BackgroundRates of self-harm and suicide appear to be increasing in young people and many attribute this to social media use. However, high quality studies examining young people’s experiences of self-harm and suicide-related content on social media, and the impact on wellbeing, are lacking. MethodsAn online national cross-sectional survey was conducted between January and March 2024. Quota sampling was used. Participants from across Australia were recruited from the Roy Morgan Single Source Panel, a panel managed by Pureprofile and via snowball sampling. Descriptive statistics were used to examine respondents’ experiences; logistic regressions examined differences between young people and adults. Findings3,663 individuals (972 young people; 2,691 adults) completed the survey. Just over half had been exposed to self-harm or suicide-related content on social media. Young people were more likely to be exposed than adults (OR 3.97; 95%CI: 3.32-4.76). For most people exposure worsened their mood and a minority reported engaging in self-harm as a result; again this was more common in young people (OR 4.46, 95%CI: 2.72-7.52). However, many people, in particular young people, reported using social media to seek support.InterpretationThere is concern about the impact of social media on self-harm and suicide and our findings support the need for improvements to online safety. However, the fact that people use social media to access help suggests that a nuanced and evidence-based approach is required that includes the perspectives of young people and those with lived experience.
The suicide rate in Australia has increased over recent years, indicating a need for novel suicide prevention interventions. A large proportion of people at risk of suicide do not seek professional help, but rather express their suicidal thoughts to close friends and family members. However, expressions of suicidal thoughts to family and friends can be indirect and ambiguous, and consequently can be missed or misunderstand, leading to dismissive response and missed opportunities for suicide prevention. A suicide prevention media campaign aimed at family members and friends may be one useful population-level suicide prevention strategy to encourage greater recognition of suicide risk and appropriate helping actions in response to suicidal communications. Current evidence for what messages would be acceptable and appropriate for inclusion in such as campaign, however, is limited.
The research described in this thesis was undertaken to develop suicide prevention messages to include in an Australian suicide prevention campaign aimed at family and friends of adults at risk of suicide. To understand what messages would be most important to include, five studies were undertaken and are described in this thesis. Study 1 was an expert consensus study involving suicide prevention professionals and people with lived experience of suicide risk. This study established which suicide prevention actions these experts believe are the most important to encourage in a suicide prevention campaign aimed at family and friends. Study 2 was an online survey study involving people with lived experience of suicide risk that aimed to assess the most and least helpful actions taken by others in response to their suicidal communications. Studies 3 to 5 used data from a nationally representative telephone survey conducted with Australian adults. Study 3 examined Australian adults’ confidence and intentions to help a person close to them at risk of suicide. Study 4 examined helping actions given and received in response to suicidal communications. Study 5 assessed the relationships between beliefs in suicide ‘myths’ and helping intentions and actions.
Overall, the findings from these studies show that Australian adults are confident and willing to assist a person close to them at risk of suicide. They intend to undertake, and indeed do undertake, a number of appropriate helping actions toward people close to them who are at risk of suicide. These appropriate actions include listening and talking to the person at risk and encouraging them to seek professional help. However, Australian adults also largely fail to ask important risk assessment questions, and commonly undertake actions that do not conform to best practice in suicide prevention. Such non-recommended actions include telling the person at risk ‘what they have going for them’ and telling them that their suicide would hurt their family and friends. A substantial minority of Australian adults also believe in suicide myths, including those related to encouraging suicidal thoughts by talking about suicide. The combined results of these studies have been utilised to make recommendations regarding the most useful messages to include in an Australian suicide prevention campaign aimed at family members and friends at people at risk of suicide.
People at risk of suicide frequently communicate suicidal thoughts to professionals and non-professionals. These groups, therefore, need to be aware of how best to respond.We aimed to identify helpful and unhelpful responses to communications of suicide risk from the perspective of those at risk to inform suicide prevention messaging and education.We conducted an online survey (n = 141) of members of an online reference group for an Australian mental health organisation with a history of suicide risk.Most respondents had repeatedly considered and attempted suicide. Indirect suicide communications were more common than direct communications. Listening without judgement was the most common helpful response and "minimizing" responses to suicidal thoughts and feelings, the most common unhelpful responses.We make recommendations for suicide prevention messages and professional education content based on these findings.
Abstract Background The Australian Mental Health Professionals Network (MHPN) is fostering a collaborative, interdisciplinary approach to mental health care through the establishment of local interdisciplinary networks of mental health professionals. This paper reports on those factors seen by MHPN participants and staff as having affected the formation and continuation of interdisciplinary networks, and therefore the likely sustainability of these groups. Method The paper draws on qualitative data from focus groups with mental health professionals participating in MHPN activities and MHPN staff. Results The findings suggest that MHPN’s approach to establishing sustainable interdisciplinary networks has been influenced by a number of factors at the micro-, meso-and macro levels. At the micro-level, factors such as clarity and structure of ongoing meetings, individual dynamics and the role of ‘champions’ can promote or constrain sustainability of ongoing networks. Those networks that had established following an initial workshop and had continued to meet as an interdisciplinary network tended to be led by well-respected co-ordinators, involve members who are enthusiastic and keen to learn from each other, have a flexible structure and meet regularly for a well-defined purpose. These features are underpinned by good communication between network members and with MHPN administration. At the meso- and macro-levels, the key issue relates to resourcing, as well as the wider policy context. Conclusions The support and practical resources provided by MHPN have been crucial in guiding successful networks as they form and continue to meet on a regular basis. The networks have also required internal leadership and support, and a clear purpose in order to form and to continue their activities. These findings are consistent with the literature, which states that sustainability of programs is reliant on factors at the project design and implementation level, as well as on factors inherent within the host organization and at the wider community level.
Abstract Background ‘Suicide hotspots’ include tall structures (for example, bridges and cliffs), railway tracks, and isolated locations (for example, rural car parks) which offer direct means for suicide or seclusion that prevents intervention. Methods We searched Medline for studies that could inform the following question: ‘ What interventions are available to reduce suicides at hotspots, and are they effective?’ Results There are four main approaches: (a) restricting access to means (through installation of physical barriers); (b) encouraging help-seeking (by placement of signs and telephones); (c) increasing the likelihood of intervention by a third party (through surveillance and staff training); and (d) encouraging responsible media reporting of suicide (through guidelines for journalists). There is relatively strong evidence that reducing access to means can avert suicides at hotspots without substitution effects. The evidence is weaker for the other approaches, although they show promise. Conclusions More well-designed intervention studies are needed to strengthen this evidence base.
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