Characterizing Use of the Internet and Social Media to Access Suicide-Related Content among Adolescents with Suicidal Ideation

Background: Adolescents frequently consult online resources regarding sensitive health topics, including suicide. Although content analyses demonstrate that online platforms contain both suicide-preventive and pro-suicide material, they rarely incorporate subjective data from adolescents at elevated suicide risk. Aims: This exploratory study examined associations between reasons for seeking suicide-related information online and the digital media used to access such content among adolescents with suicidal ideation. Method: Over one year, 131 adolescents aged 13 to 18 with current or past suicidal ideation were recruited from the Emergency Department of an urban pediatric hospital to complete a cross-sectional survey. Participants reported whether they had sought suicide-related information online, the type of information sought, and the online locations used. Mixed-effects regression models examined associations between reasons for online searches and digital media used. Results: Of 131 enrolled adolescents, 113 completed the survey; 69 (61.1%) reported ever seeking suicide-related information online. Searches were more often intended to assist with acting on suicidal thoughts than to reduce suicidal thoughts (63.7% vs. 55.1%). Social media were used for help-seeking searches slightly more often than professional health organization websites (42.1% vs. 31.6%). Among adolescents who used social media for their searches, discussion forums were significantly more likely to be used when seeking information to act on suicidal thoughts (OR=7.0, p=.02). Conclusion: The majority of adolescents with suicidal ideation may seek out suicide-related content online, particularly to facilitate suicide planning. Social media may be used as frequently as professional mental health websites like 988 or The Trevor Project for suicide-related searches.