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

Canadian Journal of Public Health volume 108, pages e462–e467 (2017)Cite this article

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.

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.

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Authors and Affiliations

  1. Department of Pediatrics, Division of Emergency Medicine, Western University, 800 Commissioners Road East, London, ON, N6A 2V5, Canada

    Naveen Poonai MD, Shruti Mehrotra, Anastasia Patmanidis MD & Michael Miller PhD

  2. Division of Emergency Medicine, Western University, London, ON, Canada

    Naveen Poonai MD & Shruti Mehrotra

  3. Children’s Health Research Institute, London Health Sciences Centre, London, ON, Canada

    Naveen Poonai MD

  4. Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, ON, Canada

    Muhammad Mamdani PhD

  5. Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada

    Muhammad Mamdani PhD

  6. Department of Psychiatry, Western University, London, ON, Canada

    Javeed Sukhera MD

  7. Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, BC Children’s Hospital, Emergency Department, Vancouver, BC, Canada

    Quynh Doan MDCM, MHSc, PhD

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  1. Naveen Poonai MD
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Correspondence to Naveen Poonai MD.

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Poonai, N., Mehrotra, S., Mamdani, M. et al. The association of exposure to suicide-related Internet content and emergency department visits in children: A population-based time series analysis. Can J Public Health 108, e462–e467 (2017). https://doi.org/10.17269/CJPH.108.6079

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  • DOI: https://doi.org/10.17269/CJPH.108.6079

Key words

  • Internet
  • suicidal behaviour
  • emergency department

Mots clés

  • Internet
  • comportement suicidaire
  • service d’urgence