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. 2024 Jun 28:44:100991.
doi: 10.1016/j.lanepe.2024.100991. eCollection 2024 Sep.

Suicide-related internet use among mental health patients who died by suicide in the UK: a national clinical survey with case-control analysis

Lana Bojanić  1 , Pauline Turnbull  1 , Saied Ibrahim  1 , Sandra Flynn  1 , Navneet Kapur  1   2   3 , Louis Appleby  1 , Isabelle M Hunt  1
Affiliations

Suicide-related internet use among mental health patients who died by suicide in the UK: a national clinical survey with case-control analysis

Lana Bojanić et al. Lancet Reg Health Eur. .

Abstract

Background: Suicide-related internet use (SRIU) has been shown to be linked to suicide. However, there is limited research on SRIU among mental health patients, who are at 4 to 7 times increased risk of suicide compared to the general population. This study aims to address this gap by exploring the prevalence of SRIU among mental health patients who died by suicide in the UK and describing their characteristics.

Methods: The study was carried out as part of the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH). Data were collected on sociodemographic, clinical, suicide characteristics and engagement in SRIU of patients who died by suicide between 2011 and 2021. The study utilised a case-control design to compare patients who engaged in suicide-related internet use with those who did not.

Findings: The presence or absence of SRIU was known for 9875/17,347 (57%) patients; SRIU was known to be present in 759/9875 (8%) patients. The internet was most often used to obtain information on suicide methods (n = 523/759, 69%) and to visit pro-suicide websites (n = 250/759, 33%) with a significant overlap between the two (n = 152/759, 20%). Engaging in SRIU was present across all age groups. The case-control element of the study showed patients who were known to have engaged in SRIU were more likely to have been diagnosed with autism spectrum disorder (OR = 2.13, 95% CI: 1.43-3.18), have a history of childhood abuse (OR = 1.70, 95% CI: 1.36-2.13) and to have received psychological treatment (OR = 1.43, 95% CI: 1.18-1.74) than controls. Additionally, these patients were more likely to have died on or near a salient date (OR = 2.11, 95% CI: 1.61-2.76), such as a birthday or anniversary.

Interpretation: The findings affirm SRIU as a feature of suicide among patients of all ages and highlight that clinicians should inquire about SRIU during assessments. Importantly, as the most common type of SRIU can expand knowledge on suicide means, clinicians need to be aware of the association between SRIU and choice of methods. This may be particularly relevant for patients approaching a significant calendar event.

Funding: The Healthcare Quality Improvement Partnership.

Keywords: Internet; Lifespan; Rare suicide methods; Researching suicide methods; Suicide.

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Conflict of interest statement

N.K. is a member of the Department of Health and Social Care (England) National Suicide Prevention Advisory Group. He chaired the NICE Guideline Development Group for the Longer-Term Management of Self-Harm and the NICE Topic Expert Group (which developed the quality standards for self-harm services). N.K. is currently chair of the updated NICE Guideline for Depression and topic advisor for the current NICE Guideline Development Group for the Longer-term Management of Self-harm and is also supported by Mersey Care NHS Foundation Trust. L.A. is Chair of the National Suicide Prevention Strategy Advisory Group, DHSC. N.K., L.A. and P.T. report grants from the Healthcare Quality Improvement Partnership and NHS England. N.K., L.A. and P.T. report grants from the Department for Education and the Medical Research Council. P.T. reports a grant from the Gambling Research Exchange Ontario. I.H. reports grants from HQIP and from the Medical Protection Society Limited (MPS). All other authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Venn diagram representing frequency and overlap between different types of suicide-related internet use of mental health patients who died by suicide. Note that the information on presence/absence of SRIU was known in 57% of all patients who died by suicide over the study period.
See this image and copyright information in PMC

References

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