Suicide Prevention and the Internet

From: The Centre for Suicide Prevention

In the last decade, the Internet has experienced a phenomenal growth as technology costs continue to fall and more and more people have mainstream access to the network. Statistics show that the Internet represents an increasingly important medium, especially among adolescents and young adults who use it as a source of information and communication. A recent study by Statistics Canada (2001) showed that 90% of 15-19 year old teenagers had used the Internet in 2000, compared to 53% for the overall population. Since the younger age group is characterized by high suicide rates, it would be wise for the suicide prevention community to capitalize on new Internet-based prevention opportunities while anticipating potential new
challenges.

Suicide Prevention on the Internet
Vulnerable and at-risk individuals accessing the Internet can find useful information and support through a variety of Internet services including: informative websites, discussion or support groups, and one-on-one counselling or support.

1. Web Sites
Websites often represent the first contact for users and the first opportunity for the suicide prevention community to reach out to individuals who may be vulnerable or suicidal. The great majority of websites currently dealing with suicide are thoughtfully designed and offer a wealth of helpful information. Many organizations, like the Centre for Suicide Prevention (www.suicideinfo.ca), provide lists of suicide risk factors, warning signs, and guidelines on how best to respond to a friend or loved one in a suicidal crisis. Individuals at imminent risk for suicide are usually directed to a crisis center or help line in their region. Information about suicide risk and prevention can be widely distributed at low cost to vulnerable people, many of whom may choose not to access more traditional services.

2. Discussion and Support Groups
The Internet also offers a variety of more interactive services to users. News groups (often referred to as discussion groups or bulletin boards) and mailing lists are services which are open to the free exchange of ideas between users. It is now possible for people to share ideas and feelings across vast distances and with enormous numbers of people. Well moderated discussion groups can serve as an opportunity for vulnerable individuals to share emotional struggles and get the social support that may be lacking in their own social network. Used in this way, Internet discussion groups may contribute to a reduction in suicide risk. However, the true effectiveness of online support groups is difficult to measure since there is little chance to assess users’ true experiences in “real life” beyond their input
within the on-line group (Stoney, 1998).

3. One on One Counselling or Support
The Internet also offers an electronic means of communication, the most popular being electronic mail, or e-mail. Internet-based modes of communication represent a new opportunity for the provision of counselling or emotional support to vulnerable individuals by trained volunteers or counselolrs. As with telephone befriending, communication is typically initiated by the vulnerable individual via e-mail or a real-time chat service. Once the initial contact is made, e-mail messages between the at-risk person and the volunteer or counsellor are exchanged over a period of time (Wilson & Lester, 1998). In the case of a chat service, a vulnerable individual can “talk” privately with a counsellor or trained volunteer in real-time. These innovative communication methods offer significant privacy for the client, even more so than with the telephone. Interestingly, preliminary research has shown that the percentage of people who are suicidal is much higher among e-mail contacts than among telephone callers or walk-ins (Bale, 2001; Wilson & Lester, 1998).

Examples of Preventive Internet Services
Youth One: Online Support Group and Crisis Chat. ---Youth One (www.youthone.com) offers Peer Support Forums and Crisis Chat services to the on-line youth community. The monitored Peer Support Forums allow youth to post and receive messages from their on-line peers. Vulnerable youth can also “talk” in real-time with a trained Support Team member through the Crisis Chat service. Between April 2002 and March 2004, the site saw a 275% increase in the use of the Peer Support Forums and close to a 2000% increase in individuals accessing the Crisis Chat
service, many with suicide related concerns (Osbourne, 2004).

Youth in BC: Crisis Chat and E-mail counselling. ---Youth in BC (www.youthinbc.com) is an innovative internet based resource for youth in crisis that has been operating since February 2004. The site presents information on a variety of topics, including suicide, and links vulnerable youth with trained volunteer listeners (who are supported by professional counsellors) through a real-time chat service, e-mail communication, or the more traditional toll-free telephone number (Miller J. et al., 2004).

Samaritans: E-mail counselling.
In 1994, the Samaritans of the United Kingdom and Republic of Ireland decided to enhance their already well-established befriending services by adding the option of e-mail contact as another means for offering emotional support. A 1999 survey showed that 53% of e-mail contacts had suicidal feelings, compared to 26% of telephone callers. It has also been observed that men are using the e-mail service more than women by ratio of two-to-one (Bale, 2001).