title: Surfing for suicide methods and help: content analysis of websites retrieved with search engines in Austria and the United States.
abstract: OBJECTIVE
  The Internet provides a variety of resources for individuals searching for suicide-related information. Structured content-analytic approaches to assess intercultural differences in web contents retrieved with method-related and help-related searches are scarce.
  
  
  METHODS
  We used the 2 most popular search engines (Google and Yahoo/Bing) to retrieve US-American and Austrian search results for the term suicide, method-related search terms (e.g., suicide methods, how to kill yourself, painless suicide, how to hang yourself), and help-related terms (e.g., suicidal thoughts, suicide help) on February 11, 2013. In total, 396 websites retrieved with US search engines and 335 websites from Austrian searches were analyzed with content analysis on the basis of current media guidelines for suicide reporting. We assessed the quality of websites and compared findings across search terms and between the United States and Austria.
  
  
  RESULTS
  In both countries, protective outweighed harmful website characteristics by approximately 2:1. Websites retrieved with method-related search terms (e.g., how to hang yourself) contained more harmful (United States: P < .001, Austria: P < .05) and fewer protective characteristics (United States: P < .001, Austria: P < .001) compared to the term suicide. Help-related search terms (e.g., suicidal thoughts) yielded more websites with protective characteristics (United States: P = .07, Austria: P < .01). Websites retrieved with U.S. search engines generally had more protective characteristics (P < .001) than searches with Austrian search engines. Resources with harmful characteristics were better ranked than those with protective characteristics (United States: P < .01, Austria: P < .05).
  
  
  CONCLUSIONS
  The quality of suicide-related websites obtained depends on the search terms used. Preventive efforts to improve the ranking of preventive web content, particularly regarding method-related search terms, seem necessary.
authors.affiliation: Suicide Research Unit, Institute of Social Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria benedikt.till@meduniwien.ac.at.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Till
authors.forename: Thomas
authors.initials: T
authors.lastname: Niederkrotenthaler
mesh_terms: D001317:Austria; D003431:Cross-Cultural Comparison; D006266:Health Education / Q000379:methods*; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D057386:Search Engine / Q000706:statistics & numerical data*; D014481:United States; D000092864:Suicide Prevention