Slide presented on Jan.22, Suicide prevention forum. Presentation of suicide prevention using internet technology. Please contact us for any further information! info@ova-japan.org

1. Outlook for Suicide prevention using
Information and Communication Technology
Specified Nonprofit Corporation OVA
Representative
Jiro Ito
International Suicide prevention forum

2. Introduction myself
Jiro ITO
Psychiatric Social Worker.
▶ Former provider of an employee assistance programs
▶ Former worker of a psychiatry clinic
Assisted business persons suspending from work by psychiatric illness to
return to their workplaces
▶ Developer of online gatekeeping (2013~)
Use Search advertising technology to prevent suicide of youth
Elected as 'Social Innovator' by The Nippon Foundation

3. Contents
1. Youth suicide in Japan
2. Internet Gatekeeping activity by OVA
3. Outlook of Suicide prevention using ICT
- Elaboration of quality of Outreach
- Establishing counseling skills and expanding acceptance

4. Around half of deaths among Japanese 20s
are caused by suicide
-Ranks of causes of deaths by age-
Age 1st 2nd 3rd
10-14 cancer（22.8％） suicide(18.9％） Accident（15.7％）
15-19 suicide（36.6％） Accident（23.6％） cancer（12.0％）
20-24 suicide（50.1％） Accident（17.4％） cancer（8.4％）
25-29 suicide（47.2％） Accident（12.3％） cancer（11.5％）
30-34 suicide（39.4％） cancer（18.4％） Accident（10.0％）
35-39 suicide（29.1％） cancer（23.8％） Heart disease（9.5％）
40-44 cancer（29.2％） suicide（20.3％） Heart disease（11.7％）
45-49 cancer（33,4％） suicide（14.5％） Heart disease（12.9％）
50-54 cancer（39,4％） Heart disease（12.9％） suicide（10.2％）
55-59 cancer（45.7％） Heart disease（11.9％） cerebrovascular disease（7.6％）
60-64 cancer（48.5％） Heart disease（12.3％） cerebrovascular disease（7.0％）
2017「suicide prevention white paper」MHLW

5. Death rate of ”suicide” among age 15-34
in developed 7 countries
Suicide of Japanese youth is serious compared to other countries
2017「suicide prevention white paper」MHLW
Italy 2012
UK 2013
USA 2014
Canada 2012
Germany 2014
France 2013
Japan 2014

6. Zama Killings
9 youth at teens and twentieth were murdered in 2months.
The suspect looked for the female victims using Twitter, searching tweets
“want to die”
He send messages “let’s die together” “I will help you die” to let them in his
house and killed the victims.
The government has discussed recurrence preventing measures
1. Countermeasure against inappropriate web post about suicide
2. Mental care for youth sending suicidal messages in the internet
3. Measures to protect youth from harmful environment in internet

7. Using Google
to screen suicide high risked

8. People googling
“want to die” “how to suicide”
130,000-240,000/month
google searches of
“want to die” in Japan
Studies show that searching about suicide has relation with risk of suicide.
We can assume that people wanting to die search about means of suicide, and
actually die of suicide.
Studies world wide
・Suicide rate and search volume of suicide related words have timeline relations.
（Yang.et al,2011;McCarthy,2009）
・History of suicide attempts and history of suicide related search have relations.（Sueki,2011）
・Around 60% of suicide website users have 1 or more attempts of suicide. (Sueki et al,2012)

9. Structure of online gatekeeping

10. Search “want to die” “means of suicide”
using PCs or smartphones
How to hang myself
Search: How to hang myself

11. Advertisement urges access to
page
want to die
To you wanting to die
Please let us know If you are suffering
alone
Other keywords: I want to disappear

12. Tell message to those thinking of
suicide and encourage them to take
help seeking
To you thinking
about suicide
I have no choice but
dying
I am a burden to people
around me
I’m alone. I have no
place to go
To you thinking like this.
If you are thinking of
suicide
Please click below and
send an email right now
Send an email
If you don’t know what
to send, just send a
word or blank.

13. Can send email with one click
anywhere, anytime and anonymous
Subject: I want to die
help
I want to die

14. •Can communicate on the page without sending email.
•Interface similar to messaging apps that youth use.
Communicating using the
chat tool
chat
Ito
Hello I’m counseler Ito
Please let us hear about you
I wan to die
Hello I’m counseler Ito
I’m bullied and have no
place in house
I was bullied today
Everyday is painful

15. Communicating with users
Email, chat, phone, and real

16. Aid model
Basic policy
Connecting users who has no connection to social resources such as
hospitals to social resources.
Basically respond within 24 hours and do follow up.
1.Empower users to take help seeking actions.
2.Assess the condition of the user.
3.Lower psychological and physical cost of access to real aid.
4.Urge help seeking in real based of 1-3
Team members are clinical psychologist or psychiatric social workers

17. Achievement of
online gatekeeper model
July 2013-Dec 2017
About 600 users
Definition of achievement:Rate of those who had positive suicide preventing change.
Had change in any of 3 points below.
Emotional change: Could see positive emotional change.
Help seeking action: Connected to new social resource.
Help seeking attitude:Could see intention of going/reserving real aid.
Achievement：Had suicide preventing change in 30-40% of users.

18. Main points at issue for new direction
of suicide prevention using ICT

19. Discussions on suicide prevention
using ICT
1. Expanding effective outreach using ICT
2. Establishing counseling skills and expanding acceptance

20. 1. Expanding effective outreach
using ICT
Issues
1. Information of means of suicide and celebrity suicide can be achieved in internet.
2. Internet filled with posts of “want to die” “suicide together”.
Cases like the Zama killing can happen again.
Development of technology enabled to visualize those at suicide high risked.
Providing information and support to those searching suicide related keywords using search
linked advertisement is one means.
However, many support organizations use search linked advertisement. Providing inappropriate
information may cause negative effect, as internet advertisements work as medias.
OVA is working on building a guideline for suicide related advertisements.

21. Study of search-linked advertisement
using suicide-related keywords
Aim : To create guideline of the advertisement placed on web pages that
showed the results of searches using suicide-related keywords
Method :
1. Make the research list of typical suicide-related keywords
ex. suicide, how to suicide, hanging, self-injury, want to die, suicide note
2. Collect the searching linkage type advertisements according to the list in
every prefectures
3. Evaluate the advertisements if they have the risk of suicide inducibility
We had already collected the 567 advertisements using 13 keywords.

22. 2. Establishing counseling skills and
expanding acceptance
Issue
Japanese youth use text messaging apps as daily communication tools.
Existing consultation services using phones is high threshold for youth.
There is not enough text based consulting services.
Building online consulting skills and services to match youth needs is urgent issue.
OVA provides email, live chat consulting.
30% of the cases are successful. We will build a online consulting model by
examining the actual successful/failed cases and the consulting means.

23. Thank you very much
ito@ova-japan.org