[WITHDRAWN] Discussions on Suicidality in Online Communities

Background and Purpose: In 2020, 12.2 million adults experienced suicidal ideation, 3.2 million adults made a plan to die by suicide, and 1.2 million adults attempted to die by suicide. An important protective factor for suicide prevention is connection to a supportive community, as many individuals experiencing suicidal ideation do not seek treatment or support due to fear of stigma, shame, and risk of involuntary psychiatric hospitalization. Semi-anonymous online peer support groups offer an alternative to professional help or in-person support groups, allowing individuals to avoid the perceived risk of complicating their personal lives with an admission of suicidal ideation. The primary objective of this phenomenological study was to explore the meaning of seeking support for suicidal ideation for individuals that engage with semi-anonymous online peer support groups; specifically, the r/suicidewatch online community. Seeking support for suicidal ideation will be generally defined as any content that expresses thoughts of wanting to die or kill oneself.

Methods: Data were obtained from users’ posts (N = 38) in r/suicidewatch. Users that engaged with the online community are semi-anonymous, which entails having a specific account that contains a history of content posted by the user, but no other identifying information (unless the user chooses to provide such information in the content posted). The posts were systematically analyzed using Taguette software by applying the phenomenological methodology established by Moustakas (1994): identifying significant statements, generating clusters of meaning into themes, developing textural and structural descriptions, and formulating the essential, invariant structure of the phenomenon.

Results: Significant statements from user posts were clustered into 12 themes related to precipitating factors to suicidal ideation (i.e. mental health, housing situation, past failures, relationship/family dynamics, student loan debt, general financial problems, employment problems, legal issues, medical problems, substance use), level of suicidality (i.e. ideation, having a plan, having intent), mental health treatment (i.e. current treatment, unsuccessful treatment, barriers to treatment), and support (seeking support, offering support, providing “cautionary tales”). Textural and structural analysis of these themes resulted in an understanding of the essence of the experience of engaging in these support groups: individuals feel liberated from the risk of stigma, shame, and potential involuntary psychiatric hospitalization that accompanies the disclosure of suicidal ideation in professional, crisis line, and in-person settings, particularly suicidal ideation that involves a plan or intent to die by suicide.

Conclusions: Semi-anonymous online peer support groups for suicidal ideation offer a non-judgmental space for users to receive support for suicidal thoughts, plans, and intent, without the risk of stigma, shame, or involuntary psychiatric hospitalization. Individuals that withhold expressing these thoughts in professional, crisis line, or in-person contexts risk increasing the severity and frequency of suicidality, which may increase the probability of attempting to die by suicide, and social workers can refer clients to these resources if suicidality is suspected, but not disclosed; however, further study is needed to assess the effectiveness of engaging in these groups to reduce attempts to die by suicide.