DNP 711 - Week 1:
INTRODUCTION/OVERVIEW: The Relationship Between Mobile Technology/Social Media Use & Self-Harm/Suicidal Behaviors in Arizona’s Emerging Adult Population
Depression and suicide as a significant public health crisis account for more than 40,000 deaths in the U.S. annually (CDC, 2017; Bridge et al., 2014). In 2015, on average, there were 129 suicides per day, and self-injury/suicide cost the U.S. $69 billion (American Foundation for Suicide Prevention, 2019b). Despite the immediate impacts that loss of life by suicide incurs, high emotional and economic costs also compound, resulting in about $44.6 billion annually in combined medical and work loss costs in the U.S. alone (Twenge et al., 2017). In 2017, suicide attempts reached an estimated 1,400,000 people (American Foundation for Suicide Prevention, 2019b).
Suicide ranks as the second leading cause of death among people ages 10-34 and is a significant global public health crisis (Xiao & Lu, 2019; Bridge et al., 2014). Suicide rates increased by 24% within the past 15 years (CDC, 2015). The time spent by adolescents and emerging adults in the past decade doubled (Orben & Przybyiski, 2019; Ofcom, 2017). Adolescent mental health issues continue to rise sharply, especially among females (Twenge et al., 2017). Dependence on our mobile devices and social media use may increase our current mental health crises, especially among emerging adults and adolescents. Understanding how digital technological advances influence the mental health of adolescents & emerging adults could impact our abilities of suicide prevention and self-harm reduction efforts.
OUR RESEARCH INTEREST
Our research interest focuses on understanding complexity at the intersection of suicide, mental health, and technological advancement in society. Specifically, the purpose of our research is to extensively examine the connections and relationships between mobile digital technology/social media use and self-harm or suicidal behaviors in young/emerging adults. One of the specific aims of our research is to develop a better model to address the complex social and behavioral interactions we have with technology/social media engagement and how it impacts our mental health and suicide risk.
The emerging collection of research exploring the relationship between technology/social media use and self-harm in young people “is rapidly evolving in an attempt to keep up with the continually changing nature of its use” (Marchant et al., 2017, p. 22). After declining or remaining stable for decades, depressive symptomologies, suicide-related outcomes, and suicide deaths are becoming increasingly prevalent among adolescents and young adults in the U.S. between 2010 and 2015, especially among females (Twenge et al., 2017). New media screen time and technological engagement activities require understanding as a critical modern risk factor that influences depression and suicidal behaviors (Twenge et al., 2017). Thus, it becomes critical for us to continue our research work and pending analyses to examine these distinct risk factors while addressing the diverse nature of large population sets (Xiao et al., 2019; Laska et al., 2009).
THE CURRENT POLICY ENVIRONMENT
The State of Arizona stands progressively at a crossroads with some forward momentum and distance down the correct and sustainable path for furthering suicide prevention efforts. However, there is substantial work and effort necessary to continue current progress while also leveraging that success into additional gains for the future.
Figure 1. Overall suicide facts and figures in Arizona based on the most recent 2017 CDC data. Adapted from the “Arizona State Fact Sheets,” by American Foundation for Suicide Prevention, 2019a. Retrieved from https://afsp.org/about-suicide/state-fact-sheets/#Arizona
CONTEMPORARY RELEVANCE
National trends of suicide rates have been increasing steadily since 2008 (as indicated by the gray-blue line in Figure 2 below). However, the green line (in Figure 2 below) represents both the increased amount and level of fluctuation of the year-over-year change of suicide rates in Arizona (Arizona Child Fatality Review Program, 2019). Such a stark indication would indicate that Arizona, albeit progressing, has substantially more work to accomplish in developing and supporting state-level policies toward suicide prevention and self-harm reduction efforts.
Figure 2. Rise in mortality rates due to suicide per 100,000 children (ages 0-17) in Arizona from 2013-2018. Adapted from the “Arizona Child Fatality Review Program: Twenty-Sixth Annual Report,” by Arizona Child Fatality Review Program, 2019, p.48. Retrieved from https://www.azdhs.gov/documents/prevention/womens-childrens-health/reports-fact-sheets/child-fatality-review-annual-reports/cfr-annual-report-2019.pdf
We are already aware of the many risk factors associated with self-injury and suicide, as highlighted by earlier studies. It is also crucial to recognize that the association between risk factors and human behavior is much smaller than previously put forth (Arizona Child Fatality Review Program, 2019; Orben & Przybyiski, 2019; Xiao et al., 2019). Such findings can have broad implications for stakeholders and policymaking regarding monetary investments into decreasing technological engagement or social media use to increase the overall well-being and mental health statuses of adolescents and young adults (Orben & Przybyiski, 2019; Department of Health and Social Care, 2018).
Figure 3. Rise in mortality rates due to suicide per 100,000 children (ages 0-17) in Arizona from 2013-2018. Adapted from “Arizona Child Fatality Review Program: Twenty-Sixth Annual Report,” by Arizona Child Fatality Review Program, 2019, p.48. Retrieved from https://www.azdhs.gov/documents/prevention/womens-childrens-health/reports-fact-sheets/child-fatality-review-annual-reports/cfr-annual-report-2019.pdf
FUTURE DIRECTIONS
Overall, there are substantial limitations in the evidence to-date on the relationships between mobile digital technology/social media use and self-harm or suicidal behaviors in young/emerging adults. Therefore, more studies are necessary to identify further the beneficial and detrimental effects of using evolving technological advancements and social media platforms by adolescents and young adults in the U.S. and elsewhere globally. Prospective, longitudinal investigations are necessary to identify the potential short- and long-term risks, harms, or benefits associated with use (Dyson et al., 2016). However, we must also recognize that we may be at a contemporary inflection point about how we develop, use, and deploy technological advancements in the future and re-evaluate those already in existence.
REFERENCES
American Foundation for Suicide Prevention (AFSP). (2019a). Suicide facts and figures: Arizona 2019. Retrieved from https://afsp.org/about-suicide/state-fact-sheets/#Arizona
American Foundation for Suicide Prevention (AFSP). (2019b). Suicide statistics: U.S. 2019. Retrieved from https://afsp.org/about-suicide/suicide-statistics/
Arizona Child Fatality Review Program (2019). Arizona child fatality review program: Twenty-sixth annual report. Retrieved from https://www.azdhs.gov/documents/prevention/womens-childrens-health/reports-fact-sheets/child-fatality-review-annual-reports/cfr-annual-report-2019.pdf
Bridge, J. A., Horowitz, L. M., Fontanella, C. A., Grupp-Phelan, J., & Campo, J. V. (2014). Prioritizing research to reduce youth suicide and suicidal behavior. American journal of preventive medicine, 47(3), S229-S234.
Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. (2017) [cited 2019 Jan 23]. Available from URL: www.cdc.gov/injury/wisqars
Centers for Disease Control and Prevention (CDC) Data and Statistics. Fatal Injury Report for 2017 [online]. (2017) [cited 2019 Jan 23]. Available from URL: https://webappa.cdc.gov/sasweb/ncipc/mortrate.html
Department of Health and Social Care. (2018). Matt Hancock Warns Of Dangers Of Social Media On Children’s Mental Health. Retrieved from https://www.gov.uk/government/news/matt-hancock-warns-of-dangers-of-social-media-on-childrens-mental-health
Dyson, M. P., Hartling, L., Shulhan, J., Chisholm, A., Milne, A., Sundar, P., ... & Newton, A. S. (2016). A systematic review of social media use to discuss and view deliberate self-harm acts. PloS one, 11(5).
Laska, M. N., Pasch, K. E., Lust, K., Story, M., & Ehlinger, E. (2009). Latent class analysis of lifestyle characteristics and health risk behaviors among college youth. Prevention Science, 10(4), 376-386.
Marchant, A., Hawton, K., Stewart, A., Montgomery, P., Singaravelu, V., Lloyd, K., ... & John, A. (2017). A systematic review of the relationship between internet use, self-harm and suicidal behaviour in young people: The good, the bad and the unknown. PLoS One, 12(8).
Ofcom. (2017). Children and Parents: Media Use and Attitudes Report. Retrieved from https://www.ofcom.org.uk/research-and-data/media-literacy-research/childrens/children-parents-2017
Orben, A., & Przybylski, A. K. (2019). The association between adolescent well-being and digital technology use. Nature Human Behaviour, 3(2), 173.
Twenge, J. M., Joiner, T. E., Rogers, M. L., & Martin, G. N. (2018). Increases in depressive symptoms, suicide-related outcomes, and suicide rates among US adolescents after 2010 and links to increased new media screen time. Clinical Psychological Science, 6(1), 3-17.
Xiao, Y., & Lu, W. (2019). Cumulative health risk behaviors and adolescent suicide: the moderating role of future orientation. American journal of health behavior, 43(6), 1086-1102.
Xiao, Y., Romanelli, M., & Lindsey, M. A. (2019). A latent class analysis of health lifestyles and suicidal behaviors among US adolescents. Journal of affective disorders, 255, 116-126.