The private sector plays an enormous role in healthcare. Many of the policies made by the public sector affect the services provided by the private sector (Longest, 2010). In Arizona, there are many different private organizations that influence mental health. Arizona has many private clinics, hospitals, and other organizations that provide direct patient care. One organization, Bayless Integrated Healthcare, provides care for both physical and mental health. They offer “Virtual Care” so patients can see their providers using their cell phones from anywhere they please (Bayless Integrated Healthcare, 2020). Flexible, innovative tele-health approaches like these can increase access to care and provide services to patients with minimal disruption to their lives. This is important for youth because they can have their behavioral health needs met without missing precious time at school.
As we know, social media plays a large role in daily life for youth and many people have written suicide notes on social media. Some studies are trying to understand the links between the internet and mental health including suicidality. Issues such as cyberbullying and harassment on social media negatively impact youth mental health and have been linked to youth suicide due to increasing feelings of isolation and hopelessness (Luxton, June, & Fairall, 2012). Although there are chat rooms where people can go for support with mental health issues, there are also chat rooms and platforms where people spread prosuicide information, such as ways for people to die by suicide.
Fortunately, some social media platforms are taking innovative approaches to solving this issue. Facebook has pages for the National Suicide Prevention Lifeline and the American Foundation of Suicide Prevention that share resources and information for suicide prevention (Luxton, June, & Fairall, 2012). Facebook began using artificial intelligence in 2017 to identify posts that signify suicidal ideations and then either send the user information about resources or the content moderators share this information with law enforcement (Goggin, 2019). Although this does open up some privacy concerns, this is intervention may lead to lives being saved. YouTube has many videos about suicide prevention that have been made by organizations and individuals (Luxton, June, & Fairall, 2012). Google’s search engine provides the National Suicide Prevention Lifeline whenever a search involves suicidal ideation or intent (Luxton, June, & Fairall, 2012). Interventions like these meet youth where they are at and provide direct suicide prevention strategies.
Other organizations are trying to use technology for suicide prevention, as well. Mobile apps for therapy and mood tracking have been created to predict and prevent suicidality, although research on their efficacy is still lacking (Vahabzadeh, Sahin, & Kalali, 2016). We know that youth suicide is a complex issue and it is great to see the innovative approaches that people are taking to tackle this issue from many different angles.
References
Bayless Integrated Healthcare. (2020). Virtual care. Retrieved from https://www.baylesshealthcare.com/virtual-care/
Goggin, B. (2019). Inside Facebook’s suicide algorithm: Here’s how the company uses artificial intelligence to predict your mental health state from your posts. Retrieved from https://www.businessinsider.com/facebook-is-using-ai-to-try-to-predict-if-youre-suicidal-2018-12
Longest, B.B. Jr. (2010). Health policymaking in the United States (5th ed.). Chicago, IL: Health Administration Press.
Luxton, D. D., June, J. D., & Fairall, J. M. (2012). Social media and suicide: a public health perspective. American journal of public health, 102(S2), S195-S200. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3477910/
Vahabzadeh, A., Sahin, N., & Kalali, A. (2016). Digital suicide prevention: can technology become a game-changer?. Innovations in clinical neuroscience, 13(5-6), 16. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5077254/
Child and Adolescent Suicide in Arizona 
Thank you for discussing the various innovative ways in which private sectors are positively influencing and impacting mental health care, specifically through ease of accessibility. I really appreciate your discussion about telehealth, particularly for youth so they do not miss classroom education. In situations such as that do you see an increase in appointment and or medication compliance? The ability for a youth, particularly in high school, to have a proactive role in their mental health seems as though it would be very empowering and may increase the “buy in” to mental health treatment compliance. Social platforms, when positive, can be an important element for adolescents, particularly in crisis. In today’s society adolescents are more comfortable utilizing technology and social media and having resources available to meet their communication comfort level is important.
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I appreciate your blog and also have been wondering what the evidence is determining how much of an influence social media has on child and adolescent suicidality. I suspect it has caused a rise in it as you mentioned the spread of prosuicide information. Kids have so much information right at their finger tips, many time inaccurate or dangerous information. Many cases I see the child has gotten help due to a friend seeing a social medica post communicating suicidality. So I can see some of the positive aspects of children having access to these connections with each other.
A systematic review by Sedgwick, Epstein, Dutta and Dennis (2019), studied suicide attempts in children younger than 18 years of age and did find an independent association between problematic social media use and suicide attempts. They point out after the study of six systematic reviews that there is a correlation between increased screen time and poorer mental health in young people. However, it also found that social media use fostered a sense of community and support for young people. They urge more longitudinal studies for further support these findings. Something I found very interesting in this article was the use of internet search history data being used a surveillance and detection ofT those at risk for suicide. The authors’ referenced an article by Chandler 2018) (as cited in Sedwick, et al, 2018) that found a positive correlation between search intensity of suicide -related terms and the number of suicides across American between 2006-2014, in particular for youth.
It seems there is a plethora of data and types of studies that can be conducted to further investigate the influence of social media and suicidality in our youth. Thanks for you work on this blog.
References
Sedgwick, R., Epstein, S., Dutta, R., & Dennis, O. (2019) Social media, internet use and suicide attempts in adolescents. Current Opinion in Psychiatry, (32) 6, 534-541.
Chandler, V. (2018) Google and suicides: What can we learn about the use of internet to prevent suicides? Public Health, 154: 144-150.
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This is an interesting topic, especially considering the role that the private sector can potentially undertake. It is great to see private social media and tech companies take a very forward-thinking role in suicide prevention by trying to bring help to those that are obviously reaching out for answers. You are right in that it is ethically complex when it comes to dealing with privacy concerns that such measures present. While I understand that suicide ideation or suicide planning is not part of mandatory reporting requirements such as child abuse or neglect falls under, would this be something from a policy standpoint that would be beneficial? Considering my background is in pediatrics, I wonder what would happen with these private businesses if suicide ideation/planning was added to the mandatory reporting laws at currently in effect for child safety. I realize that suicide ideation/planning/attempts are red flags for child abuse and neglect, as well as other social issues, but is not in and of itself mandated as a report for Arizona. However, in Arizona the White Mountain Apache Tribe mandated reporting of suicidal behavior (Surveillance Success Stories – White Mountain Apache Tribe | Suicide Prevention Resource Center, n.d.). Even then, if it was mandated, how would that affect a large corporation? Would that be a standard to hold them to? A very intriguing thought indeed.
Reference:
Surveillance Success Stories – White Mountain Apache Tribe | Suicide Prevention Resource Center. (n.d.). Retrieved March 26, 2020, from https://www.sprc.org/news/white-mountain-apache-tribe-surveillance-success-story
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I like your post which talks about the importance of social media in preventing suicide in youth. I work in an adolescent behavioral health unit and have come across many instances where suicidal ideation and plans are shared by adolescent patients on social media and then their friends inform their parents or teacher. In this manner, social media which is generally a private sector plays an important role in preventing suicide. There is no doubt that social media plays an important role in preventing suicide. Facebook provides features where one can flag friends’ suicide post and the person who has been flagged gets message from facebook with tips to talk to someone on a crisis line (Sobowale, 2016).
Reference
Sobowale, K. (2016). Using social media to prevent suicide. Retrieved from https://www.statnews.com/2016/06/20/suicide-adolescents-social-media/
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This post was fascinating to read because it reaches some of the core issues related to research on how technology use interacts with suicidal behaviors and suicide prevention efforts. Specifically, interesting was the idea that social media plays an outsized role in the daily life activities of adolescents and adults. It is also notable for agreeing that many studies and academic research on this topic occurred recently and continues to be on-going as current research projects are trying to address this connection between technology use and suicidal behaviors in adolescents and young adults. Some of my research, indeed, focuses on this particular topic as I am working on completing a systematic review on the connection between technology use and suicidal behaviors in young or emerging adults.
One of the things that I found during my research that might be of interest to you for your future research is that the connection between social media use and suicidal behaviors and psychological well-being is between weak to moderate correlation (Orben & Przybylski, 2019a; Orben & Przybylski, 2019b; Twenge et al., 2020). Unfortunately, there is an extensive gap in the research that leaves largely unaccounted research elements that have the potential for mediating variables to mitigate some of the potential adverse effects of social media use (Clarke et al., 2015; Przybylski & Weinstein, 2017; Haidt & Twenge, 2019; Orben & Przybylski, 2019a; Orben & Przybylski, 2019b). Some of the most notable problems with this body of research are a host of measurement issues, lack of transparency, small amounts of reproducible or confirmatory research, and overinterpretation or reliance on minuscule effect sizes (Orben & Przybylski, 2019a; Orben & Przybylski, 2019b).
As to your point about adolescents and young adults using the internet for dual-use purposes of seeking mental health aid and pro-suicidal information resources, two studies notably address this issue at length (Ozawa-de Silva, 2008; Haidt & Twenge, 2019; Hall et al., 2019; Collis & Eggers, 2020). Thus, the concept of internet suicide might be merely a recent and troubling manifestation of a globally-influential and widespread existence of psychological suffering that combines newer communication methods (the internet and social media) with a long-held historical threat of encountering strangers (Ozawa-de Silva, 2008).
References:
Collis, A., & Eggers, F. (2019). Effects of restricting social media usage. Available at SSRN 3518744. Retrieved from https://osf.io/preprints/socarxiv/udgxt/
Clarke, A. M., Kuosmanen, T., & Barry, M. M. (2015). A systematic review of online youth mental health promotion and prevention interventions. Journal of youth and adolescence, 44(1), 90-113.
Haidt, J., & Twenge, J. (2019). Social media use and mental health: A review. Unpublished manuscript, New York University.
Hall, J. A., Xing, C., Ross, E. M., & Johnson, R. M. (2019). Experimentally manipulating social media abstinence: results of a four-week diary study. Media Psychology, 1-17.
Przybylski, A. K., & Weinstein, N. (2017). A large-scale test of the goldilocks hypothesis: quantifying the relations between digital-screen use and the mental well-being of adolescents. Psychological Science, 28(2), 204-215.
Orben, A., & Przybylski, A. K. (2019a). The association between adolescent well-being and digital technology use. Nature Human Behaviour, 3(2), 173.
Orben, A., & Przybylski, A. K. (2019b). Screens, teens, and psychological well-being: Evidence from three time-use-diary studies. Psychological science, 30(5), 682-696.
Twenge, J. M., Blake, A. B., Haidt, J., & Campbell, W. K. (2020). Commentary: Screens, Teens, and Psychological Well-Being: Evidence From Three Time-Use-Diary Studies. Frontiers in Psychology, 11, 181.
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