Suicide Prevention and Social Media: A framework for Young Australians using

Community of Inquiry (CoI)

Suku Sukunesan and Ashir AhmedSwinburne University of Technology

Outline

• Background• Issues – Cyberbullying, Suicide ideation,

Reporting Suicide • Proposed framework – CoI• Operationalising the framework• Conclusions and Future work

Social media boasts plenty of benefits and increasingly kids are

introduced early.

• SM has presented a new set of challenges in the field of suicide prevention (Robinson et al., 2014, Katz et al., 2014) and self-harm.

Cyberbullying

• Cyberbullying is rife within SM and the numbers of victims are alarming (Price and Dalgeish, 2010; Robinson, 2012).

• Cyberbullying (Schenk and Fremouw, 2012) and SM sites that glorifies suicide (Sisask and Varnik, 2012) have a strong link to suicide ideation

• This provokes suicidal copycat behaviour called the ‘Werther effect’

Intentional self-harm hospitalisations by sex, persons of all ages and 15-24 years,

1992/93 – 2011/12 Blue – male

Red - female

Suicide rates per 100,000 population across various age groups in 2010

(Australian Bureau of Statistics, 2012) Blue – maleRed - female

The vulnerable young• Easily influenced by media, fictional movies and characters. Most

of them (especially men) believe that they are strong enough to deal with any problem without any external help or assistance

• Unwillingness to seek help is contributed partly by negative beliefs about the usefulness of therapy and therapists or having no experience of previous professional mental health care (Jarkon–Horlick and Morrissey, 1997).

• Lower intention to seek help (Rickwood et al., 2007; Wilson and Deane, 2010) and higher intention seek no help at all (Fergusson and Horwood, 2010)

• Only a small proportion of cases get timely and evidence-based treatments (Sanderson, Corry and Lapsely, 2000)

Contextual Role of SM• An advantage of using social media applications for suicide prevention and

outreach is that they facilitate social connections among peers with similar experiences (Luxton et al., 2011).

• Collin et al. (2010) argue that ‘strong sense of community and belonging fostered by social media has the potential to promote resilience, which helps young people to successfully adapt to change and stressful events’.

• Ability to update users on recent medical information including sources of help, provision of self-assessment and also the opportunity for real-time intervention (Robinson et al., 2014).

• Burns et al. (2013) presented an evidence based literature review of over 50 cases examining the use of social media by young people that showed significant benefits to their mental health by delivering educational outcomes; facilitating supportive relationships, identity formation and promoting a sense of belonging and self-esteem.

Community of Inquiry (1)

• The framework, called the Community of Inquiry (CoI) model was first proposed by Garrison, Anderson and Archer (2000) and has been used extensively in education research.

• The CoI Framework proposes that learning occurs through the interaction of 3 elements, viz. cognitive presence, social presence and teaching presence.

Community of Inquiry (2)• Cognitive presence refers to the extent to

which the participants in the community are able to construct meaning through their rich communication.

• Social presence is the extent to which participants can project their personal characteristics to the community.

• The teaching presence refers to the dual functions of design and facilitation of educational experience.

CoI in Context (1)• Cognitive Presence is enhanced through social media’s ability to

crowd source various ideas and approaches to overcome suicide prevention.

• There is no silver bullet but various social media applications as mentioned by Kaplan and Haenlein (2010) would require unique but concerted effort.

• This would facilitate vulnerable young people to build meaning through ongoing communication involving other individuals experiencing the same situation.

• This collective knowledge also helps social exploration of ideas to combat suicide prevention mainly in reducing suicide ideation (Eichenberg, 2008; Harris et al., 2009).

• This space can include external research organisations that are not affiliated with the Australian government such as the National Suicide Prevention Lifeline (www.suicidepreventionlifeline.org) or American Suicide Prevention Foundation (www.aspf.org).

CoI in context (2)• Social Presence is characterized by young people’s

ability to participate in various online social environments.

• This allows them to assume an identity while developing valuable links with the community for socio-emotional support.

• Studies have shown that young people are known to practice open collaborative social interaction (Robinson, 2012).

• Social presence is particularly important as young people are immature in decision making (Viner, 2005) and they do need to establish a healthy online social life without adverse elements like cyberbullying which has strong relationship with suicide ideation (Schenk and Fremouw, 2012).

CoI in context (3)• Teaching Presence represents guidance and structure

provided by government, health department or people with authority given the mandate to curb suicide among young people.

• This involves the usage of social media to roll out structured programs for suicide prevention involving design, facilitation and monitoring of the activities with the aim to educate young people with the support of the legal framework.

• Programs such as BoysTown (2010), and Bullying.Noway (2014), and organisations such as the Orygen Youth Health (oyh.org.au), Australian Suicide Prevention Foundation (www.aspf.com.au), Sane Australia (sane.org), Suicide Prevention Australia (suicidepreventionaust.org), Beyond Blue (www.beyondblue.org.au) and Lifeline Australia (lifeline.org.au) would fall into this category.

CoI in context (4)• Supporting Discourse is mainly characterised by young people

reaching out to general public and non-governmental bodies about suicide prevention. Various social media applications play host to support a range of forums run by qualified volunteers such as the International Suicide Prevention Wiki (http://suicideprevention.wikia.com/wiki/Online). Sites as this have discussion forums, live chats, videos, pictures and other interactive media allowing young people to share experiences and ideas from people around the world.

• Selecting Content could be described by government’s action is identifying appropriate forums using the social media platform to encourage and allow public contribution. This would include joint programs with external bodies in addressing suicide prevention such as the Orygen Youth Health (OYH) which has connections to the public. The support it has garnered has made it popular and similar model has been emulated in other parts around the world including countries such as the UK, Canada, Switzerland, Norway, Denmark, The Netherlands, Hong Kong and Singapore (OYH, 2014).

CoI in context (5)• Supporting Discourse is mainly characterised by young people

reaching out to general public and non-governmental bodies about suicide prevention. Various social media applications play host to support a range of forums run by qualified volunteers such as the International Suicide Prevention Wiki (http://suicideprevention.wikia.com/wiki/Online). Sites as this have discussion forums, live chats, videos, pictures and other interactive media allowing young people to share experiences and ideas from people around the world.

• Selecting Content could be described by government’s action is identifying appropriate forums using the social media platform to encourage and allow public contribution. This would include joint programs with external bodies in addressing suicide prevention such as the Orygen Youth Health (OYH) which has connections to the public. The support it has garnered has made it popular and similar model has been emulated in other parts around the world including countries such as the UK, Canada, Switzerland, Norway, Denmark, The Netherlands, Hong Kong and Singapore (OYH, 2014).

CoI in context (6)• Setting climate exemplifies good government initiatives in approaching

young people on suicide prevention. This space represents attempt by government and health authorities to capitalise various social media applications to create appropriate spaces suitable for various groups of young people to participate. Programs such as Bullying.Noway (2014), Itsallright (2014) by Sane Australia, OYH Youth program (OYH, 2014) and Headspace (2014) are all good examples within this space.

• Ideal Experience represents best practice where all involved parties have successfully worked together using the social media platform in addressing suicide prevention. In the recent 2014 National Suicide Prevention Conference held in Perth, one such program stood out, ReachOut (http://au.reachout.com/). The ReachOut site have been exemplary with more than 1.3 million unique visitors each year which also highlights the major health challenge facing young Australians.

• A survey on this program revealed that almost half (46%) of its visitors are more likely to seek additional help from other professional sources after visiting the service, reinforcing the critical and successful role ReachOut.com plays in reducing stigma (Robinson et al. 2014) and encouraging young people to seek further assistance (2013 ReachOut Survey, 2014).

CoI in context (7)Challenges • The Social Presence space is huge and has no bounds.• Hard to enforce guidelines and policies as most social media

applications based overseas which involves inter-jurisdictional legal issues (Katz et al., 2014).

• Monitoring all these sites is challenging where perpetrators can seamlessly move to other social applications and reoffend using other pseudonyms or assuming other alter egos.

• Other problems include, host site having poor resources or lack of accountability to curb deviant activities. Even when the host sites are responsible, some victims are so young and naïve that they are continuously bullied or discriminated over long periods of time without knowledge especially younger kids or new users (Robinson, 2012).

CoI in context (8)Challenges • Within the Cognitive Presence revolve around the issues of responding in time,

finding the right resource, getting the proper assistance and the right intervention.• Rodriguez et al. (2014) noted that there many community sites built by volunteers,

students, unqualified individuals and others who have been through suicidal ideation. Though their intent could be genuine they lack in the required skills in addressing the problem and they are not affiliated to government or health organisation.

• Due to lack of funding most of these sites are keener to promote about what they do rather than to actually deliver the service in hope to get sponsorship and get more traffic (Robinson et al., 2014).

• Responsibilities should also be taken by major social media platforms to address this crisis given the number of users and gravity of the issue. i.e. Tumblr, Facebook, Twitter, YouTube and MySpace have lately taken a keen interest in placing safety and reporting mechanisms which connect their services to police and other government bodies.

CoI in context (9)Challenges • Shortages of funding, lack of understanding about the social

media and lack of resources have been the major issues compounding the Teaching presence.

• Not all programs are successful as ReachOut despite the government’s effort in addressing suicide prevention.

• It has also been obvious that there isn’t sufficient research established to date to be modelled as an accepted practice using social media to deliver interventions while addressing the ethical concerns. Though there are several studies which are on the way, findings are still in early stages (see OYR, 2014; Young and Well Cooperative Research Centre, 2014).

Conclusion and Future

• Social media stands out as a great avenue to be explored for this research due to its uptake, features, diversity and capability.

• Authors have adapted the CoI framework to address the issue.

• Future work will involve the validation of the CoI model based on the projects mentioned above i.e ReachOut, BoysTown, Bullying.Noway, Orygen Youth Health etc.