About the research

Many cases of internet-related suicide have been reported in the popular and academic press. These highlight the existence of pro-suicide discussions and online information about methods, leading to concern that the internet can promote suicide. At the same time, there has been speculation about the potential to use the internet as a way of reaching vulnerable people through online help sites, peer-support, and as a means of delivering mental health interventions.

However, little is known about how many people use the internet when they are feeling suicidal, why they do this and how they interpret the material that they view. Understanding when, how and for whom the internet is a positive or negative resource is paramount.

This research gathered the experiences of over 1,000 people who had used the internet for suicide-related purposes or knew someone who had used the internet when planning suicide. This was achieved by surveying 8000 young people in their 20s and over 1500 people of all ages who were hospitalized following suicide attempts; and by interviewing over 60 people, including those who had used the internet in the context of suicidal feelings or self-harm, as well as bereaved family or friends. Clinicians were also interviewed about their experiences of asking patients about internet use when making assessments of suicide risk.

There is an urgent need to further develop regulation, policy and best practice around internet use and internet curatorship. This policy report recommends a number of strategies ranging from working with search engine companies, transforming online help provision, and encouraging clinicians to explore patients’ internet use and support those at risk. There is also an urgent need to encourage and promote responsible practice by all internet users.

How the evidence informs policy and practice

Some clinicians were unaware that individuals used Wikipedia and medical sites to obtain information about methods; their knowledge of chatrooms and social media was also limited. While they found it acceptable to ask patients about suicide-related internet use, at times they avoided asking this directly and several were worried that asking could ‘put ideas into a patient’s head’. However, clinicians may be in a unique position to guide internet use, and knowing about internet activity could help to identify high risk patients and contribute to clinical decision-making so that patients receive better support.

‘When you actually read what [helpsites] have to say, its signposting, suggesting your GP. These are not what I would consider to be crisis interventions. When you’re two hours away from taking those pills, make an appointment with your GP – it’s not thought through…’ Participant

Summary of Key Findings

• The internet is often used by people who self-harm and/or attempt suicide to explore possible methods and read others’ personal accounts of suicidal feelings and behaviour.
• Material that is or can be harmful is abundant and easily accessed, including from popular information sites (such as the highly accessed ‘Wikipedia’), general and specialist medical sites, question and answer sites; and through social media channels.
• The internet is also used as a forum for seeking help. While some individuals derive peer support from some sites, considerable dissatisfaction was expressed with formal online help. Information online can both increase and decrease an individual’s risk of suicide.
• This research lends weight to previous suggestions that the internet may pose a particular threat to young people. Suicide-related use was more prevalent amongst young people and more often included the use of social media.

Further information

Biddle L, Derges J, Mars B, Heron J, Donovan J, Potokar J, Piper M, Wyllie C, Gunnell D. Suicide and the Internet: Changes in the accessibility of suicide-related information between 2007 and 2014. Journal of Affective Disorders, 2016. 190 p 370-375. 

Mars B, Heron J, Biddle L, Donovan J, Holley R, Piper M, Potokar J, Wyllie C, Gunnell D. Exposure to, and searching for, information about suicide and self-harm on the Internet: Prevalence and predictors in a population based cohort of young adults. Journal of Affective Disorders, 2015. 185 p 239-245. 

Gunnell D, Derges J, Chang S-S, Biddle L. Searching for suicide methods. Crisis, 2015. 36(5): 325-331. 

Acknowledgements

Prof Jenny Donovan, Dr Jon Heron, Dr Becky Mars, Dr Prianka Padmanathan, Dr John Potokar (University of Bristol); Dr Carlie Goldsmith (Samaritans); Mr Martyn Piper (PAPYRUS Prevention of Young Suicide); Mr Chris O’Sullivan, Dr Rachel Holley (advisers); the Liaison Psychiatry teams at Bristol Royal Infirmary and Southmead Hospital, Bristol; and the Avon Longitudinal Study of Parents and Children (ALSPAC).

All material presented is drawn from independent research commissioned and funded by the Department of Health Policy Research Programme (“Exploring the use of the internet in relation to suicidal behaviour: identifying priorities for prevention”: PRP023/0163). The views expressed are those of the authors and not necessarily those of the Department of Health.