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Strauss P, Marion L, Hill NT, Gilbey D, Waters Z, Moore JK, Costanza M, Lamblin M, Robinson J, Lin A, Perry Y. Development of best practice guidelines for clinical and community service providers to prevent suicide in LGBTQA+ young people: A Delphi expert consensus study. Aust N Z J Psychiatry 2024; 58:425-434. [PMID: 38217434 DOI: 10.1177/00048674231223697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2024]
Abstract
OBJECTIVE The aim of this study was to develop best practice guidelines for preventing suicide and reducing suicidal thoughts and behaviours in LGBTQA+ young people (lesbian, gay, bisexual, trans, queer/questioning, asexual, and those of other diverse sexualities and genders) within clinical and community service settings in Australia. METHODS We conducted a Delphi expert consensus study. A systematic literature search and interviews with key informants informed an initial 270-item questionnaire. Two expert panels completed the questionnaire, delivered over two rounds: (1) Australian professionals with expertise in LGBTQA+ mental health/suicide prevention and (2) Australian LGBTQA+ young people aged 14-25 with lived experience of suicidal thoughts and/or behaviours. Items endorsed as 'essential' or 'important' by >80% of both expert panels were included in the guidelines. RESULTS A total of 115 people participated in the Delphi process; n = 52 professionals completed Round 1, and n = 42 completed Round 2; n = 63 LGBTQA+ young people completed Round 1, and n = 50 completed Round 2. A total of 290 items were included in the guidelines and grouped into: (1) general principles for creating an affirming and inclusive environment for LGBTQA+ young people; (2) assessing suicide risk and working with suicidal LGBTQA+ young people; (3) considerations for specific LGBTQA+ populations; and (4) advocating for LGBTQA+ young people. CONCLUSION These guidelines are the first of their kind in Australia. They provide practical support to service providers regardless of prior training in LGBTQ+ identities or mental health, with the aim of reducing suicidal thoughts and behaviours, and preventing suicide, in LGBTQA+ young people.
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Affiliation(s)
- Penelope Strauss
- Telethon Kids Institute, Nedlands, WA, Australia
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | | | - Nicole Tm Hill
- Telethon Kids Institute, Nedlands, WA, Australia
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Dylan Gilbey
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Zoe Waters
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Julia K Moore
- The Gender Diversity Service, Child and Adolescent Health Service - Mental Health, Perth Children's Hospital, Perth, WA, Australia
| | - Marco Costanza
- Telethon Kids Institute, Nedlands, WA, Australia
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Michelle Lamblin
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Jo Robinson
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Yael Perry
- Telethon Kids Institute, Nedlands, WA, Australia
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Trinh E, Ivey-Stephenson AZ, Ballesteros MF, Idaikkadar N, Wang J, Stone DM. CDC Guidance for Community Assessment and Investigation of Suspected Suicide Clusters, United States, 2024. MMWR Suppl 2024; 73:8-16. [PMID: 38412115 PMCID: PMC10899086 DOI: 10.15585/mmwr.su7302a2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Abstract
This report is the second of three reports in the MMWR supplement updating CDC's guidance for investigating and responding to suicide clusters. The first report, Background and Rationale - CDC Guidance for Assessing, Investigating, and Responding to Suicide Clusters, United States, 2024, describes an overview of suicide clusters, methods used to develop the supplement guidance, and intended use of the supplement reports. The final report, CDC Guidance for Community Response to Suicide Clusters, United States, 2024, describes how local public health and community leaders can develop a response plan for suicide clusters. This report provides updated guidance for the approach to assessing and investigating suspected suicide clusters. Specifically, this approach will guide lead agencies in determining whether a confirmed suicide cluster exists, what concerns are in the community, and what the specific characteristics are of the suspected or confirmed suicide cluster. The guidance in this report is intended to support and assist lead agencies and their community prepare for, assess, and investigate suicide clusters. The steps provided in this report can be adapted to the local context, culture, capacity, circumstances, and needs for each suspected suicide cluster.
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Affiliation(s)
- Eva Trinh
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
| | - Asha Z. Ivey-Stephenson
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
| | - Michael F. Ballesteros
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
| | - Nimi Idaikkadar
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
| | - Jing Wang
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
| | - Deborah M. Stone
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
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Bailey E, Bellairs-Walsh I, Reavley N, Gooding P, Hetrick S, Rice S, Boland A, Robinson J. Best practice for integrating digital interventions into clinical care for young people at risk of suicide: a Delphi study. BMC Psychiatry 2024; 24:71. [PMID: 38267895 PMCID: PMC10809499 DOI: 10.1186/s12888-023-05448-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/07/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Digital tools have the capacity to complement and enhance clinical care for young people at risk of suicide. Despite the rapid rise of digital tools, their rate of integration into clinical practice remains low. The poor uptake of digital tools may be in part due to the lack of best-practice guidelines for clinicians and services to safely apply them with this population. METHODS A Delphi study was conducted to produce a set of best-practice guidelines for clinicians and services on integrating digital tools into clinical care for young people at risk of suicide. First, a questionnaire was developed incorporating action items derived from peer-reviewed and grey literature, and stakeholder interviews with 17 participants. Next, two independent expert panels comprising professionals (academics and clinical staff; n = 20) and young people with lived experience of using digital technology for support with suicidal thoughts and behaviours (n = 29) rated items across two consensus rounds. Items reaching consensus (rated as "essential" or "important" by at least 80% of panel members) at the end of round two were collated into a set of guidelines. RESULTS Out of 326 individual items rated by the panels, 188 (57.7%) reached consensus for inclusion in the guidelines. The endorsed items provide guidance on important topics when working with young people, including when and for whom digital tools should be used, how to select a digital tool and identify potentially harmful content, and identifying and managing suicide risk conveyed via digital tools. Several items directed at services (rather than individual clinicians) were also endorsed. CONCLUSIONS This study offers world-first evidence-informed guidelines for clinicians and services to integrate digital tools into clinical care for young people at risk of suicide. Implementation of the guidelines is an important next step and will hopefully lead to improved uptake of potentially helpful digital tools in clinical practice.
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Affiliation(s)
- Eleanor Bailey
- Orygen, 35 Poplar Road, Parkville, VIC, 3052, Australia.
- Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.
| | - India Bellairs-Walsh
- Orygen, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia
| | - Nicola Reavley
- Melbourne School of Population and Global Health, University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia
| | - Piers Gooding
- Melbourne Law School, University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia
| | - Sarah Hetrick
- Faculty of Medical and Health Sciences, University of Auckland, 22-30 Park Ave, Grafton, Auckland, 1023, New Zealand
| | - Simon Rice
- Orygen, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia
| | - Alexandra Boland
- Orygen, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Jo Robinson
- Orygen, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia
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Tørmoen AJ, Myhre MØ, Kildahl AT, Walby FA, Rossow I. A nationwide study on time spent on social media and self-harm among adolescents. Sci Rep 2023; 13:19111. [PMID: 37925469 PMCID: PMC10625526 DOI: 10.1038/s41598-023-46370-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/31/2023] [Indexed: 11/06/2023] Open
Abstract
Self-harm among adolescents has increased in many countries, but few studies have examined possible explanations. One explanation could be the changes in the way adolescents socialize and use of social media. We explored the relationship between past year self-harm and time spent on social media, employing data from a nationwide cross-sectional survey among students in grades 8 through 11 in Norway (N = 37,268). The association was estimated in logistic regression models and we adjusted for identified confounders and stratified on gender, age group and depressive symptoms. A total of 16.1% of the study population reported to have self-harmed in the past year. This proportion was elevated among those spending more than 3 h daily on social media (unadjusted OR = 2.74 (CI 2.58.-2.90)). Adjustment for confounders modified the association (OR = 1.49 (CI 1.39-1.60)). In stratified analyses, adjusted OR did not differ significantly by gender or age The association between time spent on social media and self-harm was weaker among adolescents with severe depressive symptoms (adjusted OR = 1.38 (CI 1.22-1.55)), than among those with mild or no symptoms (adjusted OR = 1.70 (CI 1.56-1.86)). Risk of self-harm was elevated among those who spent 3 or more hours daily on social media, also after controlling for other factors. Further studies are needed to explore the nature and underlying mechanisms of this association. Strengthening the evidence will help informing the development of adequate measures to prevent self-harm.
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Affiliation(s)
- Anita Johanna Tørmoen
- National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway.
| | - Martin Øverlien Myhre
- National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway
| | - Anine Therese Kildahl
- National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway
| | - Fredrik Andreas Walby
- National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway
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Ropaj E, Haddock G, Pratt D. Developing a consensus of recovery from suicidal ideations and behaviours: A Delphi study with experts by experience. PLoS One 2023; 18:e0291377. [PMID: 37729121 PMCID: PMC10511083 DOI: 10.1371/journal.pone.0291377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 08/28/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Understanding recovery in mental health has received significant attention and consequently, recovery has been incorporated into health policy across many countries in the Global North. In comparison, the concept of 'recovery' from suicidal thoughts and behaviours has received little attention. However, the few studies in this area appear to suggest that recovery is a complex and an idiosyncratic process with many contributing factors. This can present a challenge for clinicians and services seeking to become more recovery focused. Thus, it seems of importance to develop a consensus on how recovery from suicidal thoughts and behaviours is conceptualised. AIM The study aimed to use the Delphi design to establish a consensus of how recovery is defined by those with lived experience of suicidal thoughts and behaviours. The Delphi method draws on the expertise of a panel, often involving clinicians, researchers and lived experience experts to develop consensus over a topic by inviting them to rate the importance of, often a series of statements to a given topic area. METHOD Lived experience experts were asked to complete two rounds of questionnaires distributed online to capture their views on recovery. RESULTS A total of 196 individuals gave their views on the first round of the study and 97 gave their views on the second round. A final list of 110 statements was developed that 80% or more of participants defined as essential or important. Statements covered items that were important in defining, facilitation and hindering the process of recovery. CONCLUSION Findings are consistent with the wider literature that suggests that recovery is an idiosyncratic process, but with many commonly shared features. Here we also show that a comprehensive definition of recovery must include factors that hinder the process of recovery. Implications and recommendations for practice, policy development and future research are discussed.
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Affiliation(s)
- Esmira Ropaj
- Division of Psychology & Mental Health, Manchester Academic Health Science Centre, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Gillian Haddock
- Division of Psychology & Mental Health, Manchester Academic Health Science Centre, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Daniel Pratt
- Division of Psychology & Mental Health, Manchester Academic Health Science Centre, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
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Robinson J, Thorn P, McKay S, Hemming L, Battersby-Coulter R, Cooper C, Veresova M, Li A, Reavley N, Rice S, Lamblin M, Pirkis J, Reidenberg D, Harrison V, Skehan J, La Sala L. #chatsafe 2.0. updated guidelines to support young people to communicate safely online about self-harm and suicide: A Delphi expert consensus study. PLoS One 2023; 18:e0289494. [PMID: 37531397 PMCID: PMC10395901 DOI: 10.1371/journal.pone.0289494] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/19/2023] [Indexed: 08/04/2023] Open
Abstract
INTRODUCTION Young people use social media to communicate about self-harm and suicide and this is associated with both potential risks and protective effects. The #chatsafe guidelines were originally developed in 2018 to equip young people to communicate safely online about suicide. They were shown to be safe, acceptable, and beneficial; however, they do not provide guidance on self-harm, and social media is constantly evolving. This study aimed to update the #chatsafe guidelines to reflect new evidence and current social media affordances, and to include guidance on self-harm. METHODS A Delphi expert consensus study was conducted, comprising six stages: 1) A systematic search of peer-reviewed and grey literature; 2) A series of roundtables with key stakeholders including social media companies, policymakers, and young people; 3) Questionnaire development; 4) Expert panel formation; 5) Data collection and analysis; and 6) Guideline development. RESULTS A total of 191 items were included in the new #chatsafe guidelines. These were organised into eight themes, which became the overarching sections of the guidelines: 1) General tips; 2) Creating self-harm and suicide content; 3) Consuming self-harm and suicide content; 4) Livestreams of self-harm and suicide acts; 4) Self-harm and suicide games, pacts, and hoaxes; 6) Self-harm and suicide communities; 7) Bereavement and communicating about someone who has died by suicide; and 8) Guidance for influencers. DISCUSSION The new guidelines include updated and new information on online communication about self-harm, livestreams, games, pacts, and hoaxes, as well as guidance for influencers. They will be disseminated via a national social media campaign and supported by a series of adult-facing resources. Given the acceptability of the original guidelines and the ubiquitous use of social media by young people, it is hoped that the new guidelines will be a useful resource for young people and adults alike, both in Australia and worldwide.
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Affiliation(s)
- Jo Robinson
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Pinar Thorn
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Samuel McKay
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Laura Hemming
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
- National Centre for Epidemiology and Population Health, Australian National University, Acton, Australian Capital Territory, Australia
| | - Rikki Battersby-Coulter
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Charlie Cooper
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Maria Veresova
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Angela Li
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Nicola Reavley
- Centre for Mental Health, School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Simon Rice
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Michelle Lamblin
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Jane Pirkis
- Centre for Mental Health, School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Dan Reidenberg
- Suicide Awareness Voices of Education, Bloomington, Minnesota, United States of America
| | - Vicki Harrison
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States of America
| | - Jaelea Skehan
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Louise La Sala
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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Balt E, Mérelle S, Robinson J, Popma A, Creemers D, van den Brand I, van Bergen D, Rasing S, Mulder W, Gilissen R. Social media use of adolescents who died by suicide: lessons from a psychological autopsy study. Child Adolesc Psychiatry Ment Health 2023; 17:48. [PMID: 37029395 PMCID: PMC10082488 DOI: 10.1186/s13034-023-00597-9] [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: 01/31/2023] [Accepted: 03/27/2023] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND while there are many benefits for young people to use social media, adverse effects such as cyberbullying, online challenges, social comparison and imitation may provoke and aggravate suicidal thoughts and behaviors. The influence of social media on mental health and suicidal thoughts and behaviours has been amply studied, but there is little empirical evidence for its potential role in adolescent suicides. The current study aimed to inform digital suicide prevention strategies by examining the meaning of social media in the lives of young suicide victims and elucidating the harmful and supportive effects of social media use on their wellbeing and distress. METHODS data were analyzed from a psychological autopsy study of 35 adolescents who died by suicide in the Netherlands (43% of all adolescents who died by suicide in that year). These were 18 girls and 17 boys. All were under the age of twenty years, with an average of seventeen years. Interpretative Phenomenological Analysis was performed of 55 semi structured interviews with peers and parents of the decedents. RESULTS young people benefitted from peer support and recovery stories. However, various themes were discussed relating to the harmful effects of social media, including dependency, triggers and imitation, challenges, cybervictimization and psychological entrapment. The themes of dependency and triggers and imitation were more salient in young females. A group of girls cultivated an online identity around their suicidal thoughts and behaviours. Next-of-kin, particularly parents, faced various challenges to talk to the adolescents about social media use, including technological illiteracy, online anonymity, and the youths' closedness. CONCLUSIONS based on the findings, we recommend education to stimulate the digital literacy of parents, health workers and educators, supporting conscientious social media use in young people, and extending the prevention of cyberbullying. We encourage future research to examine how virtual social networks may sustain suicidal thoughts and behaviour, and to further investigate the effectiveness of digital interventions, like moderated peer support and the use of positive role models.
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Affiliation(s)
- Elias Balt
- Research department, 113 Suicide Prevention, Amsterdam, the Netherlands.
| | - Saskia Mérelle
- Research department, 113 Suicide Prevention, Amsterdam, the Netherlands
| | - Jo Robinson
- Orygen, 35 Poplar Road, Parkville, Vic, 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Arne Popma
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam University Medical Centre (AUMC), Amsterdam, the Netherlands
| | - Daan Creemers
- Child and Adolescent Psychiatry, GGZ Oost Brabant, Boekel, the Netherlands
| | - Isa van den Brand
- Research department, 113 Suicide Prevention, Amsterdam, the Netherlands
| | - Diana van Bergen
- Department of Pedagogical and Educational Sciences, Faculty of Behavioural Social Sciences, University of Groningen, Groningen, the Netherlands
| | - Sanne Rasing
- Child and Adolescent Psychiatry, GGZ Oost Brabant, Boekel, the Netherlands
| | - Wico Mulder
- Youth healthcare, Dutch Centre for Youth Health (NCJ), Utrecht, The Netherlands
| | - Renske Gilissen
- Research department, 113 Suicide Prevention, Amsterdam, the Netherlands
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Susi K, Glover-Ford F, Stewart A, Knowles Bevis R, Hawton K. Research Review: Viewing self-harm images on the internet and social media platforms: systematic review of the impact and associated psychological mechanisms. J Child Psychol Psychiatry 2023. [PMID: 36940718 DOI: 10.1111/jcpp.13754] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2022] [Indexed: 03/23/2023]
Abstract
BACKGROUND Viewing self-harm and suicide-related images online can precede these behaviours. We reviewed studies of potential impacts and mechanisms associated with viewing self-harm-related images on the internet and social media. METHOD CINAHL, Cochrane Library, EMBASE, HMIC, MEDLINE, PsycArticles, PsycINFO, PubMed, Scopus, Sociological Abstracts and Web of Science Core Collection databases were searched for relevant studies from inception to 22 January 2022. Inclusion criteria were English language, peer-reviewed, empirical studies with data related to impacts of viewing self-harm images or videos on the internet or social media. Quality and risk of bias were assessed using Critical Appraisal Skills Programme tools. A narrative synthesis approach was used. RESULTS Of the 15 identified studies, all found harmful effects of viewing self-harm-related images online. These included escalation of self-harm, reinforcement of engagement behaviours (e.g. commenting and sharing images), encouragement of social comparison (comparing own self-harm with others), development of a self-harm identity, social connection perpetuating or escalating self-harm, and emotional, cognitive, and physiological impacts triggering self-harm urges and acts. Nine studies found protective effects, including self-harm mitigation or reduction, promotion of self-harm recovery, encouraging social connection and help-giving, and emotional, cognitive and physiological impacts mitigating or reducing self-harm urges and acts. Causality of impact was not determined in any study. Most of the studies did not explicitly evaluate or discuss potential mechanisms. CONCLUSIONS Viewing self-harm images online may have both harmful and protective effects, but harmful effects predominated in the studies. Clinically, it is important to assess individual's access to images relating to self-harm and suicide, and the associated impacts, alongside pre-existing vulnerabilities and contextual factors. Higher quality longitudinal research with less reliance on retrospective self-report is needed, as well as studies that test potential mechanisms. We have developed a conceptual model of the impact of viewing self-harm images online to inform future research.
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Affiliation(s)
- Karima Susi
- Oxford Institute of Clinical Psychology Training and Research, Isis Education Centre, Warneford Hospital, Oxford Health NHS Foundation Trust and University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
- Child and Adolescent Mental Health Services, Leicestershire Partnership NHS Trust, Leicester, UK
- Step 4 Psychological Therapies, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Francesca Glover-Ford
- Oxford Institute of Clinical Psychology Training and Research, Isis Education Centre, Warneford Hospital, Oxford Health NHS Foundation Trust and University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Anne Stewart
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Rebecca Knowles Bevis
- Oxford Institute of Clinical Psychology Training and Research, Isis Education Centre, Warneford Hospital, Oxford Health NHS Foundation Trust and University of Oxford, Oxford, UK
| | - Keith Hawton
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford, UK
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Leung T, La Sala L, Cooper C, Spittal M, Rice S, Lamblin M, Brown E, Nolan H, Battersby-Coulter R, Rajaram G, Thorn P, Pirkis J, May-Finlay S, Silenzio V, Skehan J, Krysinska K, Bellairs-Walsh I. Testing the Impact of the #chatsafe Intervention on Young People's Ability to Communicate Safely About Suicide on Social Media: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e44300. [PMID: 36800220 PMCID: PMC9984994 DOI: 10.2196/44300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Suicide is the leading cause of death among Australians. One commonly cited explanation is the impact of social media, in particular, the ways in which young people use social media to communicate about their own experiences and their exposure to suicide-related content posted by others. Guidelines designed to assist mainstream media to safely report about suicide are widespread. Until recently, no guidelines existed that targeted social media or young people. In response, we developed the #chatsafe guidelines and a supporting social media campaign, which together make up the #chatsafe intervention. The intervention was tested in a pilot study with positive results. However, the study was limited by the lack of a control group. OBJECTIVE The aim of this study is to assess the impact of the #chatsafe social media intervention on young people's safety and confidence when communicating on the web about suicide. METHODS The study employs a pragmatic, parallel, superiority randomized controlled design. It will be conducted in accordance with the Consolidated Standards of Reporting Trials statement over 18 months. Participants will be 400 young people aged 16-25 years (200 per arm). Participants will be recruited via social media advertising and assessed at 3 time points: time 1-baseline; time 2-8-week postintervention commencement; and time 3-4-week postintervention. They will be asked to complete a weekly survey to monitor safety and evaluate each piece of social media content. The intervention comprises an 8-week social media campaign including social media posts shared on public Instagram profiles. The intervention group will receive the #chatsafe suicide prevention content and the control group will receive sexual health content. Both groups will receive 24 pieces of content delivered to their mobile phones via text message. The primary outcome is safety when communicating on the web about suicide, as measured via the purpose-designed #chatsafe online safety questionnaire. Additional outcomes include willingness to intervene against suicide, internet self-efficacy, safety, and acceptability. RESULTS The study was funded in November 2020, approved by the University of Melbourne Human Research Ethics Committee on October 7, 2022, and prospectively registered with the Australian New Zealand Clinical Trials registry. Trial recruitment began in November 2022 and study completion is anticipated by June 2024. CONCLUSIONS This will be the first randomized controlled trial internationally to test the impact of a social media intervention designed to equip young people to communicate safely on the web about suicide. Given the rising rates of youth suicide in Australia and the acceptability of social media among young people, incorporating social media-based interventions into the suicide prevention landscape is an obvious next step. This intervention, if effective, could also be extended internationally, thereby improving web-based safety for young people not just in Australia but globally. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12622001397707; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384318. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/44300.
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Affiliation(s)
| | - Louise La Sala
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Charlie Cooper
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Matthew Spittal
- Centre for Mental Health, School of Population and Global Health, University of Melbourne, Parkville, Australia
| | - Simon Rice
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Michelle Lamblin
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Ellie Brown
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Hayley Nolan
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Rikki Battersby-Coulter
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Gowri Rajaram
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Pinar Thorn
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Jane Pirkis
- Centre for Mental Health, School of Population and Global Health, University of Melbourne, Parkville, Australia
| | - Summer May-Finlay
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Vincent Silenzio
- Department of Urban-Global Public Health, Rutgers School of Public Health, Rutgers University, Piscataway, NJ, United States
| | - Jaelea Skehan
- Everymind, Newcastle, Australia.,College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Karolina Krysinska
- Centre for Mental Health, School of Population and Global Health, University of Melbourne, Parkville, Australia
| | - India Bellairs-Walsh
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
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10
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Winstone L, Mars B, Ferrar J, Moran P, Penton-Voak I, Grace L, Biddle L. Investigating How People Who Self-harm Evaluate Web-Based Lived Experience Stories: Focus Group Study. JMIR Ment Health 2023; 10:e43840. [PMID: 36719729 PMCID: PMC9929729 DOI: 10.2196/43840] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The positive and negative effects of interacting with web-based content on mental health, and especially self-harm, are well documented. Lived experience stories are one such type of static web-based content, frequently published on health care or third-sector organization websites, as well as social media and blogs, as a form of support for those seeking help via the web. OBJECTIVE This study aimed to increase understanding about how people who self-harm engage with and evaluate web-based lived experience stories. METHODS Overall, 4 web-based focus groups were conducted with 13 people with recent self-harm experience (aged 16-40 years). In total, 3 example lived experience stories were read aloud to participants, who were then asked to share their reactions to the stories. Participants were also encouraged to reflect on stories previously encountered on the web. Data were analyzed thematically. RESULTS Overall, 5 themes were generated: stories of recovery from self-harm and their emotional impact, impact on self-help and help-seeking behaviors, identifying with the narrator, authenticity, and language and stereotyping. CONCLUSIONS Lived experience stories published on the web can provide a valuable form of support for those experiencing self-harm. They can be motivating and empowering for the reader, and they have the potential to distract readers from urges to self-harm. However, these effects may be moderated by age, and narratives of recovery may demoralize older readers. Our findings have implications for organizations publishing lived experience content and for community guidelines and moderators of web-based forums in which users share their stories. These include the need to consider the narrator's age and the relatability and authenticity of their journey and the need to avoid using stigmatizing language.
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Affiliation(s)
- Lizzy Winstone
- Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Becky Mars
- Population Health Sciences, University of Bristol, Bristol, United Kingdom
- NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - Jennifer Ferrar
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Paul Moran
- Population Health Sciences, University of Bristol, Bristol, United Kingdom
- NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - Ian Penton-Voak
- NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | | | - Lucy Biddle
- Population Health Sciences, University of Bristol, Bristol, United Kingdom
- NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
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11
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Thorn P, La Sala L, Hetrick S, Rice S, Lamblin M, Robinson J. Motivations and perceived harms and benefits of online communication about self-harm: An interview study with young people. Digit Health 2023; 9:20552076231176689. [PMID: 37252260 PMCID: PMC10214072 DOI: 10.1177/20552076231176689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/02/2023] [Indexed: 05/31/2023] Open
Abstract
Background Self-harm behaviour is prevalent among young people and online communication about self-harm is frequent. These online communications are associated with potential harms and potential benefits. To date, few studies have explored the motivations and mechanisms involved in youth online communication about self-harm. Objective This study aimed to explore why young people communicate online about self-harm and the perceived benefits and harms of these communications. Methods Twenty young people aged between 18 and 25 years completed an online interview. Interviews were audio recorded and transcribed verbatim. Thematic analysis was used to identify themes. Results Four main themes are reported: (1) crossing from offline to online-the double-edged affordances of social media: young people engaged in online communication about self-harm because they were unable or unwilling to speak about their experiences in offline contexts. Online spaces afforded anonymity and peer support, which were associated with benefits and harms; (2) user-generated is not quite the same as user-resonated: perceptions were influenced by whether the young person created or viewed or responded to the content. Written and visual content had pros and cons; (3) it's not just you, it's mostly me-individual characteristics influence perceptions: age and mental state influenced perceptions and behavior; and (4) beyond individuals-parameters are protective: leadership and platform policies and procedures aided safety. Conclusions Online communication about self-harm is neither entirely helpful nor harmful. Perceptions are influenced by individual, social, and systematic factors. Evidence-based guidelines are needed to increase young people's online self-harm literacy and help them build effective communication skills to buffer psychological and potentially physical harm.
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Affiliation(s)
- Pinar Thorn
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Louise La Sala
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Sarah Hetrick
- Department of Psychological Medicine, The
University of Auckland, Auckland CBD, Auckland, New Zealand
| | - Simon Rice
- 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
| | - Jo Robinson
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
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12
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Kruzan KP, Williams KD, Meyerhoff J, Yoo DW, O'Dwyer LC, De Choudhury M, Mohr DC. Social media-based interventions for adolescent and young adult mental health: A scoping review. Internet Interv 2022; 30:100578. [PMID: 36204674 PMCID: PMC9530477 DOI: 10.1016/j.invent.2022.100578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/18/2022] [Accepted: 09/27/2022] [Indexed: 11/18/2022] Open
Abstract
Background Mental health conditions are common among adolescents and young adults, yet few receive adequate mental health treatment. Many young people seek support and information online through social media, and report preferences for digital interventions. Thus, digital interventions deployed through social media have promise to reach a population not yet engaged in treatment, and at risk of worsening symptoms. Objective In this scoping review, we aimed to identify and review empirical research on social media-based interventions aimed at improving adolescent and young adult mental health. A secondary objective was to identify the features and functionalities of platforms described as social media. Methods Adhering to the PRISMA-ScR guidelines for scoping reviews, the search was conducted in PubMed MEDLINE; Embase Central Register of Controlled Trials (Wiley); PsycINFO (Ebsco); Scopus; Web of Science; IEEE Xplore; ACM Digital Library; and ClinicalTrials.gov from inception until November 2021. Studies were included if they involved adolescents or young adults (10-26 years of age) that meet clinical, or subclinical, levels of a mental health condition and include a pre- and post-assessment of mental health outcomes. Results Among the 18,380 references identified, 15 met full inclusion criteria and were published between 2017 and 2021-this included four randomized controlled trials, seven non-randomized pre-post trials, and four were experimental or quasi-experimental designs. Just five studies were delivered through an existing social media site (Facebook or Pixtori), with the remainder focused on purpose-built networks. Three studies involved adolescents or young adults who self-reported a mental health condition, seven involved young people diagnosed with a mental health condition by a clinician or who scored above a clinical threshold on valid clinical measure, three involved college students without a mental health inclusion criterion, and two studies focused on young people with a cancer diagnosis. Conclusions The review highlights innovations in the delivery of mental health interventions, provides preliminary evidence of the ability of social media interventions to improve mental health outcomes, and underscores the need for, and merit of, future work in this area. We discuss opportunities and challenges for future research, including the potential to leveragei existing peer networks, the use of just-in-time interventions, and scaling interventions to meet need.
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Affiliation(s)
- Kaylee Payne Kruzan
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, 750 N. Lakeshore Drive, Chicago, IL 60611, USA
| | - Kofoworola D.A. Williams
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, 750 N. Lakeshore Drive, Chicago, IL 60611, USA
| | - Jonah Meyerhoff
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, 750 N. Lakeshore Drive, Chicago, IL 60611, USA
| | - Dong Whi Yoo
- School of Interactive Computing, Georgia Institute of Technology, 85 5th St NW, Atlanta, GA 30308, USA
| | - Linda C. O'Dwyer
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, 750 N. Lakeshore Drive, Chicago, IL 60611, USA
| | - Munmun De Choudhury
- School of Interactive Computing, Georgia Institute of Technology, 85 5th St NW, Atlanta, GA 30308, USA
| | - David C. Mohr
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, 750 N. Lakeshore Drive, Chicago, IL 60611, USA
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13
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A qualitative study on negative experiences of social media use and harm reduction strategies among youths in a multi-ethnic Asian society. PLoS One 2022; 17:e0277928. [PMID: 36413566 PMCID: PMC9681068 DOI: 10.1371/journal.pone.0277928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 11/06/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study aimed to expand and inform the emerging body of research on the negative experiences of social media use among youths and how youths deal with them, in an Asian setting, using a qualitative approach. METHODS Data were collected using 11 focus group discussions (FGDs) and 25 semi-structured interviews (SIs) among youths aged 15 to 24 years residing in Singapore who were recruited via purposive sampling. Data were analysed using thematic analysis. RESULTS The salient negative effects mentioned by participants include the development of negative reactions and feelings from upward comparisons with others (e.g., others' achievements and lifestyle), receiving hurtful comments, exposure to controversial content (e.g., political events and social movements), as well as the perpetuation of negative feelings, behaviours, and sentiments (e.g., rumination, unhealthy eating behaviour, and self-harm). Participants also described strategies which they have employed or deemed to be useful in mitigating the negative effects of social media use. These include filtering content and users, taking breaks from social media, cognitive reframing, and self-affirmation, where they identify and change stress-inducing patterns of thinking by setting realistic social, physical, and lifestyle expectations for themselves, and focusing on self-development. CONCLUSION The current results highlight that while youths experience negative effects of social media use, they have high media literacy and have employed strategies that appear to mitigate the negative effects of social media use. The findings can inform various stakeholders involved in helping youths navigate the harms of social media use or provide directions for intervention studies aimed at reducing the harms of social media use.
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14
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Meinhardt I, Cargo T, Te Maro B, Bowden L, Fortune S, Cuthbert S, James S, Cook R, Papalii T, Kapa-Kingi K, Kapa-Kingi M, Prescott A, Hetrick SE. Development of guidelines for school staff on supporting students who self-harm: a Delphi study. BMC Psychiatry 2022; 22:631. [PMID: 36175876 PMCID: PMC9520113 DOI: 10.1186/s12888-022-04266-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Self-harm is a major public health issue that significantly impacts communities, making early intervention and prevention paramount in addressing this public health issue. This study aimed to develop evidence-based, culturally responsive, safe, and practical guidelines to assist school staff in effectively supporting students who self-harm. METHODS This Delphi study comprised of a five-step process, oversighted by a Rōpū Mātanga Māori (Māori clinical and cultural governance group), and drawing on the expertise and knowledge gained from existing literature, interviews with stakeholders, and two panels of experts (youth and stakeholders). The Rōpū Mātanga Māori ensured accountability to the principles of Te Tiriti o Waitangi (Treaty of Waitangi) and kept Māori processes central to the research aims. The panels completed two rounds of questionnaires, rating their endorsement of each statement. Statements rated as important or essential by 80% or more of both panels and Māori participants were included in the final guidelines. The Rōpū Mātanga Māori reviewed any remaining statements to determine inclusion. RESULTS Following the five-step process, 305 statements were included in the guidelines. These statements provided guiding actions that endorsed communication, collaborative responsibility, and wellbeing and a student-centred approach. CONCLUSION The guidelines provide guidance to all school staff that is culturally responsive and safe, consensus-based, and evidence-based. It is informed by the voices and experiences of young people and those who support them.
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Affiliation(s)
- Inge Meinhardt
- School of Psychology, Faculty of Science, University of Auckland, Science Centre, Building 302, Level 2, 23 Symonds Street, Auckland Central, Auckland, 1010, New Zealand.
| | - Tania Cargo
- grid.9654.e0000 0004 0372 3343School of Psychology, Faculty of Science, University of Auckland, Science Centre, Building 302, Level 2, 23 Symonds Street, Auckland Central, Auckland, 1010 New Zealand ,grid.9654.e0000 0004 0372 3343Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand ,A Better Start, E Tipu E Rea (Grant Number 15-02688), National Science Challenge, Auckland, New Zealand
| | - Ben Te Maro
- grid.9654.e0000 0004 0372 3343Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand ,Clinical Advisory Services Aotearoa, Auckland, New Zealand
| | - Linda Bowden
- grid.9654.e0000 0004 0372 3343Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand ,Clinical Advisory Services Aotearoa, Auckland, New Zealand
| | - Sarah Fortune
- grid.9654.e0000 0004 0372 3343Social and Community Health, Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand ,grid.29980.3a0000 0004 1936 7830Department of Psychological Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Sasha Cuthbert
- grid.9654.e0000 0004 0372 3343Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Susanna James
- grid.9654.e0000 0004 0372 3343Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand ,grid.5491.90000 0004 1936 9297School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Riley Cook
- grid.9654.e0000 0004 0372 3343Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Tania Papalii
- grid.507908.30000 0000 8750 5335Northland District Health Board, Whangarei, New Zealand
| | - Korotangi Kapa-Kingi
- grid.507908.30000 0000 8750 5335Northland District Health Board, Whangarei, New Zealand
| | | | - Annabelle Prescott
- grid.9654.e0000 0004 0372 3343Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Sarah Elisabeth Hetrick
- grid.9654.e0000 0004 0372 3343Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand ,A Better Start, E Tipu E Rea (Grant Number 15-02688), National Science Challenge, Auckland, New Zealand ,grid.1008.90000 0001 2179 088XCentre of Excellence in Youth Mental Health, The Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
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15
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Yip P, Xiao Y, Xu Y, Chan E, Cheung F, Chan CS, Pirkis J. Social Media Sentiments on Suicides at the New York City Landmark, Vessel: A Twitter Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11694. [PMID: 36141964 PMCID: PMC9517673 DOI: 10.3390/ijerph191811694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
Vessel is a landmark created by Heatherwick Studio where visitors can enjoy views of New York City from different heights and perspectives. However, between February 2020 and July 2021, four individuals jumped to their deaths from the landmark. Effective preventive solutions have yet to be identified, and the site is currently closed. In this study, we examined the trajectory of public sentiment on the suicide-related activity at Vessel on Twitter by investigating the engagement patterns and identifying themes about the four suicides from February 2020 to August 2021 (n = 3058 tweets). The results show increased levels of discussion about each successive suicide case in the first 14 days following each incident (from 6 daily tweets for the first case to 104 for the fourth case). It also took longer for relevant discussions to dissipate (4 days for the first and 14 days for the fourth case, KS statistic = 0.71, p < 0.001). Thematic analysis shows a shift from expressions of emotion to urging suicide prevention actions in the third and fourth cases; additionally, we detected growing support for restricting means. We suggest that, prior to the reopening of Vessel, collective efforts should be made to install safety protections and reduce further suicide risks.
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Affiliation(s)
- Paul Yip
- The HKJC Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China
| | - Yunyu Xiao
- Department of Population Health Sciences, Weill Cornell Medicine, NewYork-Presbyterian, New York, NY 10065, USA
| | - Yucan Xu
- The HKJC Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China
| | - Evangeline Chan
- The HKJC Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China
| | - Florence Cheung
- The HKJC Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China
| | - Christian S. Chan
- Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, Carlton VIC 3053, Australia
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16
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Doty B, Bass J, Ryan T, Zhang A, Wilcox H. Systematic review of suicide prevention studies with data on youth and young adults living in low-income and middle-income countries. BMJ Open 2022; 12:e055000. [PMID: 36691131 PMCID: PMC9453991 DOI: 10.1136/bmjopen-2021-055000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/17/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES This review aimed to provide a summary of peer-reviewed, published literature on suicide preventive interventions with data on youth and young adults in low-income and middle-income countries (LMIC). DESIGN A systematic review was conducted using electronic databases of PubMed/MEDLINE, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Education Resources Information Center and The Campbell Collaboration databases for English-language articles published between 1 January 1990 and 15 February 2022. ELIGIBILITY CRITERIA Interventions of interest could include behavioural, community, clinical/medical or policy studies, or any combination of these, so long as the studies had at least one outcome of interest and at least one control group or control period. Outcomes included suicide ideation, suicide attempt and suicide. Interventions must have been conducted in an LMIC. Studies with individuals ages 0-25 in the sample were included. Articles describing data on individuals over age 25 could be included if individuals ages 0-25 were part of the sample. RESULTS A total of 44 eligible studies were identified, representing a broad range of universal, selective and indicated interventions. Most studies assessed interventions designed to address lethal means or mental health. Most studies were conducted in lower-middle-income or upper-middle-income countries, with the largest proportion in Asia. Assessment of outcomes across studies was heterogeneous and there were few large-scale investigations tailored specifically for youth. CONCLUSIONS Most of the published, peer-reviewed suicide intervention research from LMIC is concentrated in a few countries. While geographical coverage to date has been limited, strategies and samples in included studies were diverse, representing populations in clinical, educational and community settings. While current findings hold promise, this review identified a need for large-scale studies designed specifically for youth.
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Affiliation(s)
- Benjamin Doty
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Judith Bass
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Taylor Ryan
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Allen Zhang
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Holly Wilcox
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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17
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Sinyor M, Hartman M, Zaheer R, Williams M, Pirkis J, Heisel MJ, Schaffer A, Redelmeier DA, Cheung AH, Kiss A, Niederkrotenthaler T. Differences in Suicide-Related Twitter Content According to User Influence. CRISIS 2022. [PMID: 35656646 DOI: 10.1027/0227-5910/a000865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: The content of suicide-specific social media posts may impact suicide rates, and putatively harmful and/or protective content may vary by the author's influence. Aims: This study sought to characterize how suicide-related Twitter content differs according to user influence. Method: Suicide-related tweets from July 1, 2015, to June 1, 2016, geolocated to Toronto, Canada, were collected and randomly selected for coding (n = 2,250) across low, medium, or high user influence levels (based on the number of followers, tweets, retweets, and posting frequency). Logistic regression was used to identify differences by user influence for various content variables. Results: Low- and medium-influence users typically tweeted about personal experiences with suicide and associations with mental health and shared morbid humor/flippant tweets. High-influence users tended to tweet about suicide clusters, suicide in youth, older adults, indigenous people, suicide attempts, and specific methods. Tweets across influence levels predominantly focused on suicide deaths, and few described suicidal ideation or included helpful content. Limitations: Social media data were from a single location and epoch. Conclusion: This study demonstrated more problematic content vis-à-vis safe suicide messaging in tweets by high-influence users and a paucity of protective content across all users. These results highlight the need for further research and potential intervention.
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Affiliation(s)
- Mark Sinyor
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Maya Hartman
- Michael G. DeGroote School of Medicine, McMaster University, Waterloo Regional Campus, Kitchener, ON, Canada
| | - Rabia Zaheer
- Department of Education Services, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Marissa Williams
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Athabasca University, Athabasca, AB, Canada
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Marnin J Heisel
- Departments of Psychiatry and of Epidemiology & Biostatistics, The University of Western Ontario, London, ON, Canada
| | - Ayal Schaffer
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Donald A Redelmeier
- Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Amy H Cheung
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Alex Kiss
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Thomas Niederkrotenthaler
- Medical University of Vienna, Center for Public Health, Department of Social and Preventive Medicine, Unit Suicide Research & Mental Health Promotion, Vienna, Austria
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18
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Brunner M, Rietdijk R, Togher L. Training Resources Targeting Social Media Skills to Inform Rehabilitation for People Who Have an Acquired Brain Injury: Scoping Review. J Med Internet Res 2022; 24:e35595. [PMID: 35482369 PMCID: PMC9100544 DOI: 10.2196/35595] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/04/2022] [Accepted: 03/29/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In 2020 and 2021, people increasingly used the internet to connect socially and professionally. However, people with an acquired brain injury (ABI) experience challenges in using social media, and rehabilitation professionals have reported feeling underprepared to support them in its use. To date, no review of social media skills training to inform ABI rehabilitation has been conducted. OBJECTIVE This scoping review aimed to examine research on interventions addressing social media skills and safety, with a focus on people living with health conditions; free web-based resources for the general public on social media skills training; and currently available online support groups for people with ABI. METHODS An integrative scoping review was conducted, with a systematic search strategy applied in March and November 2020 across OvidSP (MEDLINE, AMED, PsycINFO, and Embase), Scopus, Web of Science, CINAHL, Google Scholar, Google, and Facebook. The data collected were critically appraised and synthesized to describe the key content and features of social media training resources. RESULTS This review identified 47 peer-reviewed academic articles, 48 social media training websites, and 120 online support groups for people with ABI. A key recommendation was interactive training with practical components addressing cybersafety, how to use platforms, and how to connect with others. However, no social media training resources that were relevant and accessible for people with ABI were identified. CONCLUSIONS Training resources to support people with ABI in safely using social media are limited. The key content to be addressed and the features to be incorporated into web-based social media training were determined, including the need for interactive training that is co-designed and safe and incorporates practical components that support people with ABI. These findings can be used to inform the development of web-based evidence-based support for people with ABI who may be vulnerable when participating in social media.
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Affiliation(s)
- Melissa Brunner
- Faculty of Medicine and Health, University of Sydney, Eora Nation, Camperdown, Australia
| | - Rachael Rietdijk
- Faculty of Medicine and Health, University of Sydney, Eora Nation, Camperdown, Australia
| | - Leanne Togher
- Faculty of Medicine and Health, University of Sydney, Eora Nation, Camperdown, Australia
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19
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Responding to Suicide Clusters in the Community: What Do Existing Suicide Cluster Response Frameworks Recommend and How Are They Implemented? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084444. [PMID: 35457313 PMCID: PMC9031396 DOI: 10.3390/ijerph19084444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 12/10/2022]
Abstract
Suicide clusters involve an excessive number of suicides, suicide attempts, or both, that occur close in space or time or involve social links between cluster members. Although suicide clusters are rare, evidence documenting the implementation of suicide cluster response activities in communities is required yet remains limited. In this study, we identified the core components of existing suicide cluster response frameworks through a search of the grey literature and conducted an international survey to assess the implementation of the core components by stakeholders with experience responding to a suicide cluster. The following six core components were identified from five cluster response frameworks and were incorporated into a survey assessing stakeholders’ experiences of responding to a suicide cluster: (1) Preparing for a suicide cluster; (2) Routine monitoring of suicide, suicide attempts, and cluster detection; (3) Coordination with the media and monitoring social media; (4) Identifying and supporting individuals at risk; (5) Promoting help-seeking and building community resilience; and (6) Long-term follow-up and evaluation. Twenty-six stakeholders completed the online survey. Many of the core components were implemented by stakeholders. However, gaps in practice were reported in terms of cluster surveillance, monitoring of referral uptake among bereaved individuals, and long-term evaluation. Barriers to implementation included the perceived availability and suitability of mental health services, and availability of long-term funding. Strategic policy and planning that addresses the practice-based experiences of communities has the potential to facilitate a more coordinated and timely response to suicide clusters.
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Abstract
Suicide is a major public health concern in the United States. Between 2000 and 2018, US suicide rates increased by 35%, contributing to the stagnation and subsequent decrease in US life expectancy. During 2019, suicide declined modestly, mostly owing to slight reductions in suicides among Whites. Suicide rates, however, continued to increase or remained stable among all other racial/ethnic groups, and little is known about recent suicide trends among other vulnerable groups. This article (a) summarizes US suicide mortality trends over the twentieth and early twenty-first centuries, (b) reviews potential group-level causes of increased suicide risk among subpopulations characterized by markers of vulnerability to suicide, and (c) advocates for combining recent advances in population-based suicide prevention with a socially conscious perspective that captures the social, economic, and political contexts in which suicide risk unfolds over the life course of vulnerable individuals.
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Affiliation(s)
- Gonzalo Martínez-Alés
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; ,
- Department of Psychiatry, La Paz University Hospital, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Tammy Jiang
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA;
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; ,
| | - Jaimie L Gradus
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA;
- Department of Psychiatry, School of Medicine, Boston University, Boston, Massachusetts, USA;
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Kornfield R, Mohr DC, Ranney R, Lattie EG, Meyerhoff J, Williams JJ, Reddy M. Involving Crowdworkers with Lived Experience in Content-Development for Push-Based Digital Mental Health Tools: Lessons Learned from Crowdsourcing Mental Health Messages. PROCEEDINGS OF THE ACM ON HUMAN-COMPUTER INTERACTION 2022; 6:99. [PMID: 35529806 PMCID: PMC9075816 DOI: 10.1145/3512946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Digital tools can support individuals managing mental health concerns, but delivering sufficiently engaging content is challenging. This paper seeks to clarify how individuals with mental health concerns can contribute content to improve push-based mental health messaging tools. We recruited crowdworkers with mental health symptoms to evaluate and revise expert-composed content for an automated messaging tool, and to generate new topics and messages. A second wave of crowdworkers evaluated expert and crowdsourced content. Crowdworkers generated topics for messages that had not been prioritized by experts, including self-care, positive thinking, inspiration, relaxation, and reassurance. Peer evaluators rated messages written by experts and peers similarly. Our findings also suggest the importance of personalization, particularly when content adaptation occurs over time as users interact with example messages. These findings demonstrate the potential of crowdsourcing for generating diverse and engaging content for push-based tools, and suggest the need to support users in meaningful content customization.
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22
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The Tool for Evaluating Media Portrayals of Suicide (TEMPOS): Development and Application of a Novel Rating Scale to Reduce Suicide Contagion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052994. [PMID: 35270688 PMCID: PMC8910134 DOI: 10.3390/ijerph19052994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 02/06/2023]
Abstract
Research suggests that media adherence to suicide reporting recommendations in the aftermath of a highly publicized suicide event can help reduce the risk of imitative behavior, yet there exists no standardized tool for assessing adherence to these standards. The Tool for Evaluating Media Portrayals of Suicide (TEMPOS) allows media professionals, researchers, and suicide prevention experts to assess adherence to the recommendations with a user-friendly, standardized rating scale. An interdisciplinary team of raters constructed operational definitions for three levels of adherence to each of the reporting recommendations and piloted the scale on a sample of articles to assess reliability and clarify scale definitions. TEMPOS was then used to evaluate 220 news articles published during a high-risk period following the suicide deaths of two public figures. Post-hoc analyses of the results demonstrated how data produced by TEMPOS can be used to inform research and public health efforts, and inter-rater reliability analyses revealed substantial agreement across raters and criteria. A novel, wide-reaching, and practical approach to suicide prevention, TEMPOS allows researchers, suicide prevention professionals, and media professionals to study how adherence varies across contexts and can be used to guide future efforts to decrease the risk of media-induced suicide contagion.
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The Mental Health and Social Media Use of Young Australians during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031077. [PMID: 35162101 PMCID: PMC8834625 DOI: 10.3390/ijerph19031077] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 12/30/2022]
Abstract
Young people may be particularly vulnerable to the mental health impacts of the COVID-19 pandemic and may also be more likely to use social media at this time. This study aimed to explore young people’s mental health and social media use during the COVID-19 pandemic and examined their use of social media to seek and provide support for suicidal thoughts and self-harm during this period. Young people aged 16–25 (n = 371, M = 21.1) from the general population in Australia completed an anonymous, cross-sectional online survey advertised on social media from June to October 2020. Participants reported high levels of psychological distress, with over 40% reporting severe levels of anxiety and depression, and those with a mental health diagnosis were more likely to perceive the pandemic to have had a negative impact on their mental health. Gender-diverse participants appeared the most negatively impacted. Social media use was high, with 96% reporting use at least once a day, and two-thirds reporting an increase in social media use since the start of the pandemic. One-third had used social media to seek support for suicidal thoughts or self-harm, and half had used it to support another person. This study adds to a growing literature suggesting social media can provide an opportunity to support young people experiencing psychological distress and suicide risk. Uniquely, this study points to the utility of using social media for this purpose during high-risk periods such as pandemics, where access to face-to-face support may be limited. To promote the quality and safety of support provided on social media, resources for help-seekers and help-givers should be developed and disseminated. Social media companies must consider the vulnerability of some users during pandemics and do what they can to promote wellbeing and safety.
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Farsi D, Martinez-Menchaca HR, Ahmed M, Farsi N. Social Media and Health Care (Part II): Narrative Review of Social Media Use by Patients. J Med Internet Res 2022; 24:e30379. [PMID: 34994706 PMCID: PMC8783277 DOI: 10.2196/30379] [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: 05/14/2021] [Revised: 08/25/2021] [Accepted: 11/30/2021] [Indexed: 12/15/2022] Open
Abstract
Background People are now connected in a borderless web-based world. The modern public, especially the younger generation, relies heavily on the internet as the main source of health-related information. In health care, patients can use social media for more tailored uses such as telemedicine, finding a provider, and for peer support. Objective The aim of this narrative review is to discuss how social media has been used in the health care industry from the perspective of patients and describe the main issues surrounding its use in health care. Methods Between March and June 2020, a review of the literature was conducted on PubMed, Google Scholar, and Web of Science for English studies that were published since 2007 and discussed the use of social media in health care. In addition to only English publications that discussed the use of social media by patients, publications pertaining to ethical and legal considerations in the use of social media were included. The studies were then categorized as health information, telemedicine, finding a health care provider, peer support and sharing experiences, and influencing positive health behavior. In addition, two more sections were added to the review: issues pertaining to social media use in health care and ethical considerations. Results Initially, 75 studies were included. As the study proceeded, more studies were included, and a total of 91 studies were reviewed, complemented by 1 textbook chapter and 13 web references. Approximately half of the studies were reviews. The first study was published in 2009, and the last was published in 2021, with more than half of the studies published in the last 5 years. The studies were mostly from the United States (n=40), followed by Europe (n=13), and the least from India (n=1). WhatsApp or WeChat was the most investigated social media platform. Conclusions Social media can be used by the public and patients to improve their health and knowledge. However, due diligence must be practiced to assess the credibility of the information obtained and its source. Health care providers, patients, and the public need not forget the risks associated with the use of social media. The limitations and shortcomings of the use of social media by patients should be understood.
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Affiliation(s)
- Deema Farsi
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hector R Martinez-Menchaca
- Department of Comprehensive Dentistry, School of Dentistry, University of Louisville, Louisville, KY, United States
| | | | - Nada Farsi
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Cleverley K, McCann E, O’Brien D, Davies J, Bennett K, Brennenstuhl S, Courey L, Henderson J, Jeffs L, Miller J, Pignatiello T, Rong J, Rowland E, Stevens K, Szatmari P. Prioritizing core components of successful transitions from child to adult mental health care: a national Delphi survey with youth, caregivers, and health professionals. Eur Child Adolesc Psychiatry 2022; 31:1739-1752. [PMID: 34089382 PMCID: PMC9666300 DOI: 10.1007/s00787-021-01806-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/15/2021] [Indexed: 02/07/2023]
Abstract
Youth accessing mental health care often experience a disruption in care as they attempt to transition between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS). Few studies have evaluated interventions seeking to improve the experience and outcomes of CAMHS-AMHS transitions, in part due to lack of consensus on what constitutes best practices in intervention success. As such, the aim of this study was to engage patients, caregivers, and clinicians to prioritize core components of successful CAMHS-AMHS transitions which can be used in the design or evaluation of transition interventions. As such, a Delphi study was conducted to determine core components of successful CAMHS-AMHS transitions. Guided by the principles of patient-oriented research, three balanced expert panels consisting of youth, caregivers, and clinicians ranked and provided feedback on the importance and feasibility of core components of CAMHS-AMHS transitions. Components endorsed as feasible or important with ≥ 70% agreement from any panel moved to the next round. As a result, a list of 26 core components of CAMHS-AMHS transitions has been refined which can be used in the design, implementation, or evaluation of interventions intended to improve transition experiences and outcomes for youth in mental health care. Youth and families were engaged in an expert advisory role throughout the research process, contributing their important perspectives to the design and implementation of this study, as well as interpretation of the findings.
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Affiliation(s)
- Kristin Cleverley
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON, M5T 1P8, Canada. .,Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada. .,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Emma McCann
- grid.17063.330000 0001 2157 2938Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON M5T 1P8 Canada
| | | | - Julia Davies
- grid.17063.330000 0001 2157 2938Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON M5T 1P8 Canada ,grid.155956.b0000 0000 8793 5925Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Kathryn Bennett
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Sarah Brennenstuhl
- grid.17063.330000 0001 2157 2938Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON M5T 1P8 Canada
| | - Lynn Courey
- grid.491040.8Sashbear Foundation, Toronto, Canada
| | - Joanna Henderson
- grid.155956.b0000 0000 8793 5925Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Lianne Jeffs
- grid.17063.330000 0001 2157 2938Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON M5T 1P8 Canada ,grid.250674.20000 0004 0626 6184Lunenfeld-Tanenbaum Research Institute, Sinai Health, System, Toronto, Canada ,grid.17063.330000 0001 2157 2938Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada ,grid.415502.7Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Canada
| | - Joshua Miller
- grid.155956.b0000 0000 8793 5925Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada ,grid.17063.330000 0001 2157 2938Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Tony Pignatiello
- grid.17063.330000 0001 2157 2938Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada ,grid.42327.300000 0004 0473 9646Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada
| | - Jessica Rong
- grid.155956.b0000 0000 8793 5925Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Emily Rowland
- grid.17063.330000 0001 2157 2938Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON M5T 1P8 Canada
| | - Katye Stevens
- grid.155956.b0000 0000 8793 5925Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Peter Szatmari
- grid.155956.b0000 0000 8793 5925Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada ,grid.42327.300000 0004 0473 9646Centre for Brain and Mental Health and Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada ,grid.155956.b0000 0000 8793 5925The Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada
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Lockwood J, Babbage C, Bird K, Thynne I, Barsky A, Clarke DD, Townsend E. A comparison of temporal pathways to self-harm in young people compared to adults: A pilot test of the Card Sort Task for Self-harm online using Indicator Wave Analysis. Front Psychiatry 2022; 13:938003. [PMID: 36713895 PMCID: PMC9878399 DOI: 10.3389/fpsyt.2022.938003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 12/12/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Self-harm is complex, multifaceted, and dynamic, typically starts in adolescence, and is prevalent in young people. A novel research tool (the Card Sort Task for Self-harm; CaTS) offers a systematic approach to understanding this complexity by charting the dynamic interplay between multidimensional factors in the build-up to self-harm. Sequential analysis of CaTS has revealed differences in key factors between the first and the most recent episode of self-harm in adolescence. Rates of self-harm typically decline post-adolescence, but self-harm can continue into adulthood. A comparison between factors linked to self-harm in young people vs. adults will inform an understanding of how risk unfolds over time and clarify age-specific points for intervention. A pilot online adaptation (CaTS-online) and a new method (Indicator Wave Analysis; IWA) were used to assess key factors in the build-up to self-harm. METHODS Community-based young people (n = 66; 18-25 years, M = 21.4; SD = 1.8) and adults (n = 43; 26-57 years, M = 35; SD = 8.8) completed CaTS-online, documenting thoughts, feelings, events, and behaviours over a 6-month timeline for the first ever and most recent self-harm. A notable interdependence between factors and time points was identified using IWA. RESULTS Positive emotion at and immediately after self-harm exceeded the threshold for both groups for both episodes. Feeling better following self-harm was more pronounced for the first-ever episodes. Impulsivity was an important immediate antecedent to self-harm for both groups at both episodes but most markedly for young people. Acquired capability was notable for adults' most recent episodes, suggesting this develops over time. Burdensomeness was only more notable for adults and occurred 1 week prior to a recent episode. Both groups revealed patterns of accessing support that were helpful and unhelpful. CONCLUSION Commonalities and differences in the temporal organisation of factors leading to and following self-harm were identified in young people and adult pathways which shed light on age-specific factors and possible points of intervention. This has implications for clinical support and services around approaches to positive feelings after self-harm (especially for first-ever self-harm), feeling of burdensomeness, impulsivity, and acquired capability leading up to self-harm. Support is provided for card-sort approaches that enable the investigation of the complex and dynamic nature of pathways to self-harm.
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Affiliation(s)
- Joanna Lockwood
- National Institute of Health Research MindTech MedTech Co-operative, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Camilla Babbage
- National Institute of Health Research MindTech MedTech Co-operative, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Katherine Bird
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Imogen Thynne
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Andrey Barsky
- School of Computational Biology, University of Birmingham, Birmingham, United Kingdom
| | - David D Clarke
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Ellen Townsend
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
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Law PCF, Too LS, Hill NTM, Robinson J, Gould M, Occhipinti JA, Spittal MJ, Witt K, Sinyor M, Till B, Osgood N, Prodan A, Zahan R, Pirkis J. A Pilot Case-Control Study of the Social Media Activity Following Cluster and Non-Cluster Suicides in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:343. [PMID: 35010601 PMCID: PMC8751152 DOI: 10.3390/ijerph19010343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/21/2021] [Accepted: 12/25/2021] [Indexed: 06/14/2023]
Abstract
Social media may play a role in the "contagion" mechanism thought to underpin suicide clusters. Our pilot case-control study presented a novel methodological approach to examining whether Facebook activity following cluster and non-cluster suicides differed. We used a scan statistic to identify suicide cluster cases occurring in spatiotemporal clusters and matched each case to 10 non-cluster control suicides. We identified the Facebook accounts of 3/48 cluster cases and 20/480 non-cluster controls and their respective friends-lists and retrieved 48 posthumous posts and replies (text segments) referring to the deceased for the former and 606 for the latter. We examined text segments for "putatively harmful" and "putatively protective" content (e.g., discussion of the suicide method vs. messages discouraging suicidal acts). We also used concept mapping, word-emotion association, and sentiment analysis and gauged user reactions to posts using the reactions-to-posts ratio. We found no "putatively harmful" or "putatively protective" content following any suicides. However, "family" and "son" concepts were more common for cluster cases and "xx", "sorry" and "loss" concepts were more common for non-cluster controls, and there were twice as many surprise- and disgust-associated words for cluster cases. Posts pertaining to non-cluster controls were four times as receptive as those about cluster cases. We hope that the approach we have presented may help to guide future research to explain suicide clusters and social-media contagion.
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Affiliation(s)
- Phillip Cheuk Fung Law
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3053, Australia; (L.S.T.); (M.J.S.); (J.P.)
| | - Lay San Too
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3053, Australia; (L.S.T.); (M.J.S.); (J.P.)
| | - Nicole T. M. Hill
- Telethon Kids Institute, Nedlands 6009, Australia;
- School of Population and Global Health, The University of Western Australia, Nedlands 6009, Australia
| | - Jo Robinson
- Orygen, Parkville 3052, Australia; (J.R.); (K.W.)
- Centre for Youth Mental Health, The University of Melbourne, Parkville 3053, Australia
| | - Madelyn Gould
- Departments of Epidemiology and Psychiatry, Columbia University, New York, NY 10032, USA;
| | - Jo-An Occhipinti
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney 2050, Australia; (J.-A.O.); (A.P.)
- Computer Simulation and Advanced Research Technologies (CSART), Sydney 2021, Australia
| | - Matthew J. Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3053, Australia; (L.S.T.); (M.J.S.); (J.P.)
| | - Katrina Witt
- Orygen, Parkville 3052, Australia; (J.R.); (K.W.)
- Centre for Youth Mental Health, The University of Melbourne, Parkville 3053, Australia
| | - Mark Sinyor
- Sunnybrook Health Sciences Centre, Department of Psychiatry, University of Toronto, Toronto, ON M4N 3M5, Canada;
| | - Benedikt Till
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria;
| | - Nathaniel Osgood
- Department of Computer Science, University of Saskatchewan, Saskatoon, SK S7N 5C9, Canada; (N.O.); (R.Z.)
| | - Ante Prodan
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney 2050, Australia; (J.-A.O.); (A.P.)
- Translational Health Research Institute, Western Sydney University, Penrith 2751, Australia
| | - Rifat Zahan
- Department of Computer Science, University of Saskatchewan, Saskatoon, SK S7N 5C9, Canada; (N.O.); (R.Z.)
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3053, Australia; (L.S.T.); (M.J.S.); (J.P.)
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28
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Nasier B, Gibson K, Trnka S. “PM me” or “LOL”: Young peoples’ observations of supportive and unsympathetic responses to distress on social media. COMPUTERS IN HUMAN BEHAVIOR 2021. [DOI: 10.1016/j.chb.2021.106933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Robinson J, Teh Z, Lamblin M, Hill NTM, La Sala L, Thorn P. Globalization of the #chatsafe guidelines: Using social media for youth suicide prevention. Early Interv Psychiatry 2021; 15:1409-1413. [PMID: 32935440 DOI: 10.1111/eip.13044] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 08/30/2020] [Indexed: 01/24/2023]
Abstract
UNLABELLED Young people use social media to communicate about suicide, however, they often feel ill-equipped to share their own experiences or to respond to expressions of risk by others. AIMS To describe the adaptation of the Australian #chatsafe guidelines for an international audience, and their initial roll out via social media. METHODS An online survey (n = 48) and two workshops (n = 47) conducted between August and December 2019. Thirty-eight countries were represented. RESULTS Minimal adaptation of the Australian guidelines was required however, an abbreviated version and a suite of social media assets were developed. In the 6 weeks following publication the international guidelines were downloaded ~4100 times and the social media content reached over one million young people. CONCLUSION The fact that the guidelines and campaign content appear to have had such success speaks to the need for young people to feel better equipped to communicate safely about suicide online.
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Affiliation(s)
- Jo Robinson
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Zoe Teh
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Michelle Lamblin
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Nicole T M Hill
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.,Telethon Kids Institute, Perth, Western Australia, Australia
| | - Louise La Sala
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Pinar Thorn
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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Hennings J. Das Verstärkermodell der Suizidalität: Chronische Suizidalität bei der Borderline-Persönlichkeitsstörung verstehen und behandeln. VERHALTENSTHERAPIE 2021. [DOI: 10.1159/000518239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Trotz großer Fortschritte in der evidenzbasierten Psychotherapie wird unser Versorgungssystem durch chronisch suizidale Patienten mit einer Borderline-Persönlichkeitsstörung (BPS) weiterhin stark herausgefordert. Die BPS ist mit einem hohen Suizidrisiko von 5–10% sowie einem hohen Selbstverletzungsrisiko von bis zu 80% behaftet. Therapeuten wie Angehörige fühlen sich oft überfordert und hilflos, wenn sie mit der Suizidalität der Patienten konfrontiert sind. Immer wieder kommt es so zu Therapieabbrüchen, Vorstellungen in Notaufnahmen oder akut-psychiatrischen Einweisungen. Bei der nichtsuizidalen Selbstverletzung (NSSV) – einem Verhaltensmuster, das gehäuft zusammen mit chronischer Suizidalität bei BPS auftritt – tragen Verstärkermechanismen (z.B. Nachlassen von Anspannung) dazu bei, dass sich Borderline-Patienten trotz längerfristig unangenehmen Folgen immer wieder selbst verletzen. Die Motive für NSSV und suizidales Verhalten können sehr unterschiedlich sein. Es spricht jedoch einiges dafür, dass die zugrunde liegenden Mechanismen ähnlich sind und sich hieraus wichtige therapeutische Interventionsmöglichkeiten ableiten lassen. In dieser Übersichtsarbeit werden die Hintergründe und Unterschiede von NSSV, Suizidideationen sowie Suizidversuchen bei chronisch suizidalen Borderline-Patienten dargestellt. Neuere Erkenntnisse der modernen Neuro- und Verhaltenswissenschaft werden in ein Verstärkermodell der Suizidalität integriert, von dem verhaltenstherapeutische Interventionen abgeleitet werden, die Therapeuten in ihrer Arbeit mit chronisch suizidalen Patienten unterstützen können.
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La Sala L, Teh Z, Lamblin M, Rajaram G, Rice S, Hill NTM, Thorn P, Krysinska K, Robinson J. Can a social media intervention improve online communication about suicide? A feasibility study examining the acceptability and potential impact of the #chatsafe campaign. PLoS One 2021; 16:e0253278. [PMID: 34129610 PMCID: PMC8205132 DOI: 10.1371/journal.pone.0253278] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 06/01/2021] [Indexed: 11/19/2022] Open
Abstract
There is a need for effective and youth-friendly approaches to suicide prevention, and social media presents a unique opportunity to reach young people. Although there is some evidence to support the delivery of population-wide suicide prevention campaigns, little is known about their capacity to change behaviour, particularly among young people and in the context of social media. Even less is known about the safety and feasibility of using social media for the purpose of suicide prevention. Based on the #chatsafe guidelines, this study examines the acceptability, safety and feasibility of a co-designed social media campaign. It also examines its impact on young people's willingness to intervene against suicide and their perceived self-efficacy, confidence and safety when communicating on social media platforms about suicide. A sample of 189 young people aged 16-25 years completed three questionnaires across a 20-week period (4 weeks pre-intervention, immediately post-intervention, and at 4-week follow up). The intervention took the form of a 12-week social media campaign delivered to participants via direct message. Participants reported finding the intervention acceptable and they also reported improvements in their willingness to intervene against suicide, and their perceived self-efficacy, confidence and safety when communicating on social media about suicide. Findings from this study present a promising picture for the acceptability and potential impact of a universal suicide prevention campaign delivered through social media, and suggest that it can be safe to utilize social media for the purpose of suicide prevention.
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Affiliation(s)
- Louise La Sala
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Zoe Teh
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Michelle Lamblin
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Gowri Rajaram
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Simon Rice
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Nicole T. M. Hill
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
- Telethon Kids Institute, Perth, Western Australia, Australia
| | - Pinar Thorn
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Karolina Krysinska
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
- Centre for Mental Health, The Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Jo Robinson
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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Lai K, Li D, Peng H, Zhao J, He L. Assessing Suicide Reporting in Top Newspaper Social Media Accounts in China: Content Analysis Study. JMIR Ment Health 2021; 8:e26654. [PMID: 33983127 PMCID: PMC8160790 DOI: 10.2196/26654] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 03/07/2021] [Accepted: 04/15/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Previous studies have shown that suicide reporting in mainstream media has a significant impact on suicidal behaviors (eg, irresponsible suicide reporting can trigger imitative suicide). Traditional mainstream media are increasingly using social media platforms to disseminate information on public-related topics, including health. However, there is little empirical research on how mainstream media portrays suicide on social media platforms and the quality of their coverage. OBJECTIVE This study aims to explore the characteristics and quality of suicide reporting by mainstream publishers via social media in China. METHODS Via the application programming interface of the social media accounts of the top 10 Chinese mainstream publishers (eg, People's Daily and Beijing News), we obtained 2366 social media posts reporting suicide. This study conducted content analysis to demonstrate the characteristics and quality of the suicide reporting. According to the World Health Organization (WHO) guidelines, we assessed the quality of suicide reporting by indicators of harmful information and helpful information. RESULTS Chinese mainstream publishers most frequently reported on suicides stated to be associated with conflict on their social media (eg, 24.47% [446/1823] of family conflicts and 16.18% [295/1823] of emotional frustration). Compared with the suicides of youth (730/1446, 50.48%) and urban populations (1454/1588, 91.56%), social media underreported suicides in older adults (118/1446, 8.16%) and rural residents (134/1588, 8.44%). Harmful reporting practices were common (eg, 54.61% [1292/2366] of the reports contained suicide-related words in the headline and 49.54% [1172/2366] disclosed images of people who died by suicide). Helpful reporting practices were very limited (eg, 0.08% [2/2366] of reports provided direct information about support programs). CONCLUSIONS The suicide reporting of mainstream publishers on social media in China broadly had low adherence to the WHO guidelines. Considering the tremendous information dissemination power of social media platforms, we suggest developing national suicide reporting guidelines that apply to social media. By effectively playing their separate roles, we believe that social media practitioners, health institutions, social organizations, and the general public can endeavor to promote responsible suicide reporting in the Chinese social media environment.
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Affiliation(s)
- Kaisheng Lai
- School of Journalism and Communication, Jinan University, Guangzhou, China
| | - Dan Li
- School of Journalism and Communication, Jinan University, Guangzhou, China
| | - Huijuan Peng
- School of Journalism and Communication, Jinan University, Guangzhou, China
| | - Jingyuan Zhao
- School of Journalism and Communication, Jinan University, Guangzhou, China
| | - Lingnan He
- School of Communication and Design, Sun Yat-Sen University, Guangzhou, China.,Department of Psychology, Sun Yat-Sen University, Guangzhou, China.,Guangdong Key Laboratory for Big Data Analysis and Simulation of Public Opinion, Guangzhou, China
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Côté D, Williams M, Zaheer R, Niederkrotenthaler T, Schaffer A, Sinyor M. Suicide-related Twitter Content in Response to a National Mental Health Awareness Campaign and the Association between the Campaign and Suicide Rates in Ontario. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2021; 66:460-467. [PMID: 33563028 PMCID: PMC8107951 DOI: 10.1177/0706743720982428] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Mental health awareness (MHA) campaigns have been shown to be successful in improving mental health literacy, decreasing stigma, and generating public discussion. However, there is a dearth of evidence regarding the effects of these campaigns on behavioral outcomes such as suicides. Therefore, the objective of this article is to characterize the association between the event and suicide in Canada's most populous province and the content of suicide-related tweets referencing a Canadian MHA campaign (Bell Let's Talk Day [BLTD]). METHODS Suicide counts during the week of BTLD were compared to a control window (2011 to 2016) to test for associations between the BLTD event and suicide. Suicide tweets geolocated to Ontario, posted in 2016 with the BLTD hashtag were coded for specific putatively harmful and protective content. RESULTS There was no associated change in suicide counts. Tweets (n = 3,763) mainly included content related to general comments about suicide death (68%) and suicide being a problem (42.8%) with little putatively helpful content such as stories of resilience (0.6%) and messages of hope (2.2%). CONCLUSIONS In Ontario, this national mental health media campaign was associated with a high volume of suicide-related tweets but not necessarily including content expected to diminish suicide rates. Campaigns like BLTD should strongly consider greater attention to suicide-related messaging that promotes help-seeking and resilience. This may help to further decrease stigmatization, and potentially, reduce suicide rates.
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Affiliation(s)
- David Côté
- Department of Psychiatry, 71545Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,University of Toronto, Ontario, Canada
| | - Marissa Williams
- Department of Psychiatry, 71545Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Athabasca University, Alberta, Canada
| | - Rabia Zaheer
- Department of Psychiatry, 71545Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,University of Waterloo, Ontario, Canada
| | - Thomas Niederkrotenthaler
- Center for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Unit Suicide Research & Mental Health Promotion, Vienna, Austria
| | - Ayal Schaffer
- Department of Psychiatry, 71545Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Ontario Canada
| | - Mark Sinyor
- Department of Psychiatry, 71545Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Ontario Canada
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Sinyor M, Williams M, Zaheer R, Loureiro R, Pirkis J, Heisel MJ, Schaffer A, Redelmeier DA, Cheung AH, Niederkrotenthaler T. The association between Twitter content and suicide. Aust N Z J Psychiatry 2021; 55:268-276. [PMID: 33153274 DOI: 10.1177/0004867420969805] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE A growing body of research has established that specific elements of suicide-related news reporting can be associated with increased or decreased subsequent suicide rates. This has not been systematically investigated for social media. The aim of this study was to identify associations between specific social media content and suicide deaths. METHODS Suicide-related tweets (n = 787) geolocated to Toronto, Canada and originating from the highest level influencers over a 1-year period (July 2015 to June 2016) were coded for general, putatively harmful and putatively protective content. Multivariable logistic regression was used to examine whether tweet characteristics were associated with increases or decreases in suicide deaths in Toronto in the 7 days after posting, compared with a 7-day control window. RESULTS Elements independently associated with increased subsequent suicide counts were tweets about the suicide of a local newspaper reporter (OR = 5.27, 95% CI = [1.27, 21.99]), 'other' social causes of suicide (e.g. cultural, relational, legal problems; OR = 2.39, 95% CI = [1.17, 4.86]), advocacy efforts (OR = 2.34, 95% CI = [1.48, 3.70]) and suicide death (OR = 1.52, 95% CI = [1.07, 2.15]). Elements most strongly independently associated with decreased subsequent suicides were tweets about murder suicides (OR = 0.02, 95% CI = [0.002, 0.17]) and suicide in first responders (OR = 0.17, 95% CI = [0.05, 0.52]). CONCLUSIONS These findings largely comport with the theory of suicide contagion and associations observed with traditional news media. They specifically suggest that tweets describing suicide deaths and/or sensationalized news stories may be harmful while those that present suicide as undesirable, tragic and/or preventable may be helpful. These results suggest that social media is both an important exposure and potential avenue for intervention.
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Affiliation(s)
- Mark Sinyor
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Marissa Williams
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Graduate Centre for Applied Psychology, Athabasca University, Athabasca, AB, Canada
| | - Rabia Zaheer
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Raisa Loureiro
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Marnin J Heisel
- Departments of Psychiatry and of Epidemiology and Biostatistics, University of Western Ontario, London, ON, Canada
| | - Ayal Schaffer
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Donald A Redelmeier
- Department of Medicine, University of Toronto, Toronto, ON, Canada.,Sunnybrook Research Institute, Toronto, ON, Canada.,Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Amy H Cheung
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Thomas Niederkrotenthaler
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
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Keyes KM, Whitley R, Fink D, Santaella J, Pirkis J. The global impact of celebrity suicides: implications for prevention. World Psychiatry 2021; 20:144-145. [PMID: 33432751 PMCID: PMC7801848 DOI: 10.1002/wps.20761] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public HealthColumbia UniversityNew YorkNYUSA
| | - Rob Whitley
- Department of Psychiatry, Douglas Hospital Research CentreMcGill UniversityMontrealQCCanada
| | - David Fink
- Department of Epidemiology, Mailman School of Public HealthColumbia UniversityNew YorkNYUSA
| | | | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneVICAustralia
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Swedo EA, Beauregard JL, de Fijter S, Werhan L, Norris K, Montgomery MP, Rose EB, David-Ferdon C, Massetti GM, Hillis SD, Sumner SA. Associations Between Social Media and Suicidal Behaviors During a Youth Suicide Cluster in Ohio. J Adolesc Health 2021; 68:308-316. [PMID: 32646827 PMCID: PMC8366066 DOI: 10.1016/j.jadohealth.2020.05.049] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 05/19/2020] [Accepted: 05/22/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE Youth suicide clusters may be exacerbated by suicide contagion-the spread of suicidal behaviors. Factors promoting suicide contagion are poorly understood, particularly in the advent of social media. Using cross-sectional data from an ongoing youth suicide cluster in Ohio, this study examines associations between suicide cluster-related social media and suicidal behaviors. METHODS We surveyed 7th- to 12th-grade students in northeastern Ohio during a 2017-2018 suicide cluster to assess the prevalence of suicidal ideation (SI), suicide attempts (SAs), and associations with potential contagion-promoting factors such as suicide cluster-related social media, vigils, memorials, news articles, and watching the Netflix series 13 Reasons Why before or during the cluster. Generalized estimating equations examined associations between potential contagion-promoting factors and SI/SA, adjusting for nonmodifiable risk factors. Subgroup analyses examined whether associations between cluster-related factors and SI/SA during the cluster varied by previous history of SI/SA. RESULTS Among participating students, 9.0% (876/9,733) reported SI and 4.9% attempted suicide (481/9,733) during the suicide cluster. Among students who posted suicide cluster-related content to social media, 22.9% (267/1,167) reported SI and 15.0% (175/1,167) attempted suicide during the suicide cluster. Posting suicide cluster-related content was associated with both SI (adjusted odds ratio 1.7, 95% confidence interval 1.4-2.0) and SA during the cluster (adjusted odds ratio 1.7, 95% confidence interval 1.2-2.5). In subgroup analyses, seeing suicide cluster-related posts was uniquely associated with increased odds of SI and SA during the cluster among students with no previous history of SI/SA. CONCLUSIONS Exposure to suicide cluster-related social media is associated with both SI and SA during a suicide cluster. Suicide interventions could benefit from efforts to mitigate potential negative effects of social media and promote prevention messages.
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Affiliation(s)
- Elizabeth A Swedo
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Jennifer L Beauregard
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sietske de Fijter
- Ohio Violence and Injury Prevention Program, Ohio Department of Health, Columbus, Ohio
| | - Luke Werhan
- Ohio Violence and Injury Prevention Program, Ohio Department of Health, Columbus, Ohio
| | | | - Martha P Montgomery
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Ohio Violence and Injury Prevention Program, Ohio Department of Health, Columbus, Ohio
| | - Erica B Rose
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Corinne David-Ferdon
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Greta M Massetti
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan D Hillis
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia; Office of the Global AIDS Coordinator, Washington, District of Columbia
| | - Steven A Sumner
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Hill NT, Spittal MJ, Pirkis J, Torok M, Robinson J. Risk factors associated with suicide clusters in Australian youth: Identifying who is at risk and the mechanisms associated with cluster membership. EClinicalMedicine 2020; 29-30:100631. [PMID: 33294825 PMCID: PMC7691728 DOI: 10.1016/j.eclinm.2020.100631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/18/2020] [Accepted: 10/27/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND It is unclear who is at risk of being involved in a suicide cluster and whether suicide clusters are influenced by the social transmission of suicidal behaviour, assortative relating, or a combination of both. METHODS Suicide clusters involving two or more young people were identified from the free text of electronic police and coroners reports in Australia's National Coronial Information System in a nationwide cross-sectional study. The duration of survival among exposed cases were estimated using time-to-event methods. The casewise concordance of demographic, social and clinical characteristics and circumstances of death were examined among index and exposed cases. FINDINGS We identified links between 117 young people (51 suicide clusters). 50% of young people died within 90 days of the index suicide. Individuals exposed to railway suicide had an 80% probability of dying by the same method. Those exposed to the suicide of a person aged 10-18 years had an 86% probability of being from the same age group. Young people had a 67% and 60% probability of sharing the same characteristics as the index suicide when the index suicide resided in a remote community or was of Aboriginal and Torres Strait Islander descent. INTERPRETATION Suicide clusters may be associated with both the social transmission of suicidal behaviour and assortative relating. Individuals who were close to the deceased should be provided with access to postvention support, particularly within the first 90 days of exposure to an index suicide. FUNDING Australian Rotary Health, National Health and Medical Research Council.
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Affiliation(s)
- Nicole T.M. Hill
- Telethon Kids Institute, 15 Hospital Ave, Nedlands, Perth, WA 6008, Australia
- Orygen, Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Matthew J. Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Michelle Torok
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Jo Robinson
- Orygen, Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
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Suicide prevention is everyone's business: Challenges and opportunities for Google. Soc Sci Med 2020; 262:112691. [DOI: 10.1016/j.socscimed.2019.112691] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 11/16/2019] [Indexed: 02/03/2023]
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Biernesser C, Sewall CJ, Brent D, Bear T, Mair C, Trauth J. Social Media Use and Deliberate Self-Harm Among Youth: A Systematized Narrative Review. CHILDREN AND YOUTH SERVICES REVIEW 2020; 116:105054. [PMID: 32773916 PMCID: PMC7413131 DOI: 10.1016/j.childyouth.2020.105054] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Suicide is now the 2nd leading cause of death among adolescents and young adults. Social media's influence on youth suicidal risk or attenuation of risk is a novel and rapidly expanding topic of research that requires attention from a broad range of mental health services professionals. We aimed to provide an updated review of social media-related risk and protective factors to youth deliberate-self harm (DSH) to guide mental health services professionals in offering care and support to youth vulnerable to suicide. METHODS Studies on which primary research was conducted that evaluated young people's use of social media platforms related to DSH were systematically searched via Scopus and identified through expert recommendation and the Association for Computing Machinery's digital library of conference materials. The search focused on the timeframe June 2014 to September 2019, to offer an update since the time the most recent systematic reviews on this topic concluded their literatures searches. Quality was reviewed using the Mixed Methods Appraisal Tool (MMAT). RESULTS A total of 38 articles were eligible, and 24 articles rated as high quality were included in a narrative review. Of the included articles, 19 explored DSH risk and 8 explored DSH protection. Most articles reported on cross-sectional quantitative or qualitative studies. Opportunities for both risks and benefits were explored, and potential influences of social media use were considered for subgroups of youth who may be especially vulnerable to suicide. CONCLUSIONS In the relatively short period of review, the association between social media use and youth DSH was tested in population-based studies, offering preliminary evidence for suicide prevention and treatment efforts. Further research is needed to understand the contribution of social media use to youth DSH, particularly among youth most vulnerable to suicidal risk.
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Affiliation(s)
- Candice Biernesser
- Department of Psychiatry, School of Medicine, University of
Pittsburgh, 3811 O’Hara St., Pittsburgh, PA 15213
- Department of Behavioral and Community Health Sciences,
Graduate School of Public Health, University of Pittsburgh, 130 De Soto St.
6 Floor, Pittsburgh, PA 15261
| | - Craig J.R. Sewall
- School of Social Work, University of Pittsburgh, 2117
Cathedral of Learning, 4200 Fifth Ave., Pittsburgh, PA 15260
| | - David Brent
- Department of Psychiatry, School of Medicine, University of
Pittsburgh, 3811 O’Hara St., Pittsburgh, PA 15213
| | - Todd Bear
- Department of Behavioral and Community Health Sciences,
Graduate School of Public Health, University of Pittsburgh, 130 De Soto St.
6 Floor, Pittsburgh, PA 15261
| | - Christina Mair
- Department of Behavioral and Community Health Sciences,
Graduate School of Public Health, University of Pittsburgh, 130 De Soto St.
6 Floor, Pittsburgh, PA 15261
| | - Jeanette Trauth
- Department of Behavioral and Community Health Sciences,
Graduate School of Public Health, University of Pittsburgh, 130 De Soto St.
6 Floor, Pittsburgh, PA 15261
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Krysinska K, Curtis S, Lamblin M, Stefanac N, Gibson K, Byrne S, Thorn P, Rice SM, McRoberts A, Ferrey A, Perry Y, Lin A, Hetrick S, Hawton K, Robinson J. Parents' Experience and Psychoeducation Needs When Supporting a Young Person Who Self-Harms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3662. [PMID: 32456022 PMCID: PMC7277421 DOI: 10.3390/ijerph17103662] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Self-harm in young people can have a substantial negative impact on the well-being and functioning of parents and other carers. The "Coping with Self-Harm" booklet was originally developed in the UK as a resource for parents and carers of young people who self-harm, and an adaptation study of this resource was conducted in Australia. This paper presents qualitative analysis of interviews with parents about their experiences and psychoeducational needs when supporting a young person who engages in self harm. METHODS The qualitative study drew on semi-structured individual and group interviews with parents (n = 19 participants) of young people who self-harm. Data were analysed using Thematic Analysis. RESULTS The analysis identified six themes: (1) the discovery of self-harm, (2) challenges in the parent-young person relationship, (3) parents' need to understand self-harm, (4) parents' emotional reactions to self-harm, (5) the importance of self-care and help-seeking among parents, and (6) the need for psychoeducational resources. CONCLUSION The study highlights the need for support for parents and carers of young people who engage in self-harm, including development and adaptation of resources, such as the "Coping with Self-Harm" booklet, of which an Australian version has now been developed.
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Affiliation(s)
- Karolina Krysinska
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Sophie Curtis
- North Western Mental Health, Parkville, VIC 3050, Australia
| | - Michelle Lamblin
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Nina Stefanac
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Kerry Gibson
- School of Psychology, The University of Auckland, Auckland 1142, New Zealand
| | - Sadhbh Byrne
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Pinar Thorn
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Simon M Rice
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | | | - Anne Ferrey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Yael Perry
- Telethon Kids Institute, University of Western Australia, Nedlands, WA 6009, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, University of Western Australia, Nedlands, WA 6009, Australia
| | - Sarah Hetrick
- Orygen, Parkville, VIC 3052, Australia
- Department of Psychological Medicine, The University of Auckland, Auckland 1142, New Zealand
| | - Keith Hawton
- Centre for Suicide Research, University of Oxford, Oxford OX3 7JX, UK
- Oxford Health NHS Foundation Trust, Oxford OX3 7JX, UK
| | - Jo Robinson
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
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Braun M, Till B, Pirkis J, Niederkrotenthaler T. Suicide Prevention Videos Developed by and for Adolescents. CRISIS 2020; 42:114-120. [PMID: 32431196 DOI: 10.1027/0227-5910/a000696] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background: One strategy to prevent youth suicide is awareness-raising video campaigns. To date, little is known about how best to include adolescents in the production process, and how they experience their involvement. Aims: This study used a participatory qualitative research approach to explore the experiences of adolescents producing suicide prevention videos targeting other adolescents in a school setting. Method: The project was conducted in Vienna, Austria, from 09/2018 to 01/2019. Eighteen high school students aged 15-19 produced suicide prevention videos. Focus group discussions with 17 of these students captured qualitative information on their experiences related to the process. Focus group content was analyzed following the documentary method. Results: Students produced seven suicide prevention videos in groups of two to three individuals. The production process was found to be positive, and numerous benefits and learning effects were noted. Limitations: No conclusions can be made about video effects on adolescents not involved in the process. Conclusion: Including adolescents in the process of developing suicide prevention videos has multiple benefits. The process researched here can inform similar campaigns with adolescents.
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Affiliation(s)
- Marlies Braun
- 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
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Thomas Niederkrotenthaler
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria
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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: 20] [Impact Index Per Article: 5.0] [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.
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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
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43
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Sinyor M, Williams M, Zaheer R, Loureiro R, Pirkis J, Heisel MJ, Schaffer A, Cheung AH, Redelmeier DA, Niederkrotenthaler T. The Relationship Between Suicide-Related Twitter Events and Suicides in Ontario From 2015 to 2016. CRISIS 2020; 42:40-47. [PMID: 32366171 DOI: 10.1027/0227-5910/a000684] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background: Many studies have demonstrated suicide contagion through mainstream journalism; however, few have explored suicide-related social media events and their potential relationship to suicide deaths. Aims: To determine whether Twitter events were associated with changes in subsequent suicides. Methods: Suicide-related Twitter events that garnered at least 100 tweets originating in Ontario, Canada (July 1, 2015 to June 30, 2016) were identified and characterized as putatively "harmful" or "innocuous" based on recommendations for responsible media reporting. The number of suicides in Ontario during the peak of each Twitter event and the subsequent 6 days ("exposure window") was compared with suicides occurring during a pre-event period of the same length ("control window"). Results: There were 17 suicide-related Twitter events during the period of study (12 putatively harmful and five putatively innocuous). The number of tweets per event ranged from 121 for "physician-assisted suicide law in Quebec" to 6,202 for the "Attawapiskat suicide crisis." No significant relationship was detected between Twitter events and actual suicides. Notably, a comprehensive examination of the details of Twitter events showed that even the putatively harmful events lacked many of the characteristics commonly associated with contagion. Limitations: This was an uncontrolled experiment in only one epoch and a single Canadian province. Discussion: This study found no evidence of suicide contagion associated with Twitter events. This finding must be interpreted with caution given the relatively innocuous content of suicide-related Tweets in Ontario during 2015-2016.
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Affiliation(s)
- Mark Sinyor
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, ON, Canada
| | - Marissa Williams
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Graduate Centre for Applied Psychology, Athabasca University, AB, Canada
| | - Rabia Zaheer
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Raisa Loureiro
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, VIC, Australia
| | - Marnin J Heisel
- Department of Psychiatry, The University of Western Ontario, London, ON, Canada
| | - Ayal Schaffer
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, ON, Canada
| | - Amy H Cheung
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, ON, Canada
| | - Donald A Redelmeier
- Department of Medicine, University of Toronto, ON, Canada.,Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.,Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Thomas Niederkrotenthaler
- Centre for Public Health, Department of Social and Preventive Medicine, Unit Suicide Research & Mental Health Promotion, Medical University of Vienna, Austria
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Hennings JM. Function and Psychotherapy of Chronic Suicidality in Borderline Personality Disorder: Using the Reinforcement Model of Suicidality. Front Psychiatry 2020; 11:199. [PMID: 32256412 PMCID: PMC7093558 DOI: 10.3389/fpsyt.2020.00199] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 03/02/2020] [Indexed: 12/12/2022] Open
Abstract
Although great advancements in evidence-based therapies, chronic suicidal patients with borderline personality disorder (BPD) still challenge our mental health system. While BPD patients continue suffering from distress and aversive emotions, therapists and relatives feel often stunned and helpless when confronted with suicidality resulting in interruption of therapies, repeated presentations to emergency rooms and referrals to hospitals. Reviewing the current knowledge of the functions and background of non-suicidal self-injury, we learned that reinforcement mechanisms play an important role to understand why individuals act in deliberate self-mutilation. While individual motives for non-suicidal self-injury and suicidal behavior including suicidal ideations can differ, the principle mechanisms appear to be transferrable. Elucidating the individual motives and function of suicidal behavior is an important therapeutic step, giving us access to very central maladaptive schemes and false believes that we need to address in order to reduce chronic suicidality in BPD patients. This Perspective article aims to give a better idea of what is behind and what are the differences between non-suicidal self-injury, suicidal ideations and suicide attempts. It further integrates recent developments of behavioral science in a reinforcement model of suicidality that can provide therapists a practical armamentarium in their work with chronic suicidal clients.
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Affiliation(s)
- Johannes M. Hennings
- Department of Dialectical Behavioral Therapy, kbo-Isar-Amper-Klinikum Munich-East, Munich, Germany
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45
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Abstract
PURPOSE OF REVIEW Suicide is the second leading cause of death in youth aged 10-24 years old globally, but detecting those at risk is challenging. Novel preventive strategies with wide influence across populations are required. Interest in the potential for both detrimental and supportive influences of social media/internet use on suicidal behaviour has been growing; however, the relationship remains unclear. RECENT FINDINGS A systematic search of articles from database inception up to 25 January 2019 across five databases: Medline, PsycINFO, EMBASE, HMIC and CINAHL revealed nine independent studies investigating social media/internet use and suicide attempts in young people less than 19 years old (n = 346 416). An independent direct association was found between heavy social media/internet use and increased suicide attempts in seven studies (adjusted ORs ranged from 1.03 to 5.10), although adjusting for cyberbullying victimization and sleep disturbance reduced the strength of this association. Two studies found that some social media/internet use, versus no use, may be associated with fewer suicide attempts. There were no studies investigating the relationship between social media/internet use and completed suicide. SUMMARY There is an independent association between problematic use of social media/internet and suicide attempts in young people. However, the direction of causality, if any, remains unclear. Further evaluation through longitudinal studies is needed.
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Abstract
Although recent years have seen large decreases in the overall global rate of suicide fatalities, this trend is not reflected everywhere. Suicide and suicidal behaviour continue to present key challenges for public policy and health services, with increasing suicide deaths in some countries such as the USA. The development of suicide risk is complex, involving contributions from biological (including genetics), psychological (such as certain personality traits), clinical (such as comorbid psychiatric illness), social and environmental factors. The involvement of multiple risk factors in conveying risk of suicide means that determining an individual's risk of suicide is challenging. Improving risk assessment, for example, by using computer testing and genetic screening, is an area of ongoing research. Prevention is key to reduce the number of suicide deaths and prevention efforts include universal, selective and indicated interventions, although these interventions are often delivered in combination. These interventions, combined with psychological (such as cognitive behavioural therapy, caring contacts and safety planning) and pharmacological treatments (for example, clozapine and ketamine) along with coordinated social and public health initiatives, should continue to improve the management of individuals who are suicidal and decrease suicide-associated morbidity.
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47
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Hawton K, Hill NTM, Gould M, John A, Lascelles K, Robinson J. Clustering of suicides in children and adolescents. THE LANCET CHILD & ADOLESCENT HEALTH 2019; 4:58-67. [PMID: 31606323 DOI: 10.1016/s2352-4642(19)30335-9] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/28/2019] [Accepted: 09/09/2019] [Indexed: 02/05/2023]
Abstract
Suicide is one of the major causes of death in young people, in whom suicide can occur in clusters. In this Review, we have investigated definitions and epidemiology of such clusters, the factors associated with them, mechanisms by which they occur, and means of intervening and preventing them. Clustering of suicidal behaviour is more common in young people (<25 years) than adults. Suicide clusters can occur as a greater number of episodes than expected at a specific location, including in institutions (eg, schools, universities, psychiatric units, and youth offender units). They might also involve linked episodes spread out geographically. Locations exposed to clusters can be at risk for future clusters. Mechanisms involved in clusters include social transmission (particularly via person-to-person transmission and the media), perception that suicidal behaviour is widespread, susceptible young people being likely to socialise with others at risk of suicidal behaviour, and social cohesion contributing to the diffusion of ideas and attitudes. The internet and social media might have particularly important roles in spreading suicidal behaviour. The effect of suicide clusters on communities and institutions is usually profound. Experience of intervening in clusters has resulted in best practice guidance. This guidance includes preparation for occurrence of clusters in both community and institutional settings. Identification of clusters in the community requires real-time monitoring of suicidal behaviour. Effective intervention is more likely if a cluster response group is established than if no such group exists. The response should include bereavement support, provision of help for susceptible individuals, proactive engagement with media interest, and population-based approaches to support and prevention. Social media can provide a powerful means for disseminating information and reaching young people at risk.
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Affiliation(s)
- Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK; Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.
| | - Nicole T M Hill
- Orygen, The National Centre of Excellence for Youth Mental Health, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Madelyn Gould
- Division of Child & Adolescent Psychiatry, and Department of Epidemiology, Columbia University Medical Center, New York, NY 10032, USA
| | - Ann John
- Division of Applied Population Data Science, Population Psychiatry, Suicide and Informatics, Swansea University Medical School, Swansea University, Swansea, UK
| | - Karen Lascelles
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK; Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Jo Robinson
- Orygen, The National Centre of Excellence for Youth Mental Health, University of Melbourne, Melbourne, VIC 3052, Australia
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48
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Padmanathan P, Biddle L, Hall K, Scowcroft E, Nielsen E, Knipe D. Language use and suicide: An online cross-sectional survey. PLoS One 2019; 14:e0217473. [PMID: 31194768 PMCID: PMC6563960 DOI: 10.1371/journal.pone.0217473] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 05/12/2019] [Indexed: 12/03/2022] Open
Abstract
Background There has been a recent focus on language use in relation to suicide, with concerns raised about the potential to cause distress, perpetuate stigma and discourage help-seeking. While some terms are promoted as more sensitive than others, empirical research exploring the views of people affected by suicide to inform academic and media guidelines is lacking. Methods An anonymous, cross-sectional online survey was promoted opportunistically via online channels. Participation was requested from adults affected by suicide. Participants were asked to rate descriptors pertaining to suicidal behaviour according to perceived acceptability. A descriptive analysis of quantitative data was conducted alongside thematic content analysis of free-text data. Outcomes There were 2,719 responses, of which 1,679 (61·8%) were complete. Of phrases describing non-fatal suicidal behaviour, “attempted suicide” had the highest median acceptability score. Of phrases describing fatal suicidal behaviour, “took their own life” and “died by suicide” had the highest median acceptability scores. The scores for “commit suicide” were most variable and spanned the range of acceptability scores. Free text data illustrated the nuances in decision-making. Interpretation Variation in opinion exists amongst people affected by suicide regarding most phrases, often depending on contextual factors. “Attempted suicide”, “took their own life”, “died by suicide” and “ended their life” were however considered most acceptable. We argue that academic and media guidelines should promote use of these phrases.
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Affiliation(s)
- Prianka Padmanathan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- * E-mail:
| | - Lucy Biddle
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Katherine Hall
- Avon & Wiltshire Mental Health Partnership NHS Trust, Bristol, United Kingdom
| | | | - Emma Nielsen
- Self-Harm Research Group, School of Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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