Exploring Suicide-Related Internet Use Among Suicidal Mental Health Patients: Findings from an Online Survey (Preprint)

BACKGROUND The dual nature of suicide-related internet use (SRIU) as preventative or harmful is well-documented, but its characteristics in mental health patient population remain underresearched. Some evidence suggests mental health patients use SRIU differently from the general population. OBJECTIVE This study explores the types, motivations, frequency, and perceived impacts of SRIU in suicidal mental health patients, as well as their engagement with online prevention resources. METHODS A cross-sectional study was conducted using an anonymous online survey distributed between June and December 2023. Participants (N=696) were UK adults with secondary mental health service contact and recent suicidal thoughts and/or behaviours. Of these, 523 (75%) engaged in SRIU. Collected data included sociodemographic details, clinical history, types and motivations for SRIU, and interactions with suicide prevention resources. Analysis utilized descriptive statistics, chi-square, and Wilcoxon tests, with multiple testing corrections applied. RESULTS The most common SRIU type was searching for suicide-related content (87.4%), followed by connecting with others (51.8%). Motivations included seeking information on suicide methods (60.8%) and support for suicidality (57.2%), with significant overlap. Participants perceived SRIU as neither harmful nor helpful overall, with those seeking suicide methods rating it as more harmful. Most participants encountered suicide prevention messaging, but less than half engaged with it. Only 27.5% disclosed SRIU to clinicians, with only 1 in 10 being asked about it by their clinician. CONCLUSIONS This study underscores the dual role of suicide-related internet use (SRIU) as both a source of support and a potential risk for mental health patients. Despite high exposure to prevention messaging, engagement remains low, with significant gaps in clinical communication about SRIU. Despite high exposure to suicide prevention messaging, engagement was limited, suggesting inefficiencies in current intervention designs. Clinicians rarely inquired about SRIU, and voluntary disclosure by patients was low, representing missed opportunities for intervention. Proactive discussions about SRIU in clinical settings could improve risk identification and support planning. Addressing its harmful aspects while leveraging its potential for support requires integrated online and offline strategies.