Research reportSuicide and the Internet: Changes in the accessibility of suicide-related information between 2007 and 2014
Introduction
Against a backdrop of rapid developments in the online environment over more than a decade, there have been a substantial number of cases of suicide in which the Internet has been implicated. These have included instances of cyber-bullying and cluster suicides (Birbal et al., 2009, Boyce, 2010, Becker and Schmidt, 2004, Cheng et al., 2012, Daine et al., 2013). Scrutiny of the Internet and social media has also emerged within academia, where a small number of empirically-based studies have been conducted looking at use of the Internet and its relationship to self-harm and suicide (Baker and Fortune, 2008; Barak, 2007; Biddle et al., 2012; Cash et al., 2013; Collings and Niederkrotenthaler, 2012; Dunlop et al., 2011; Gilat and Tobin, 2009; Harris et al., 2014; McCarthy, 2010; Mitchell and Ybarra, 2007; Sisask and Varnik, 2012). These studies have identified the potentially beneficial as well as harmful effects of the Internet on suicidal behaviour whilst emphasising its mixed content (Gunn and Lester, 2013, Hagihara et al., 2012, Westerlund, 2011, Yang et al., 2011), which allows individuals who are suicidal to access help but also the information with which to make a suicide attempt (Alao et al., 2006, Daine et al., 2013, Durkee et al., 2011, Sueki et al., 2014).
In recent years there have been a series of Internet search studies investigating the ease with which a suicidal individual can access information about suicide on the web and what they might find when searching for information about methods (Biddle et al., 2008; Till and Niederkrotenthaler, 2014; Pirkis et al., 2006; Recupero et al., 2008; Sakarya et al., 2013; Wong et al., 2013). These studies show that information on suicide is readily available; through news sites, factual information-based sites and within dedicated or ‘pro-suicide’ sites. However, the online environment is evolving and becoming more complex (Daine et al., 2013, Hitosugi et al., 2007). In particular, there has been an expansion in user-generated content, both social and information-based, such as personal websites and participation in interactive discussion forums and chat rooms, thus expanding opportunities to access and exchange information on a global scale. This is perhaps especially pertinent where site moderation is limited, or even absent.
To begin assessing the impact of such changes on online content, we replicated our Internet search study of 2007 (Biddle et al., 2008) examining what a suicidal individual might find on searching the web for information on suicide methods. As in 2007, the study reported here focused specifically on searches for methods of suicide rather than help or support, in order to establish specifically, what someone who is suicidal and looking for methods would find on the Internet. This will assist in addressing some of the concerns currently being expressed in the media and the public health sector (Gov. Report, DOH, 2014; Gunnell et al., 2012; Boyce, 2010; Barak, 2007). As well as directly comparing our findings with those obtained in 2007, we expanded our analysis to explore in more detail the content of the sites retrieved by focussing on additional themes such as: peer support, images, site moderation and help offered within discussion forums and blog sites. The study also took into consideration new and emerging methods of suicide that were being discussed online and which were reported to be increasing as methods of suicide, both in the UK and other parts of the world (Grassberger and Krauskopf, 2007, Howard et al., 2010; WHO, 2014).
Section snippets
Search strategy
We conducted Internet searches between February and March 2014 using the same 12 search terms as those in our previous study (Biddle et al., 2008): (a) suicide, (b) suicide methods, (c) suicide sure methods, (d) most effective methods of suicide, (e) methods of suicide, (f) ways to commit suicide, (g) how to commit suicide, (h) how to kill yourself, (i) easy suicide methods, (k) best suicide methods, (l) pain-free suicide and, (m) quick suicide. These were selected as terms a suicidal user
Results
We visited and analysed 480 web addresses (‘hits’) and 135 different sites (taking account of duplicate hits). This compared to 240 different sites from the 480 hits in our 2007 search.
The frequency and accessibility of hits in the two time periods is shown in Table 2. In 2014, 111 (23.1%) hits were for dedicated suicide sites, somewhat higher than the number in 2007 (90 (19%)), the main growth occurring in relation to hits describing methods without specifically encouraging suicidal behaviour
Discussion
Our updated search of the Internet for suicide methods showed that dedicated, pro-suicide sites were slightly more prominent amongst the hits returned in our 2014 search compared to 2007. Hits for prevention and support sites had reduced by nearly half, whereas factual information sites – many of which provide highly explicit ‘how to’ information on methods – had tripled. Information sites also typically ranked the highest in searches showing they are easily accessed. Google searches returned
Acknowledgments
We are extremely grateful to Mike Matthews for running the 2014 searches for this study. We also thank Rachel Holley, Jen Russell and Chris O’Sullivan for their comments during the planning of this study, and Rachel Holley for her comments on a draft of the paper.
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