title: Accessing suicide-related information on the internet: a retrospective observational study of search behavior.
abstract: BACKGROUND
  The Internet's potential impact on suicide is of major public health interest as easy online access to pro-suicide information or specific suicide methods may increase suicide risk among vulnerable Internet users. Little is known, however, about users' actual searching and browsing behaviors of online suicide-related information.
  
  
  OBJECTIVE
  To investigate what webpages people actually clicked on after searching with suicide-related queries on a search engine and to examine what queries people used to get access to pro-suicide websites.
  
  
  METHODS
  A retrospective observational study was done. We used a web search dataset released by America Online (AOL). The dataset was randomly sampled from all AOL subscribers' web queries between March and May 2006 and generated by 657,000 service subscribers.
  
  
  RESULTS
  We found 5526 search queries (0.026%, 5526/21,000,000) that included the keyword "suicide". The 5526 search queries included 1586 different search terms and were generated by 1625 unique subscribers (0.25%, 1625/657,000). Of these queries, 61.38% (3392/5526) were followed by users clicking on a search result. Of these 3392 queries, 1344 (39.62%) webpages were clicked on by 930 unique users but only 1314 of those webpages were accessible during the study period. Each clicked-through webpage was classified into 11 categories. The categories of the most visited webpages were: entertainment (30.13%; 396/1314), scientific information (18.31%; 240/1314), and community resources (14.53%; 191/1314). Among the 1314 accessed webpages, we could identify only two pro-suicide websites. We found that the search terms used to access these sites included "commiting suicide with a gas oven", "hairless goat", "pictures of murder by strangulation", and "photo of a severe burn". A limitation of our study is that the database may be dated and confined to mainly English webpages.
  
  
  CONCLUSIONS
  Searching or browsing suicide-related or pro-suicide webpages was uncommon, although a small group of users did access websites that contain detailed suicide method information.
authors.affiliation: Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Pokfulam, China, Hong Kong. paulw@hku.hk
authors.forename: Paul Wai-Ching
authors.initials: PW
authors.lastname: Wong
authors.forename: King-Wa
authors.initials: KW
authors.lastname: Fu
authors.forename: Rickey Sai-Pong
authors.initials: RS
authors.lastname: Yau
authors.forename: Helen Hei-Man
authors.initials: HH
authors.lastname: Ma
authors.forename: Yik-Wa
authors.initials: YW
authors.lastname: Law
authors.forename: Shu-Sen
authors.initials: SS
authors.lastname: Chang
authors.forename: Paul Siu-Fai
authors.initials: PS
authors.lastname: Yip
mesh_terms: D016208:Databases, Factual; D006801:Humans; D020407:Internet; D008490:Medical Informatics; D012189:Retrospective Studies; D012307:Risk Factors; D057386:Search Engine; D017216:Telemedicine; D000092864:Suicide Prevention