Does the internet influence suicidal behavior?

People searching the Internet for information about suicide methods are most likely to come across sites that encourage suicide rather than sites offering help and support, finds a study in this week's issue of the BMJ.

Media reporting of suicide and its portrayal on television are known to influence suicidal behaviour, particularly the choice of method used, but little is known about the influence of the internet.

Recent reports in the popular press have highlighted the existence and possible influence of internet sites that promote suicide and web forums that may encourage suicide in young people.

But despite these recent controversies, the ease with which these sites may be found on the internet has not been systematically documented nor the kind of information they contain been described.

Researchers from the Universities of Bristol, Oxford and Manchester set out to replicate a typical search that might be undertaken by a person looking for instructions and information about methods of suicide using the four most popular search engines—Google, Yahoo, MSN, and Ask—and 12 simple search terms.

They analysed the first ten sites from each search, giving a total of 480 hits.

Altogether 240 different sites were found and just under half of these provided some information about methods of suicide. Almost a fifth of hits (90) were for dedicated suicide sites, of which half were judged to be encouraging, promoting, or facilitating suicide.

Sixty-two (13%) sites focused on suicide prevention or offered support and 59 (12%) sites actively discouraged suicide.

Almost all dedicated suicide and factual information sites provided information about methods of suicide. But, a fifth (21%) of support and prevention sites and over half (55%) of academic or policy sites, and all news reports of suicides also provided information about methods.

Overall, Google and Yahoo retrieved the highest number of dedicated suicide sites, whereas MSN had the highest number of prevention or support sites and academic or policy sites.

In addition, the three most frequently occurring sites were all pro-suicide, whereas the information site Wikipedia was fourth. All top four sites evaluated methods of suicide including detailed information about speed, certainty, and the likely amount of pain associated with each method.

However, there is currently no regulation of suicide sites in the UK because they are not illegal.

Self-regulation by internet providers and use of filtering software by parents to block sites are the main approaches to reducing potential harm from suicide sites. However, efforts to remove some of the most detailed technical descriptions of suicide methods may be easily circumvented, say the authors.

They conclude that service providers might pursue website optimisation strategies to maximise the likelihood that sites aimed at preventing suicide are preferentially sourced by people seeking information about suicide methods rather than potentially harmful sites.

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