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Social Media and Suicide Prevention

In 2017, a 15-year-old girl from Bedford, PA, was trying to live an ordinary teenage life until her classmates began bullying her. They attacked her on social media sites like Facebook and Kik about her red hair and braces, some going as far as telling her that she should kill herself. Her mother remembers finding the young girl sobbing for hours because of what people were saying about her in school and online. Even though her mother took her phone and tried to comfort the girl, less than a week later she would die by suicide.

While the rate of death by suicide among teenage girls is at an all-time high, they’re not the highest risk demographic of the more than 40,000 people who die by suicide in the U.S. each year. According to the CDC, seven of 10 suicides in 2015 were men, making men 3.5x more likely than women to die by suicide. Now the third-leading cause of death among adults age 15-44 worldwide, the global rate of suicide will hit 1.53 million per year by 2020, which constitutes one death by suicide every 20 seconds, according to the World Health Organization.

Children as young as 11 are dying by suicide as a result of experiences on social media, and we know of at least three examples of children broadcasting their own death to live audiences using social media tools such as Facebook live, Twitter and YouTube.

How are leaders responding?

In response to these disturbing trends, Facebook has partnered with organizations like the National Suicide Prevention Lifeline to develop a set of tools intended to help individuals find resources and support who are considered “at risk” for self-harm.

The first of these tools is a new suicide-prevention feature on Facebook that uses artificial intelligence (AI) to identify posts indicating suicidal or harmful thoughts. The AI scans the posts and their associated comments, compares them with others that merited intervention and, in some cases, passes them along to its community team for review. The company plans to reach out to users it believes are at risk, showing them a screen with suicide-prevention resources including options to contact a helpline or contact a friend.

While in some cases the artificial intelligence software will notify the Facebook community if it flags a situation as “very likely urgent,” in most cases it will simply work in the background to offer messaging and advice to the friends and family of a person in need.

See also: Blueprint for Suicide Prevention  

Dr. John Draper, of the National Suicide Prevention Lifeline, said that he feels that the software sounds promising. “If a person is in the process of hurting themselves and this is a way to get to them faster, all the better,” he told BuzzFeed News. “In suicide prevention, sometimes timing is everything.”

Facebook is also making certain suicide prevention organizations available via Facebook Messenger, its instant messaging app. Facebook users will be able to flag posts that they feel indicate “at risk behavior,” which Facebook will respond to with an on-screen option to receive suicide-prevention resources.

Can we use social media to predict suicide?

New research out of Korea suggests that we might be able to begin using social media to predict suicidal behavior.

The three-year study looks at the social and environmental factors that contribute to suicidal behavior and describes correlations between public mood and suicide and how data from social media sources and weblogs (blogs) might be used to predict that behavior; their primary hypothesis being that social media variables are meaningfully associated with nationwide suicide numbers.

At the end of the study, the research team concluded that, “We found a significant association of social media data with national suicide rate, resulting in a robust, proof-of-principle predictive model,” and the team suggests social media data be used in future predictive modeling.

How suicide prevention advocates are using social media.

Sites like the Suicide Prevention Coalition of Colorado, the Mighty and To Write Love on Her Arms are also using social media to engage audiences with messages of help and hope.

The Suicide Prevention Coalition of Colorado, an organization of which the author of this article is a member, uses Facebook, Twitter and email newsletters as educational and communications tools to promote events, raise awareness of mental health legislation and bridge the gap between service providers across the state of Colorado that might not have the resources they need as solo practitioners.

To Write Love On Her Arms (TWLOHA) is a site that offers hope and help to those struggling with depression, addiction, self-injury and suicide.

With a Facebook following of more than 1.5 million and a Twitter following of nearly 300,000, they share individual stories of hope and recovery and work to destigmatize suicide and self-harm.

The Mighty is a blog with more than 5,000 contributors and 150 million readers that also gives people suffering from mental health disabilities a place to find resources, encouragement and support.

This site, like TWLOHA, focuses on shared experiences. Individuals struggling with disability, disease and mental illness write in and share their stories of hope and recovery.

Bell Canada, a telephone company in Canada, is running a “Let’s Talk” campaign dedicated to raising $100 million for mental health programs by 2020 and encouraging people to find the strength to come out and talk to someone if they find themselves struggling with thoughts of self-harm.

See also: 6 Things to Do to Prevent Suicides  

What you can do to get involved today.

Twitter is a wonderful conversation tool where you can do a search for keywords like #SuicidePrevention and become a part of the conversation with leaders, educators, individuals struggling and those with experience. A continued effort to destigmatize mental health issues helps those struggling realize that there is help.

You can use social media to interact with your legislature. Most politicians today are active on social media, and some even have live events on social media, giving us the opportunity to ask them where they stand on issues such as mental healthcare as well as share our opinions on the issues.

You can share resources on social media, especially around the death of a celebrity, to help further the conversation online and help someone find resources who might not have the strength to ask for help.

Finally, if you or anyone you know is struggling with thoughts of suicide and need to talk to someone right away, reach out to the National Suicide Prevention Lifeline at 1-800-273-8255 or visit online at http://suicidepreventionlifeline.org/talk-to-someone-now/.

If you need support for suicide grief or suicidal thoughts but are not in crisis, the National Suicide Prevention Lifeline offers resources on how to help either yourself or a loved one.

Employers’ Role in Preventing Suicide

American adults working full time spend an average of 47 hours per week at their workplace (Gallup 2013). For those dealing with a mental health issue or thoughts of suicide, employers have an important opportunity to create safeguards to protect those who may be at risk.

There are many reasons why an employee may keep concerns about his or her mental health private. Stigma, fear of losing one’s job, and lack of awareness can prevent an individual from seeking help. It can also prevent someone who is concerned about a co-worker from reaching out when they may be needed most.

Research shows that 70% of those who die by suicide tell someone or give warning signs before taking their own life. Coworkers see each other every day and are more apt to notice changes in mood and behavior. For this reason, they play a key role in identifying potential suicide risk and mental health crises in their peers.

See also: Blueprint for Suicide Prevention  

Mental health education and awareness programs can help to create an environment where employees feel comfortable reaching out for help and should be a primary component of workplace wellness initiatives. Employers can implement the following strategies that not only connect their employees with help but also promote a culture of mental health awareness:

Health Promotion

Health promotion programs enable employees to take action to better their health. While employers often use health promotion to encourage physical health changes, employers can use health promotion to discuss mental health issues and encourage a culture of employee engagement and connection, as well. National Depression Screening Day, held on Oct. 6 this year, raises awareness for depression and related mood and anxiety disorders. The annual campaign provides employers with an opportunity to start the conversation with employees about mental health.

Online Screenings

Anonymous online screenings are a proven way to reach those in need and help direct them to appropriate assistance. Employees can take a screening to determine if the symptoms they are experiencing are consistent with a mental health disorder (i.e., depression, generalized anxiety disorder, bipolar disorder, post-traumatic stress disorder, an eating disorder or a substance use disorder). Upon completion of a screening, employees are provided with immediate results and linked back to employee assistance program or local community resources. If your organization does not currently have an online screening program, a more general anonymous screening can be taken here.

Suicide Prevention Awareness

The Centers for Disease Control and Prevention recently released data showing a 24% increase on average of suicide rates from 1999 to 2014. It is critical that employees learn how to talk with someone about mental health, understand how to recognize warning signs of suicide and know the actions to take to get themselves or a coworker the help they need.

The National Action Alliance for Suicide Prevention’s Workplace Task Force champions suicide prevention as a national priority and cultivates effective programming and resources within the workplace. The task force provides support for employers and motivates them to implement a comprehensive, public health approach to suicide prevention, intervention and “postvention” in the workplace. Programs like the Workplace Task Force are important sources of knowledge and assistance for employers.

See also: 6 Things to Do to Prevent Suicides  

Employers can provide resources such as Stop a Suicide Today, which educates individuals about the warning signs of suicide and steps to take if they are concerned about a coworker or loved one. There are also other lifesaving resources, like the National Suicide Prevention Lifeline (1-800-273-TALK (8255)).

The World Health Organization estimates that depression will be the second leading cause of disability by 2020. Employers have the option to act as catalysts for early detection and prevention when it comes to mental health disorders and suicide, which can lead to improved quality of life for individuals, as well as for the organization itself.

Why Employers Must Help Stop Suicide

The American Association of Suicidology said it best when it created this logo for the association: “Suicide prevention is everyone’s business.” By everyone, the association includes employers and work organizations. Considering that the workplace is where the majority of working-age adults spend a significant portion of their day, and sometimes night, it only makes sense that employers and coworkers join the national fight against suicide.

Over the past 10 years, work organizations have begun to realize that they can help identify and treat working adults suffering from depression — a leading risk factor for suicide and also the leading cause of lost work productivity. Despite the knowledge that depression is highly correlated with suicide risk, workplaces have been slow to embrace their potentially critical role in preventing suicide through workplace-based programs. Many of the programs already being offered by employers address depression and can be easily and often freely expanded to also include elements of suicide prevention. The connection between depression and suicide is clear, and employers, large and small, have an important role to take in addressing the public health problem of suicide in our country.

Detecting and treating depression among employees is one way employers can play a significant role. In fact, many employers are already making inroads in minimizing the negative effects of depression and related mental health issues through employer-sponsored benefits such as employee assistance programs (EAPs), workplace wellness programs and occupational health services.

Some of the more commonly offered employer-sponsored interventions at the workplace to identify and respond to depression include workplace-based public awareness campaigns that involve posting suicide warning signs, referral resources and general anti-stigma messages, workplace-based depression screening, such as the program offered through Screening for Mental Health and other early interventions that can be cost-effectively offered through EAP counseling, wellness programs and related occupational health programs.

Improving the detection and treatment of depression and therefore preventing suicide will have a positive impact on the employee and, in the process, the business success of the company. By expanding existing workplace-based wellness programs that often focus heavily on identification and treatment of depression among employees, employers are able to increase the number of employees seeking and obtaining treatment — depression often has low rates of treatment because it is not accurately identified. In fact, prior research shows that, at any given time, depression affects between one-tenth and one-fifth of U.S. employees (Kessler et al., 2008). For employers, this means that for every 100 employees, depression costs employers about $62,000 annually. The majority of this cost does not come from treatment (treatment only accounts for about $9,000), but, rather, costs related to lost work time resulting from sick day absence, work disability (short term and long term disability days) and “presenteeism” (underperformance at the workplace because of illness). In addition, depression and suicide contribute to hidden costs to employers such as lowered morale, increased stress and lower employee engagement and loyalty. The effect of a suicide on coworkers can also be devastating.

In addition to treatment of depression, employers who work with their EAPs and other wellness programs to identify and respond to depression will improve other chronic health conditions. This is because employees who suffer from depression also suffer from an average of 5.1 other chronic health conditions that can complicate treatment and increase costs to the workplace. For example, some of the most serious comorbid conditions in terms of lost productivity with depression include anxiety (48% of employees with depression also have anxiety); chronic fatigue (46%), obesity (29%), chronic sleeping problems (26%) and chronic back and neck pain (32%). (The statistics are from data collected by Integrated Benefits Institute, a leading research organization in health and productivity. See www.ibiweb.org for more information.)

Research suggests that medication and psychotherapy are effective in 70% to 80% of depression cases (RAND, 2008). Employers can require their EAPs and other workplace wellness programs to screen all employees for depression using free and simple validated tools such as the 9-item Patient Health Questionnaire (PHQ-9), where the ninth question asks specifically about suicide risk. Employers can also provide comprehensive depression care management programs for employees screened or otherwise identified to have serious depressive symptoms or for those at increased risk, such as employees who recently went out of the workplace on short-term disability (Desiron, de Rijk, Van Hoof, & Donceel, 2011; Lerner, Rodday, Cohen, & Rogers, 2013; Lo Sasso, Rost, & Beck, 2006).

EAPs are one way through which workplaces have historically and effectively provided help to employees with depression and other mental health and personal problems. EAPs have been shown to be effective in reducing depressive symptoms among employees, including thoughts about suicide (University of Michigan Depression Center). EAPs can provide identification and screening services, such as on-site employee depression screening; however, EAP services go well beyond simple screening and identification. Depending on the services purchased by the employer, EAPs can provide comprehensive assessment, short-term counseling and referral and case management services for longer-term help in the community. Additionally, well-positioned EAPs, those with more on-site access and easy access to consultation with workplace managers and leaders, help to ensure that EAPs are even more effective at recognizing and responding quickly to employee problems such as suicide risk.

Additionally, strategically positioned programs can offer responses that are integrated and in line with the culture of the broader work organization to better serve employees while also supporting workplace productivity. Highly visible and management-supported EAPs can help to reduce stigma toward mental health problems, which in turn will encourage employees to seek help at an earlier stage of their problems and be more responsive to early intervention.

It is important that all employees in the workplace take suicide risk seriously. They should be trained to identify depression and suicide risk among coworkers, not be afraid to ask questions about the well-being of coworkers and refer them to EAPs or other resources when needed. Some examples of companies working to train employees (a designated employee, group of employees or all employees) and raise awareness of suicide and mental health in general are: Chesapeake Energy, DuPont and Johnson & Johnson (see Partnership for Workplace Mental Health for these and other examples).

EAPs can work with employers to develop appropriate training material to help reduce the stigma of mental health problems, not limited to just depression and suicide, so that everyone is able to play a role in contributing to the well-being of the workplace. Just as employees understand and can identify physical safety risks such as falling hazards and safe lifting practices, employees should also understand what to look for when employees may be at risk for a mental health problem.

Even employers who are not able to provide comprehensive services such as EAPs and workplace wellness programs can take small steps that can have a huge impact on saving lives.

One simple first step employers can take to increase awareness of depression and suicide at the workplace is to promote the phone number for the National Suicide Prevention Lifeline (1-800-273-8255) at different locations throughout the workplace where employees will readily see signs, posters and online messages. The Lifeline is a free hotline that can be utilized by anyone who might want to talk with a professional about mental health issues and well-being. Promoting the Lifeline is free to the employer and can be a good way to demonstrate the employer’s interest in the mental wellness of employees. Utilizing free hotline services such as Lifeline is especially important for employees who don’t have access to EAP or other workplace wellness programs.

Overall, we know that workplaces that offer more control to their employees with regard to working conditions that can lower workplace stress, do better with regard to workplace productivity and depression. Therefore, it is critical that employers step up the plate and review and revise workplace policies and programs that are designed to support employees who may be suffering from depression and therefore have increased risk for suicide. By expanding existing programs to include assessment and treatment for depression, employers are working to improve productivity while also preventing suicide at the same time. It is a win-win for employers, employees and society as a whole.

This article was written by Dr. Jacobson Frey; Kimberly Jinnett, PhD; and Jungyai Ko, MSSA.

Stand Up for Robin Williams. . .

On Monday, Aug. 11, 2014, we lost Robin Williams. He was a brilliant actor and comic…a man most of us grew up with. We knew him as a funny guy, an alien, a genie, a nanny, an inspirational teacher and so much more. We also knew he struggled with depression, addiction and possibly bipolar disorder.

Collectively, we grieve for his loss. Williams had an uncanny ability to make us smile. Even when playing more dramatic roles, he brought light, laughter and inspiration to our lives.

We grieve, too, for thousands of other people who have died by suicide. Fathers, mothers, sisters, daughters, sons, brothers…suicide isn’t just about the person who dies. Its painful ripples spread far and wide, affecting every one of us.

We believe every suicide death is preventable, that not another person should die in desperation and alone. Those with behavioral health challenges like major depressive disorder, bipolar disorder and schizophrenia have suicide rates 10 to 15 times greater than the general population. Yet, millions survive, and many find a way to thrive. Recovery is possible!

The bitter irony of Williams’ death was the support he gave for another disease that takes lives: cancer. Williams was a strong backer of St. Jude’s Research Center and Stand Up to Cancer. He would visit cancer patients, sometimes in their own homes, bringing joy into lives that would invariably be cut short, just as Williams’ was.

The cancer prevention movement has been so effective in getting people involved – in prevention, in fundraising, in advocacy.  Now many people – whether or not they’ve been directly affected by cancer – Stand Up in solidarity to help fight the battle. They stand shoulder to shoulder with people who are fighting for their lives? They stand to honor those who’ve passed with dignity. They got people like Robin Williams to lean in, and say, “I care. What can I do to help?”

The suicide prevention movement can learn a lot from the successes of the cancer prevention movement.

How has the cancer prevention movement achieved its goals? It advanced science and promoted stories of hope and recovery. Those who want to stand up for suicide prevention can do this, too.

As Dr. Sean Maguire in the movie “Good Will Hunting,” Williams counsels Matt Damon’s Will Hunting on life, love and grief before telling him, “Your move, chief.”

Now it’s our move. Let’s honor Williams’ memory, and that of every person who has died by suicide, by making suicide a thing of the past.  What can you do to Stand Up for suicide prevention?

  • Reach out and ask others who may be going through difficult life challenges, “Are you okay? What can I do to support you?” Let them know they are not alone and that you can help them link to resources.
  • Promote the National Suicide Prevention Lifeline (800-273-8255) everywhere – schools, workplaces, faith communities, neighborhoods.
  • Volunteer and participate in suicide prevention work like community walks, town hall meetings, crisis line support and more.
  • Donate to suicide prevention organizations.
  • Learn about the real facts about suicide and the strategies that have been shown to prevent it.
  • Then bring others into the circle – your healthcare providers, your employer, your educators and so on. Elevate the conversation and make suicide prevention a health and safety priority.
  • Ask your healthcare plan and provider to join you.

As a society, we’ve stood up for so many other important things. It’s time for us to stand up to suicide.

When we all stand up and move together, we create a movement. Together, our voices can create significant change in systems, in policy, in funding and in the general view of suicide. We can restore dignity and offer hope and empowerment and save lives.

This article was written by Sally Spencer-Thomas with four other members of the National Action Alliance for Suicide Prevention:

  • David Covington, LPC, MBA, Recovery Innovations and Zero Suicide Advisory Group
  • John Draper, National Suicide Prevention Lifeline and The Way Forward Suicide Attempt Survivors Task Force
  • Mike Hogan, Hogan Health Services and Zero Suicide Advisory Group
  • Eduardo Vega, Mental Health Association of San Francisco and The Way Forward Suicide Attempt Survivors Task Force

#standup2suicide #zerosuicide #wayforward