Communication about suicide in YouTube videos: Content analysis of German-language videos retrieved with method-and help-related search terms

Online searches for information on suicide are very common but studies on how the topic is addressed on one of the the most relevant platforms, YouTube, are missing. We performed a content analysis of German-language videos retrieved with the basic term "suicide", a method-related search term ("how to hang yourself"), and a help-related term ("suicide prevention"). We assessed the quality of n=232 randomly selected videos based on media recommendations for suicide reporting. Characteristics of videos retrieved with the method- and help-related search term, were compared to search results for "suicide". Videos retrieved with the help-related term had more potentially protective and fewer harmful characteristics than those retrieved with the other search terms. For example, these videos significantly more often debunked suicide myths and provided contact information to help services. In total, the mean number of harmful and protective characteristics per video were 1.6 and 1.3 for basic searches; 1.7 and 1.0 for method-related searches, and 0.4 and 2.8 for help-related searches, respectively. Videos retrieved in the help-related search were often from help organizations. Only 3% and 8% of videos retrieved with "suicide" and "how to hang yourself", respectively, were age-restricted. Collaborations between suicide prevention and Youtube are warranted to improve the visibility of protective contents and ensure a better implementation of Youtube's own policies regarding self-harm.