Mental Health
Social Support from Online Communities: A Protective Factor Against Suicidal Ideation in U.S. Veterans Julie Kittel* Julie Kittel Kittel Kittel Kittel VA Rocky Mountain MIRECC
Veteran suicide prevention remains a critical public health concern as suicide rates have increased more than 60% since 2001 despite prevention efforts. Primary prevention strategies for veteran suicide may be bolstered by understanding protective factors for not only suicide, but also suicidal ideation (SI), a major risk factor for suicide. Perceived social support is a well-established protective factor for SI. However, limited research has evaluated the role of social support delivered by online communities, despite the ubiquity of such communities. We addressed this gap by evaluating the association of perceived social support from online platforms and past-month SI in a population-based, cross-sectional survey of 17,396 U.S. veterans. Overall online social support and specific subtypes (i.e., emotional-information, affectionate, and positive social interaction) were assessed, along with platform (e.g., Facebook, Instagram). Poisson regression models with robust standard errors were fit to compute prevalence ratios (PRs), adjusting for demographic and military service confounders. Analyses were stratified by platform, gender, age, and rurality to examine effect modification. Overall, online social support was associated with past-month SI: a 10-point increase in social support score (range 0-100) was associated with a 10% decrease in prevalence of past-month SI (PR=0.90; 95%CI=0.86-0.94) after adjustment. Similar findings were observed for all support subtypes and across most platforms examined, except LinkedIn and TikTok. No effect modification was observed by gender, age, or rurality; online social support remained protective for most subgroups examined. Findings indicate that online social support across many different platforms can potentially protect against SI within the heterogenous veteran population, regardless of type of support. Efforts to develop primary suicide prevention strategies focused on social support delivered virtually are warranted.