Where We are Now: Youth, Social Media Use, and Suicide. Presented by: Nicholas Parr, MPH Doctoral Student, Prevention Science

Transcription

1 Where We are Now: Youth, Social Media Use, and Suicide Presented by: Nicholas Parr, MPH Doctoral Student, Prevention Science

2 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

3 Youth Social Media Use Today Social Media Use by Platform, February 2017: Ages Years (Statista, 2018) N = 2,000; Sources: Edison Research, Triton Digital, MarketingCharts 3

4 Youth Social Media Use Today Frequency of Internet Use by Teens, 2015: Ages Years 94% of teens who go online with mobile devices do so daily 71% of teens use more than one social media platform (Pew Research Center, 2015) N = 1,016; Source: Pew Research Center s Teens Relationships Survey 4

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

6 Cyberbullying / Online Peer Victimization Targeted harassment by peers toward individuals in the form of s, 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 (Hinduja & Patchin, 2010; Hinduja & Patchin, 2011; Luxton et al., 2012) 6

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

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

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

10 Intervention Considerations and Potential Approaches

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

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

13 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) (Facebook, 2017) 13

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

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

16 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 selfefficacy to safely discuss suicide with peers, and to assist their peers in seeking help (Rice, Robinson, et al., 2016; Robinson et al., 2017) 16

17 Social Media redefines local.

18 References Bach, D. (2015). Forefront and Facebook launch suicide prevention effort. Retrieved December 14, 2017, from Baume, P., Cantor, C. H., & Rolfe, A. (1997). Cybersuicide: The role of interactive suicide notes on the Internet. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 18(2), Beatson, S., & Hosty, G. (2000). Suicide and the Internet. Psychiatric Bulletin, 21(11), 434. Bell, V. (2007). Online information, extreme communities and internet therapy: Is the Internet good for our mental health? Journal of Mental Health, 16(4), Birjali, M., Beni-Hssane, A., Erritali, M. (2017). Machine learning and semantic sentiment analysis based algorithms for suicide sentiment prediction in social networks. Procedia Computer Science, 113(2017), Dunlop, S. M., More, E., & Romer, D. (2011). Where do youth learn about suicides on the Internet, and what influence does this have on suicidal ideation? Journal of Child Psychology and Psychiatry and Allied Disciplines, 52(10), Dyson, M. P., Hartling, L., Shulhan, J., Chisholm, A., Milne, A., Sundar, P., Newton, A. S. (2016). A systematic review of social media use to discuss and view deliberate self-harm acts. PLoS ONE, 11(5). Hinduja, S., & Patchin, J. W. (2010). Bullying, cyberbullying, and suicide. Archives of Suicide Research, 14(3), Hinduja, S., & Patchin, J. W. (2011). High-tech cruelty. Educational Leadership, 68(5), Luxton, D. D., June, J. D., & Fairall, J. M. (2012). Social media and suicide: A public health perspective. American Journal of Public Health, 102(Suppl. 2), Pew Research Center. (2015). Teens, Social Media & Technology Overview Retrieved on March 12, 2017, from Rice, S., Gleeson, J., Davey, C., Hetrick, S., Parker, A., & Alvarez-Jimenez, M. (2016). Moderated online social therapy for depression relapse prevention in young people: Pilot study of a next generation online intervention: Online depression relapse prevention. Early Intervention in Psychiatry. Rice, S., Robinson, J., Bendall, S., Hetrick, S., Cox, G., Bailey, E., Alvarez-Jimenez, M. (2016). Online and social media suicide prevention interventions for young people: A focus on implementation and moderation. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 25(2), Robinson, J., Bailey, E., Hetrick, S., Paix, S., O Donnell, M., Cox, G., Skehan, J. (2017). Developing social media-based suicide prevention messages in partnership with young people: Exploratory study. Journal of Medical Internet Research: Mental Health, 4(4). Robinson, J., Hetrick, S., Cox, G., Bendall, S., Yuen, H., Yung, A., & Pirkis, J. (2016). Can an Internet-based intervention reduce suicidal ideation, depression and hopelessness among secondary school students: Results from a pilot study. Early Intervention in Psychiatry, 10(1), Robinson, J., Hetrick, S., Cox, G., Bendall, S., Yung, A., & Pirkis, J. (2015). The safety and acceptability of delivering an online intervention to secondary students at risk of suicide: Findings from a pilot study. Early Intervention in Psychiatry, 9(6), Robinson, J., Rodrigues, M., Fisher, S., Bailey, E., & Herrman, H. (2015). Social media and suicide prevention: Findings from a stakeholder survey. Shanghai Archives of Psychiatry, 27(1), Statista. (2018). Reach of leading social media and networking sites used by teenagers and young adults in the United States as of February Retrieved March 9, 2017, from 18