Research conducted by members of the Suicide and Self-harm group at the University of Bristol has had substantial impact, and has gone on to shape global health, agricultural and media policy and guidance.  This work was submitted to the Research Excellence Framework (REF) in 2021 as an impact case study. Title: Preventing access to highly lethal pesticides and harmful media content to reduce suicides and self-harm worldwide. Contributors: Gunnell D, Biddle L, Donovan J, Metcalfe C, Knipe D, Mars B, Heron J. See below for more details:

Toxic pesticides

Pesticide self-poisoning is one of the most frequently used suicide methods worldwide, accounting for over 110,000 deaths/year, i.e. one-in-seven of the world’s 800,000 annual suicide deaths. SASH researchers (Knipe, Gunnell, Metcalfe) have evaluated the impact of pesticide bans on suicide rates in several countries including South Korea, Sri Lanka, and Bangladesh. In all cases the bans were followed by falls in suicide rates. For example, in Sri Lanka, pesticide bans are thought to have led to 93 000 fewer suicide deaths between 1995 and 2015.

Research from the SASH group has provided definitive evidence that bans on highly toxic pesticides reduce suicide rates whilst alternative approaches are ineffective

This research has influenced global pesticide guidance including recommendations made by the World Health Organisation (WHO) and Food and Agriculture Organisation (FAO), to identify and ban highly hazardous pesticides. The guidance also cites evidence from the world’s largest Randomised Controlled Trial of a suicide prevention intervention. This study found that that the industry-preferred alternative to pesticide bans (lockable household pesticide storage containers) is ineffective at reducing the number of pesticide-related suicides.
SASH researchers also worked with the World Health Organisation to model the cost effectiveness of pesticide regulation. Based on this analysis, pesticide bans were recommended by the WHO as a ‘Best Buy’ (a cost-effective and feasible intervention) for non-communicable disease at the 2020 World Health Assembly in November 2020.
Dr Knipe works closely with the WHO to support their activities to encourage other countries where pesticide suicided deaths are a particular problem, to ban highly hazardous pesticides to reduce suicide deaths globally.

Online suicide content

SASH researchers have raised awareness among UK policymakers, UK news journalists, and the global online industry of the risks of contagion arising from the publicising of suicide and self-harm methods. As a result, the researchers have shaped media policy debate, journalistic practices and online media policy. These steps all promote the safety of media users by limiting access to content which could lead to suicide. The research on online suicide content, led by Dr Lucy Biddle has fed directly into to recommendations made to Government to moderate harmful content and support users.

In addition to the above, Dr Biddle has worked with Samaritans to:

  • Deliver training sessions with local and national news editors and journalists in the UK to advise on how to report on suicide to prevent method contagion
  • Co-host a series of awareness-raising engagements for the online industry. These included international roundtable events held with Safety and policy leads from Google, Twitter, Facebook, Wikimedia, Apple, YouTube and Instagram
  • Co-produce an advisory video for content moderator training
Research from the SASH group has shown that easy access to media reports and online discussion of suicide methods (viewed by around 1 in 4 adults with high suicide intent) increase suicide and self-harm rates

This work culminated in the establishment of a three-year strategic partnership between Samaritans, Online industry and Department of Health to improve management of suicide content within the online environment. A key output from this partnership is Samaritans’ Industry Guidelines for Online providers published in 2020, which Dr Biddle contributed to as academic advisory panel member. Dr Biddle’s findings around suicidal individuals’ preferences for live and immediate online help services has also informed Samaritans own digital strategy, and her work was fundamental to the establishment of their ‘online chat’ service.

Dr Biddle has also provided expert input to Facebook and Instagram regarding their safety policies relating to self-harm content and moderation. This led to a change to their policies, published February 2019, disallowing users to share graphic content of self-harm. More recently, Dr Biddle and colleagues have developed good practice indicators to assist mental health practitioners to engage young people in conversations about their online activities during mental health consultations.