Keeping safe online: Managing suicide risk in online mental health forums

The safety of online spaces for people who are at risk of suicide continues to be a source of contention in the research literature and among health professionals. Online spaces are places that “do not necessarily pose a risk to participants” (Mok et al., 2015. p. 703) yet there is “significant potential for harm from online behaviour” (Merchant et al., 2018. p. 2). The risk of going online for suicidal thoughts and/or behaviours (STBs) are constituted in the literature as a tension between uncontained hazards and user benefits linked to support from lived/living experience. Unlike going online for other health related reasons, going online for suicide related reasons brings with it a multiplied sense of danger. There is the risk that the person brings with them into the space. Further, there is risk from interacting with others with lived/living experience of STBs with an accompanying perception that this may encourage rather than deter. What hasn’t been considered is how participants manage and make sense of suicide risk, how participants are kept safe during heightened periods of suicide risk, and how online spaces can be safe places for those at risk of taking their own life. Taking up an intersubjectivity of safety position, we focus on how suicide risk is constituted in
doing safety online. Our focus is on member interactions and how they work with each other (and at times moderators) to keep the member at risk, safe. The data are interactions between online forum members themselves (and moderators) from two online forums. Conversation analysis and ethnomethodology have been used as the analytic approach. These multi-party risk interactions are unlike other risk interactions that typically occur between the person at risk and one other, commonly a health professional. Findings will be discussed in relation to how such spaces can be both places of risk and safety at the same time.

References
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Mok, K., Jorm, A. F., & Pirkis, J. (2015). Suicide-related Internet use: A review. Australian & New Zealand
Journal of Psychiatry, 49(8), 697–705. https://doi.org/10.1177/0004867415569797