Suicidal behaviours and moderator support in online health communities: a scoping review

Abstract

ObjectivesOnline support can be a crucial source of support for individuals experiencing suicidal behaviours, with forum moderators being pivotal in terms of the role they play in times of personal mental health emergencies. This study identified what is empirically known about the professional practices of health professionals who are online mental health forum moderators and provide support to individuals experiencing suicidal behaviours.DesignThe Levac, Colquhoun and O’Brien extension of the Arksey and O’Malley scoping review framework was used.Search strategyThe Psychology Collection (EBSCO), PsycINFO (EBSCO), Web of Science, Taylor and Francis Online, SAGE Journals and Science Direct databases were searched for articles that featured a result relating to an online forum; included participants who worked as online moderators or facilitators and focused on suicide or self-harm. Results were limited to peer-reviewed articles published in English from 1990 onwards. As a quality assurance measure, grey literature (nonacademic literature) was not included. Reference lists of included articles were hand-searched.ResultsThere were 397 articles initially identified after applying inclusion and exclusion criteria, with five articles included for synthesis. All articles received a moderate quality rating. Only one article featured a moderator who was a qualified health professional; the moderators in the remaining articles were volunteers who undertook preservice training. We found that there is little research that examines the professional working practices of online moderators who support individuals experiencing suicidal behaviours.ConclusionsThe dearth of research focusing on the professional practices of online forum moderators is cause for concern given that individuals experiencing suicidal behaviours are increasingly turning to online forums when in crisis. Future research should focus on online moderators’ practice through interviewing moderators about their professional practices and by examining online moderator practice as it occurs in situ.

Identifying key challenges and needs in digital mental health moderation practices supporting users exhibiting risk behaviours to develop responsible AI tools: the case study of Kooth

“…moderators prompting at-risk users to access counselling services, or counsellors being active in online moderation). Digital counselling, despite its increasing popularity, is a service still considered complex and controversial (Hendry et al 2017;Saha et al 2020;Stoll et al 2020;Perry et al 2021;Barker and Barker 2022;Khan et al 2022). In digitally mediate service encounters, counsellors deal with relatively new challenges, mostly linked to the increased accessibility and participation to the services offered, but also linked to the type of interactions they come across (which entail, for instance, reduced emotional proximity and the absence of non-verbal cues, see Bambling et al 2008), their broader administrative tasks (Tummers et al 2015;Breit et al 2021), and risks of vicarious traumatisation (Furlonger and Taylor 2013).…”

Online suicidal thoughts and/or behaviours talk: A scoping review protocol

“…A quality assessment limitation will also be implemented during the search stage. Although quality or critical assessment of studies is not a scoping review requirement [ 56 , 57 ], some published scoping review protocols [ 68 , 69 ] and reviews [ 70 – 73 ] include such an assessment. Further, as one of the purposes of the proposed review is to identify gaps in the literature, quality assessment has been recommended in such situations [ 74 ].…”

“…Reviewer 1 will engage in extracting data from the remaining studies with reviewer 2 undertaking an audit of a random selection of 20% of the remaining extractions to check for errors, omissions, and biases. The 20% figure has been used in a number of reviews as an appropriate study audit percentage [ 70 , 71 , 75 ]. This audit also offers an opportunity for further refinement of the extraction form.…”

“I Want to Be Stepping in More” - Professional Online Forum Moderators' Experiences of Supporting Individuals in a Suicide Crisis

“…A scoping review undertaken by Perry et al ( 18 ) that examined suicidal behaviors and moderator support in online mental health communities, found limited research focused specifically on moderator experiences. The research that they did identify focused on peer moderators ( n = 4) rather than professional moderators ( n = 1).…”

“…Within this study suicide prevention is defined as the identification of risk and subsequent interventions employed to prevent an at-risk individual from moving from suicidal ideation to suicide attempt ( 22 ). We chose to specifically focus on professional moderators, because of the different skills that these moderators bring to the online space ( 18 ); the different ways they can work with individuals who are in crisis compared to peer moderators ( 23 ); and the different responsibilities they may have toward users in preventing suicide. As demand for online support increases, it is likely that more qualified health professionals will be working in online mental health forums in the future to meet this increased user demand.…”