Use of digital media in suicide prevention in adolescents and young adults.

Suicide is the leading cause of death in young adults of age group 15–29 years, second only to road traffic accidents and violence. At ages 15–29, suicide is the leading cause of death in both males and females and is almost similar to death by road accidents in males and maternal deaths in women.[1] In India, suicide is still thought to be underreported, and suicidal attempts are estimated to be twenty times that of completed suicides as per death records.[2] Suicidal prevention has remained a prime focus of the WHO. In a similar vein, the National Mental Health Policy of India has suicidal prevention as a major goal.[3] There are limited programs and few effective interventions to prevent suicide and related behaviors in young population although it is highly prevalent in this group worldwide. Restricting access to means, suicide helplines, school mental health programs, school and college counseling, and enlisting support of the peers have been employed as interventions to prevent suicide and proved to be potentially helpful.[4] Both internet use and suicide are highly prevalent among young adults. It makes a case for the use of digital media in the prevention of suicide for adolescents and young adults. People are now spending most of their time interacting in digital media. The time spent on face-to-face conversation is much less compared to that in the virtual world. This rapid increase in the usage of digital media in young people is due to the rapid introduction and upgradation of smartphones. Thus, when one plans to make an impact on these individuals, it is better to approach them through digital media.

DIGITAL MEDIA AND ADOLESCENT SUICIDE

In Saving and Empowering Young Lives in Europe project involving nine European countries, risk behaviors were categorized into illegal drug use, heavy smoking, reduced sleep, overweight and underweight, sedentary behavior, truancy, and high media exposure (defined as 5 h or more of nonessential media and Internet usage).[5] Apart from direct Internet usage, other risk factors such as sleep deprivation, sedentary habits, and weight gain can be the consequences of heavy media usage. Durkee et al.[6] reporting from the same study mentioned the pathological use of the Internet in 4.4% of the participants. Heavy Internet usage has been linked to different psychiatric disorders including depression and suicidal ideation and attempts.[5] In a recent review article published in this journal, it was reported that greater time spent on online social networking sites leads to greater exposure and greater chance of self-harm behavior in adolescents.[7] Copycat and live streaming of suicide are on the rise. In India, there were cases of live streaming of suicide and those were shared by many people, but due to lack of sensitivity and effective mechanisms in place, their lives could not be saved. Most of the literature and experience warn about the negative consequences of Internet usage on mental health. However, it is established that adolescents spend more time with virtual community rather than real friends and communities. This may be annoying to many of us, but this cannot be wished away. This virtual network of friends and communities has to be utilized to prevent suicide and promote mental health.

DIGITAL MEDIA IN THE PREVENTION OF SUICIDES

There have been instances when suicide could be prevented because people responded to messages on Facebook, nearby people and police were informed, and potential victims were connected with suicidal helplines. Durkheim project is one such project that has been undertaken to prevent suicide in American veterans with the help of Facebook.[8]

INDIAN SCENARIO

Smartphones are reaching the remote corners of India and by the end of 2018, the number of smartphone users would touch 337 million mark.[9] An average Indian adolescent spends more time on nonacademic use of smartphones and the Internet than his/her counterparts in other countries. This makes our adolescents highly vulnerable to adverse mental health consequences of digital media exposure including suicide. Hence, it is necessary to target these individuals by promoting suicidal prevention through digital media. Some of the effective measures in this direction could be as follows:

Monitoring the content of social media and identifying suicidal thoughts or plans through artificial intelligence

Training and educating youth and teachers (gatekeeper training) to identify warning signs in their peers and having clear procedures to be followed like connecting to suicidal helplines who in turn can take further action

Using digital media to run awareness programs

Putting positive content related to mental well-being on Internet blogs.

Use of digital media is destined to increase for both essential and nonessential purposes with its accompanying positive and negative consequences. Its enormous potential has to be harnessed for positive mental health and suicidal prevention, particularly in adolescents and young adults.