In her sophomore year at Lake Forest College near Chicago, Sam Sekulich had reached a breaking point. On top of the pressure she felt from classes and student clubs, she was fighting with her parents and not consistently taking medication for her bipolar disorder. Feeling anxious and overwhelmed, she went to the one place where someone is always listening: Facebook.
She posted that she hated life and wished maybe she could just 鈥済ive up on it.鈥�
The help poured in. Friends commented on her post, asking if she was OK. A faculty member at her college checked on her through email. A good friend sent her a text and then visited her in her dorm room later that day.
Ms. Sekulich didn鈥檛 think anybody would pay much attention to her post. But now, healthy and free of that despair, she said deep down, she was really asking for help.
鈥淚 wasn鈥檛 going to do anything about it. I wasn鈥檛 suicidal 鈥� but I was getting to that point,鈥� said Ms. Sekulich, now a junior at the college.
Partnership鈥檚 Role
As Internet users increasingly chronicle their emotional ups and downs on social-networking sites, psychologists said interventions like those with Ms. Sekulich show the Internet鈥檚 potential to prevent a mental-health crisis. But in this emerging social landscape, mental-health professionals, universities, and K-12 schools are facing new questions about how the Internet should be used to help emotionally suffering individuals.
The National Suicide Prevention Lifeline announced in December a revamped partnership with Facebook. Under the suicide-prevention program, users are encouraged to report to Facebook when a 鈥渇riend鈥� writes a post that indicates he or she is potentially suicidal. The original poster is then sent an email with a number to the National Suicide Prevention Lifeline and a link directing the user to an online chat with a crisis worker.
The nonprofit is hoping to reach two overlapping groups: the potentially suicidal and Facebook users. More than 34,000 people in the United States commit suicide and more than 376,000 people are treated in hospitals for self-inflicted injuries each year, according to the federal Centers for Disease Control and Prevention. And nearly four out of five active Internet users visit social-media sites and blogs, according to a 2011 report by the Nielsen Co.
The American Psychological Association and the Association of State and Provincial Psychology Boards have also commissioned a joint task force, launched in 2010, to draft new ethical guidelines for psychologists about how and when they should use electronic forms of communication in their professional lives. The task force aims to finish the guidelines by the end of this year.
Balancing Privacy, Safety
The thorny ethical questions now facing mental-health professionals and schools run the gamut: Should a teacher accept a Facebook friend request from a student? Could sending a client an email violate his or her confidentiality? Is it OK to Google a potential client before the client comes in for a consultation?
鈥淚 think there was a time psychologists didn鈥檛 want to be involved in all of that,鈥� said Terrence Koller, the executive director of the Illinois Psychological Association. 鈥淵ou鈥檙e talking to people all day long; 鈥� the idea that there are more ways to communicate was kind of overwhelming.鈥�
As K-12 schools strive to balance the need to protect individuals鈥� privacy and the need to keep students safe, some experts said it鈥檚 likely that schools will have to clarify how their staff members handle electronic communication when responding to students in distress.
鈥淧articularly in K-12 settings, there must be conversation about this,鈥� said Steve Jones, a communications professor at the University of Illinois at Urbana-Champaign.
Last school year, 27 percent of the 1,752 calls placed to the Chicago public schools鈥� crisis center were for concerns that a student could be suicidal, according to the office of communications.
District policy says teachers, administrators, and crisis center workers should investigate and look at social-networking sites if it鈥檚 in the interest of protecting students or the educational process. However, faculty members in the 404,000-student district are not permitted to accept a friend request from a student.
鈥淥ne potential downside to that prohibition is that you would potentially miss an opportunity to intervene,鈥� Mr. Jones said.
鈥楩alse Positives鈥�
And while the Internet might be an easy way to stumble across an emotional rant, some psychologists worry that social media make it hard to distinguish the real mental-health threats from the false alarms.
鈥淵ou get a lot of false positives,鈥� said Daniel Kaplan, a Chicago-based psychologist. 鈥淭he Internet is kind of a clumsy tool. It鈥檚 not going to help make those fine distinctions.鈥�
