Despite accelerating interest in the impact of the internet on suicidal behaviour, empirical work has not captured detailed narratives from those who engaged in suicide-related internet use. This study explored the suicide-related online behaviour of two contrasting samples of distressed users, focusing on their purpose, methods and the main content viewed. In-depth interviews were conducted in the UK between 2014–2016 with i) young people in the community; and ii) self-harm patients presenting to hospital emergency departments. Data were analysed using methods of constant comparison. Suicide-related internet use varied according to the severity of suicidal feelings. In the young people sample, where severity was lower, use was characterised by disorganised browsing without clear purpose. A range of content was ‘stumbled upon’ including information about suicide methods. They also pursued opportunities to interact with others and explore online help. Self-harm patients were a higher severity group with a history of suicidal behaviour. Their use was purposeful and strategic, focused around ‘researching’ suicide methods to maximise effectiveness. They made specific choices about content viewed; many consulting factual content in preference to user generated accounts, while help content and communication was avoided. Findings indicate further action is necessary to improve online safety. Also, novel online help approaches are needed to engage individuals experiencing suicidal crisis. Awareness of the nature of suicide-related internet use and how this may reflect the status of an individual’s suicidal thinking could be beneficial to clinicians to promote safety and indicate risk.

Purpose Internet use is common among people with suicidal feelings and a considerable amount of suicide help material is available online. Despite attempts to promote formal help sites (e.g. governmental and charity sector) in internet search results, users' evaluation of these sites is lacking. This study, therefore, aimed to explore distressed users' perceptions of formal online help and their experiences of using this in times of crisis. Methods In-depth interview study of 53 adults reporting suicide-related internet use. Results While highly valued in relation to general mental health problems, formal sites were not perceived to meet the different needs of those experiencing suicidal thoughts, and did not engage individuals in crisis. Sites were criticised for being impersonal, dispassionate, too focused on information-giving, and lacking solutions that were novel or sensitive to reasons why an individual may choose to seek help online. Most participants criticised the tendency for sites to signpost to offline services as their primary response. Participants desired immediacy and responsive online help incorporating 'live chat', self-help tools, opportunities to interact with others and lived-experience content. Positive accounts of seeking online help described sites incorporating these features. Conclusions Formal online help services should be reappraised to ensure they meet users' needs for immediacy and responsive help to capitalise upon the opportunity available for suicide prevention.

Purpose Substantial government investment has accelerated innovation activity in children’s social care in England over the past decade. Ethical concerns emerge when innovation seems to be propelled by a drive for efficiency and over-reliance on process output indicators, as well as, or even instead of, improving the lives of children, families and societies. No ethical framework exists at present to act as a check on such drivers. This paper reviews the literature with the aim of considering how best to address this gap. Design/methodology/approach This paper draws on a review of innovation in children’s social care, conducted as part of an Economic and Social Research Council-funded project exploring innovation in services for young people exposed to extra-familial risk and harm. Findings This study proposes a new conception of “trustworthy innovation” for the sector that holds innovation in children’s social care to the standards and principles of the code of ethics for social work. This study offers an ethical framework, informed by the interdisciplinary school of organisational ethics, to operationalise this extended definition; the analytic framework guides policymakers and the practice sector to question at every stage of the innovation process whether a particular model is ethically appropriate, as well as practically feasible within a specific context. Implications for local decision-making and national policy are set out, alongside questions raised for future research. Originality/value This paper is the first to offer an ethical framework for innovation in children's social care. The conception of “trustworthy innovation” offers a guide to policymakers and the practice sector, which they can use to ethically test every stage of the innovation process and make decisions about whether a particular model is ethically appropriate, as well as practically feasible within a specific context.

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