The association between Twitter content and suicide

Abstract

Objective: A growing body of research has established that specific elements of suicide-related news reporting can be associated with increased or decreased subsequent suicide rates. This has not been systematically investigated for social media. The aim of this study was to identify associations between specific social media content and suicide deaths. Methods: Suicide-related tweets ( n = 787) geolocated to Toronto, Canada and originating from the highest level influencers over a 1-year period (July 2015 to June 2016) were coded for general, putatively harmful and putatively protective content. Multivariable logistic regression was used to examine whether tweet characteristics were associated with increases or decreases in suicide deaths in Toronto in the 7 days after posting, compared with a 7-day control window. Results: Elements independently associated with increased subsequent suicide counts were tweets about the suicide of a local newspaper reporter (OR = 5.27, 95% CI = [1.27, 21.99]), ‘other’ social causes of suicide (e.g. cultural, relational, legal problems; OR = 2.39, 95% CI = [1.17, 4.86]), advocacy efforts (OR = 2.34, 95% CI = [1.48, 3.70]) and suicide death (OR = 1.52, 95% CI = [1.07, 2.15]). Elements most strongly independently associated with decreased subsequent suicides were tweets about murder suicides (OR = 0.02, 95% CI = [0.002, 0.17]) and suicide in first responders (OR = 0.17, 95% CI = [0.05, 0.52]). Conclusions: These findings largely comport with the theory of suicide contagion and associations observed with traditional news media. They specifically suggest that tweets describing suicide deaths and/or sensationalized news stories may be harmful while those that present suicide as undesirable, tragic and/or preventable may be helpful. These results suggest that social media is both an important exposure and potential avenue for intervention.

Suicide-related Twitter Content in Response to a National Mental Health Awareness Campaign and the Association between the Campaign and Suicide Rates in Ontario

“…As previously described, social learning theory predicts that Werther narratives, if propagated through BLTD, could cause harm while Papageno narratives might confer benefit. [9][10][11][12] Examining suicide counts, we did not find evidence of either a Werther or Papageno effect. It is, however, notable that tweets related to suicide much more commonly emphasized the problem of suicide and death by suicide than putatively protective/Papageno content.…”

“…17 However, groups of tweets with specific putatively harmful and protective content were associated with subsequent increases and decreases in suicides respectively. 12 Therefore, the results presented here identify a potential opportunity for BLTD organizers and others promoting large mental health–related events on social media to improve discourse surrounding suicide and its prevention. This may be especially important given that people who experience suicidal ideation, particularly youth, are often social media users and frequently use it as a platform to communicate distress.…”

“…To assess the relationship, counts of suicide in Ontario obtained from the Office of the Chief Coroner were compared between "exposure" and "control" windows in 2011 to 2016 (i.e., years in which the campaign occurred) according to previously established procedures. 12,13,14 Exposure windows were predefined as 7-day epochs spanning day 0 to day þ6 with day 0 specified as BLTD in each year. Two control windows of the same length (day À14 to day À8 and À21 to À15) were used as comparators.…”

“…9 Alternatively, media reports emphasizing coping and resilience in the face of suicidal crises can be associated with fewer suicides across a population, a phenomenon known as the Papageno effect. [10][11][12] Based on social learning theory, we would expect that Werther narratives disseminated as part of MHA campaigns like BLTD could cause harm while Papageno narratives might confer benefit.…”

A Pilot Case-Control Study of the Social Media Activity Following Cluster and Non-Cluster Suicides in Australia

“…Whether social media confers harm or benefit may depend on the content that is shared through it. We have examined the kind of content that might be described as “putatively harmful” and “putatively protective” [ 23 ]. The former might include content that describes a suicide in detail (e.g., providing explicit information about the suicide method) or sensationalises the death, and the latter might include content that presents suicide as undesirable or tragic outcome that can be prevented [ 23 ].…”