Suicide prevention content in multiple languages on major platforms
Google, Facebook, YouTube and Instagram feature suicide prevention resources on English language searches in the US, but are those resources available to a broader audience? Performance varies across countries and languages and supportive content appears more frequently in wealthy European and East Asian countries and less frequently other regions.
A note: This post discusses suicide and self-harm in the context of ways major online platforms can enhance their suicide prevention efforts.
In April 2010, at the suggestion of employees, Google implemented a change to search that displayed the contact information for the National Suicide Prevention Lifeline (NSPL) at the top of search results for select search terms in the United States. The change was well received, and in November of that same year, they expanded the feature to 13 additional countries: Australia, Belgium, France, Germany, Hungary, Italy, Netherlands, New Zealand, Norway, Spain, Sweden, Switzerland and the United Kingdom. Facebook launched its first suicide prevention efforts the following year through the introduction of new reporting features in partnership with the NSPL.
In the process of research for SIO’s Trust and Safety projects, researchers on our team observed that searches for suicide related terms in Spanish on Google did not yield the same suicide prevention search results as the same terms in English. Our team decided to conduct a simple comparison study across two Google products – Search and YouTube – and two Facebook products – Facebook and Instagram – to see how results compared on some of their most common languages. We chose three search terms: “suicide,” “I want to kill myself,” and “I want to die.” We compared the top level results for these searches across nine different languages to see whether these platforms featured suicide prevention information in the searches.
Key takeaways:
Google and Facebook provided the most frequent suicide prevention messaging, while YouTube provided the least.
Results for the same Googled terms yielded different results when the country was changed. The search for “suicide” in Spanish in Spain or French in France popped up a hotline resource link, but Spanish in Mexico and Argentina did not.
Russian and Arabic had the fewest help results. This is particularly concerning because the Russian Federation has the highest suicide rate in the world.
We recommend that platforms ensure that their help content is available regardless of language or region.
Search terms:
These languages were chosen because they rank among the top ten most used languages online. English, Spanish and Chinese (including Mandarin, Cantonese and other dialects) are the three most commonly spoken languages in the United States.
Results
We conducted searches for each term above across the four platforms to compare results. In an effort to be as consistent as possible, we conducted each Google search in an Incognito Chrome browser window, changing the search language to the target language and running the search with the region set as both the United States and a country that speaks the target language. Similarly, we conducted YouTube searches in an Incognito Chrome window changing the Youtube language and country. For Facebook, we used the logged in accounts belonging to several members of the SIO team and changed the account language to conduct searches. We tried those searches on multiple accounts. For Instagram, we used a separate profile to conduct the searches and primarily focused on hashtags using the terms. We changed the account language on Instagram for all languages except Arabic, which was not offered as a primary language choice. We coded the results based on whether the platform provided a specialized help message or showed organic results. For Instagram specifically, we indicate whether they have filtered the results for the specific hashtags or made them non-searchable. The below tables compare each platform’s performance by search term.
Search term: "suicide"
Search term: "I want to kill myself"
Search term: "I want to die"
We find that Google served up the most suicide prevention content on its search terms across the languages, while YouTube (a Google product) performed the worst. However, Google results varied across countries. For example, the search for “suicidio” in Spanish gave no help message when the country was set as the United States, Mexico or Argentina, but did show a help message when the country was sent to Spain:
Search results for “suicidio” (“suicide” in Spanish) when the country is set to Spain (top left), the US (bottom left), Mexico (top right) and Argentina (bottom right). The top result link in all four countries is a suicide prevention organization website, but only Spain shows a styled and featured lifeline number. The results for the US and Mexico both feature a styled dictionary definition.
It is not clear why this should be the case, since the United States NSPL offers its hotline services and full website in Spanish. In fact, searches for the other two terms in Spanish in the U.S. did feature the NSPL hotline number.
Facebook also performed well in the results. In every language except Arabic the platform displayed a “can we help?” message and resource link for at least one search term. Facebook’s resource link lists a searchable network of global partner organizations. The link has the advantage of providing a range of resources, including links to organizations that support specific communities such as veterans or the LGBTQ+ community.
Results for the search “suicide” on Facebook in English.
“Can we help?” messages on Facebook in (clockwise from top left) German, Portuguese, Russian, Spanish, Japanese and French.
Instagram has the most aggressive approach among the platforms queried. On Instagram we focused exclusively on hashtags that matched our search terms. After searching and selecting a hashtag, the app served up a full screen support message and filtered results for posts using that hashtag. Instagram has publicly disabled results for many hashtags “associated with content that doesn't follow [their] Terms of Use or Community Guidelines.” Instagram provided those messages for certain searches we conducted in English, Spanish, Portuguese, French, Japanese and German.
Left: a full screen message on Instagram offering support; Right: filtered results for the hashtag search that feature recovery and support related content or news.
The platform with the most troubling results of the four tested was YouTube, which, despite it’s importance as a source of instruction content and popularity with young people, rarely showed suicide prevention messages. Top search results varied and included mostly videos explaining warning signs, sharing recovery stories, or offering religious salvation content. However, in an Arabic-language search (user location set to Lebanon on the site), the first hit was a video about an Egyptian youth’s Facebook Live suicide that featured a graphic screen still, and a top result for one of the Spanish searches was an up-beat “Top Ten Suicide Notes that will change your life!!” video that celebrated the text of famous suicide notes.
Looking cross-platform at specific languages, it was surprising to see that after Arabic, Russian was the language for which we observed the fewest help messages. According to the World Health Organization’s 2020 suicide rate estimates, Russia has the highest suicide rate in the world. In our searches, “самоубийство” (“suicide” in Russian) showed a help hotline for the Google search when the country was set as Russia, and a “can we help?” message on Facebook. The other Russian-language queries on the tested platforms brought up results for music videos, dictionary definitions, related Facebook groups, etc., but did not trigger an intervention by the platforms.
We also compared some search terms in traditional versus simplified Chinese and found more help messages when using the traditional characters. We believe this may be because traditional Chinese is more widely used in Taiwan while simplified is common in mainland China where all four platforms are banned.
*We tested the Arabic search terms in multiple Arab countries and in the US but were not able to surface any prevention messages on any platforms. Arabic has wide dialectic variants and the terms used may not be relevant in some countries, so while we find the results concerning, we do not feel comfortable making an assessment about the prevalence of suicide prevention messaging.
Comments on platform suicide prevention policies
The comparison conducted above does not assess the work platforms have taken to develop complex detection and reporting flows to better serve up help allow concerned users to help others. Platforms have in recent years enlisted the advice of mental health experts and incorporated their recommendations into platform designs and reporting flows. In the United States, the NSPL has developed a toolkit for social media companies on this issue.
When a platform chooses to feature a hotline number it must vet that organization to ensure that resource is legitimate and qualified to respond to the referral, and that it can support the potential for increased traffic. As an example, in 1998 the National Center for Missing and Exploited Children (NCMEC) created their CyberTipline. Shortly thereafter, the US Congress passed legislation requiring electronic service providers to report all known incidents of child sexual exploitation on their platforms to the CyberTipline. Initially that was a volume of 10,000 reports annually, but in 2019, the tipline received over 16 million. NCMEC has had to scale their operations to respond to the growing reports. Many suicide prevention organizations are volunteer based and as civil society partners may not be able to handle that volume of referrals, making this an area where cross-company collaboration and economic support could allow tech platforms to significantly improve the services available around the world.
Conclusion and recommendations
Our primary concern in conducting this search was to see whether the first order platform interventions reach marginalized communities, including users in the United States who are more comfortable in languages other than English, and people in countries without strongly established suicide prevention resource systems. We encourage platforms to make sure that as they use AI and algorithmic detection to identify suicidal tendencies, those innovations do not come at the cost of serving simpler prevention content to users in diverse languages.
Our recommendations:
In the United States, feature the NSPL information even when the searches are conducted in languages other than English. The lifeline supports over 150 languages through tele interpretation.
Test interventions to make sure they are accessible to non-English speakers
Find ways to provide support resources in countries where platforms may not have clear civil society partners such as inorganically serving up supportive content like “it gets better” videos or recovery community groups
Include in the list of flagged hashtags and terms additional suicide related keywords and related words in other languages
In the United States, the National Suicide Prevention Lifeline is available 24/7 at 1-800-273-8255 and in Spanish at 1-888-628-9454. They offer Tele-Interpreter services in over 150 additional languages.
En los Estados Unidos, la Red Nacional de Prevención del Suicidio está disponible 24/7 en español a 1-888-628-9454 y en inglés a 1-800-273-8255. Ellos ofrecen servicios de teleinterpretación en más de 150 otros idiomas.
Further resources:
The International Association for Suicide Prevention lists regional and country specific crisis centers around the world on their website, https://www.iasp.info/resources/Crisis_Centres/
Befrienders Worldwide, a global network of emotional support centers
