Christopher St. Germain, Ph.D.
AbstractThis paper examines the technological changes in suicide prevention outreach efforts being utilized through social media and other online formats. Research has shown that suicide remains a common threat to many Americans. The creation of mobile apps, blogs, websites, hotlines, and chat rooms have changed the way that suicide prevention is conducted and the way that it reaches individuals in the community who may be suffering. The new developments in suicide prevention are not only targeting those experiencing suicide ideation, but also allows for resources for individuals who may know someone with suicidal ideation and who want to help. This paper explores some of the benefits and drawbacks of these technological changes and the incorporation of the cyber world on outreach efforts to help prevent suicide. Suicide prevention strategies have continued to evolve across the globe as new opportunities for prevention through online methods have become available. Suicide remains a common threat for many Americans. While there were noted drops in the national suicide rate between the years 1990 and 2000, a 2013 Centers for Disease Control and Prevention (CDC) report indicates a continuous increase of suicides over the last several years. While the exact cause of this rise in suicide completion remains uncertain and complex, many researchers believe that it may have something to do with the life and financial circumstances unique to individuals from the generation of baby boomers. The impact of this boost in suicides is felt in communities, workplaces, and families. Most recently, it has come to the attention of many that this concerning trend is also infiltrating institutions of higher education. The National Alliance on Mental Illness (NAMI) conducted a national survey of college students and reported that several colleges are reporting an increase in the prevalence and severity of mental illness on college campuses (NAMI, 2012). While this may be a positive indication that many students with severe mental illness are now securing educations that will be helpful for their future, it also brings severe mental illness into a more obvious light on campuses nationwide and illustrates the importance of providing resources to meet the increasing demands. Davenport (2009) found that there has been a shift in the role of counselors on college campuses. This shift has created a need for college counselors to become “risk managers,” due to the increased demands and expectations of duties. Suicide remains the second leading cause of death for college-aged students (CDC, 2013) and research suggests that there may be developmental and external factors contributing to this. Students in college are more likely to be impulsive and attracted to risky behaviors than older adults. Additionally, the adjustment to college and, to a larger extent, to adulthood can be fraught with stress and challenges. Pair this with abnormal sleep schedules, academic and familial pressures, separation from home, and typical biological changes associated with young adult development and college students appear to be a potentially vulnerable target to suicidal ideation. Research would indicate that the impact of social media may also contribute to college student suicide risk. Things like cyber bullying, cyber harassment, and cyber stalking can leave someone feeling victimized, vulnerable, and further isolated from others (Luxton, June, & Fairall, 2012). The use of chat rooms and message boards can open the door for like-minded people to find one another. If these individuals were suicidal this could create further devotion to their current thinking. It could also contribute to establishing suicidal pacts- which is a topic that has been widely discussed across social media platforms (Luxton et al., 2012). The Internet also contains several sites that provide step-by-step how-to instructions (some with videos) on how to complete suicide. To a distressed college student, these elements of social media could contribute to a very dark and difficult spiral. Social media, however, has also created several new forms of combating suicide and has introduced some resources that may be saving lives. With the increased mental health needs on college campuses and the often unavailable resources for these students, this type of intervention could not have come at a better time! These online resources and mobile applications are intended to fill the gap between available services and the needs for communities at risk. Downloadable apps like HELP Prevent Suicide, Suicide Crisis Support (for Android), Suicide Lifeguard, Ulster County SPEAK, Just in Case, and After Deployment are just some of the many mobile applications available at a person’s fingertips for suicide prevention using cell phones or other mobile devices. Aguirre, McCoy, and Roan (2013) investigated 27 available mobile apps intended to assist with suicide prevention. In their research they identified that there are several benefits to having mobile applications targeted to individuals with suicidal ideation and intent. Some of these benefits include providing immediate care to individuals who are on a waiting list for services, assisting people who will not or are not eligible to access services, and providing care to those who may be geographically distant from services (Aguirre et al., 2013). This study also highlights some of the features available on these suicide prevention mobile apps. Some apps, for example, use Global Positioning Systems (GPS) to track where application users are located (Aruirre et al., 2013). This can be highly advantageous in these crisis emergency situations because when a location of a suicidal individual is known, emergency medical personnel may be dispatched to their location and can bring them to the hospital or other necessary treatment facilities. In a sense, downloading one of these apps on a phone may provide a struggling individual with the support that they need at their fingertips. In addition to mobile applications, individuals who may be at risk of suicide can also access suicide prevention websites, hotlines, or online chat rooms. These additional modalities share many of the benefits of the mobile applications for suicide prevention. They are also easily accessible to people in need of care but who may not have the means, access, or eligibility to access it. Sites like that of the National Suicide Prevention Lifeline (http://www.suicidepreventionlifeline.org) offer multiple modalities to assist people who need immediate assistance. This website includes a toll free 24/7 phone line, a chat program, referral sources for mental health providers, and psychoeducation to those who access this site. By allowing different modalities of outreach, individuals may be able to use the methods they feel most comfortable with when reaching out for help. There are a number of national campaigns and organizations with an online presence that aim to protect individuals from suicide. The “It Gets Better Project” (http://www.itgetsbetter.org/), for example, is a campaign intended to aid in the prevention of suicide of lesbian, gay, bisexual, and transgender youth around the world. According to the CDC (2011), lesbian, gay, and bisexual (LGB) youth are four times more likely to attempt suicide as their straight peers. The “It Gets Better Project”, originally developed in 2010, uses social media and popular websites like YouTube to post videos of individuals providing hope to LGB youth who are struggling with suicidal ideation. This project, which now also has an international presence, includes videos from every day people, corporations, politicians, famous actors, musicians, comedians, and even President Barack Obama. These creative uses of online platforms as a tool for suicide prevention help to reach a large community. Many of these mobile applications, hotlines, and online services are free of charge and are available to anyone with internet capability. Individuals who do not have personal internet or mobile devices may still have access to these resources through online capabilities in their local schools or public libraries. For a society that has a strong dependency on technology, these services provide a potentially life-saving resource to individuals struggling with suicidal ideation or intent, and reaches potentially struggling individuals in ways that traditional care and services have not historically been able to. According to the CDC (2013), there were 41,149 documented completed suicides in the United States in 2013. It has been voluminously documented that suicide impacts more than just the individual who is contemplating, attempting, or who has completed suicide. It can significantly impact a person’s family, friends, and support network, too. For many who are not familiar with what to do in a crisis situation like suicide or who feel helpless watching a loved one suffer, modern technology has also provided mobile applications, websites, blogs, and other cyber modalities to get the support and information needed to help someone that may be struggling. For example, The Jason Foundation (http://jasonfoundation.com/), an organization aimed to prevent youth suicide, developed a mobile application called “A Friend Asks.” This free app provides essential information and resources to individuals who are concerned about the safety of someone they know. It includes information that may be helpful in situations where someone may be struggling, like identifying the warning signs of suicidal ideation, how to connect a friend a help and resources, how to act immediately in the event of a suicidal emergency, and the “dos and dont’s” of what to say when reaching out to someone. Individuals who are concerned about someone else’s suicidal ideation may benefit from downloading this or similar apps to their phones/laptops/tablets/computers to have handy in the event of an emergency. Individuals may also benefit from downloading some of the online resources targeting individuals with suicidal ideation so that they may be able to share these with a friend who may be struggling. While these technological resources offer much in the way of benefits, there are limitations to the services they can provide. First, these resources may be little to no use for those whom technological devices and online access are unattainable or not accessible. There are also some concerns with the anonymity for many users on these applications/websites/phone lines. While this anonymity may seem desirable for people who are struggling and want their personal information unknown, it can have drawbacks (Aguirre et al., 2013). It is important for someone who is having frequent suicidal ideation or any suicidal intent to connect with a professional in the mental health field. By not gathering any information on their users, many of these resources offer little to no help in allowing the appropriate professional and medical services to locate the users and provide them with the emergency services they may need. While there are some applications that are equipped with GPS, many are not. It is also important to note that these resources should not be used as a replacement to seeking appropriate mental healthcare. Individuals with concerns about the safety of others should educate themselves on the topic of suicide and become familiar with the warning signs. This can be done by speaking with professional mental health workers or by using some of the suicide prevention technologies available. It is important that a concerned individual speaks up, acts quickly, and connects the suicidal individual with a professional. These latest technologies in suicide prevention help to make this possible and quicker than in the past. If the threat of harm is immediate and emergency services are needed right away, an individual should call 9-1-1 rather than trying to access these suicide prevention technologies. As the technological world continues to advance, the integration of these technologies begins to offer services that were previously unavailable. The integration of technology in mental health has shown great promise in specific areas, like suicide prevention. These advances provide important information, resources, and sometimes, important person-to-person connections that may just save a life. With the use of technology, mental health professionals are able to reach others for which services were once unattainable or not accessible, providing struggling individuals with an important outlet for mental healthcare. Technologies have developed to not only serve those struggling with suicidal ideation, but also to serve those who wish to support those in need by providing them with important information and resources. These technologies can be beneficial to lots of different at-risk groups. They may be particularly useful resources for college students who tend to be technology-savvy and in great need of mental health resources, given the high discrepancies between mental health needs and available resources. These technological advances in suicide prevention help provide a resource that is accessible, helpful, and typically easy to navigate. These developments are changing the way suicide prevention is being conducted and reaching out to those who need it. Suicide remains a common threat in the United States, but the approaches to preventing suicide have developed to become anything but common. References Aguirre, R.P., McCoy, M.K., & Roan, M. (2013). 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