In this digital age, more and more patients are utilizing social media to communicate and empathize with each other. Generally speaking, this is regarded as a healthy practice. It promotes patient autonomy; it empowers patients to take control of their disease; and it allows for collaborative exchange of coping strategies.
But what happens when this communication is counterproductive? What happens when collaborative online communication becomes a threat to patients’ health?
This question was left untouched until very recently, when word got out that pro-suicidal images are circulating through Instagram—the popular picture-based social media platform with over 80 million users. Although the founders of Instagram have taken a firm stance against the promotion and glorification of self-harm, a recent study uncovered heaps of images showing bleeding cuts, active cutting, pill overdose, and actual methods of suicide.
More than a quarter of the images found in the study have a pro-self-harm theme, and none of these images mentions the use of any mental health resources. Furthermore, only 5% of the images demonstrate any glimmer of hope. The majority of the images are laden with depressive content, and virtually none of them promote psychiatric intervention.
These findings are alarming for a number of reasons, but chiefly because they contradict the goals of the e-patient movement. According to e-patients.net, participatory medicine is a “model of cooperative health care that seeks to achieve active involvement by patients, professionals, caregivers, and others across the continuum of care.” It is an ethical approach to care that also holds promise to improve outcomes, reduce medical error, and increase patient satisfaction.
Instagram, a platform that is frequently used by e-patients to promote healthy lifestyle choices, may actually be promoting content with suicidal themes. Whenever an Instagram user posts a photo with the hashtag “ #suicide,” a message appears on the screen that directs the user to various resources for suicide prevention. In theory, this is an excellent solution; but in practice, not so much.
One would imagine that the people posting images of their own suicide attempts are already in a very vulnerable place. When they are promoting content with hastags such as #iwanttodie and #lifeisover, the brief message on suicide prevention only serves to magnify their feelings of inadequacy and isolation.
Dr. Arshya Vahabzadeh, a resident physician in child and adolescent psychiatry at Massachusetts General Hospital, commented on the medical implications of his findings: “A lot of our patients engage with social media.,” he says, “and they often describe incidents of bullying or difficult interactions they’ve had with their peers.”
What a site like Instagram allows these patients to do, though, is validate their depressive feelings and suicidal thoughts by reaching out to other patients on the verge of suicide. The conversation that ensues is not one of encouragement and praise; it is one of injury and contempt.
This study shows us that, although social media can serve as a beneficial tool for patient-to patient communication, it can also endorse and even encourage harmful acts such such as self-mutilation. Moving forward, we must engage with social media platforms to ensure that issues such as these do not go unnoticed. It’s important to proceed with caution. We must use this as an opportunity to educate users of social media on the severity of suicidal content.