Changes in accessibility of suicide-related information on websites in Taiwan during 2016 and 2019

Background/purpose: To the best of our knowledge, no studies have examined longitudinal changes in the accessibility of suicide-related content on Chinese-language websites. We investigated changes between 2016 and 2019 in suicide-related materials likely to be accessed by individuals through websites in Taiwan. Methods: In March 2019, we searched the Taiwanese versions of Google and Yahoo! using six suicide-related terms and compared the results to a search performed in 2016. Website characteristics (e.g., pro-oranti-suicide) generated by various keywords were calculated and compared in 2016 and 2019. Results: The number of anti-suicide websites exceeded that of pro-suicide websites in 2016 and 2019. Between 2016 and 2019, the proportion of pro-suicide sites decreased slightly from 16.3% (61 out of 375 sites) to 12.3% (51 out of 417 sites) (p = 0.10). User-generated webpages constituted the primary source of pro-suicide content at both time points. Over the same period, the proportion of pro-suicide information on internet forums decreased from 59.1% to 17.8% (p < 0.001); by contrast, pro-suicide content on news websites increased significantly, from 1.9% to 11.3% (p = 0.005). Searches with the term "painless suicide" were more likely to yield pro-suicide websites and less likely to generate anti-suicide ones than searches with "sui-cide" in both 2016 and 2019. Conclusion: Harmful suicide-related information circulating on websites remained easily accessible to internet users in Taiwan, particularly through user-generated and news websites. Proper site moderation and implementation of online suicide reporting guidelines are still war-ranted. Copyright 2021, Formosan Medical Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).