The use of social media has for many become an indispensable part of everyday life, offering access to news, insights, and social interaction. On average users spend almost 2 h a day interacting with social media platforms [1], and their relatively decentralized form has made them a useful tool during emergencies and natural disasters, helping provide real-time updates, allocate resources and organize volunteers [2]. Social media has also been used by many social activists as an effective platform for information exchange and coordination in social movement worldwide during the past decade [3] and has been identified as a key method of mobilizing participants in Hong Kong’s Umbrella Movement protests in 2014 [4] and Anti-Extradition Law Amendment Bill (Anti-ELAB) protests in 2019 [5].
As an open forum, social media allows researchers to see the “digital footprint” of political participation, which is essential to understanding the dynamics of modern-day activism, particularly when “leaderless” or self-organized and uncoordinated political actions are commonplace [3]. Despite the utility of social media during certain events and incidents, there are concerns about how information may be misrepresented (intentionally or unintentionally), and the impact on social behaviours and mental health. The spread of “fake news” has been a concern, including surrounding political events such as the US election of 2016, and the risks of misinformation over social media have been described by the World Economic Forum as one of the major global threats to society [6]. Evidence shows that the demographic characteristics of the deceased person may influence emotional responses, and some emotional responses like sadness and anger show positive correlation with following days’ suicide count [27]. Meanwhile, certain forms of reporting of suicide in the media have been shown to increase the suicide rate [7, 8], and there is evidence that social media engagement with prominent suicides may also increase incidence of suicide [9].
During the period June 2019–January 2020, Hong Kong saw the largest series of protests in recent history, triggered by the proposed Anti-Extradition Law Amendment Bill (Anti-ELAB). Mass marches and peaceful rallies were interspersed with increasingly confrontational stand-offs over the following 6 months, culminating in fiery street clashes between police and demonstrators across the city, including in the central business districts and at a number of universities in November 2019. It is estimated that more than 16,000 rounds of tear gas were fired across the 6-month period.
From January 2020, the frequency of protest gatherings began to subside with the emergence of COVID-19, after which very strict social distancing measures have been in place. During the period of social unrest, nearly 10,000 protesters, mainly young people, had been arrested and many were charged with serious offences such as rioting.
Over the protest period, several suspected protest-related suicides were widely reported. In particular, the death of a 35-year-old man (Mr Leung Ling-kit) with an Anti-ELAB banner who, despite the efforts of firemen, policemen and onlookers, fell from a building in Admiralty, Hong Kong, gained considerable public attention. Tribute art portraying the yellow raincoat worn by Mr. Leung was widely circulated and there was much discussion. Further suspected suicides followed and were linked to the protest movement by media reports and online discussion. Figure 1 shows the trend of social media hot threads (top 10% threads with most replies) during January 2019–May 2020, where the discussion peaks usually followed those suspected suicides and/or related deaths.
Remembrance gatherings related to the deaths and other forms of recognition of these cases were presented as an opportunity for cathartic collective grieving and sense-making of the incident as part of wider concerns about the government bill, and such gatherings may have conceivably offered comfort to loved ones, as well as encouraging social support and help-seeking behaviours for those that may have been feeling desperate, potentially contributing to a positive social cohesion effect [10]. On the other hand, there were concerns that the attention around these deaths and possible subsequent romanticisation may contribute to overly sensationalized and dramatized reporting, leading to increased suicidal risk amongst those who may be unstable and vulnerable, or copycat suicides of the kind found by researchers to occur after highly reported suicide deaths of famous people (known as the “Werther Effect”) [7, 8, 11, 12].
Additional suspected suicides and other undetermined deaths of protesters that were reported online and discussed in social media occurred in subsequent days, weeks and months, coinciding with the most intense period of the protests. Following an incident between police and protesters at a Hong Kong subway station in late August 2019, rumours of deaths being covered up or suppressed to avoid political consequences increased, and speculation about possible foul play relating to two particular deaths in September and November ensued, including that evidence was concealed [13]. These were the deaths of Ms. Chan Yin-lam (aged 15, a student, found unclothed at sea) and Mr Chow Tsz-lok (aged 22, a student that fell from a height in a carpark compound). Both deaths stirred considerable media suspicion, emotion and rumours of possible foul play. Some protesters even took to social media to share videos or photos in which they stated categorically that they would not take their own lives, in order to address fears involving suspicions and mistrust, should anything happen to them [14]. It turns out the two cases have been given the verdict of underdetermined cause of death for Ms. Chan and an open verdict to Mr Chow death by the Coroner Court recently. Unhelpful and sensational speculation (intentionally and/or unintentionally) may have been avoided had these cases been investigated by the Coroner Court more urgently.
It is well established that suicide is a complex phenomenon generally resulting from many factors [15]. However, a desire to attribute a suspected suicide to specific causes may be particularly strong in certain political circumstances, and contribute to perceptions of suicide as a form of political martyrdom, or expression of collective frustrations or despair over perceived social injustice, stirring up the emotions in the community to provide the spark or sustenance for a social movement, such as in the case of Thich Quang Duc in Vietnam in 1963 [16], Ryszard Siwiec in Warsaw in 1968 [17], Jan Palach in Prague in 1969 [18], and Mohamed Bouazizi prior to the Arab Spring protests in 2010 [19]. This raises questions over how these deaths in Hong Kong may have influenced the ensuing escalation in social unrest.
Suicide prevention professionals and media operators can find themselves in a difficult position. On the one hand, they have a duty to mitigate the risk of suicide contagion, a phenomenon that has been seen also in protest-related suicides [20]; on the other hand, where there are major social tensions, journalists may be concerned about appearing to suppress coverage of acts that could be perceived as political statements, or of undermining freedom of speech [21]. This was a situation that Hong Kong found itself in during the 2019 protests, as suspected suicides became linked in the media, not only locally but also internationally, to themes of martyrdom and self-sacrifice [23,24,25]. Such portrayals are discouraged by the best practice guidelines of suicide reporting due to concerns of the possibility of similar copycat incidents, as per the Werther Effect [25].
Evidence linking media reporting on suicide with suicide cases has led to media being urged to avoid sensationalizing cases or giving too much detail [25], with some experts suggesting reducing the coverage of suicides altogether [26]. There is evidence that the quantity of social media responses to suicide deaths, and the sentiment characterized by those responses, may predict subsequent incidence of suicide [9, 27]. This may be especially pertinent during times of political upheaval or social unrest, when citizen journalists or activists may use media to stimulate emotions or conversations. At present, there is little research into how existing media guidelines and suppression of suicide stories may or may not lead to discussions being pushed underground into social media channels, at risk of further stirring speculation and reliance on unauthoritative source materials. Good media management for suicide prevention must consider political contexts and secondary effects beyond traditional media.
One important consideration for understanding the social movement and suicide contagion risks involves the mechanisms by which social media may have propagated narratives and speculation relating to these deaths. In this paper, first, we examine the patterning of suspected suicides and deaths with undetermined causes, and the level of engagement and discussion they created in social media. While these protest deaths are not the sort of “celebrity deaths” that have been well studied for copycat effects, it is suggested that the impact on vulnerable individuals could be as much if not more due to the perception that they were fellow members of the protest movement and, therefore, highly relatable. This paper, second, looks at the evidence for an increase in suicide rate during the protest period.
By analyzing social media data and the characteristics and phenomena of social media discussion on suicide in this article, we also consider whether these deaths and the beliefs around them, including speculation that the deaths involved acts of self-sacrifice or foul play, may have been the catalyst for increased social media engagement and provided an emotional anchor to unite protesters together, possibly romanticizing the deaths and offering impetus to sustain the social movement through the end of 2019.