This material was presented in the 25th European Congress of Psychiatry which was organised by the European Psychiatry Association in Florence, Italy from 1-4th April 2017. I had access to the material as I attended the full Congress. Please note that this material remains the intellectual property of the European Psychiatry Association and its authors and any citation should include a full reference to it. For more information on the EPA and how to become a member, please visit: http://www.europsy.net/

1. Theme 3
Help-
seeking
Damian Jacob M. Sendler
(1) Department of Psychiatry, Sexual and Urologic Consultation Clinics, University of Lublin Medical School, Lublin, Poland
*Correspondence: djs508@nyu.edu; www.damiansendler.com
1*
25 European Congress of Psychiatry, Florence, Italy: 1-4 April 2017
1) Matthew Devine et al. (2017). Psychological Issues in Medically Underserved Patients. Primary care.
2) Karolina Krysinska et al. (2017). A Mapping Study on the Internet and Suicide. Crisis.
3) M Pheister. (2014). Suicide prevention and postvention resources: What psychiatry residencies can learn from the veteran's administration experience. Academic Psychiatry.
REFERENCES
▪ Suicide risk is increasing among all population groups, and no
effective prevention method has been established due to high
variability of risk factors.
Objectives:
▪ (1) determine risk factors in people who video-streamed
unsuccessful suicide attempt,
▪ (2) assess whether screening video blog websites is an effective
suicide prevention.
▪
▪ Participants (N=24, 14M and 10F, age range=19 to 53) with past history of suicidal attempts
were recruited online to participate in encrypted video qualitative interview.
▪ Three scales assessed suicidal tendencies and internet addiction: Columbia-Suicide Severity
Rating (C-SSRS), Suicide Assessment Five-step Evaluation and Triage (SAFE-T), validated internet
addiction scale of own design.
▪ Reported data are mixed quantitative and qualitative measures.
Results+
Conclusions
▪ Mean age=26.9, Range 19 to 53 y/o
▪ 14M, 10F
▪ n=13 White, n=1 Black, n=7Asian, n=3 Hispanic
▪ n=10 Full time student, n=2 Engineer, n=3 Business/Event
manager, n=9 Other occupations
▪ Mode of streamlining suicidal attempt: n=7 Skype/private video
chat, n=13 Public video streaming service, n=3 Private chat
room, n=1 Instagram live video
▪ Tool used to commit suicide: n=10 Hanging, n=4 Gunshot, n=3
Drug overdosing, n=3 Slitting veins, n=4 Other
▪ Suicidal attempt outcome: n=22 Attempted suicide and failed at
it, n=2 Never attempted suicided but idealized it heavily
▪ Participants were stratified into two age categories (students vs. working professionals), and all
were determined to be addicted to internet.
▪ Each group engaged in minimum 15 suicide ideation-related postings, prior to attempting suicide.
▪ Young participants typically posted impulsive, quick massages capturing distress caused by peers
and family conflicts; seeking short-time recognition was evidenced by eliciting more “likes” and
“comments” for each post.
▪ Working professionals posted less, but each video was lengthier and messages were emotional,
usually ending in tearful summary of life events leading up to suicidal thoughts.
▪ While students expressed anger with “the system” as motivation to die, working professionals had
financial problems and trouble forming long-lasting friendships.
INTRODUCTION METHODS
IMPORTANT POINTS DEMOGRAPHICS
▪ People of all age groups increasingly document intention to die via blog video posts.
▪ These messages can be captured by prevention professionals, who can reach out to troubled students and working adults and offer psychiatric health.
▪ Developing tools to selectively screen text data containing suicidal ideations plans is an effective new strategy for identifying people at risk of committing
suicide.
▪ Modern technology allows automatization of such screening practices.
SUICIDAL IDEATION IN ONLINE VIDEO DIARIES
NEW FORM OF SHARING INTENTION TO DIE
Characteristic
Theme 2
Gore, thirst
for pain
Theme 1
Sensation-
seeking
✓ Behavior noted for the audience of live videos of suicidal attempt;
✓ Main intention is to replace actively encourage others to proceed with suicidal plans;
✓ In over 80% of cases, members of audience were the first to suggest live-streaming of suicidal attempt by
participants;
Theme 4
Suicide
video
streaming
✓ Many members of the audience exchange comments that suggest their predilection for consuming violent content;
✓ Some go as far as to offer advise on the form of suicide that would cause quickest death;
✓ Little remorse expressed over active suicidal ideations of the participants;
✓ Audience often accuses video bloggers of being selfing, unappreciative of life;
✓ Participants who video blog about suicidal ideations often seek support of strangers;
✓ Younger participants typically expressed distress associated with school;
✓ Working adults typically expressed distress associated with financial problems, lack of meaningful friendships, as
well as poor family relationships;
✓ Since technology is widely accessible, participants often assume mistakenly that they will gain access to digital
support communities, but instead are often faces with hard comments;
✓ Act encouraged primarily by the audience;
✓ Skype was the most popular platform for live streaming suicidal attempt, followed by private chat rooms;
✓ It takes about a month for a person who video blogs about having suicidal thoughts to move forward with committing
suicide live on air;
✓ The severity of suicidal thoughts can be ascertained by looking for changes in visual and verbal cues provided by
video bloggers in each successive post;
✓ Generally, a video blogger who ends three consecutive video posts crying attempts suicide within the next 2-3 days;
Figure 1. Main themes identified in the behavior of people attempting to commit suicide live on
the Internet, as well as response of their audience.