Social Media and Suicide: A Review of Technology-Based Epidemiology and Risk Assessment.

Introduction: Suicide is a significant public health problem among teenagers and young adults in the United States, placing significant stress on emergency departments (EDs) to effectively screen and assess for the presence of suicidality in a rapid yet efficient manner.
Methods: A literature search was performed using PubMed and MEDLINE with the following terms: "Social media," "Suicide," "Facebook®," "Twitter®," "MySpace®," "Snapchat®," "Ethics," "Digital Media," and "Forums and Blog." Data were extracted from each article, specifically the sample size, study setting, and design. Only English-language studies were included. We reviewed the reference lists of included articles for additional studies, as well. Abstracts, unpublished data, and duplicate articles were excluded.
Results: A total of 363 articles met our initial criteria. Studies older than 10 years and/or in a language other than English were removed. After review, a total of 31 peer-reviewed articles were included in the study. Teenagers and young adults often fail to disclose risk factors to physicians, despite sharing them with the public on social media platforms such as Facebook and Twitter. Therefore, physician access to a patient's social media can assist in identifying suicidal ideation and/or acts. Conclusions: Viewing a patient's social media accounts can help ED physicians gain perspective into his or her mental health status and identify those at risk for suicide; however, ethical and privacy concerns associated with this method of data gathering make implementation of such a practice controversial. To justify its use, formal prospective studies analyzing if and how physician access to a patient's social media influences care should be performed.