JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic has raised concerns about a growing mental health crisis, including an increase in thoughts of suicidal [1]. In response, online communities have played a role by providing support and communication for those dealing with mental health challenges. Recognizing the early signs of suicide thoughts is complex, often linked with symptoms of depression. This complexity makes timely intervention challenging. Understanding user dynamics and thematic trends within online mental health communities contributes to strengthening suicide prevention initiative and enhancing mental health support.

Objective:

This study delves into overlapping user behavior within two Reddit communities r/SuicideWatch and r/Depression, spanning the timeframe from 2019 to 2022. Employing Natural Language Processing (NLP) and statistical methodology, its aim is to gain insights into early signs of distress through post content, transition patterns, and themes related to depression behaviors and thoughts of suicide. Central to this investigation is the analysis of transition from discussions centered around depression to the explicit expression of Suicidal Ideation (SI). The goal is to leverage these insights as potent tools for enhancing the development of the early-stage online mental health support.

Methods:

The dataset was extracted from the r/Depression and r/SuicideWatch Reddit communities, encompassing a diverse range of posts contributed by approximately 400,000 distinct users. Our investigation consists of two primary components. Firstly, we focused on the posts from overlapping users, applying trend analysis and survival analysis to gain insights into posting behavior and dynamic. Secondly, our analysis was centered on users’ posts within r/Depression, specifically among those in the overlapping user group. To uncover underlying themes, we utilized Word2Vec embedding along with factor analysis. Additionally, to observer the topic discussed by users with suicide thoughts in depression community, we applied the BERTopic model to the posts of overlapping users in r/Depression. This allowed us to compare topics based on whether these users exhibited suicide ideation in r/SuicideWatch or not. To achieve accurate classification of posts of suicide ideation in r/SuicideWatch users, we fine-tuned a DistilBERT model.

Results:

In our analysis of overlapping users, a pivotal turning point emerged on August 16, 2020, when the post count within r/SuicideWatch surpassed that of r/Depression. The transition periods from r/Depression to r/SuicideWatch in 2020 were observed to be the shortest, spanning 26 days within the dataset timeframe. Factor analysis revealed a correlation among the collated themes. Notably, the theme "therapy and treatment" exhibits a strong association with both "life and comparison" and "skill and learning." BERTopic analysis showed different topic relationships in posts within r/Depression. For users expressing thoughts of suicide in r/SuicideWatch, the topic of "Emotion Reflection" exhibited a correlation with the topic of "Drugs and Overdose." On contrast, the topic of "Reflective Emotion and Connection" maintained a link with "Personal Care".

Conclusions:

Our study offers insights into the posting behavior and dynamics of individuals dealing with challenging emotions within online communities. These findings underscore the need to foster stable, responsive, and empathetic interactions as a foundation for effective mental health support. These online platforms extend a lifeline to those in need by proving essential resources such as mental health information, guidance on substance-related issues, personal success stories, and real-time chat exchanges. Furthermore, our study suggests that the integration of empathetic human chatbots and online community counseling could complement traditional methods of mental health support. This comprehensive approach, tailored to address the challenges posed by the pandemic and the ongoing journey ahead, holds the potential to bring about a meaningful and positive transformation in the realm of mental well-being.