Facebook and Suicide Prevention

Facebook and Suicide Prevention -Written by Linda May Grobman, MSW, LSW, ACSW  

Facebook announced in December 2011 a new partnership with the Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Suicide Prevention Lifeline 1-800-273-TALK. Through the new service, Facebook users who see a suicidal comment posted by a friend can report this to Facebook using the “Report Suicidal Content” link or the report links found throughout Facebook. Facebook will then send an e-mail to the person who posted the suicidal comment, encouraging him or her to call the National Suicide Prevention Lifeline or to click on a link to begin a confidential chat session with a crisis worker.

    With 800 million active users, Facebook has the potential to make an enormous impact with this new service.
    “Facebook and the Lifeline are to be commended for addressing one of this nation’s most tragic public health problems,” says Surgeon General Regina M. Benjamin, MD, MBA. “Nearly 100 Americans die by suicide every day—36,035 lives every year. These deaths are even more tragic because they are preventable.”
    Social worker Brad A. Palmertree, BSW, who is co-chair of the Gay, Lesbian, and Straight Education Network (GLSEN) of Middle Tennessee, says of the partnership, “[It] is a natural progression of social service professionals meeting the clients where they are. Social media has become a place where individuality and personal expression is not just accepted but expected and embraced. So it’s only natural that life’s troubles show up alongside its triumphs.”
    He adds, “I think it’s a wonderful step in the right direction. As someone who works daily on creating and maintaining safe spaces for lesbian, gay, bisexual, transgender, or questioning (LGBTQ) youth, social media has been a double-edged sword. It allows young people to freely express themselves while building community with others who are navigating the murky waters of adolescence with an identity that is not always easily accepted or understood. But it also allows for a space where the bullies come at full force, often anonymously. Those who self-identify as LGBTQ, or even those who do not but are labeled as such because of preconceived gender norms, are bullied and harassed at a rate much higher than their heterosexual and cisgender counterparts. When school is not a safe haven and neither is home, LGBTQ youth turn to the Internet to seek answers, counseling, or simply validation.”
    The Lifeline has actually partnered with Facebook since 2006, but the new partnership adds the option of chatting online with a crisis counselor. John Draper, Ph.D., the Lifeline’s project director, says, “We have heard from our Facebook fans and others that there are many people in crisis who don’t feel comfortable picking up the phone. This...provides a way for them to get the help they need in the way they want it.”
    Ellen Fink-Samnick, MSW, ACSW, LCSW, of EFS Supervision Strategies LLC, believes the new collaboration, “on face value alone...is a promising means to enhance suicide intervention.” However, like others, she thinks that related ethical concerns warrant equal attention.  “Courtesy of rapidly emerging technology innovation, the framing of professional ethics has changed from ‘what one does while nobody watches,’  to ‘what one does while everyone watches, 24/7 in cyber-space,’ ” she points out.
    For social workers and other clinical professionals who may be involved in these efforts, Fink-Samnick says ethical concerns include:

State-to-state licensure: It would seem  there is a high likelihood that professionals will find themselves practicing across state lines as they assess clients in cyberspace. Will the professionals be appropriately licensed, credentialed in all jurisdictions?
With respect to “duty to warn,” what will the turn-around time be from identification to assessment to intervention?
How will professional liability be addressed?

    Others have brought up concerns about privacy and “Big Brother”-like worries. What happens when Facebook sends an e-mail to a suicidal user, and that e-mail address is a shared address with the user’s spouse, parents, children,  or co-workers? Is this a violation of the person’s health information privacy? And if so, is it excusable, given that it is for the purpose of saving the person’s life? Does the answer to this question depend on who is employed by Facebook to perform this task? And while we’re at it, what is a social worker’s responsibility when he or she comes across suicidal content, on Facebook or elsewhere online?
    Any effort to prevent suicide is commendable. At the same time, the best way to implement this plan is yet to be seen. The suicide reporting tool may be hard to find. There is no obvious “Report Suicidal Content” button in big red letters.