JMIR Publications

ABSTRACT

Background:

A “concerning post” is a display of a user’s emotional crisis on a social media platform. A better understanding of concerning posts is relevant to suicide prevention, but little is known about social media users’ attitudes and responses to concerning posts. Military veterans in the United States are disproportionately affected by suicide, often use social media, and may have exposure to individuals with elevated suicide risk via concerning posts.

Objective:

To: 1) obtain insight into whether and how U.S. military veterans respond to members of their social network on social media (“friends”) who are experiencing substantial emotional distress; and 2) identify potential interventions that could assist in responding to concerning posts.

Methods:

We recruited veterans through Facebook and conducted semi-structured interviews with 30 participants between June and December 2017. We used a summary template for rapid analysis of each interview, followed by double-coding using a codebook based on topic domains from the interview guide. Members of the research team met regularly to discuss emerging patterns in the data, generate themes, and select representative quotes selected for inclusion in the manuscript.

Results:

Veterans are reluctant to disclose emotional and health issues on Facebook, but they are open to reaching out to others’ concerning posts. There is a complex calculus underlying whether and how veterans respond to a concerning post, which involves considering: 1) physical proximity to the person posting; 2) relationship closeness; 3) existing responses to the post; and 4) ability to maintain contact with the person. Veterans desire suicide prevention training that prepares them to assist others in emotional crisis.

Conclusions:

Training for veterans to assist peers experiencing significant emotional distress merits exploration as a suicide prevention intervention to increase helpful and proactive responses to concerning posts.