The #chatsafe project. Developing guidelines to help young people communicate safely about suicide on social media: A Delphi study

IntroductionMany countries have developed guidelines advocating for responsible reporting of suicidal behaviour in traditional media. However, the increasing popularity of social media, particularly among young people, means that complementary guidelines designed to facilitate safe peer-peer communication are required. The aim of this study was to develop a set of evidence informed guidelines to assist young people to communicate about suicide via social media with the input of young people as active participants of the study.MethodsSystematic searches of the peer-reviewed and grey literature were conducted resulting in a 284-item questionnaire identifying strategies for safe communication about suicide online. The questionnaire was delivered over two rounds to two panels consisting of Australian youth advocates; and international suicide prevention researchers and media and communications specialists. Items were rerated if they were endorsed by 70–79.5% of both panels, or if 80% or more of one panel rated the item as essential or important. All items that were endorsed as essential or important by at least 80% of both panels were included in the final guidelines.ResultsA total of 173 items were included in the final guidelines. These items were organised into the following five sections: 1) Before you post anything online about suicide; 2) Sharing your own thoughts, feelings, or experience with suicidal behaviour online; 3) Communicating about someone you know who is affected by suicidal thoughts, feelings or behaviours; 4) Responding to someone who may be suicidal; 5) Memorial websites, pages and closed groups to honour the deceased.DiscussionThis is the first study to develop a set of evidence-informed guidelines to support young people to talk safely about suicide on social media. It is hoped that they will be a useful resource for young people and those who support them (e.g., parents, teachers, community workers and health professionals).

引言
诸多国家已制定针对传统媒体中自杀行为负责任报道的指南。然而，社交媒体（social media）的普及率持续攀升，尤其在青年群体中，因此亟需制定配套指南以保障同伴间关于自杀话题的安全沟通。本研究旨在以青年作为研究积极参与者提供输入，开发一套循证指南，助力青少年通过社交媒体开展自杀相关话题的安全交流。

方法
本研究对同行评议文献及灰色文献开展系统检索，最终形成包含284个条目、用于识别网络自杀安全沟通策略的问卷。问卷分两轮发放至两个专家小组：其一为澳大利亚青年倡导者小组，其二为国际自杀预防研究人员、媒体与传播专家小组。若某一条目同时获得两个小组70%~79.5%的认可，或获得任一小组80%及以上比例认定为必要或重要，则需对其重新评级。最终纳入指南的条目需同时获得两个小组至少80%的比例认定为必要或重要。

结果
最终指南共纳入173个条目，分为以下五个板块：1）在线发布自杀相关内容前；2）在线分享自身与自杀行为相关的想法、感受或经历；3）谈论你所认识的受自杀念头、情绪或行为影响的对象；4）回应可能存在自杀倾向的对象；5）用于纪念逝者的纪念类网站、主页及封闭群组。

讨论
本研究是首个针对青少年在社交媒体上安全讨论自杀话题开发循证指南的研究。本指南期望可为青少年及其支持群体（如家长、教师、社区工作者及卫生专业人员）提供实用参考资源。