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Abstract

The media and the Internet may be having an influence on suicidal behavior. Online social networks such as Facebook represent a new facet of global information transfer. The impact of these online social networks on suicidal behavior has not yet been evaluated. To discuss potential effects of suicide notes on Facebook on suicide prevention and copycat suicides, and to create awareness among health care professionals. We present a case involving a suicide note on Facebook and discuss potential consequences of this phenomenon based on literature found searching PubMed and Google. There are numerous reports of suicide notes on Facebook in the popular press, but none in the professional literature. Online social network users attempted to prevent planned suicides in several reported cases. To date there is no documented evidence of a copycat suicide, directly emulating a suicide announced on Facebook. Suicide notes on online social networks may allow for suicide prevention via the immediate intervention of other network users. But it is not yet clear to what extent suicide notes on online social networks actually induce copycat suicides. These effects deserve future evaluation and research.
T.D. Ruder et al.: Suicide Announ cement on FacebookCrisis2011; V ol. 32(5): 280–282© 2011 Hogrefe Publishing
Short Report
Suicide Announcement
on Facebook
Thomas D. Ruder
1
,GaryM.Hatch
1
, Garyfalia Ampanozi
1
,
Michael J. Thali
1
, and Nadja Fischer
1,2
1
Institute of Forensic Medicine, University of Bern, Switzerland
2
Psychiatric Services Grisons, Clinic Waldhaus, Chur, Switzerland
Abstract. Background: The media and the Internet may be having an influence on suicidal behavior. Online social networks such as
Facebook represent a new facet of global information transfer. The impact of these online social networks on suicidal behavior has not
yet been evaluated. Aims: To discuss potential effects of suicide notes on Facebook on suicide prevention and copycat suicides, and to
create awareness among health care professionals. Methods: We present a case involving a suicide note on Facebook and discuss potential
consequences of this phenomenon based on literature found searching PubMed and Google. Results: There are numerous reports of
suicide notes on Facebook in the popular press, but none in the professional literature. Online social network users attempted to prevent
planned suicides in several reported cases. To date there is no documented evidence of a copycat suicide, directly emulating a suicide
announced on Facebook. Conclusions: Suicide notes on online social networks may allow for suicide prevention via the immediate
intervention of other network users. But it is not yet clear to what extent suicide notes on online social networks actually induce copycat
suicides. These effects deserve future evaluation and research.
Keywords: social network, suicide, Werther effect, Facebook, media
Suicide reports in the media are known to induce copycat
suicides, an effect frequently called the Werther effect
(Stack 2003; Pirkis, Blood, Beautrais, Burgess, & Skehan
2006),basedonJohannWolfgangvonGoethes18th-
century novel. The Internet can also influence suicidal
behavior, albeit in a more complicated and not necessar-
ily enabling fashion. For example, health care profession-
als may provide assistance to Internet users who seek
help online, even while Internet forums and websites
dedicated to suicide may actively encourage forum users
to commit suicide (Alao, Soderberg, Pohl, & Alao, 2006;
Becker, Mayer, Nagenborg, El-Faddagh, & Schmidt,
2004; Harris, McLean, & Sheffield, 2009). Other re-
search indicates that websites and forums dedicated to
suicide might counterintuitively serve a preventive role
– even in the absence of intervention by health care pro-
fessionals – via mechanisms of constructive support, em-
pathy, and community belonging (Baker & Fortune,
2008; Eichenberg, 2008). Online social networks are a
new forum for information transfer via the Internet,
where users can share personal details of their lives on-
line. Here, we report a case of a young man who an-
nounced his suicide on the online social network Face-
book, and we discuss potential consequences of this new
form of suicide note, as it relates to suicide induction and
suicide prevention.
Case Details
A 28-year-old male, without prior history of psychiatric
illness, drug abuse, suicide attempt, or suicidal ideation,
posted his intention to commit suicide online on his Face-
book profile as a status update. The man, an otherwise
physically healthy mechanic who lived alone, also in-
cluded the location where he planned to jump to his
death, but not the precise time. One of his Facebook
friends noticed the post and informed the family and the
police. Immediately afterward, the friend went to the site
of the planned suicide with the intention of intervening,
but tragically arrived too late. Our forensic institute was
called, as is the practice in the region, to rule out foul
play and to confirm the identity of the deceased. Inter-
views later revealed that the man had been left by his
fiancée 2 months prior to the suicide. Some case details
have been altered slightly to protect anonymity, without
changing their significance to the case history.
Discussion
Facebook is one of the largest online social networks
with more than 500 million active users worldwide
DOI: 10.1027/0227-5910/a000086
Crisis 2011; Vol. 32(5): 280–282 © 2011 Hogrefe Publishing
(Facebook Press Room, 2010). The main purpose of
Facebook is to maintain contact with friends and to share
information about everyday life. Each Facebook user cre-
ates an individual profile page, where he or she can up-
load personal information, photos, and report on his or
her status. Users define who may or may not access their
profile page by inviting other Facebook users to become
their Facebook friends. According to statistics published
by Facebook, an average user has 130 friends and spends
approximately 1 h on Facebook every day (Facebook
Press Room, 2010).
Across the world, several Facebook users have posted
suicide notes on their profile page, a trend covered by the
popular press, but not yet by the professional literature.
For example, a 48-year-old female British expat living in
Spain, the alleged victim of abuse at the hands of her
fiancé, leapt to her death after posting her suicide note
on Facebook (Govan, 2010). In Scotland, a 32-year-old
male hung himself and was found 3 h later by the police,
who were notified by Facebook users concerned about
his most recent postings (Fields, 2009). In New York, a
30-year-old male posted his intention to commit suicide
and hung himself hours later in a park (Gendar & Connor,
2009). Finally, in Israel, a police manhunt was initiated
after other Facebook users saw a suicide note posted on-
line by their friend, a 44-year-old male, who was found
the following day injured but alive in a crevasse (Levy-
Stein, 2009). All three men had had a history of relation-
ships recently ended.
Facebook operators reacted to this problem by offering
contact information for helplines and services to both in-
dividuals with suicidal thoughts and individuals who
want to help other users posting suicide notes (Facebook
Help Center, 2010). Additionally, Facebook offers a link
to report suicidal content on the network. Facebook pro-
file pages of deceased users can be turned into “memorial
accounts” by Facebook operators or removed completely,
both at the request of family members (Facebook Help
Center, 2010). According to the professional literature,
media reports on suicides have the tendency to induce
copycat suicides (Pirkis et al., 2006; Stack, 2003). This
tendency is frequently called the Werther effect, after Jo-
hann Wolfgang von Goethe’s novel “Die Leiden des jun-
gen Werther” (“The Sorrows of Young Werther”). The
same tendency can therefore be expected following me-
dia coverage of Facebook-related suicides. Moreover,
suicide notes on Facebook may create a variation of the
Werther effect: Predisposed individuals who read a net-
work users’ suicide announcement on Facebook may also
be encouraged to attempt suicide. However, this potential
internal effect has not yet been studied, and our literature
search revealed no case reports of such a Facebook-in-
duced Werther effect.
If we assume that Facebook has the potential to induce
a Werther effect, the lack of reports of such an occurrence
could be related to the only relatively recent launch and
rise in popularity of Facebook. It might also be secondary
to the relatively small number of friends linked to the
average account on Facebook, compared to the much
wider reach and distribution of traditional print and tele-
vision media. Additionally, as Stack points out, media
coverage of famous suicides are much more likely to in-
duce a copycat suicide. It follows then that, unless the
Facebook user is famous, the impact would be small. Re-
garding the potential audience of a post, Facebook ac-
count privacy settings can be opened to allow any other
user to access a profile, potentially creating an audience
of millions. With regard to fame and copycat suicides,
the closer connection between Facebook friends (versus
knowledge of a celebrity’s or a strangers suicide) could
play a role in moderating copycat behavior from Face-
book suicide notes, although this has not, or not yet, been
evaluated.
Besides these effects, which may encourage or enable
suicide, there also seems to be a positive effect related to
suicide announcements on Facebook. Different from tra-
ditional suicide notes, the suicide notes posted on Face-
book are instantly available to a large number of individ-
uals. This provides an opportunity for other network us-
ers to intervene directly or to seek help from health care
professionals and emergency medical services. As the
case presented illustrates, Facebook users do indeed ac-
tively intervene to prevent suicide attempts of other net-
work users. The potential for intervention also exists be-
fore full-blown suicidal ideation and/or planning occur,
when an individual is depressed or perseverating on a
trigger issue, and therefore may prevent the downward
spiral of emotion in a vulnerable individual before a sui-
cide note is posted or plans are enacted.
Conclusions
Posting suicide notes on online social networks like Face-
book is a recent phenomenon. Health care providers need
to be aware of this new type of suicide announcement and
its possible consequences. To date, it is unclear if the over-
all effect of such notes will in fact lead to greater encour-
agement of suicide or to greater opportunities for suicide
prevention. Careful evaluation of these competing factors
is necessary in the future, given the widespread use of on-
line social networks.
Conflicts of Interest
The authors have no personal or professional conflicts of
interest to disclose.
T. D. Ruder et al.: Suicide Announcement on Facebook 281
© 2011 Hogrefe Publishing Crisis 2011; Vol. 32(5): 280–282
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About the authors
Thomas Ruder is a forensic radiologist with the Virtopsy Project
at the University of Bern, Switzerland. His research interests in-
clude postmortem magnetic resonance imaging, disaster victim
identification, general forensic practice, and medical humanities.
Gary Hatch is a forensic radiologist with the Virtopsy Project at
the University of Bern, Switzerland. In addition to general topics
in diagnostic radiology, his research interests include postmortem
cardiopulmonary imaging, fire fatalities, and public health aspects
of forensic imaging.
Garyfalia Ampanozi is a forensic pathologist with the Virtopsy
Project at the University of Bern, Switzerland. Her research in-
terests include postmortem imaging of the cardiovascular system,
postmortem angiography, and forensic radiology in general.
Michael Thali is a Professor of Forensic Medicine at the Institute
of Forensic Medicine at the University of Bern, Switzerland. He
is the principle investigator and a founding member of the Vir-
topsy Project and has authored numerous scientific articles, re-
views, and texts about forensic medicine, ballistics, and virtual
autopsy.
Nadja Fischer is a resident at the Psychiatric Clinic in Chur, Swit-
zerland, with training in forensic pathology. Her research topics
include forensic psychiatry and general forensic pathology.
Thomas D. Ruder
Institute of Forensic Medicine
University of Bern
Buehlstrasse 20
CH-3012 Bern
Switzerland
Tel. +41 31 631-8411
Fax +41 31 631-3833
E-mail thomas.ruder@irm.unibe.ch
282 T. D. Ruder et al.: Suicide Announcement on Facebook
Crisis 2011; Vol. 32(5): 280–282 © 2011 Hogrefe Publishing
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The objective of this study was to better help those in suicidal crisis by examining the types of suicide-risk individuals who make use of the Internet in relation to their suicidal problems. An anonymous online survey examined suicide-risk individuals who went online for suicide-related purposes (n = 165) and a reference group of suicide-risk individuals with no such experience (n = 125). Suicide-risk individuals who went online for suicide-related purposes, compared with online users who did not, reported greater suicide-risk symptoms, were less likely to seek help, and perceived less social support. Online, many reported more support, felt less alienated, believed they reduced their suicidality, but also sought suicide methods and were likely to visit "pro suicide" sites. Implications include designing help sites that allow peer-to-peer communications and anonymous professional support.
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Self-harm and suicide websites have been heavily criticized both in the literature and the wider media, despite the fact that very little is known about them. To date, no study has interviewed users of these sites about them. This qualitative study aims to explore the accounts of young adults who engage in self-harming and suicidal behaviors and use websites dedicated to these issues, in order to develop a broader understanding of these websites and to identify potential implications for future research. In-depth interviews were conducted via e-mail with 10 participants, who were recruited directly from self-harm and suicide websites. Using discourse analysis, we identified three main ways in which participants wrote about the sites. They constructed them as sources of empathy and understanding, as communities, and as a way of coping with social and psychological distress. These discourses gave users access to important, socially valued identities, such as being understood, belonging to a community and coping with their problems. If health professionals and researchers hope to understand people who use self-harm and suicide websites, and engage them in their services, they must take a more balanced view and not focus solely on the possible risks associated with using such sites.
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A total of 293 findings from 42 studies on the impact of publicized suicide stories in the media on the incidence of suicide in the real world were analyzed by logistic regression analysis. Studies measuring the effect of either an entertainment or political celebrity suicide story were 14.3 times more likely to find a copycat effect than studies that did not. Studies based on a real as opposed to fictional story were 4.03 times more likely to uncover a copycat effect. Research based on televised stories was 82% less likely to report a copycat effect than research based on newspapers. A review of recent events in Austria and Switzerland indicates that suicide prevention organizations can successfully convince the media to change the frequency and content of their suicide coverage in an effort to reduce copycat effects.
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There is strong evidence for the existence of the Werther effect, or the phenomenon of an observer copying suicidal behavior he or she has seen modelled in the media. As a consequence, a number of countries have developed guidelines that promote responsible reporting of suicide. Using nine such guidelines as examples, this paper demonstrates that they tend to have similar content (emphasizing, for example, that suicide should not be glamorized or sensationalized and that explicit descriptions should be avoided, and stressing the importance of providing information about help services), but differ in the way in which they have been developed (e.g., the extent to which media professionals have been involved) and implemented (e.g., whether their "roll-out" has involved a considered dissemination strategy). The paper also reviews the evidence from evaluations of media guidelines, and concludes that it is too limited to determine whether the guidelines have had an impact on the behavior of media professionals or on completed and attempted suicide rates. It makes recommendations for further evaluative work, and suggests that the lessons from well-designed evaluations should be shared.
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Clinical psychological discourse contains a varied array of evaluations of the risks and/or benefits of Internet message boards where people can discuss their suicidal thoughts. Public opinion contends they are harmful. To assess this assumption, an online questionnaire (N = 164) survey was conducted on a German message board for suicidal people. Three user types were identified with differing motives for visiting the forum and different usage effects of the message board. The results contradict the assumptions that suicide message boards are generally a source of potential harm and that they foster suicidal tendencies and point instead to their predominantly constructive or even suicide-preventive functions.
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The present case report describes a 17-year-old female who explicitly visited suicide web forums, where she researched reliable suicide methods, contacted an anonymous user and purchased substances for the implementation of suicide. The risk of Internet use by vulnerable youth is discussed. Psychiatric exploration should include questions of manner and frequency of media use. The application of media guidelines for suicide prevention is demanded for websites, as are accessible self-help sites for suicidal persons targeted to youthful users.
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The internet as a widespread source of communication is already having a significant influence in medicine and psychiatry. Although the internet has great potential in psychiatric education, clinical care, and research, its impact on social issues should not be underestimated. Firstly, the internet as a means of communication may encourage suicidal behavior by depicting ways by which suicide may be committed. Secondly, some internet websites may discourage people with mental illness from seeking psychiatric help, condone suicide, and forbid entry to anyone offering to discourage users from committing suicide. However, the internet could be a resource to help a potentially suicidal person get help, and can be used to identify those at risk for suicide, communicate with them, and potentially prevent suicide. If used appropriately, the internet is a powerful communication tool that can be used to benefit suicidal patients.
Parasuicide online: Can suicide web-sitestriggersuicidalbehaviorinpredisposedadolescents?Nor-dic
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Becker, K., Mayer, M., Nagenborg, M., El-Faddagh, M., & Schmidt, M.H. (2004). Parasuicide online: Can suicide web-sitestriggersuicidalbehaviorinpredisposedadolescents?Nor-dic Journal of Psychiatry, 58, 111–114
Woman posted " suicide note " on Facebook then jumped to her death. Telegraph. Retrieved from http:// www.telegraph.co.uk/news/worldnews/europe/spain/7206611/ Woman-posted-suicide-note-on-facebook-then-jumped-to-he r-death
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Govan, F. (2010). Woman posted " suicide note " on Facebook then jumped to her death. Telegraph. Retrieved from http:// www.telegraph.co.uk/news/worldnews/europe/spain/7206611/ Woman-posted-suicide-note-on-facebook-then-jumped-to-he r-death.html
Facebook suicide threat sparks massive manhunt in Eilat
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Levy-Stein, R. (2009). Facebook suicide threat sparks massive manhunt in Eilat. Haaretz. Retrieved http://www.haaretz. com/news/facebook-suicide-threat-sparks-massive-manhunt- in-eilat-1.3436