Suicide and the internet

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Abstract
What searches findWe analysed the first 10 sites from each search, giving a total of 480 hits. Altogether 240 different sites were identified. Just under a fifth of hits (90) were for dedicated suicide sites (table 1⇓). Half of these were judged to be encouraging, promoting, or facilitating suicide; 43 contained personal or other accounts of suicide methods, providing information and discussing pros and cons but without direct encouragement; and two sites portrayed suicide or self harm in fashionable terms. A further 44 (9%) hits were sites or pages that provided information about suicide methods in a purely factual (24), partly joking (12), or completely joking (8) fashion. Twelve hits were chat rooms or discussion boards that talked about methods of suicide.View this table: In this window In a new window Table 1 Frequency and accessibility of sites related to suicide from searches using 12 different search terms in four search enginesSites focusing on suicide prevention or offering support and sites forbidding or discouraging suicide accounted for 62 (13%) and 59 (12%) hits respectively.The nature of sites retrieved with the four search engines varied. Google and Yahoo retrieved the highest number of dedicated suicide sites (Google 29, Yahoo 24, MSN 16, ASK 21), whereas MSN had the highest number of prevention or support sites (21), academic or policy sites (27), and irrelevant or unavailable hits (31).Sites providing factual information about suicide, pro-suicide sites, and chat rooms discussing general issues relating to suicide occurred most often within the first few hits of a search and thus are more likely to be accessed. Dedicated suicide sites and sites giving factual information about suicide had the highest proportion of number one ranks across searches (25% and 27%, respectively, of all first ranked sites). Addresses that were not available or relevant to the search term were the third most likely to be top ranked. This is partly because of eight references to a withdrawn Satan Service page.The box shows the 10 most frequently occurring sites found in our searches. The three most frequently occurring sites were all pro-suicide. Alt Suicide Holiday (ASH), whose material on methods of suicide was accessed using 10 different web addresses, appeared in half of all our 48 searches. Wikipedia was the fourth most frequently occurring site. The top four sites provided not only information but also evaluation of methods of suicide. This included, for instance, detailed information about speed, certainty, and the likely amount of pain associated with a method. View this table: In this window In a new window Table 2 Top 10 most frequently occurring sites Just under half of the 480 web pages visited provided some information about methods of suicide. Almost all dedicated suicide and factual information sites provided such information but, notably, a fifth (21%) of support or prevention sites, over half (55%) of academic or policy sites, and all news reports of suicides also provided information about methods. A quarter of the hits provided more detailed evaluation of methods, most of which were dedicated suicide sites or other information sites. Chat rooms and discussion boards also regularly provided information about methods. A third of the hits referenced hanging.This research shows it is very easy to obtain detailed technical information about methods of suicide, not just from the suicide sites that have caused recent concerns but also from information sites such as Wikipedia. Although dedicated suicide sites were the three most frequently occurring web pages, the searches retrieved an almost equal number of sites aimed at preventing suicide. Some of these seem to have used website optimisation methods to ensure their site is preferentially sourced by people seeking information about suicide methods.