially harmful. There is a need to further develop tailored suicide specific online crisis support for young people and students, which is able to 'speak to' their age-specific needs and preferences. While lived experience may provide a valuable means of supporting young audiences, caution is required since this may have unintended negative consequences and further research is needed to understand the safe framing of such material.
Collapse
Affiliation(s)
- Rachel Cohen
- Centre for Academic Mental HealthBristol University Medical SchoolBristolUK
| | - Raphael Rifkin‐Zybutz
- Centre for Academic Mental HealthBristol University Medical SchoolBristolUK
- University Hospitals Bristol and Weston NHS TrustBristolUK
| | - Paul Moran
- Centre for Academic Mental HealthBristol University Medical SchoolBristolUK
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation TrustBristolUK
| | - Lucy Biddle
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation TrustBristolUK
- Population Health SciencesBristol University Medical SchoolBristolUK
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Kirchner S, Till B, Plöderl M, Niederkrotenthaler T. Effects of "It Gets Better" Suicide Prevention Videos on Youth Identifying as Lesbian, Gay, Bisexual, Transgender, Queer, or Other Sexual or Gender Minorities: A Randomized Controlled Trial. LGBT Health 2022; 9:436-446. [PMID: 35575732 PMCID: PMC9499448 DOI: 10.1089/lgbt.2021.0383] [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] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Purpose: The “It Gets Better” project (IGBP) features video narratives of lesbian, gay, bisexual, transgender, queer persons or persons with other sexual or gender minority identities (LGBTQ+) of overcoming coming-out-related difficulties. This is the first experimental study investigating effects of these videos. Methods: We conducted a double-blind randomized controlled trial on-site in Austria and online in German-language settings from January to November 2020 with LGBTQ+ youth (14–22 years; n = 483), randomized to an IGBP (n = 242) or control video (n = 241). Suicidal ideation (primary outcome), help-seeking intentions, hopelessness, mood, and sexual identity were assessed at baseline (T1), postexposure (T2), and 4-week follow-up (T3). We assessed differences among gender identities, sexual orientations, with regard to depressive symptoms, and the role of identification. Data were analyzed with linear mixed models and mediation analysis. Results: There was no overall effect on suicidal ideation, but nonbinary/transgender individuals experienced a small-sized improvement (T2: mean change [MC] from baseline MC = −0.06 [95% confidence interval {CI} −0.16 to 0.05], p = 0.60; mean difference [MD] to controls MD = −0.42 [95% CI −0.79 to −0.06], p = 0.02, d = −0.10). An indirect preventive effect on suicidal ideation at T2 through the degree of identification with the protagonist in the video was observed. There was improvement in help-seeking intentions in the intervention group (T2: MC = 0.25 [95% CI 0.15 to 0.35], p < 0.001; MD = 0.28 [95% CI 0.01 to 0.54], p < 0.05, d = 0.09). Conclusion: Video narratives featuring coping might have some potential to decrease suicidal ideation and encourage help-seeking among vulnerable youth identifying with videos, but effects are small and short-lived. Study Registration: German Clinical Trial Registry (DRKS00019913).
Collapse
Affiliation(s)
- Stefanie Kirchner
- Unit Suicide Research and Mental Health Promotion, Department for Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Benedikt Till
- Unit Suicide Research and Mental Health Promotion, Department for Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Martin Plöderl
- Department for Crisis Intervention and Suicide Prevention, University Clinic for Psychiatry, Psychotherapy, and Psychosomatics, Paracelsus Medical University, Salzburg, Austria
| | - Thomas Niederkrotenthaler
- Unit Suicide Research and Mental Health Promotion, Department for Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
10
|
Tucker RP, Haydel R, Zielinski M, Niederkrotenthaler T. Storytelling of suicide attempt recovery and its relationship with mental health treatment-seeking attitudes and behaviors: An experimental study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:801-809. [PMID: 32529929 DOI: 10.1080/07448481.2020.1767110] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 04/28/2020] [Accepted: 05/05/2020] [Indexed: 06/11/2023]
Abstract
ObjectiveThis experimental study investigated if watching a brief video detailing an individual's recovery following a suicide attempt increased college student mental health treatment-seeking attitudes and resource engagement more than viewing a psychoeducational video about suicide. Participants: Undergraduate student participants (N = 218) completed the study online. Methods: Participants were randomized to see either the storytelling or one of two narrated psychoeducation videos and complete self-report measures following video viewing. Results: Video condition as well as its interaction with levels of identification with the storyteller/video narrator generally did not predict treatment-seeking attitudes as hypothesized. A small but not statistically significant effect for immediate resource engagement was seen as those in the storytelling condition interacted with online suicide prevention more than those in one of the psychoeducation conditions. Conclusions: These results suggest that brief viewing of storytelling about lived experience with suicide may have minimal impact on treatment-seeking propensity in college students.
Collapse
Affiliation(s)
- Raymond P Tucker
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
- Department of Psychiatry, Louisiana State University Health Sciences Center, Baton Rouge, Louisiana, USA
| | - Rachel Haydel
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Mark Zielinski
- Department of Psychiatry, Louisiana State University Health Sciences Center, Baton Rouge, Louisiana, USA
| | - Thomas Niederkrotenthaler
- Medical University of Vienna, Center for Public Health, Department of Social and Preventive Medicine, Unit Suicide Research & Mental Health Promotion, Vienna, Austria
| |
Collapse
|
11
|
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
|
12
|
Brennan C, Saraiva S, Mitchell E, Melia R, Campbell L, King N, House A. Self-harm and suicidal content online, harmful or helpful? A systematic review of the recent evidence. JOURNAL OF PUBLIC MENTAL HEALTH 2022. [DOI: 10.1108/jpmh-09-2021-0118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
There are calls for greater regulation of online content related to self-harm and suicide, particularly that which is user-generated. However, the online space is a source of support and advice, including an important sharing of experiences. This study aims to explore what it is about such online content, and how people interact with it, that may confer harm or offer benefit.
Design/methodology/approach
The authors undertook a systematic review of the published evidence, using customised searches up to February 2021 in seven databases. The authors included empirical research on the internet or online use and self-harm or suicide content that had been indexed since 2015. The authors undertook a theoretically driven narrative synthesis.
Findings
From 4,493 unique records, 87 met our inclusion criteria. The literature is rapidly expanding and not all the evidence is high quality, with very few longitudinal or intervention studies so little evidence to understand possible causal links. Very little content online is classifiable as explicitly harmful or definitively helpful, with responses varying by the individual and immediate context. The authors present a framework that seeks to represent the interplay in online use between the person, the medium, the content and the outcome.
Originality/value
This review highlights that content should not be considered separately to the person accessing it, so online safety means thinking about all users. Blanket removal or unthinking regulation may be more harmful than helpful. A focus on safe browsing is important and tools that limit time and diversify content would support this.
Collapse
|
13
|
Niederkrotenthaler T, Tran US, Gould M, Sinyor M, Sumner S, Strauss MJ, Voracek M, Till B, Murphy S, Gonzalez F, Spittal MJ, Draper J. Association of Logic's hip hop song "1-800-273-8255" with Lifeline calls and suicides in the United States: interrupted time series analysis. BMJ 2021; 375:e067726. [PMID: 34903528 PMCID: PMC8667739 DOI: 10.1136/bmj-2021-067726] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess changes in daily call volumes to the US National Suicide Prevention Lifeline and in suicides during periods of wide scale public attention to the song "1-800-273-8255" by American hip hop artist Logic. DESIGN Time series analysis. SETTING United States, 1 January 2010 to 31 December 2018. PARTICIPANTS Total US population. Lifeline calls and suicide data were obtained from Lifeline and the Centers for Disease Control and Prevention. MAIN OUTCOME MEASURES Daily Lifeline calls and suicide data before and after the release of the song. Twitter posts were used to estimate the amount and duration of attention the song received. Seasonal autoregressive integrated moving average time series models were fitted to the pre-release period to estimate Lifeline calls and suicides. Models were fitted to the full time series with dummy variables for periods of strong attention to the song. RESULTS In the 34 day period after the three events with the strongest public attention (the song's release, the MTV Video Music Awards 2017, and Grammy Awards 2018), Lifeline received an excess of 9915 calls (95% confidence interval 6594 to 13 236), an increase of 6.9% (95% confidence interval 4.6% to 9.2%, P<0.001) over the expected number. A corresponding model for suicides indicated a reduction over the same period of 245 suicides (95% confidence interval 36 to 453) or 5.5% (95% confidence interval 0.8% to 10.1%, P=0.02) below the expected number of suicides. CONCLUSIONS Logic's song "1-800-273-8255" was associated with a large increase in calls to Lifeline. A reduction in suicides was observed in the periods with the most social media discourse about the song.
Collapse
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
| | - Madelyn Gould
- New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Mark Sinyor
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Psychiatry, University of Toronto, Canada
| | - Steven Sumner
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - 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
| | - 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
- National Suicide Prevention Lifeline, Vibrant Emotional Health, New York, NY, USA
| | - Frances Gonzalez
- National Suicide Prevention Lifeline, Vibrant Emotional Health, New York, NY, USA
| | - Matthew J Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - John Draper
- National Suicide Prevention Lifeline, Vibrant Emotional Health, New York, NY, USA
| |
Collapse
|
14
|
Dreier M, Ludwig J, Baumgardt J, Härter M, von dem Knesebeck O, Bock T, Liebherz S. [Development of an online intervention on suicidality-providing knowledge and reducing suicide stigma]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 65:47-57. [PMID: 34902052 PMCID: PMC8732802 DOI: 10.1007/s00103-021-03471-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/24/2021] [Indexed: 12/05/2022]
Abstract
Bei Suizidalität können die Angst, von anderen stigmatisiert zu werden, sowie Selbststigmatisierung und unzureichende Informationen dazu führen, dass Hilfsangebote weniger oder gar nicht in Anspruch genommen werden. E‑Mental-Health-Interventionen sind eine Möglichkeit, niederschwellig viele Betroffene über die Thematik zu informieren und auf persönliche Hilfsangebote vorzubereiten. Am Universitätsklinikum Hamburg-Eppendorf wurde eine komplexe Intervention entwickelt, gefördert im Rahmen des Förderschwerpunkts „Suizidprävention (A: Entstigmatisierung)“ des Bundesministeriums für Gesundheit. Entwicklung und Inhalte dieser Onlineintervention sollen im vorliegenden Beitrag beschrieben werden. Nach einer repräsentativen Telefonbefragung der deutschen Allgemeinbevölkerung, mit der Wissenslücken und Stigmatisierungstendenzen zum Thema Suizid untersucht wurden, entstand auf Basis eines australischen Suizidpräventionsprojekts und in Zusammenarbeit mit Betroffenen und Angehörigen die Onlineintervention „8 Leben – Erfahrungsberichte und Wissenswertes zum Thema Suizid“. Darin wurden sowohl wissenschaftlich-klinische Fakten rund um das Thema Suizidalität als auch eine gesellschaftlich-kulturelle Perspektive beleuchtet sowie auf Selbsthilfemöglichkeiten und professionelle Hilfsangebote verwiesen. Es wurden Videoerfahrungsberichte von Betroffenen und Angehörigen gezeigt. Aktuell wird das Projekt ausgewertet. Eine Weiterführung ist geplant. In der Intervention werden verschiedene Sichtweisen gezeigt und die Personen, die die Intervention in Anspruch nehmen, werden sowohl auf kognitiver als auch auf emotionaler Ebene angesprochen. Aufgrund der Prävalenz von Suizidalität und der dennoch bestehenden Tabuisierung des Themas scheinen seriöse, evidenzbasierte und niedrigschwellige Präventions- und Informationsangebote besonders relevant.
Collapse
Affiliation(s)
- Mareike Dreier
- Institut und Poliklinik für Medizinische Psychologie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
| | - Julia Ludwig
- Institut für Medizinische Soziologie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Johanna Baumgardt
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Vivantes Klinikum Am Urban, Berlin, Deutschland
| | - Martin Härter
- Institut und Poliklinik für Medizinische Psychologie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| | - Olaf von dem Knesebeck
- Institut für Medizinische Soziologie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Thomas Bock
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Sarah Liebherz
- Institut und Poliklinik für Medizinische Psychologie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| |
Collapse
|
15
|
Till B, Tran US, Niederkrotenthaler T. The Impact of Educative News Articles about Suicide Prevention: A Randomized Controlled Trial. HEALTH COMMUNICATION 2021; 36:2022-2029. [PMID: 32867541 DOI: 10.1080/10410236.2020.1813953] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Media stories featuring stories of personal experiences of coping with suicidal ideation have been shown to decrease suicide risk, but it is unclear whether more impersonal awareness materials have similar effects. This study aimed to test the impact of impersonal educative news articles featuring interviews with suicide prevention experts. Because the impact of news articles may be determined by the articles' pull quotes and headlines, we also aimed to compare the impact of two versions of the same suicide prevention news article. One version featured headlines and pull quotes highlighting the message that suicide is preventable, whereas the other version focused on the message that suicide is prevalent. In a web-based randomized controlled trial, n = 425 participants either read a news article featuring a prevention expert with one of the above versions of the same text or an article unrelated to suicide. Data on suicidal ideation, stigmatizing attitudes toward suicidal individuals, policy attitudes toward suicide prevention, help-seeking intentions, and assumptions on the prevalence of suicide-related behavior were measured with questionnaires. The assumed prevalence of suicide in the population was greater in both intervention groups than in the control group, but the articles did not have an impact on other outcomes, and there were no differences for variations in headlines and pull quotes. Impersonal suicide prevention articles appear safe to use and do not have an impact on suicide risk factors in general population samples.
Collapse
Affiliation(s)
- Benedikt Till
- Unit Suicide Research and Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna
- Wiener Werkstaette for Suicide Research
| | - Ulrich S Tran
- Wiener Werkstaette for Suicide Research
- Department of Cognition, Emotion, and Methods in Psychology, School of Psychology, University of Vienna
| | - Thomas Niederkrotenthaler
- Unit Suicide Research and Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna
- Wiener Werkstaette for Suicide Research
| |
Collapse
|
16
|
Braun M, Till B, Pirkis J, Niederkrotenthaler T. Effects of suicide prevention videos developed by and targeting adolescents: a randomized controlled trial. Eur Child Adolesc Psychiatry 2021; 32:847-857. [PMID: 34817663 PMCID: PMC8611173 DOI: 10.1007/s00787-021-01911-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/08/2021] [Indexed: 11/25/2022]
Abstract
Suicide prevention videos featuring young people's personal narratives of hope and recovery are increasingly used in suicide prevention, but research on their effects is scarce. A double-blind randomized controlled trial was conducted to test the effects of a suicide prevention video featuring an adolescent mastering his suicidal ideation by getting help on 14 to 19-year-olds. N = 299 adolescents were randomly allocated to watch the intervention video (n = 148) or a control video unrelated to mental health (n = 151). Questionnaire data were collected before (T1) and immediately after exposure (T2), and 4 weeks later (T3). Data were analyzed with a repeated-measures ANCOVA. The primary outcome was suicidal ideation, assessed with the Reasons for Living Inventory for Adolescents. Secondary outcomes were help-seeking intentions, attitudes towards suicide, stigmatization of suicidality, and mood. There was an immediate beneficial effect of the intervention on suicidal ideation (T2 mean change from baseline within intervention group MChange = - 0.16 [95% CI - 0.20 to - 0.12], mean difference compared to control group MDiff = - 0.09 [95% CI - 0.15 to - 0.03], ηp2 = 0.03), which was not maintained at T3. Participants reported significantly higher help-seeking intentions, which was maintained at 4-week follow-up. They also reported a sustained reduction of favorable attitudes to suicide. Effects on suicidal ideation were mediated by identification with the featured protagonist. Adolescents appear to benefit from suicide prevention narratives featuring personal stories from peers on coping with suicidal ideation and help-seeking.Trial registration DRKS00017405; 24/09/19; retrospectively registered.
Collapse
Affiliation(s)
- Marlies Braun
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Benedikt Till
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Thomas Niederkrotenthaler
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| |
Collapse
|
17
|
Chen W, Boggero A, Del Puente G, Olcese M, Prestia D, Jahrami H, Chalghaf N, Guelmami N, Azaiez F, Bragazzi NL. Googling for Suicide-Content and Quality Analysis of Suicide-Related Websites: Thematic Analysis. JMIR Form Res 2021; 5:e29146. [PMID: 34689118 PMCID: PMC8663606 DOI: 10.2196/29146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 08/11/2021] [Accepted: 10/01/2021] [Indexed: 11/25/2022] Open
Abstract
Background Suicide represents a public health concern, imposing a dramatic burden. Prosuicide websites are “virtual pathways” facilitating a rise in suicidal behaviors, especially among socially isolated, susceptible individuals. Objective The aim of this study is to characterize suicide-related webpages in the Italian language. Methods The first 5 most commonly used search engines in Italy (ie, Bing, Virgilio, Yahoo, Google, and Libero) were mined using the term “suicidio” (Italian for suicide). For each search, the first 100 webpages were considered. Websites resulting from each search were collected and duplicates deleted so that unique webpages could be analyzed and rated with the HONcode instrument Results A total of 65 webpages were included: 12.5% (8/64) were antisuicide and 6.3% (4/64) explicitly prosuicide. The majority of the included websites had a mixed or neutral attitude toward suicide (52/64, 81.2%) and had informative content and purpose (39/64, 60.9%). Most webpages targeted adolescents as an age group (38/64, 59.4%), contained a reference to other psychiatric disorders or comorbidities (42/64, 65.6%), included medical/professional supervision or guidance (45/64, 70.3%), lacked figures or pictures related to suicide (41/64, 64.1%), and did not contain any access restraint (62/64, 96.9%). The major shortcoming to this study is the small sample size of webpages analyzed and the search limited to the keyword “suicide.” Conclusions Specialized mental health professionals should try to improve their presence online by providing high-quality material.
Collapse
Affiliation(s)
- Wen Chen
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, China
| | - Andrea Boggero
- Department of Educational Science, University of Genoa, Genoa, Italy
| | - Giovanni Del Puente
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genoa, Genoa, Italy
| | - Martina Olcese
- Department of Educational Science, University of Genoa, Genoa, Italy
| | - Davide Prestia
- Department of Psychiatry, Istituto di ricovero e cura a carattere scientifico Ospedale Policlinico San Martino, Genoa, Italy
| | - Haitham Jahrami
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.,Ministry of Health, Manama, Bahrain
| | - Nasr Chalghaf
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Noomen Guelmami
- Higher Institute of Sport and Physical Education of Kef, University of Jendouba, Jendouba, Tunisia
| | - Fairouz Azaiez
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| |
Collapse
|
18
|
Arendt F, Mestas M, Forrai M. Uncovering Blind Spots in the Intention to Provide Adequate Help to Suicidal Individuals. CRISIS 2021; 43:493-499. [PMID: 34463533 DOI: 10.1027/0227-5910/a000819] [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: An adequate reaction from families, friends, and colleagues who can provide help to suicidal individuals is a preventive factor. Despite the logical assumption that the mere presence of risk factors in individuals needing help may affect others' helping intentions, empirical evidence is lacking in this regard. Method: We tested whether the presence of various risk factors influences the intention to provide help to suicidal individuals. Individuals (N = 890) were exposed to a vignette in which they were asked to imagine meeting a distant acquaintance. Such persons talk about serious problems and suddenly use the word "suicide." In a one-factorial between-subjects design with 21 groups, we manipulated person-related attributes corresponding to risk factors for suicide. Results: Some attributes increased helping intentions: male gender, very young and old age, homosexuality and transsexuality, terminal illness, previous nonsuicidal self-injury, previous suicide attempt, and seeking out lethal means. However, some attributes did not: female gender, major depression, chronic pain, different stressful life events, previously experienced violence, a family history of suicide, and a cry for help. Limitations: We measured self-reported behavioral intentions. Conclusions: Although people seem to adapt their helping intentions in response to some attributes, there seem to be many blind spots.
Collapse
Affiliation(s)
- Florian Arendt
- Department of Communication, University of Vienna, Austria
| | - Manina Mestas
- Department of Communication, University of Vienna, Austria
| | | |
Collapse
|
19
|
Bell J, Westoby C. Suicide Exposure in a Polymediated Age. Front Psychol 2021; 12:694280. [PMID: 34385961 PMCID: PMC8353229 DOI: 10.3389/fpsyg.2021.694280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/21/2021] [Indexed: 11/21/2022] Open
Abstract
With growing evidence that media plays a vital role in shaping public understanding of suicidality and influencing behaviours, media portrayals of suicidality have for some time been the focus of suicide prevention efforts. Traditional media has changed, and now exists alongside and within an instantaneous, interactive sharing of information created and controlled by anyone; the way most people use it today incorporates a wide variety of online communication media. Polymedia describes media communication as both a product and process, where anyone can contribute and act as producers, consumers, audiences, and critics. In a “Polymediated age,” media exposure becomes much more complex. To understand how media exposure to suicide influences and impacts on others, it is important to take into account the communicative ecology of media technologies and the different interactions we can have with them. We researched the effects of this type of exposure by conducting in-depth interviews with a purposive sample of individuals who have lived experience and/or knowledge of suicide exposure via polymediated communication in the aftermath of a suicide. Using thematic analysis, our data demonstrates how exposure to suicide has become more complex as a result of new communicative media technology: it can be both a gift and a curse, difficult to distinguish, predict or control. Polymedia has the power to determine new forms of narrative and new forms of behaviour that on the one hand can provide support and prevention efforts, while on the other hand can promote conflict and cast an adverse influence on suicidal behaviour. Polymedia provides novel affordances for very intimate collective exposure to suicide. Our findings shed important new light on how the interplay between news media and social media has transformed our relationship with the information to which we’re exposed. We highlight important suggestions for those working in suicide prevention to develop (1) media strategies that recognise the multiple ways in which users are exposed and impacted, and (2) mechanisms for a strategic amplification and moderation of specific types of content. Media organisations and users of social media alike can contribute to maximising the beneficial capacity of polymediated exposure to suicide.
Collapse
Affiliation(s)
- Jo Bell
- Faculty of Health Sciences, University of Hull, Hull, United Kingdom
| | - Christopher Westoby
- Faculty of Arts, Cultures and Education, University of Hull, Hull, United Kingdom
| |
Collapse
|
20
|
Mann JJ, Michel CA, Auerbach RP. Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review. Am J Psychiatry 2021; 178:611-624. [PMID: 33596680 PMCID: PMC9092896 DOI: 10.1176/appi.ajp.2020.20060864] [Citation(s) in RCA: 193] [Impact Index Per Article: 64.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors sought to identify scalable evidence-based suicide prevention strategies. METHODS A search of PubMed and Google Scholar identified 20,234 articles published between September 2005 and December 2019, of which 97 were randomized controlled trials with suicidal behavior or ideation as primary outcomes or epidemiological studies of limiting access to lethal means, using educational approaches, and the impact of antidepressant treatment. RESULTS Training primary care physicians in depression recognition and treatment prevents suicide. Educating youths on depression and suicidal behavior, as well as active outreach to psychiatric patients after discharge or a suicidal crisis, prevents suicidal behavior. Meta-analyses find that antidepressants prevent suicide attempts, but individual randomized controlled trials appear to be underpowered. Ketamine reduces suicidal ideation in hours but is untested for suicidal behavior prevention. Cognitive-behavioral therapy and dialectical behavior therapy prevent suicidal behavior. Active screening for suicidal ideation or behavior is not proven to be better than just screening for depression. Education of gatekeepers about youth suicidal behavior lacks effectiveness. No randomized trials have been reported for gatekeeper training for prevention of adult suicidal behavior. Algorithm-driven electronic health record screening, Internet-based screening, and smartphone passive monitoring to identify high-risk patients are understudied. Means restriction, including of firearms, prevents suicide but is sporadically employed in the United States, even though firearms are used in half of all U.S. suicides. CONCLUSIONS Training general practitioners warrants wider implementation and testing in other nonpsychiatrist physician settings. Active follow-up of patients after discharge or a suicide-related crisis should be routine, and restricting firearm access by at-risk individuals warrants wider use. Combination approaches in health care systems show promise in reducing suicide in several countries, but evaluating the benefit attributable to each component is essential. Further suicide rate reduction requires evaluating newer approaches, such as electronic health record-derived algorithms, Internet-based screening methods, ketamine's potential benefit for preventing attempts, and passive monitoring of acute suicide risk change.
Collapse
Affiliation(s)
- J. John Mann
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, and Department of Psychiatry and Radiology, Columbia University, New York, NY
| | - Christina A. Michel
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY
| | - Randy P. Auerbach
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, and Department of Psychiatry, Columbia University, New York, NY,Division of Clinical Developmental Neuroscience, Sackler Institute
| |
Collapse
|
21
|
Rassy J, Bardon C, Dargis L, Côté LP, Corthésy-Blondin L, Mörch CM, Labelle R. Information and Communication Technology Use in Suicide Prevention: Scoping Review. J Med Internet Res 2021; 23:e25288. [PMID: 33820754 PMCID: PMC8132980 DOI: 10.2196/25288] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/10/2021] [Accepted: 03/16/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The use of information and communication technology (ICT) in suicide prevention has progressed rapidly over the past decade. ICT plays a major role in suicide prevention, but research on best and promising practices has been slow. OBJECTIVE This paper aims to explore the existing literature on ICT use in suicide prevention to answer the following question: what are the best and most promising ICT practices for suicide prevention? METHODS A scoping search was conducted using the following databases: PubMed, PsycINFO, Sociological Abstracts, and IEEE Xplore. These databases were searched for articles published between January 1, 2013, and December 31, 2018. The five stages of the scoping review process were as follows: identifying research questions; targeting relevant studies; selecting studies; charting data; and collating, summarizing, and reporting the results. The World Health Organization suicide prevention model was used according to the continuum of universal, selective, and indicated prevention. RESULTS Of the 3848 studies identified, 115 (2.99%) were selected. Of these, 10 regarded the use of ICT in universal suicide prevention, 53 referred to the use of ICT in selective suicide prevention, and 52 dealt with the use of ICT in indicated suicide prevention. CONCLUSIONS The use of ICT plays a major role in suicide prevention, and many promising programs were identified through this scoping review. However, large-scale evaluation studies are needed to further examine the effectiveness of these programs and strategies. In addition, safety and ethics protocols for ICT-based interventions are recommended.
Collapse
Affiliation(s)
- Jessica Rassy
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Research Center, Institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
- School of Nursing, Université de Sherbrooke, Longueuil, QC, Canada
- Quebec Network on Nursing Intervention Research, Montréal, QC, Canada
| | - Cécile Bardon
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Luc Dargis
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
| | - Louis-Philippe Côté
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Laurent Corthésy-Blondin
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Carl-Maria Mörch
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
- Algora Lab, Université de Montréal, Montréal, QC, Canada
- Mila, Quebec Artificial Intelligence Institute, Montréal, QC, Canada
| | - Réal Labelle
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Research Center, Institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
- Department of Psychiatry, Université de Montréal, Montréal, QC, Canada
| |
Collapse
|
22
|
Kirchner S, Till B, Plöderl M, Niederkrotenthaler T. Perceptions of LGBQ+ youth and experts of suicide prevention video messages targeting LGBQ+ youth: qualitative study. BMC Public Health 2020; 20:1845. [PMID: 33267858 PMCID: PMC7709299 DOI: 10.1186/s12889-020-09853-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 11/08/2020] [Indexed: 11/19/2022] Open
Abstract
Background Young lesbian, gay, bisexual, transgender, queer as well as other sexual/gender minorities (LGBTQ+) persons have higher rates of suicidal ideation and behavior compared to their non-LGBTQ+ peers, particularly during their coming out. The “It Gets Better” project is a multi-national media campaign that aims to reduce suicide among LGBTQ+ adolescents by providing personal narratives of hope delivered by mainly adult LGBTQ+ persons. There is only little knowledge so far on how young LGBTQ+ people as well as experts in suicide prevention and counseling perceive these videos, and how to potentially improve the videos based on their perceptions. Methods A total of n = 19 LGBQ+ adolescents and young adults and n = 9 experts participated in focus groups to discuss perceptions of a selection of “It Gets Better” videos. Eight focus groups were conducted to assess perceptions on the process of watching the videos, possible effects on young LGBQ+ viewers in general, and suicidal LGBQ+ youth in particular, as well as factors that were relevant to their perceptions. Results Messages were found to be helpful in terms of promoting hope. LGBQ+ youth identified several key strategies to increase identification with messages, which they considered crucial for their effectiveness. Criticism emerged from a perceived lack of diversity in terms of portrayed sexual identities, and some shallowness in the portrayal of suicidal ideation and how things can get better. The experts’ perceptions of the videos were largely consistent with LGBQ+ youth, highlighting a positive potential of videos to support coming out and identity building processes. Conclusions Young people and experts view the videos as helpful and relevant, but identified several strategies to better tailor them to the needs of LGBTQ+ adolescents, including suicidal peers. The insights gained are useful to the increasing number of suicide prevention projects using personal narratives of coping delivered via media to help prevent suicide. Supplementary Information Supplementary information accompanies this paper at 10.1186/s12889-020-09853-5.
Collapse
Affiliation(s)
- Stefanie Kirchner
- Department for Social and Preventive Medicine, Medical University of Vienna, Center for Public Health, Unit Suicide Research & Mental Health Promotion, Kinderspitalgasse 15/1, 1090, Vienna, Austria
| | - Benedikt Till
- Department for Social and Preventive Medicine, Medical University of Vienna, Center for Public Health, Unit Suicide Research & Mental Health Promotion, Kinderspitalgasse 15/1, 1090, Vienna, Austria
| | - Martin Plöderl
- Department for Crisis Intervention and Suicide Prevention, Christian Doppler Clinic, Paracelsus Medical University, Ignaz-Harrer-Straße 79, 5020, Salzburg, Austria
| | - Thomas Niederkrotenthaler
- Department for Social and Preventive Medicine, Medical University of Vienna, Center for Public Health, Unit Suicide Research & Mental Health Promotion, Kinderspitalgasse 15/1, 1090, Vienna, Austria.
| |
Collapse
|
23
|
Niederkrotenthaler T, Till B. Effects of suicide awareness materials on individuals with recent suicidal ideation or attempt: online randomised controlled trial. Br J Psychiatry 2020; 217:693-700. [PMID: 31843026 DOI: 10.1192/bjp.2019.259] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Awareness materials featuring ways of coping with suicidal ideation can reduce suicidal ideation, the so-called Papageno effect. All of the previous experimental studies on this subject have been conducted with individuals not at risk of suicide. AIMS To assess effects of suicide awareness materials in a sample of individuals with recent suicidal ideation. Trial registration: German Clinical Trial Registry ID number DRKS00013613. METHOD Adults (n = 266) with recent self-reported suicidal ideation or attempt were randomised to read an educative article featuring a lay individual with personal experience of suicidality (n = 86), a similar article featuring a mental health expert (n = 90), or an unrelated article (n = 90) in a double-blind online randomised controlled trial. Questionnaire data were collected before (T1) and immediately after exposure (T2) as well as 1 week later (study end-point, T3) and analysed with linear mixed models. The primary outcome was suicide risk as assessed using the Survival and Coping Beliefs subscale of the Reasons for Living Inventory (RFLI); secondary outcomes were suicide-prevention knowledge and mood. RESULTS There was an immediate beneficial effect on suicide risk in the intervention group exposed to the message delivered by the individual with personal experience (group 1) as compared with the control group that was maintained until the study end-point (study end-point: RFLI score mean difference from baseline within group 1 MD = -0.36 (95% CI -0.66 to -0.06), mean difference compared with control group MD = -0.71 (95% CI -1.27 to -0.14); d = -0.18). The effect was particularly pronounced for individuals with recent suicide attempt (RFLI score at T3, compared with control group: MD = -1.55 (95% CI -2.52 to -0.57); d = -0.23). Participants in this group also showed increased prevention-related knowledge compared with the control group. CONCLUSIONS Individuals with a recent suicide attempt appear to benefit from a printed narrative of positive coping with suicidal ideation. The intervention materials do not increase short-term suicide risk.
Collapse
Affiliation(s)
- Thomas Niederkrotenthaler
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria
| | - Benedikt Till
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria
| |
Collapse
|
24
|
Investigating Google's suicide-prevention efforts in celebrity suicides using agent-based testing: A cross-national study in four European countries. Soc Sci Med 2020; 262:112692. [DOI: 10.1016/j.socscimed.2019.112692] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/03/2019] [Accepted: 11/16/2019] [Indexed: 11/22/2022]
|
25
|
Ganesh R, Singh S, Mishra R, Sagar R. The quality of online media reporting of celebrity suicide in India and its association with subsequent online suicide-related search behaviour among general population: An infodemiology study. Asian J Psychiatr 2020; 53:102380. [PMID: 32937236 PMCID: PMC7455521 DOI: 10.1016/j.ajp.2020.102380] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 08/25/2020] [Indexed: 01/25/2023]
Abstract
The literature reports increased suicide rates among general population in the weeks following the celebrity suicide, known as the Werther effect. The World Health Organization (WHO) has developed guidelines for responsible media reporting of suicide. The present study aimed to assess the quality of online media reporting of a recent celebrity suicide in India and its impact on the online suicide related search behaviour of the population. A total of 200 online media reports about Sushant Singh Rajput's suicide published between 14th to 20th June 2020 were assessed for quality of reporting following the checklist prepared using the WHO guidelines. Further, we examined the change in online suicide-seeking and help-seeking search behaviour of the population following celebrity suicide for the month of June using selected keywords. In terms of potentially harmful media reportage, 85.5 % of online reports violated at least one WHO media reporting guideline. In terms of potentially helpful media reportage, only 13 % articles provided information about where to seek help for suicidal thoughts or ideation. There was a significant increase in online suicide-seeking (U = 0.5, p < 0.05) and help-seeking (U = 6.5, p < 0.05) behaviour after the reference event, when compared to baseline. However, the online peak search interest for suicide-seeking was greater than help-seeking. This provides support for a strong Werther effect, possibly associated with poor quality of media reporting of celebrity suicide. There is an urgent need for taking steps to improve the quality of media reporting of suicide in India.
Collapse
Affiliation(s)
- Ragul Ganesh
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India
| | - Swarndeep Singh
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India
| | - Rajan Mishra
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India.
| |
Collapse
|
26
|
Laido Z, Till B, Niederkrotenthaler T. Short-Term Effects of Media Reports on Terrorism That Are Consistent vs. Not Consistent with Media Recommendations on Mass Shootings: A Randomized Controlled Trial. Suicide Life Threat Behav 2020; 50:948-962. [PMID: 32267019 PMCID: PMC7687194 DOI: 10.1111/sltb.12636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 01/19/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Media recommendations for the reporting of events where one person or a small group kills multiple others in public settings have been developed recently by suicide prevention experts. Evidence on the effects of reports that are compliant or noncompliant with these recommendations is lacking. METHODS We conducted a randomized controlled trial with n = 148 participants who were randomly assigned to read newspaper articles (A) on acts of terrorism assumed to be conducted by Islamist terrorists and not consistent with media recommendations, (B) the same articles differing only in their compliance with recommendations, or (C) articles of similar style that were about homicide. Islamophobia as well as suicidal ideation, stress, and mood were measured before reading the article (T1), immediately afterwards (T2), and one week later (T3). The primary hypothesis was that there is an increase in islamophobia after exposure to media portrayals not consistent with media recommendations. RESULTS Compared to the control group, only participants reading media reports that were not consistent with media recommendations showed a short-term increase in islamophobia. CONCLUSION These findings suggest that reporting on terrorism that is not consistent with media recommendations appears to increase islamophobia. In the context of reporting on Islamist terrorism, consistency with recommendations might help reduce negative attitudes toward Muslim minorities.
Collapse
Affiliation(s)
- Zrinka Laido
- Unit Suicide Research and Mental Health PromotionDepartment of Social and Preventive MedicineCentre for Public HealthMedical University of ViennaViennaAustria
| | - Benedikt Till
- Unit Suicide Research and Mental Health PromotionDepartment of Social and Preventive MedicineCentre for Public HealthMedical University of ViennaViennaAustria
| | - Thomas Niederkrotenthaler
- Unit Suicide Research and Mental Health PromotionDepartment of Social and Preventive MedicineCentre for Public HealthMedical University of ViennaViennaAustria
| |
Collapse
|
27
|
Niederkrotenthaler T, Schacherl R, Till B. Communication about suicide in YouTube videos: Content analysis of German-language videos retrieved with method-and help-related search terms. Psychiatry Res 2020; 290:113170. [PMID: 32526517 DOI: 10.1016/j.psychres.2020.113170] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 05/29/2020] [Accepted: 05/30/2020] [Indexed: 10/24/2022]
Abstract
Online searches for information on suicide are very common but studies on how the topic is addressed on one of the the most relevant platforms, YouTube, are missing. We performed a content analysis of German-language videos retrieved with the basic term "suicide", a method-related search term ("how to hang yourself"), and a help-related term ("suicide prevention"). We assessed the quality of n=232 randomly selected videos based on media recommendations for suicide reporting. Characteristics of videos retrieved with the method- and help-related search term, were compared to search results for "suicide". Videos retrieved with the help-related term had more potentially protective and fewer harmful characteristics than those retrieved with the other search terms. For example, these videos significantly more often debunked suicide myths and provided contact information to help services. In total, the mean number of harmful and protective characteristics per video were 1.6 and 1.3 for basic searches; 1.7 and 1.0 for method-related searches, and 0.4 and 2.8 for help-related searches, respectively. Videos retrieved in the help-related search were often from help organizations. Only 3% and 8% of videos retrieved with "suicide" and "how to hang yourself", respectively, were age-restricted. Collaborations between suicide prevention and Youtube are warranted to improve the visibility of protective contents and ensure a better implementation of Youtube's own policies regarding self-harm.
Collapse
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.
| | - Ronja Schacherl
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical 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
| |
Collapse
|
28
|
Till B, Braun M, Gahbauer S, Reisinger N, Schwenzner E, Niederkrotenthaler T. Content analysis of suicide-related online portrayals: changes in contents retrieved with search engines in the United States and Austria from 2013 to 2018. J Affect Disord 2020; 271:300-309. [PMID: 32479330 DOI: 10.1016/j.jad.2020.03.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 01/14/2020] [Accepted: 03/22/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND In recent years, efforts in suicide prevention in the United States and Europe have been made to change the conversation on suicide to incorporate more preventive aspects. The majority of information-seeking occurs online. Structured analyses assessing qualitative changes in retrieved online material on suicide over time, however, are scarce. We replicated a content analysis of suicide-related websites retrieved with popular search engines in the United States and Austria aiming to assess how suicide-related online portrayals have changed in the past five years. METHOD We retrieved 396 websites using the search term suicide, method-related search terms (e.g., how to hang yourself), and help-related search terms (e.g., suicide help) in the United States and 286 websites from Austrian searches. We performed a content analysis based on media recommendations for suicide reporting and compared the findings to 335 websites in the United States and 396 websites in Austria retrieved in 2013 with the same procedure. RESULTS In both countries, the number of both protective (United States: p < .001, Austria: p < .001) and harmful characteristics (United States: p < .001, Austria: p < .001) increased. The ratio of protective to harmful characteristics improved to 3.3:1 in the United States and to 2.4:1 in Austria. LIMITATIONS No assumptions about the actual impact of the retrieved contents can be assumed. CONCLUSION There has been an increase in potentially protective aspects in online portrayals of suicidality, but also an increase in potentially harmful characteristics, which may suggest an increasing polarization of suicide-related contents. Future prevention efforts need to address this potential polarization.
Collapse
Affiliation(s)
- Benedikt Till
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, 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
| | - Susanne Gahbauer
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Nikolaus Reisinger
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Ewald Schwenzner
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Thomas Niederkrotenthaler
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
29
|
Thorn P, Hill NT, Lamblin M, Teh Z, Battersby-Coulter R, Rice S, Bendall S, Gibson KL, Finlay SM, Blandon R, de Souza L, West A, Cooksey A, Sciglitano J, Goodrich S, Robinson J. Developing a Suicide Prevention Social Media Campaign With Young People (The #Chatsafe Project): Co-Design Approach. JMIR Ment Health 2020; 7:e17520. [PMID: 32391800 PMCID: PMC7248803 DOI: 10.2196/17520] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/31/2020] [Accepted: 02/03/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Young people commonly use social media platforms to communicate about suicide. Although research indicates that this communication may be helpful, the potential for harm still exists. To facilitate safe communication about suicide on social media, we developed the #chatsafe guidelines, which we sought to implement via a national social media campaign in Australia. Population-wide suicide prevention campaigns have been shown to improve knowledge, awareness, and attitudes toward suicide. However, suicide prevention campaigns will be ineffective if they do not reach and resonate with their target audience. Co-designing suicide prevention campaigns with young people can increase the engagement and usefulness of these youth interventions. OBJECTIVE This study aimed to document key elements of the co-design process; to evaluate young people's experiences of the co-design process; and to capture young people's recommendations for the #chatsafe suicide prevention social media campaign. METHODS In total, 11 co-design workshops were conducted, with a total of 134 young people aged between 17 and 25 years. The workshops employed commonly used co-design strategies; however, modifications were made to create a safe and comfortable environment, given the population and complexity and sensitivity of the subject matter. Young people's experiences of the workshops were evaluated through a short survey at the end of each workshop. Recommendations for the campaign strategy were captured through a thematic analysis of the postworkshop discussions with facilitators. RESULTS The majority of young people reported that the workshops were both safe (116/131, 88.5%) and enjoyable (126/131, 96.2%). They reported feeling better equipped to communicate safely about suicide on the web and feeling better able to identify and support others who may be at risk of suicide. Key recommendations for the campaign strategy were that young people wanted to see bite-sized sections of the guidelines come to life via shareable content such as short videos, animations, photographs, and images. They wanted to feel visible in campaign materials and wanted all materials to be fully inclusive and linked to resources and support services. CONCLUSIONS This is the first study internationally to co-design a suicide prevention social media campaign in partnership with young people. The study demonstrates that it is feasible to safely engage young people in co-designing a suicide prevention intervention and that this process produces recommendations, which can usefully inform suicide prevention campaigns aimed at youth. The fact that young people felt better able to safely communicate about suicide on the web as a result of participation in the study augurs well for youth engagement with the national campaign, which was rolled out across Australia. If effective, the campaign has the potential to better prepare many young people to communicate safely about suicide on the web.
Collapse
Affiliation(s)
- Pinar Thorn
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Nicole Tm Hill
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Michelle Lamblin
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Zoe Teh
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | | | - Simon Rice
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Sarah Bendall
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Kerry L Gibson
- The University of Auckland, Auckland CBD, Auckland, New Zealand
| | - Summer May Finlay
- The University of Canberra, Bruce, ACT, Australia
- The University of Wollongong, Wollongong, NSW, Australia
| | | | | | | | | | | | | | - Jo Robinson
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| |
Collapse
|
30
|
Niederkrotenthaler T, Till B. Effects of awareness material featuring individuals with experience of depression and suicidal thoughts on an audience with depressive symptoms: Randomized controlled trial. J Behav Ther Exp Psychiatry 2020; 66:101515. [PMID: 31610437 DOI: 10.1016/j.jbtep.2019.101515] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 09/09/2019] [Accepted: 09/22/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Suicide prevention plans support individuals with personal experience of mental disorders and suicidality to provide their narratives of coping in the media. The evidence how such portrayals impact on individuals with similar symptoms is limited and there are concerns about unwanted side effects. METHODS This was a double-blinded randomized controlled online trial conducted from August to November 2018. N = 158 young adults aged 18-24 with current depressive symptoms and suicidal thoughts were randomized to watch a short film featuring a young individual with personal experience of depression and suicidality (n = 81), or a thematically unrelated control film (n = 77) with similar stylistic elements. Questionnaire data were collected before and immediately after exposure and analysed with ANOVA. The primary outcome was suicidal ideation; secondary outcomes were depressed mood and help-seeking intentions. We also tested the moderating effects of the degree of depressive symptoms on the effects. RESULTS Depressed mood was significantly lower, with small-to medium effect size, in the intervention group compared to the control group (F(1,111) = 4.13, P < .05, ηp2 = .036). There was no effect on suicidal ideation or help-seeking intentions in the total sample. Participants screening positive for moderately severe depression or higher experienced an increase in suicidal ideation in the control group. LIMITATIONS Self-reported variables in an online setting. CONCLUSIONS Videos featuring personal experience of coping with depression appear safe for young individuals with similar or higher symptoms of depression and suicidal ideation on the short run, and might have some benefits. TRIAL REGISTRATION German Clinical Trial Registry, DRKS00015095 (registration date: 2018-07-16).
Collapse
Affiliation(s)
- Thomas Niederkrotenthaler
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, A-1090, Vienna, Austria.
| | - Benedikt Till
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, A-1090, Vienna, Austria
| |
Collapse
|
31
|
Campo-Arias A, Herazo E. Suicide reporting in mass media in the state of Magdalena, Colombia. DUAZARY 2020. [DOI: 10.21676/2389783x.3213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In 2016 and 2017, the suicide rate in Colombia went up from 5.20 to 5.72, respectively. The same trend was observed for the State of Magdalena for the same period with an increase in the rates that went from 3.37 in 2016 and 4.27 per one hundred thousand inhabitants in 20171,2. The suicide rate in the State of Magdalena occupies third place among the departments of the Colombian Caribbean region1
Collapse
|
32
|
Arendt F, Scherr S, Pasek J, Jamieson PE, Romer D. Investigating harmful and helpful effects of watching season 2 of 13 Reasons Why: Results of a two-wave U.S. panel survey. Soc Sci Med 2019; 232:489-498. [DOI: 10.1016/j.socscimed.2019.04.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 03/05/2019] [Accepted: 04/06/2019] [Indexed: 01/13/2023]
|
33
|
Abstract
PURPOSE OF REVIEW The purpose of this article is to present notable findings and developments in suicide prevention research and in particular, strategies to detect persons at risk for suicide as well as strategies to reduce suicide risk among the general population and specific risk groups. RECENT FINDINGS Popular strategies to detect persons at risk for suicide include scanning social media posts, prediction models using electronic health record data as well as the use of experienced sampling methodology to enhance our understanding of the suicidal process. Emerging approaches to reduce suicide risk include the development of media reporting recommendations, mass media campaigns to improve knowledge, attitudes and behaviour as well as technology-enhanced interventions. SUMMARY Recently, promising approaches to detect individuals at risk for suicide as well as effective strategies to reduce suicide risk emerged. Whether these new opportunities will translate into an effective reduction in suicide rates remains to be demonstrated.
Collapse
|
34
|
Arafat SMY, Khan MM, Niederkrotenthaler T, Ueda M, Armstrong G. Assessing the Quality of Media Reporting of Suicide Deaths in Bangladesh Against World Health Organization Guidelines. CRISIS 2019; 41:47-53. [PMID: 31140319 DOI: 10.1027/0227-5910/a000603] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background: Media reporting of suicide events has thus far gone without sufficient scrutiny in Bangladesh. Aim: The purpose of this study was to assess the quality of newspaper reporting of suicides in Bangladesh against international guidelines. Methods: We used content analysis to assess the quality of suicide reporting in six daily newspapers in Bangladesh. The newspapers were hand-searched between November 2016 and April 2017 and 327 articles reporting on suicide deaths were retrieved. Results: The mean number of suicide articles per day per newspaper was 0.3 (range across newspapers 0.11-0.70) and the mean length was 11.3 sentences. Harmful reporting practices were very common (for example, a detailed suicide method was reported in 75.5% of articles) while almost no potentially helpful reporting practices were observed (for example, no articles gave contact details for a suicide support service). Limitations: The findings are limited to print mass media. Conclusions: We observed that explicit and simplistic reports of suicide deaths were frequently observed in newspapers in Bangladesh. Attempts should be made to understand the perspectives of media professionals in relation to suicide reporting, and to devise strategies to boost the positive contribution that media can make to suicide prevention in this context.
Collapse
Affiliation(s)
- S M Yasir Arafat
- Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Murad M Khan
- Department of Psychiatry, Aga Khan University, Karachi, Pakistan
| | | | - Michiko Ueda
- Faculty of Political Science and Economics, Waseda University, Tokyo, Japan
| | - Gregory Armstrong
- Nossal Institute for Global Health, The University of Melbourne, VIC, Australia
| |
Collapse
|
35
|
Whiteside U, Richards J, Huh D, Hidalgo R, Nordhauser R, Wong AJ, Zhang X, Luxton DD, Ellsworth M, Lezine D. Development and Evaluation of a Web-Based Resource for Suicidal Thoughts: NowMattersNow.org. J Med Internet Res 2019; 21:e13183. [PMID: 31045498 PMCID: PMC6521196 DOI: 10.2196/13183] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 03/14/2019] [Accepted: 04/12/2019] [Indexed: 11/24/2022] Open
Abstract
Background Nearly half of people who die by suicide see a health care provider in the month before their death. With the release of new care guidelines, detection of suicidal patients will likely increase. Providers need access to suicide-specific resources that can be used as part of immediate, brief interventions with a suicidal patient. Web-based suicide prevention resources have the potential to address this need. Objective This study aimed to describe the development of the NowMattersNow.org website as a resource for individuals with suicidal thoughts and to evaluate the utility of the site via user experience surveys. Methods NowMattersNow.org is an online video-based free public resource that provides evidence-based teachings, examples, and resources for managing suicidal thoughts and intense emotions focused largely around skills from dialectical behavior therapy. Developed with assistance from mental health consumers, it is intended to address gaps in access to services for suicidal patients in health care systems. Visitors stay an average of a minute and a half on the website. From March 2015 to December 2017, a user experience survey measured self-reported changes on a 1 (not at all) to 5 (completely overwhelming) scale regarding intensity of suicidal thoughts and negative emotions while on the website. Longitudinal regression analyses using generalized estimating equations evaluated the magnitude and statistical significance of user-reported changes in suicidal ideation and negative emotion. In secondary analyses, user-reported changes specific to subgroups, including men aged 36 to 64 years, mental health care providers, and other health care providers were evaluated. Results During the period of analysis, there were 138,386 unique website visitors. We analyzed surveys (N=3670) collected during that time. Subsamples included men aged 36 to 64 years (n=512), mental health providers (n=460), and other health care providers (n=308). A total of 28% (1028/3670) of survey completers rated their suicidal thoughts as a 5 or “completely overwhelming” when they entered the website. We observed significant reductions in self-reported intensity of suicidal thoughts (–0.21, P<.001) and negative emotions (–0.32, P<.001), including decreases for users with the most severe suicidal thoughts (–6.4%, P<.001), most severe negative emotions (–10.9%, P<.001), and for middle-aged men (–0.13, P<001). Results remained significant after controlling for length of visit to website (before the survey) and technology type (mobile, desktop, and tablet). Conclusions Survey respondents reported measurable reductions in intensity of suicidal thoughts and emotions, including those rating their suicidal thoughts as completely or almost completely overwhelming and among middle-aged men. Although results from this user-experience survey administered at one point in time to a convenience sample of users must be interpreted with caution, results provide preliminary support for the potential effectiveness of the NowMattersNow.org website as a tool for short-term management of suicidal thoughts and negative emotions.
Collapse
Affiliation(s)
- Ursula Whiteside
- NowMattersNow.org, Seattle, WA, United States.,School of Social Work, University of Washington, Seattle, WA, United States
| | - Julie Richards
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States.,Department of Health Services, University of Washington, Seattle, WA, United States
| | - David Huh
- School of Social Work, University of Washington, Seattle, WA, United States.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Rianna Hidalgo
- NowMattersNow.org, Seattle, WA, United States.,Berkeley School of Law, University of California, Berkeley, CA, United States
| | | | | | | | - David D Luxton
- NowMattersNow.org, Seattle, WA, United States.,School of Social Work, University of Washington, Seattle, WA, United States
| | | | - DeQuincy Lezine
- NowMattersNow.org, Seattle, WA, United States.,Prevention Communities, Fresno, CA, United States
| |
Collapse
|
36
|
Reports of Adolescent Psychiatric Outpatients on the Impact of the TV Series "13 Reasons Why": A Qualitative Study. J Adolesc Health 2019; 64:414-415. [PMID: 30819333 DOI: 10.1016/j.jadohealth.2018.11.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 11/26/2018] [Indexed: 11/23/2022]
|
37
|
Robinson J, Bailey E, Witt K, Stefanac N, Milner A, Currier D, Pirkis J, Condron P, Hetrick S. What Works in Youth Suicide Prevention? A Systematic Review and Meta-Analysis. EClinicalMedicine 2018; 4-5:52-91. [PMID: 31193651 PMCID: PMC6537558 DOI: 10.1016/j.eclinm.2018.10.004] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 10/14/2018] [Accepted: 10/15/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Young people require specific attention when it comes to suicide prevention, however efforts need to be based on robust evidence. METHODS We conducted a systematic review and meta-analysis of all studies examining the impact of interventions that were specifically designed to reduce suicide-related behavior in young people. FINDINGS Ninety-nine studies were identified, of which 52 were conducted in clinical settings, 31 in educational or workplace settings, and 15 in community settings. Around half were randomized controlled trials. Large scale interventions delivered in both clinical and educational settings appear to reduce self-harm and suicidal ideation post-intervention, and to a lesser extent at follow-up. In community settings, multi-faceted, place-based approaches seem to have an impact. Study quality was limited. INTERPRETATION Overall whilst the number and range of studies is encouraging, gaps exist. Few studies were conducted in low-middle income countries or with demographic populations known to be at increased risk. Similarly, there was a lack of studies conducted in primary care, universities and workplaces. However, we identified that specific youth suicide-prevention interventions can reduce self-harm and suicidal ideation; these types of intervention need testing in high-quality studies.
Collapse
Affiliation(s)
- Jo Robinson
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Vic 3052, Australia
| | - Eleanor Bailey
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Vic 3052, Australia
| | - Katrina Witt
- Turning Point, Eastern Health Clinical School, Monash University, 110 Church Street, Richmond, VIC 3121, Australia
| | - Nina Stefanac
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Vic 3052, Australia
| | - Allison Milner
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, 235 Bouverie Street, Vic 3010, Australia
| | - Dianne Currier
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, 235 Bouverie Street, Vic 3010, Australia
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, 235 Bouverie Street, Vic 3010, Australia
| | - Patrick Condron
- University Library, The University of Melbourne, Parkville, Vic 3010, Australia
| | - Sarah Hetrick
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Vic 3052, Australia
- Department of Psychological Medicine, Faculty of Medicine and Health Sciences, University of Auckland, Support Building Auckland Hospital, 2 Park Rd, Auckland 1142, New Zealand
| |
Collapse
|
38
|
Till B, Fraissler M, Voracek M, Tran US, Niederkrotenthaler T. Associations Between Suicide Risk Factors and Favorite Songs. CRISIS 2018; 40:7-14. [PMID: 29848079 DOI: 10.1027/0227-5910/a000523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND For several decades, the question of whether personal suicidality is reflected in individual music preferences has been the subject of debate in suicide research. Despite many studies investigating the relationship between music use and suicidal behavior, it is still unclear whether suicide risk is reflected in individual music preferences. AIMS The present study aimed to assess whether music preferences are reflected in suicide risk factors. METHOD We assessed suicidal ideation, depression, and hopelessness among 943 participants in a cross-sectional online survey. Participants provided up to five examples of their favorite music. We conducted a content analysis and coded all reported songs as suicide-related, coping-related, or unrelated to suicide. RESULTS Multivariate analyses controlling for gender, age, education level, and amount of daily music use indicated associations of preferences for suicide-related songs with suicidal ideation and depression. LIMITATIONS Limitations of the present study include the use of a convenience sample and a cross-sectional design, the small number of participants with preferences for coping-related songs, and the relatively small effect size of the associations found. CONCLUSION Music preferences appear to reflect suicide risk factors, with individuals who prefer suicide-related songs scoring higher in terms of suicidal ideation and depression.
Collapse
Affiliation(s)
- Benedikt Till
- 1 Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria.,3 Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Michael Fraissler
- 1 Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria.,3 Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Martin Voracek
- 2 Department of Basic Psychological Research and Research Methods, School of Psychology, University of Vienna, Austria.,3 Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Ulrich S Tran
- 2 Department of Basic Psychological Research and Research Methods, School of Psychology, University of Vienna, Austria.,3 Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Thomas Niederkrotenthaler
- 1 Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria.,3 Wiener Werkstaette for Suicide Research, Vienna, Austria
| |
Collapse
|
39
|
Arendt F, Scherr S, Niederkrotenthaler T, Till B. The role of language in suicide reporting: Investigating the influence of problematic suicide referents. Soc Sci Med 2018; 208:165-171. [PMID: 29730000 DOI: 10.1016/j.socscimed.2018.02.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 02/05/2018] [Accepted: 02/10/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Although suicide experts recommend using neutral suicide referents in news media reporting, this recommendation has not yet been tested empirically. This recommendation, based on the empirically yet untested assumption that problematic suicide referents carry meaning that is inappropriate from a prevention perspective, may lead to a different perspective on suicide, termed "framing effects." For example, in German-speaking countries, the neutral term Suizid (suicide) is recommended. Conversely, Freitod ("free death") and Selbstmord ("self-murder") convey associative meanings related to problematic concepts such as free will (Freitod) and crime/murder (Selbstmord), and are therefore not recommended. METHOD Using a web-based randomized controlled trial focused on German speakers (N = 451), we tested whether the news media's use of Suizid, Selbstmord, and Freitod elicits framing effects. Participants read identical news reports about suicide. Only the specific suicide referents varied depending on the experimental condition. Post-reading, participants wrote short summaries of the news reports, completed a word-fragment completion test and a questionnaire targeting suicide-related attitudes. RESULTS We found that the news frame primed some frame-related concepts in the memory and also increased frame-related word choice. Importantly, we found that participants reading the free will-related Freitod frame showed greater attitudinal support for suicide among individuals suffering from incurable diseases. CONCLUSIONS This study highlights the importance of how the news media write about suicide and supports the language recommendations put forward by suicide experts.
Collapse
Affiliation(s)
- Florian Arendt
- Department of Communication Science and Media Research, University of Munich (LMU), Germany.
| | - Sebastian Scherr
- Leuven School for Mass Communication Research, KU Leuven, Belgium
| | - Thomas Niederkrotenthaler
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria
| | - Benedikt Till
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria
| |
Collapse
|
40
|
Laukkala T, Vuorio A, Bor R, Budowle B, Navathe P, Pukkala E, Sajantila A. Copycats in Pilot Aircraft-Assisted Suicides after the Germanwings Incident. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018. [PMID: 29534475 PMCID: PMC5877036 DOI: 10.3390/ijerph15030491] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Aircraft-assisted pilot suicide is a rare but serious phenomenon. The aim of this study was to evaluate changes in pilot aircraft-assisted suicide risks, i.e., a copycat effect, in the U.S. and Germany after the Germanwings 2015 incident in the French Alps. Aircraft-assisted pilot suicides were searched in the U.S. National Transportation Safety Board (NTSB) accident investigation database and in the German Bundestelle für Flugunfalluntersuchung (BFU) Reports of Investigation database five years before and two years after the deliberate crash of the Germanwings flight into the French Alps in 2015. The relative risk (RR) of the aircraft-assisted pilot suicides was calculated. Two years after the incident, three out of 454 (0.66%) fatal incidents were aircraft-assisted suicides compared with six out of 1292 (0.46%) in the prior five years in the NTSB database. There were no aircraft-assisted pilot suicides in the German database during the two years after or five years prior to the Germanwings crash. The relative aircraft-assisted pilot suicide risk for the U.S. was 1.4 (95% CI 0.3–4.2) which was not statistically significant. Six of the pilots who died by suicide had told someone of their suicidal intentions. We consider changes in the rate to be within a normal variation. Responsible media coverage of aircraft incidents is important due to the large amount of publicity that these events attract.
Collapse
Affiliation(s)
- Tanja Laukkala
- Mehiläinen Kielotie Health Centre, Vantaa 01300, Finland.
| | - Alpo Vuorio
- Department of Forensic Medicine, University of Helsinki and Mehiläinen Airport Health Centre, Lentäjäntie 1 E, 01530 Vantaa, Finland.
| | - Robert Bor
- Royal Free Hospital, Pond Street, London NW3 2QG, UK.
- Centre for Aviation Psychology, London NW3 1ND, UK.
| | - Bruce Budowle
- Center for Human Identification, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, USA.
- Center of Excellence in Genomic Medicine Research (CEGMR), King Abdulaziz University, Jeddah 21577, Saudi Arabia.
| | | | - Eero Pukkala
- Faculty of Social Sciences, University of Tampere, 33100 Tampere, Finland.
| | - Antti Sajantila
- Department of Forensic Medicine, University of Helsinki, 00014 Helsinki, Finland.
| |
Collapse
|
41
|
Ortiz P, Khin Khin E. Traditional and new media's influence on suicidal behavior and contagion. BEHAVIORAL SCIENCES & THE LAW 2018; 36:245-256. [PMID: 29659071 DOI: 10.1002/bsl.2338] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 01/19/2018] [Accepted: 01/24/2018] [Indexed: 06/08/2023]
Abstract
The role of nonfictional and fictional media in suicide contagion has been well established, ostensibly beginning with the publication of Goethe's The Sorrows of Young Werther in 1774. In recent decades, the emergence of several new forms of media (e.g. websites, social media, blogs, smartphone applications) has revolutionized the communication and social interaction paradigms. This article reviews "the Werther effect" (or suicide contagion related to media), special populations who are more influential or susceptible, current media reporting guidelines and their effectiveness, and the latest research on new media and its effect on suicide and suicide contagion. The aim is to update recommendations on how to mitigate the potential negative effects of both traditional and new media on suicidal behavior and suicide contagion.
Collapse
Affiliation(s)
- Patricia Ortiz
- George Washington University, Department of Psychiatry and Behavioral Sciences, Washington, DC, USA
| | - Eindra Khin Khin
- George Washington University, Department of Psychiatry and Behavioral Sciences, Washington, DC, USA
| |
Collapse
|
42
|
Cheng Q, Chen F, Lee EST, Yip PSF. The role of media in preventing student suicides: A Hong Kong experience. J Affect Disord 2018; 227:643-648. [PMID: 29174737 DOI: 10.1016/j.jad.2017.11.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 09/19/2017] [Accepted: 11/04/2017] [Indexed: 11/15/2022]
Abstract
INTRODUCTION In view of the surge of student suicides in March 2016, a large-scale media involvement was engaged to minimize copycat effects and to extensively spread more preventive information. METHODS Trend differences between student suicides in overall as well as youth suicides between 2003 and 2016 were examined. Impacts of media involvement were examined as to the changes of their intensities in reporting student suicides in different manners. Local polynomial smoothing method was used to estimate the intensities throughout the study period. RESULTS The intensity of students' suicides has been slowly increasing since 2006, which was in contrast to the decreasing trend of overall suicide intensity. After our engagement with the media, acute descriptive-reporting in student suicide news has sharply dropped and remained low since then, whereas preventive-reporting has increased sharply in March and April 2016, but dropped back to normal afterwards. The higher intensity of preventive-reporting seemed to have a protective effect on student suicide. LIMITATIONS Data of student suicides in 2016 were substantially extracted from the local news, which may not contain complete information. The analyses suggested, but could not confirm, a causal relationship between the changes of student suicide news-reporting and the incidents of suicides themselves. CONCLUSIONS The recent surge of student suicides in Hong Kong was statistically abnormal. Media engagement has changed local suicide news-reporting to become more preventive, which could have contributed to the drop of student suicides. It is essential to sustain the media's coverage of preventive reporting to maintain its enduring effect.
Collapse
Affiliation(s)
- Qijin Cheng
- Hong Kong Jockey Club Center for Suicide Research and Prevention, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Feng Chen
- School of Mathematics and Statistics, University of New South Wales, Sydney, NSW 2052, Australia
| | - Esther S T Lee
- Hong Kong Jockey Club Center for Suicide Research and Prevention, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Paul S F Yip
- Hong Kong Jockey Club Center for Suicide Research and Prevention, and Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong Special Administrative Region.
| |
Collapse
|