SUPPORT FOR SUICIDAL

SUPPORT FORSUICIDALINDIVIDUALSON SOCIAL AND DIGITAL MEDIA

TABLE OF CONTENTSIntroduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Why Establish Digital Policies for Those at Suicidal Risk? . . . . . . . . . . . . . . 2How to Identify Someone at Risk for Suicide Online . . . . . . . . . . . . . . . . . 3The Exception to All Rules: Imminent Risk . . . . . . . . . . . . . . . . . . . . . . . . . . 5How to Engage an Individual in Crisis Online . . . . . . . . . . . . . . . . . . . . . . . . 6How to Build a Digital Safety Resource Bank . . . . . . . . . . . . . . . . . . . . . . . . 8Additional Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Crisis and Suicide Prevention Resource List–U.S.-Based. . . . . . . . . . . . . . 10Crisis and Suicide Prevention Resource List–International . . . . . . . . . . . . 19

INTRODUCTIONDigital communities and social media platforms provide important vehicles to expressourselves, find information, and communicate with one another. This is also true forindividuals in distress who are potentially suicidal. Too often their posts go unnoticed ornot responded to. There are compelling reasons for social media companies to establishdigital policies that will reduce the risk of suicide for these individuals as well as mitigaterisk for the company. Not only will it save lives, it is the socially responsible thing to do.The “Support for Suicidal Individuals on Social and Digital Media” free toolkit wasdeveloped by the staff of the National Suicide Prevention Lifeline to help digitalcommunity managers and social media platforms establish safety policies for helpingindividuals in suicidal crisis.This toolkit is designed to help community managers understand:Over the past decade,social media platformsand digital organizationshave collaborated withThe National SuicidePrevention Lifeline andVibrant Emotional Healthto develop their processesand safety policiesconcerning suicidalcommunity members,including:What to look for concerning suicidal content in an online community.When to respond to community members who have made statementsrelated to suicide.How to approach situations with at-risk individuals so that a communitymember can be connected to the appropriate resources.The guidelines listed within this toolkit are free to use. They are informed by bestpractices established by the National Suicide Prevention Lifeline and VibrantEmotional Health. For those interested in building a more customized or expansiveset of safety policies and support resources, Vibrant Emotional Health experts areavailable to provide consultative services. (See Additional Services)Compiled by:Thomas Shukis, Network Engagement CoordinatorFrances Gonzalez, Director of CommunicationsNational Suicide Prevention Lifeline, Vibrant Emotional HealthPublished September 20181

WHY ESTABLISH DIGITAL POLICIESFOR THOSE AT SUICIDAL RISK?Suicide is a LEADING causeof death in the United StatesSuicide is a national public health crisis9.3MILLIONPEOPLEexperiencethoughts of suicideEVERY YEAR 1SUICIDE IS THE 10TH LEADINGCAUSE OF DEATH FOR ADULTSAND IS THE 2ND LEADINGCAUSE OF DEATH FORINDIVIDUALS AGE 15-34 YEARSWe can all take action to prevent suicide and provide support.Despite these concerning numbers, suicide is preventable. With the right resourcesand intervention, individuals can find help or learn how to provide support to others,potentially saving lives.The majority of Americans socialize or find resources online.84%OF ADULTAMERICANS USETHE INTERNETThe Pew Research Center finds that nearly 84 percent of adult Americans use theinternet,2 with 65 percent of adults using at least one social networking site.3Online communities and social media platforms are a large component of anindividual’s internet experience.With the progression of social-minded technology, more people are reaching outfor help in online communities and on social media. Creating a process for someoneto reach out and find support online makes it possible for an individual to get helpwhen they need it dults-use-social-networking-sites/2

HOW TO IDENTIFY SOMEONEAT RISK FOR SUICIDE ONLINEOne of the first hurdles to cross in establishing a process for suicidal community members is oneof identification. How do you know if someone may be in suicidal crisis?People often express one or more warning signs before attempting suicide. In general, a person expressing one ormore of the following warning signs in a comment, message, profile, or post online may be considering suicide:Talking about wanting to die or kill oneselfExpressing the desire to kill or injure themselvesLooking for information about methods of suicideTalking about feeling hopeless or having no reason to liveTalking about feeling trapped or in unbearable painTalking about being a burden to others (“People are better off without me”)Increasing the use of alcohol or drugsActing anxious or agitated; behaving recklesslyWithdrawing or feeling isolatedShowing rage or talking about seeking revengeDisplaying extreme mood swingsTalking about wishing to harm themselvesExpressing a heightened fixation with death or violence3

HOW TO IDENTIFY SOMEONEAT RISK FOR SUICIDE ONLINEExamples of a community post from someone who may be at-risk:“Hi, I really need some help, can someone please contact me.”“My daughter has fibromyalgia and the treatment alone costs too much for us to keep up with everythingelse. It’s become a full-time job to take care of her and I don’t know how I can keep going on like this. I feelhopeless with all of this and don’t know how I can keep going.”“My 15-year-old son has been texting one of his friends and he has been having what appears to bethoughts of suicide. What should I do?”“I’ve been really depressed lately and I don’t know how to fix this. I have been thinking about suicidelately, my grandfather committed suicide 10 years ago. I’m so scared about all of this.”Risk factors are characteristics that may make it more likely that an individual will consider or attempt suicide.However, they can’t cause or predict an attempt. If any of the following risk factors are expressed inconjunction with the above warning signs, this person may be at considerable risk of suicide:Stressful life events such as the death of a loved one, divorce, or job loss.Prolonged stress factors such as harassment, bullying, social humiliation, relationship problems,or unemployment.Easy access to lethal methods including firearms or drugs.Prior suicide attempt(s) and/or prolonged history of self-harming behaviors.Barriers to accessing health care and treatment.Social isolation and/or alienation.These risk factors and warning signs can provide helpful guideposts in determining which individuals in yourdigital community may be considering suicide or in suicidal crisis and would benefit from your platform’ssupport resources, a local crisis center’s intervention, or the Lifeline.4

THE EXCEPTION TO ALL RULES:IMMINENT RISKRegardless of protocols, warning signs, or risk factors, there may be posts, profile details, orcomments that may indicate a need for immediate action outside of your community’sresources. Imminent risk is a term used to define a situation in which an individual is atimmediate risk of harming themselves or another person.To decide whether a person is at imminent risk of harming themselves or others, look for three distinct variables:plan (how), date/time (when) and/or place (where). If the individual identifies a specific method of suicide (theplan) and/or indicates a specific day or time in which they will carry out this method (the timeline), and/or stateswhere he/she wishes to attempt suicide, then that individual is likely at imminent risk of suicide.Examples of a community post from someone who may be at imminent risk:“I GIVE UP. Save your thoughts, I’m killing myself later tonight.”“I have no one, I’m completely done and I’m numb. I have NO purpose. I’m just wondering what is mostefficient to end it, but I think I’m going to use my gun tonight because it should be painless. I’ll be homealone, so I have plenty of time to do it.”I’m going to die by the end of tomorrow. I have a plan but I wanted to say goodbye to all of you before I do it.”In situations where a person is perceived to be at imminent risk of harming themselves or others, it isimperative to connect that individual to emergency services or 911 for immediate assistance. Local emergencyservices are the fastest way to help a person who is at imminent risk of suicide. Other resources or protocolsmay be inappropriate during this situation and should not be applied.It will also be important to share within your community a procedure on how community members can reachout to emergency services if they come across other members who are at imminent risk of harming themselvesor another person. Within these guidelines, important information to share with 911 or other emergencyservices should include:As much information as is possible about the person at risk (including name, current address or whereabouts,telephone number, or other mode of contact).The nature of the emergency, including information about what the person posted, behavior or actionsabout to be taken or in the process of being taken, how the caller learned about the emergency (whatwebsite, post, chat forum was found).You (or the caller’s) name, location, and relationship with the digital community.Any other information that may be relevant to the situation.5

HOW TO ENGAGE ANINDIVIDUAL IN CRISIS ONLINEIf you have identified an individual that is at risk of suicide or in suicidal crisis but doesn’t seem tobe at imminent risk, research suggests that the community moderator reach out to that individualdirectly, through a set of clear processes established by and best suited to the needs of yourplatform or community.There are four factors to consider when developing your community’s guidelines regardingengagement with at-risk individuals online:1Always consider a post about suicide to be serious and genuine.2Develop a system of monitoring and responding to community membersin a timely, uniform, and unbiased manner.3Craft responses that are sensitive to the situation, yet realistic about your ability4Keep in mind the exception to all rules: imminent risk.While we can imagine instances where a statement could be disingenuous or a joke,it is absolutely important to err on the side of caution and to recognize anyconcerning posts as an honest and true expression of suicidal crisis.Only offering a response to certain posters or with irregular frequency may comeacross as disengaged or insincere to your community members, while also raisingthe possibility that individuals in need of support may go unanswered.to support an at-risk individual. It is not your responsibility to provide total supportfor community members who are experiencing thoughts of suicide. Instead, aim toconnect people to appropriate support services during a time of crisis.If, in the course of communicating with an individual, you discover that this person isat imminent risk of suicide, reach out to emergency services immediately. Similarly,if another user reports to you that they have found a post that shows another usermay be at imminent risk, have a procedure in place to manage the situation.While we encourage active moderation and response online, we do not encourage community managers to takeon the role of mental health care professionals. All engagement with an at-risk individual should be designed toprovide appropriate support while connecting that individual to mental health or crisis resources like theNational Suicide Prevention Lifeline, your local crisis center, or other local mental health providers. You can use6