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Canadian Journal of Public Health

, Volume 108, Issue 5–6, pp e462–e467 | Cite as

The association of exposure to suicide-related Internet content and emergency department visits in children: A population-based time series analysis

  • Naveen PoonaiEmail author
  • Shruti Mehrotra
  • Muhammad Mamdani
  • Anastasia Patmanidis
  • Michael Miller
  • Javeed Sukhera
  • Quynh Doan
Quantitative Research
  • 1 Downloads

Abstract

OBJECTIVES: Suicide-related emergency department (ED) visits by children are increasing in tandem with suicide-related Internet content. Following the announcement of Amanda Todd’s suicide, her YouTube video received widespread views, providing an opportunity to explore this association.

METHODS: Our research question was: Among Ontario children age 11–17 years, was the release of Amanda Todd’s YouTube video following her death announcement in October 2012 associated with an increase in average monthly ED visit rates for suicide-related diagnoses? We performed an interrupted time series analysis from April 2002 to December 2013, with the primary outcome as a composite of the average monthly rate of initial ED visits for suicidal ideation, intentional self-poisoning, and intentional self-harm. Secondary outcomes were average monthly rates of intensive care unit (ICU) admission and death resulting from the index visit.

RESULTS: There was a statistically significant increase in the monthly ED visit rate for the composite outcome (p = 0.02) and death or ICU admission (p = 0.006) from April 2002 to December 2013. There was no significant change in ED visit rate for the composite outcome before and after the announcement of Amanda Todd’s death, overall (119.8 versus 219.2 respectively, p = 0.5), among females (167.4 versus 316.8 respectively, p = 0.47) or among males (74.7 versus 116.9 respectively, p = 0.33).

CONCLUSIONS: Ontario ED visits for suicide-related diagnoses in 11–17 year olds increased from 2002 to 2013. However, the increase from October 2012 to December 201 3 could not be attributed to a highly publicized adolescent suicide. Our findings suggest that suicide-related Internet content is not associated with the increase in ED visits for suicidal behaviour.

Key words

Internet suicidal behaviour emergency department 

Résumé

OBJECTIFS: Les visites d’enfants aux services d’urgence (SU) qui sont liées au suicide augmentent de pair avec les contenus liés au suicide sur Internet. Après l’annonce du suicide d’Amanda Todd, sa vidéo sur YouTube a été largement visionnée, ce qui nous a donné l’occasion d’explorer cette association.

MÉTHODE: Notre question de recherche était la suivante: Chez les enfants de 11 à 17 ans en Ontario, la diffusion de la vidéo d’Amanda Todd sur YouTube après l’annonce de sa mort en octobre 2012 a-t-elle été associée à une augmentation des taux de visites mensuelles moyennes aux SU pour des diagnostics liés au suicide? Nous avons effectué une analyse des séries chronologiques interrompues d’avril 2002 à décembre 2013, le résultat principal englobant les taux mensuels moyens des visites initiales aux SU dues à l’idéation suicidaire, à l’auto-empoisonnement intentionnel et à l’automutilation intentionnelle. Les résultats secondaires étaient les taux mensuels moyens d’admission aux unités de soins intensifs (USI) et de décès résultant de la visite primaire.

RÉSULTATS: Il y a eu une augmentation significative du taux mensuel des visites aux SU pour le résultat composite (p = 0,02) et pour les décès ou les admissions aux USI (p = 0,006) entre avril 2002 et décembre 201 3. Il n’y a eu aucun changement significatif dans les taux de visites aux SU pour le résultat composite avant et après l’annonce de la mort d’Amanda Todd, ni dans l’ensemble (119,8 contre 219,2 respectivement, p = 0,5), ni chez les filles (167,4 contre 316,8 respectivement, p = 0,47), ni chez les garçons (74,7 contre 116,9 respectivement, p = 0,33).

CONCLUSIONS: Les visites aux SU pour des diagnostics liés au suicide chez les enfants de 11 à 17 ans ont augmenté de 2002 à 2013 en Ontario. Toutefois, l’augmentation d’octobre 2012 à décembre 2013 n’a pas pu être imputée au suicide hautement médiatisé d’une adolescente. Nos constatations indiquent que les contenus liés au suicide trouvés sur Internet ne sont pas associés à l’augmentation des visites aux SU dues aux comportements suicidaires.

Mots clés

Internet comportement suicidaire service d’urgence 

References

  1. 1.
    Skinner R, McFaull S. Suicide among children and adolescents in Canada: Trends and sex differences, 1980–2008. CMAJ 2012;184(9):1029–34. PMID: 22470172. doi: 10.1503/cmaj. 111867.CrossRefGoogle Scholar
  2. 2.
    Ting SA, Sullivan AF, Boudreaux ED, Miller I, Camargo CA Jr. Trends in US emergency department visits for attempted suicide and self-inflicted injury, 1993–2008. Gen Hosp Psychiatry 2012;34(5):557–65. PMID: 22554432. doi: 10. 1016/j.genhosppsych.2012.03.020.CrossRefGoogle Scholar
  3. 3.
    Luxton DD, June JD, Fairall JM. Social media and suicide: A public health perspective. Am J Public Health 2012;102(2):S195–200. PMID: 22401525. doi: 10.2105/AJPH.2011.300608.CrossRefGoogle Scholar
  4. 4.
    Leon SL, Cloutier P, Bélair M-A, Cappelli M. Media coverage of youth suicides and its impact on paediatric mental health emergency department presentations. Healthc Policy 2014;10(1):e97–107. PMID: 25410699.Google Scholar
  5. 5.
    O’Carroll PW, Potter LB. Suicide contagion and the reporting of suicide: Recommendations from a national workshop. MMWR Recomm Rep 1994; 43(RR-6):9–18. PMID: 8015544.PubMedGoogle Scholar
  6. 6.
    Gould MS. Suicide and the media. Ann NY Acad Sci 2001;932(1):200–24. doi: 10.1111/j.1749-6632.2001.tb05807.x.CrossRefGoogle Scholar
  7. 7.
    Stack S. Suicide in the media: A quantitative review of studies based on nonfictional stories. Suicide Life Threat Behav 2005;35(2):121–33. PMID: 15843330. doi: 10.1521/suli.35.2.121.62877.CrossRefGoogle Scholar
  8. 8.
    Swanson SA, Colman I. Association between exposure to suicide and suicidality outcomes in youth. CMAJ 2013;185(10):870–77. PMID: 23695600. doi: 10.1503/anaj. 121377.CrossRefGoogle Scholar
  9. 9.
    Dunlop SM, More E, Romer D. Where do youth learn about suicides on the Internet, and what influence does this have on suicidal ideation?: Influence of the Internet on suicidal ideation. J Child Psychol Psychiatry 2011;52(10):1073–80. PMID: 21658185. doi: 10.1111/j.1469-7610.2011.02416.X.CrossRefGoogle Scholar
  10. 10.
    Gould M, Jamieson P, Romer D. Media contagion and suicide among the young. Am Behav Sci 2003;46(9):1269–84. doi: 10.1177/0002764202250670.CrossRefGoogle Scholar
  11. 11.
    Alexa. The Top 500 Sites on the Web. 2016 [updated September 2016]. Available at: http://www.alexa.com/topsites (Accessed January 15, 2017).Google Scholar
  12. 12.
    ComScore. U.S. Desktop Online Video Rankings. 2015 [updated 2016]. Available at: https://www.comscore.com/Insights/Rankings/comScore-Releases-August-2015-US-Desktop-Online-Video-Rankings.Google Scholar
  13. 13.
    Seabrook J. Annals of technology. The New Yorker, 2016. Available at: http://www.newyorker.com/magazine/2012/01/16/streaming-dreamss (Accessed January 15, 2017).Google Scholar
  14. 14.
    Watch M. Canadians’ YouTube, Twitter, Facebook Usage Surpasses that in U.S. 2017. Available at: http://www.stageoflife.com/StageHighSchool/TeenYouTubeStatistics.aspx (Accessed January 15, 2017).Google Scholar
  15. 15.
    Lewis SP, Heath NL, Sornberger MJ, Arbuthnott AE. Helpful or harmful? An examination of viewers’ responses to nonsuicidal self-injury videos on youtube. J Adolesc Health 2012;51(4):380–85. PMID: 22999839. doi: 10. 1016/j.jadohealth.2012.01.013.CrossRefGoogle Scholar
  16. 16.
    Lewis SP, Heath NL, St Denis JM, Noble R. The scope of nonsuicidal self-injury on YouTube. Pediatrics 2011;127(3):e552–57. PMID: 21339269. doi: 10.1542/peds.2010-2317.CrossRefGoogle Scholar
  17. 17.
    YouTube. My Story: Struggling, Bullying, Suicide, Self Harm, 2012. Available at: https://www.youtube.com/watch?v=vOHXGNx-E7E (Accessed January 12, 2016).Google Scholar
  18. 18.
    Sachedina O. Tormenters Target Amanda Todd’s Online Memorials Amid Police Probe. 2012. Available at: http://www.ctvnews.ca/canada/tormenters-target-amanda-tod-s-online-memorials-amid-police-probe-1.994594 (Accessed January 15, 2017).Google Scholar
  19. 19.
    Bridge JA, Goldstein TR, Brent DA. Adolescent suicide and suicidal behavior. J Child Psychol 2006;47(3-4):372–94. doi: 10.1111/J.1469-7610.2006.01615.X.CrossRefGoogle Scholar
  20. 20.
    Bethell J, Bondy SJ, Wendy Lou WY, Guttmann A, Rhodes AE. Emergency department presentations for self-harm among Ontario youth. Can J Public Health 2013;104(2):e124–30. PMID: 23618204.PubMedGoogle Scholar
  21. 21.
    McMartin SE, Kingsbury M, Dykxhoorn J, Colman I. Time trends in symptoms of mental illness in children and adolescents in Canada. CMAJ 2014;186(18):E672–78. PMID: 25367419. doi: 10.1503/cma].140064.CrossRefGoogle Scholar
  22. 22.
    Cheung A, Sacks D, Dewa CS, Pong J, Levitt A. Pediatric prescribing practices and the FDA black-box warning on antidepressants. J Dev Behav Pediatr 2008; 29(3):213–15. PMID: 18550990. doi: 10.1097/DBP.0b013e31817bd7c9.CrossRefGoogle Scholar
  23. 23.
    Gibbons RD, Brown CH, Mann JJ. SSRI prescribing rates and adolescent suicide: Is the black box hurting or helping? Psychiatr Times 2007;24(12):33–37.Google Scholar
  24. 24.
    Sueki H. The effect of suicide-related internet use on users’ mental health: A longitudinal study. Crisis 2013;34(5):348–53. PMID: 23685338. doi: 10.1027/0227-5910/a000201.CrossRefGoogle Scholar
  25. 25.
    Daine K, Hawton K, Singaravelu V, Stewart A, Simkin S, Montgomery P. The power of the Web: A systematic review of studies of the influence of the Internet on self-harm and suicide in young people. PLoS ONE 2013;8(10): e77555. PMID: 24204868. doi: 10.1371/journal.pone.0077555.CrossRefGoogle Scholar
  26. 26.
    Bessiere K, Pressman S, Kiesler S, Kraut R. Effects of Internet use on health and depression: A longitudinal study. J Med Internet Res 2010;12(1):e6. PMID: 20228047. doi: 10.2196/jmir.H49.CrossRefGoogle Scholar
  27. 27.
    Judd F, Cooper A-M, Fraser C, Davis J. Rural suicide-people or place effects? Aust N Z J Psychiatry 2006;40(3):208–16. PMID: 16476147. doi: 10.1080/j. 1440-1614.2006.01776.X.PubMedPubMedCentralGoogle Scholar
  28. 28.
    Hacker K, Collins J, Gross-Young L, Almeida S, Burke N. Coping with youth suicide and overdose: One community’s efforts to investigate, intervene, and prevent suicide contagion. Crisis 2008;29(2):86–95. PMID: 18664234. doi: 10. 1027/0227-5910.29.2.86.CrossRefGoogle Scholar
  29. 29.
    Robertson L, Skegg K, Poore M, Williams S, Taylor B. An adolescent suicide cluster and the possible role of electronic communication technology. Crisis 2012;33(4):239–45. PMID: 22562859. doi: 10.1027/0227-5910/a000140.CrossRefGoogle Scholar
  30. 30.
    Westerlund M, Hadlaczky G, Wasserman D. The representation of suicide on the internet: Implications for clinicians. J Med Internet Res 2012;14(5):e122. PMID: 23010086. doi: 10.2196/jmir.l979.CrossRefGoogle Scholar
  31. 31.
    Liu C, Yu CP. Can Facebook use induce wellbeing? Cyberpsychol Behav Soc Netw 2013;16(9):674–78. PMID: 24028138. doi: 10.1089/cyber.2012.0301.CrossRefGoogle Scholar
  32. 32.
    Livingston JD, Cianfrone M, Korf-Uzan K, Coniglio C. Another time point, a different story: One year effects of a social media intervention on the attitudes of young people towards mental health issues. Soc Psychiatry Psychiatr Epidemiol 2014;49(6):985–90. PMID: 24401914. doi: 10.1007/s00127-013-0815-7.CrossRefGoogle Scholar
  33. 33.
    Eggertson L, Patrick K. Canada needs a national suicide prevention strategy. CMAJ 2016;188(13):E309–10. PMID: 27601606. doi: 10.1503/cma].160935.CrossRefGoogle Scholar

Copyright information

© The Canadian Public Health Association 2017

Authors and Affiliations

  • Naveen Poonai
    • 1
    • 2
    • 3
    Email author
  • Shruti Mehrotra
    • 1
    • 2
  • Muhammad Mamdani
    • 4
    • 5
  • Anastasia Patmanidis
    • 1
  • Michael Miller
    • 1
  • Javeed Sukhera
    • 6
  • Quynh Doan
    • 7
  1. 1.Department of Pediatrics, Division of Emergency MedicineWestern UniversityLondonCanada
  2. 2.Division of Emergency MedicineWestern UniversityLondonCanada
  3. 3.Children’s Health Research InstituteLondon Health Sciences CentreLondonCanada
  4. 4.Li Ka Shing Knowledge Institute of St. Michael’s HospitalTorontoCanada
  5. 5.Institute of Health Policy, Management, and EvaluationUniversity of TorontoTorontoCanada
  6. 6.Department of PsychiatryWestern UniversityLondonCanada
  7. 7.Division of Emergency Medicine, Department of PediatricsUniversity of British Columbia, BC Children’s Hospital, Emergency DepartmentVancouverCanada

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