Where We are Now: Youth, Social Media Use, and Suicide · Reported users are rapidly provided a personalized message with online suicide prevention and helpline information §Potential

Where We are Now: Youth, Social Media Use, and Suicide

Presented by: Nicholas Parr, MPHDoctoral Student, Prevention Science

Overview

§ Youth Social Media Use Today

§ Potential Suicide and Self-Harm Risks of Internet and Social Media Use

§ Considerations for Social Media-based Interventions

§ Survey of Suicide Detection, Prevention, and Postvention Approaches for Social Media

2

Youth Social Media Use Today

3(Statista, 2018)

N = 2,000; Sources: Edison Research, Triton Digital, MarketingCharts

Social Media Use by Platform, February 2017: Ages 12-24 Years

Youth Social Media Use Today

4(Pew Research Center, 2015)

N = 1,016; Source: Pew Research Center’s Teens Relationships Survey

Frequency of Internet Use by Teens, 2015: Ages 13-17 Years

§ 94% of teens who go online with mobile devices do so daily

§ 71% of teens use more than one social media platform

Potential Suicide and Self-Harm Risks of Internet and Social Media Use

Cyberbullying / Online Peer Victimization

§ Targeted harassment by peers toward individuals in the form of emails, social media posts, text messages, or messaging service communications

§ Surveys have reported rates of up to 40% of social media users have experienced cyberbullying

§ Has been shown to increase feelings of social isolation and hopelessness among those already experiencing mental health stressors

§ Has been associated with increased likelihood of suicide attempts among middle school children

6(Hinduja & Patchin, 2010; Hinduja & Patchin, 2011; Luxton et al., 2012)

Self-harm / Suicide Instruction & Lethal Means Access

§ Information on methods for carrying out self-harm or attempting suicide, and means with which to do so, can be accessed online

§ Social media platforms, message boards, forums, and websites can host prosuicide content, including how-to depictions and discussion of plans and motivations

§ Online pharmacy sites have been implicated in suicide deaths, having provided pharmaceutical-based means to victims

7(Beatson & Hosty, 2000; Dyson et al., 2016; Luxton et al., 2012)

Peer Influence & Extreme Behavior Normalization

§ Internet sites, including social media platforms, can provide opportunities for prosuicide peer influence to occur

§ Behaviors include encouraging suicide, idolizing those who have died by suicide, and forming suicide pacts

§ Normalization of suicide and other self-injurious behaviors has been observed in online discussion groups

§ More significant effect among individuals who are ambivalent or undecided about a suicide attempt

8(Baume, Cantor, & Rolfe, 1997; Bell, 2007; Luxton et al., 2012)

Media Contagion Effects

§ Suicide contagion via media reporting of a suicide event is well documented, and has been shown to influence suicidal ideation and methods

§ Occurrence and extent of contagion effect on social media platforms has not been extensively studied

§ Social media sites do provide an access point to media reporting of suicide events, particularly for adolescents and young adults

§ Exposure to discussion of suicide reporting on online discussion forum sites has been linked to increased suicide ideation

9(Dunlop, More, & Romer, 2011; Luxton et al., 2012)

Intervention Considerations andPotential Approaches

Considerations for Social Media-based Interventions

§ Varied and rapidly changing landscape of social media: � Social media platform popularity and functionality� User base characteristics and demographics� User engagement approaches (rates, behaviors)

§ Ethical concerns:� Frequently anonymous nature of social media use

(limits follow up to high-risk users)� Lack of widely-agreed upon research and

implementation guidelines� Platform integration challenges (e.g., lack of

developed safety and implementation monitoring protocols and systems)

11(Robinson, Rodrigues, et al., 2015)

Considerations for Social Media-based Interventions

§ Most research describes delivery of online interventions outside of social media context

§ Implementation issues are being examined:� Feasibility: Can online interventions be sufficiently

moderated to detect and intervene in emergency situations, suicide pact formation, or prosuicide peer influence

� Sustainability: New interventions must be responsive to changing social media platform technologies and user behaviors

� Safety: Whether participation in interventions induces or worsens suicide ideation

12(Rice, Robinson, et al., 2016; Robinson, Rodrigues, et al., 2015)

Approaches: Detecting Suicide Ideation Among At-risk Users

§ Currently platforms offer tools which allow users to report or “flag” posts they feel indicate suicide or self-harm ideation or behavior � Reported users are rapidly

provided a personalized message with online suicide prevention and helpline information

§ Potential future direction: Automated detection of content posted by individuals experiencing suicide ideation (Sentiment Analysis; Birjali, Beni-Hssane, & Erritali, 2017) 13

(Facebook, 2017)

Approaches: Strengths- and Skills-Building Interventions

§ Recently studied intervention used a peer-to-peer online social network focused on building mental health skillsets:� Use of strengths� Reducing rumination� Increasing self-compassion

§ High usage of intervention’s social networking system, with most participants rating the intervention as helpful

§ Significant improvements at the end of the 12-week study period in number of participants in depression remission compared to baseline

§ Showed trend of improved use of strengths among participants

14(Rice, Gleeson, et al., 2016; Rice, Robinson, et al., 2016)

Approaches: Strengths- and Skills-Building Interventions

§ Intervention focused on increasing participant skills/ capacity to: � Identify problems and tolerate distress � Employ help seeking, problem solving, coping,

and reframing behaviors

§ Exploratory study paired online, monitored CBT intervention with in-person intervention delivered by school-based mental health staff

§ Study found significant decreases in levels of suicide ideation, hopelessness, and depression symptoms, and no increase in distress or suicide ideation

15(Robinson et al., 2016; Robinson, Hetrick, et al., 2015)

Approaches: Engaging Users in Intervention Development

§ Leverages social media platforms’ high accessibility to proactively engage at-risk users in the development and use of online interventions

§ A recent pilot of a postvention intervention used a closed Facebook group to facilitate peer-led development of suicide prevention messaging to be disseminated among peer group on social media platforms

§ Intervention showed no increase in suicide ideation among participants and an increase in participant self-efficacy to safely discuss suicide with peers, and to assist their peers in seeking help

16(Rice, Robinson, et al., 2016; Robinson et al., 2017)

Social Media redefines local.

References

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