People searching the web for suicide help are more likely to find sites encouraging them rather than offering support, says a study published in the BMJ. Many professionals are now supporting calls for sites like these to be banned in the UK. Michelle Connolly looks at the rise of pro-suicide websites, the people who use them and arguments for their existence.
Type in some simple suicide-related search terms into four popular search engines and the results will show sites like 'Alt Suicide Holiday', 'Satan Service' and 'suicidemethods.net'. Even academic discussion groups are occasionally 'hijacked' as a forum for pro-sucicide discussion. 'Alt Suicide Holiday' was initially established as a newsgroup in the late 1980s to discuss why suicides increase during holiday periods but has since evolved into a pro-suicide site.
Researchers from Bristol, Manchester and Oxford analysed the first ten sites in each search for suicide. 19 percent were dedicated pro-suicide sites with personal accounts of failed suicide attempts and discussion on the pros and cons of particular methods. Two of the sites went as far as portraying suicide and self-harm in a glamourous light.
Nine percent provided information on suicide methods either in a factual, semi-jocular or completely jocular manner. Sites focusing on suicide prevention accounted for a meager 13 percent.
Pro-suicide sites host forums where those taking part in chatroom discussions encourage suicidal people to take their own lives, idolise those who have committed suicide and facilitate suicide pacts. Such discussion is likely to allay the fears suicidal people may have. Memberships of those discouraging suicide are revoked. The sites often describe specific suicides in graphic detail, frequently including copies of suicide notes, death certificates and photographs of the deceased.
A report published by the Australian Institute for Suicide Research described three individuals who posted suicide notes on 'Alt Suicide Holiday' which read like a pre-suicide diary. Typically, the individual notified the forum of his intent to commit suicide and enquired of the best method and how to obtain any necessary items. The replies would contain very specific information, for example how to precisely aim a pistol in the mouth for maximum effect.
In two cases, the suicides were apparently successful via the use of firearms and self-poisoning. In the first case, discussion of the suicide on the site centred on whether the encouragement the deceased received was appropriate. The third individual was not successful in his attempt to poison himself with carbon monoxide and was admitted to a psychiatric hospital. Shortly after his discharge he discouraged other forum members from using this method.
Sites currently legal
Unlike Australia, pro-suicide sites are not illegal in the UK, although the Suicide Act (1961) indirectly makes it unlawful to aid, abet, counsel, procure or incite someone to kill themselves. The charity Papyrus, established to tackle youth suicide, said the Act should be amended to make it illegal to publish such information online. In response, the UK Internet Service Providers Association has said it will remove sites but only those deemed illegal. Those determined to circumvent an ISP-enforced ban can at present easily do so by the means of a disclaimer, while still leaving the damaging content accessible.
One positive case report highlighted in the Psychiatric Bulletin showed how the internet can intervene in potential acts of suicide. It recounted how a woman who had posted a suicide note, and subsequently taken a potentially lethal overdose, was saved after a hacker traced her whereabouts in the UK and alerted the police who broke into her home and took her to hospital.
 Biddle L, Donovan J, Hawton K, Kapur N & Gunnel D (2008). Suicide and the internet. BMJ. 336: 800-802.
 Baume P, Cantor CH, Rolfe A (1997). Cybersuicide: the role of interactive suicide notes on the Internet. Crisis. 18: 73-9.
 Suresh K & Lynch S (1998). Psychiatry and the WWW: some implications. Psych. Bull. 22: 256-257.