Social media, self-harm and suicide

Another missed opportunity in the Molly Russell case

There are two views of how people with mental health problems experience social media. In one view they are places where you wander alone, drawn into an immersive atmosphere of depressive messages and images – self-harm and enticement to suicide everywhere you look. In the other they offer a space where you can come out of hiding, share otherwise secret fears with peers, gain an element of support and advice.

In the former view, risk of suicide is increased by the mood lowering effect of the content and by a sort of creeping familiarity with the idea of self-harm or suicide – called sometimes desensitisation or normalisation – and greater awareness of the methods involved.  In the latter view the social or networking function creates opportunity for reducing the sense of disconnection or lack of belonging, and the sharing of detail allows some alleviation of the burdensomeness of feeling uniquely troubled ¹.

The Janus-faced nature of social media is outlined in a report by Barnardo’s about young people, social media and mental health – Left to Their Own Devices. The natural conclusion is that different people are likely to be affected differently by their online experiences, and the same person may be affected differently on different occasions. Which raises the question – how to minimise risk without at the same time suppressing useful content? It’s a tricky question and one that requires (you might hope) a careful public debate involving as many interested parties as possible in coming to a solution that considers all the competing demands of the situation.

In the UK, a fair bit of this public debate has centred recently around the suicide of teenager Molly Russell, not least because her father has pressed forcibly the case for the damaging effect of social media and the need to suppress content that might (in his view definitely does) encourage suicide.

Once the case surfaced, the early signs were not encouraging for those of us looking for a wide-ranging and informed discussion. The BBC opened their coverage with an oafish interview of Steve Hatch, the MD for Facebook in Europe, by the BBC’s Media Editor Amol Rajan who, as far as I am aware, knows nothing about self-harm or suicide.

After some grandstanding political outrage by the likes of health secretary Matt Hancock the government produced a White Paper – Online Harms – that bundled encouraging self-harm or suicide with incitement to terrorist activities, dissemination of child pornography, and drug dealing in the dark web. The main direction hasn’t therefore been about self-harm and suicide prevention at all, it’s been about steps to regulate the tech giants.

The response from the principal player in this case – Facebook/Instagram – has been as dispiriting as one might expect.  After a laughable attempt to use Nick Clegg as a front man to reassure us of their good intentions, they announced earlier this year a ban on images of self-harm described as graphic or explicit – with no definition of either offered by way of clarification. Now Instagram has announced a ban on drawings or cartoons.  There’s again lack of clarity about exactly what this means; in the linked article the specific example is of text linked to an innocuous drawing.

Where is the commission-like meeting of organisations, clinicians, academics, people with personal experience, that should be leading the debate and informing the decisions? The social media companies don’t want it – they want to manage the debate and avoid swingeing statutory regulation.  The government doesn’t seem want it – they’ve had long enough to organise it if they did. The mainstream media don’t want it – they just want a story to tell, sentimental or sensational if possible. Samaritans has an interest but it’s a slow train coming.

Where are the professional bodies in all this – my own Royal College of Psychiatrists, the British Psychological Society, the Royal College of Nursing, the Health and Care Professions Council? I don’t mean where are they in offering uncontentious opinions, I mean where are they in organising the high profile, mature debate that’s needed to replace what’s going on now?  They are nowhere, and that failure of leadership is what represents the real missed opportunity.  

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¹ These and other ideas about risk of suicide are covered in Thomas Joiner’s book Why People Die by Suicide (Harvard UP 2005)