Since the first documented Internet suicide pact in Japan in 2000, public health officials have struggled to understand what role the Web plays in suicidal behavior. A new study suggests that social media is only making it more difficult to find answers to those questions.

Social media sites have increased both the rate of suicide and efforts to prevent suicide, according to a study published this month in the American Journal of Public Health. Online forums, including mainstream social networks such as Facebook and YouTube and more dedicated, pro-suicide chat rooms and message boards, are raising concerns. But at the same time, researchers see opportunities to use social media to identify people at risk for suicide and intervene.

The study by David D. Luxton, Jennifer D. June and Jonathan M. Fairall for the National Center for Telehealth and Technology comes in response to several high-profile cases of cyberbullying that lead to suicide. It follows up on similar studies that have made preliminary findings in the field and started debate in public health and policy circles.

The report also raises issues about how difficult it is to study the subject. 

Suicide has a low base rate of about 300,000 per year in the U.S. and 1 million worldwide, which makes it difficult to study, regardless of the context. Add in the complexities of variable use patterns of social media, and it gets even more difficult to understand what role social media plays in suicidal behavior and whether it can effectively predict risk factors, the authors said. 

Increased Access to Suicide Information Can Have Consequences

Among the ways social media may be helping to encourage suicidal behavior:

  • In preliminary studies, increased Internet use in a country has been tied to increased suicide rates (Japan, for example, recorded 34 suicides in 2003 and 91 suicides in 2005).
  • Cyberbullying has been tied, both anecdotally and empirically, to increased suicide risks, particularly among adolescents.
  • Social media may help people form suicide pacts. “Traditional suicide pacts have typically developed among individuals who know each other, such as a couple or friends,” the study noted. “A primary characteristic that differentiates cybersuicide pacts from traditional suicide pacts is that these pacts are usually formed among complete strangers.”
  • The Internet gives people access to “how-to” methods for committing suicide. One recent study found that “of 719 individuals aged 14 to 24 years, 79% reported being exposed to suicide-related content through family, friends, and traditional news media such as newspapers, and 59% found such content through Internet sources.”
  • Video sites, including YouTube, are increasingly playing a role in exposing people to “pro-suicide” and self-harm content.

“In sum, evidence is growing that social media can influence pro-suicide behavior,” according to the study's researchers. “Because the Internet eliminates geographic barriers to communication between people, the emergence of pro-suicide social media sites may present a new risk to vulnerable people who might otherwise not have been exposed to these potential hazards.”

Social Media Offers Signs of Hope

The study did, however, offer some reason for optimism and laid out a framework for further study. It pointed to efforts by Facebook to make it easier for users to report people they were worried about who may be using the social network to share suicide warning signs. The report also mentioned efforts by the U.S. military to use social media as a suicide prevention tool.

Other sites, such as YouTube and dedicated websites, have been used to share content to raise awareness about the problem and direct people to help.

“Those administering suicide prevention and outreach public health campaigns must also stay current with social media trends and user preferences, as well as pertinent legal issues,” the report concluded. “Ultimately, proactively using social media to increase public awareness of and education on mental health issues is a logical modern public health approach that can potentially save lives.”