Sir: Although Prasad and Owen's recent findings on the internet as a source of self-help for people who self-harm (Psychiatric Bulletin, June 2001, 25, 222-225) provided a valuable insight into internet sites devoted to deliberate self-harm, some of their other conclusions were inaccurate. Specifically, although they acknowledge that other authors have located sites giving explicit instructions on committing suicide, they conclude that because they didn't find these sites using their search criteria (HOW TO COMMIT SUICIDE), such information is not easily available. In their discussion, they also state that “although nine out of 10 hospital contacts resulting from self-harm involve self-poisoning, we found few sites that dealt with self-poisoning”, implying that the internet is unlikely to facilitate self-poisoning.
Sadly, information on how to commit suicide and the number of pro-suicide groups on the internet are burgeoning, as evidenced by the amount of information (especially concerning self-poisoning) and the increasing number of high-traffic newsgroups encouraging suicide present on the internet, compared to my review of such sites in 1999 (editorial, Psychiatric Bulletin, August 1999, 23, 449-451). These sites can be located using a search criterion of SUICIDE or PROSUICIDE. Details of how lethal chemicals can be purchased over the internet, and lethal doses, are very explicit. We already know that both American and British individuals (Reference Alao, Yolles and ArmentaAlao et al, 1999; Reference Suresh and LynchSuresh & Lynch, 1998) have attempted and completed suicide using this information.
Although it is true that many regard internet information about self-harm as a valuable service (especially sites devoted to prevention and self-help), a growing body of potentially destructive information that has been acted upon remains, and it would be difficult to recommend that patients contemplating suicide should surf the internet.
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