Social media and suicide is a relatively new phenomenon, which concerns social media’s influence on suicide-related behavior. Suicide is a leading cause of death worldwide: approximately 1.54 million people will die from suicide in the year 2020, according to the World Health Organization. Suicide has been identified not only as an individual phenomenon, but as being influenced by social and environmental factors, and there is increasing evidence that the Internet and social media can influence suicide-related behavior. As the internet becomes more ingrained in people’s everyday life, the mental and emotional damage it can potentially cause to an individual increases.
There is increasing evidence that the Internet and social media can influence suicide-related behavior. Important questions are whether this influence poses a significant risk to the public and how public health approaches might be used to address the issue. To address these questions, we provide an overview of ways that social media can influence suicidal behavior, both negatively and positively, and we evaluate the evidence of the risk. We also discuss the legal complexities of this important topic and propose future directions for research and prevention programs based on a public health perspective.
Public health is concerned with protecting and improving the health of entire populations,whether those populations are small commu-nities or large nations. Social media, as weunderstand it today, has created virtual com-munities without physical borders. We havepresented evidence showing that social mediamay pose a risk to vulnerable groups who arepart of these virtual communities. We have also provided some examples of extant social me-dia—based prevention applications and pro-grams that follow from a public health—basedapproach. Framing the topic of social media and suicide from a public health perspective toaddress the issue and guide prevention pro-grams makes sense.More research is needed on the degree andextent of social media’s negative and positiveinﬂuences, as are evaluations of the effective-ness of social media—based suicide preventionprograms. Further examination of subgroups that might be most vulnerable to suicide-pro-moting inﬂuences of social media is also war-ranted. A focus on adolescents and youngadults is intuitive given that suicide is the thirdleading cause of death among these groups andthat these groups have a high likelihood ofencountering suicide-associated content on theInternet. 24,33,69,70Moreover, people withmental illness and alcohol and substance abuseproblems, who may already be at high risk for suicide,71may be more likely than others touse the Internet to discuss and learn about suicide methods.6Preliminary data have also been gathered regarding gender-based risk.Clarke and van Amerom72examined blogscreated by depressed people and found thatdepressed men were more likely thandepressed women to discuss suicide or self-harm via blogs. Ultimately, additional researchin this area will help to inform public health—based approaches to suicide prevention.Several signiﬁcant difﬁculties emerge, how-ever, when conducting research on this topic.First, conducting research with suicide rates asan outcome variable is difﬁcult because ofsuicide’s low base rate. Moreover, the variabil-ity in social media format, use patterns, andother inﬂuences on suicidal behavior makesit very difﬁcult to test social media as a variablethat predicts suicidal behavior. For example,an increased prevalence of other risk factors,such as alcohol use and availability of ﬁrearmsamong teens, might also explain the rise insuicide rates among this vulnerable group.73Moreover, the causal role of social media ina person’s decision to die by suicide or toacquire the means to do so may not be direct.That is, whether an at-risk person is morelikely to die by suicide because he or she canobtain information about it via the Internetcannot be easily demonstrated.Legal issues must also be considered whencontemplating public health approaches toaddressing some of the problems of socialmedia and suicide. In particular are the legalcomplexities associated with the monitoringand ﬁltering of content on the Internet. Al-though some countries are able to controlInternet Web sites created within their borders,international jurisprudence makes it difﬁcult toobtain jurisdiction over sites that originateoutside the United States.74,75Debate has alsoarisen as to whether the public sector or theprivate sector should be responsible forrestricting content on the Internet and howmuch restriction should be allowed.75In gen-eral, the Internet is less regulated than otherforms of media. Fiedorowicz and Chigurupati6pointed out that when radio, television, andnewspapers broadcast or publish material ofquestionable intent or accuracy, they may bescrutinized by regulators or possibly lose rat-ings as a consequence. The generation andtransmission of information via the Internetand social media, however, are decentralizedand constantly being changed and updated byend users. Thus, the Internet is an opengateway with few restrictions on content.Ultimately, the control of Internet content in-volves First Amendment rights of freedom ofspeech and expression. Restrictions on Internetcontent may possibly present a slippery-slopeproblem that can lead to additional restrictionsof these rights.The role of social media and its potentialinﬂuence on suicide-related behavior is a rela-tively new and evolving phenomenon thatsociety is only beginning to assess and un-derstand. The emerging data regarding theinﬂuence of the Internet and social media onsuicide behavior have suggested that theseforms of technology may introduce new threatsto the public as well as new opportunities forassistance and prevention. Because social me-dia are mostly created and controlled by endusers, the opportunity for surveillance andprevention can be extended to all users. Tohelp facilitate this user-driven approach tosurveillance and prevention, all social mediasites could adopt simple-to-use methods forusers to report malicious Web sites and activ-ities of other users. Moreover, the public pro-motion of direct and easy avenues for people toaccess help through social media sites shouldbe a priority. Public health campaigns thatleverage the Internet and social media to raiseawareness of the issue in schools, colleges,and other settings might also be beneﬁcial.Those administrating suicide prevention andoutreach public health campaigns must alsostay current with social media trends and userpreferences, as well as pertinent legal issues.Ultimately, proactively using social media toincrease public awareness of and educationon mental health issues is a logical modernpublic health approach that can potentiallysave lives.