#chatsafe 2.0. updated guidelines to support young people to communicate safely online about self-harm and suicide: A Delphi expert consensus study

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.

13 Reasons Why: The Evidence Is in and Cannot Be Ignored

Decades of research overwhelmingly supports the public health necessity of safe, balanced, and responsible news media reporting on suicide.^1,2 When news media follow recommendations for safe reporting, the risk of copycat suicide decreases.³ The Recommendations for Media Reporting on Suicide were developed by leading experts in suicide prevention and in collaboration with several international suicide prevention and public health organizations, schools of journalism, media organizations, and key journalists, as well as Internet safety experts (www.reportingonsuicide.org). The recommendations are based on more than 100 international studies on suicide contagion. Furthermore, in recent years, Niederkrotenthaler and others have specifically examined suicide-related media portrayals focused on messages of hope, recovery, or mastery over a crisis. Research demonstrates that following such portrayals, those exposed experience a decrease in suicidal ideation, diminished distress, and an increased sense of hope.^4,5 Importantly, in some cases, fewer suicides are observed across the exposed population.¹ In other words, both suicide and resilience are contagious behaviors, and the content of suicide-related news media messaging can and does prevent tragic deaths.

Increases in Demand for Crisis and Other Suicide Prevention Services After a Celebrity Suicide

OBJECTIVE

This study examined data on acute (i.e., within 30 days) increases in suicides, help and information seeking, and service capacity after a celebrity suicide.

METHODS

Daily suicide data, call volume to the National Suicide Prevention Lifeline (NSPL), and visits to two suicide prevention Web sites before and after entertainer Robin Williams' death on August 11, 2014, were examined.

RESULTS

Before August 11 in 2012, 2013, and 2014, daily suicide deaths averaged between 113 and 117; in 2014, the count increased to 142, an increase not observed in 2012 and 2013. The number of calls to the NSPL rose by up to 300%, but answered calls decreased from an average of 71% to 57%. Visits to both Web sites also increased dramatically.

CONCLUSIONS

Dramatic increases in all three measured outcomes in the days after a celebrity suicide were noted, suggesting the need for contingency plans to meet immediate increased demand.

Changing the Direction of Suicide Prevention in the United States

It is axiomatic that the goal of suicide prevention is the prevention of suicide. Yet in spite of significant efforts to this end since the middle of the last century, and most notably in the last decade, the rate of suicide in the U.S. has not declined; rather, it has increased. To address this issue, Suicide Awareness Voices of Education (SAVE) brought together leading prevention specialists from other public health problems where successes have been achieved, representatives from countries where suicide rates have declined, and U.S. based suicide prevention researchers and program directors, to "think outside the box" and propose innovative, scalable approaches that might better drive success in achieving desired results from U.S. suicide prevention efforts. The recommendations should challenge our preconceptions and force us outside our own mental constraints to broaden our perspectives and suggest catalysts for real change in suicide prevention.