Michael Westerlund*, Karolinska Institutet, Stockholm, Sweden and Stockholm University, Stockholm, Sweden, Stockholm, Sweden Gergo Hadlaczky*, Karolinska Institutet, Stockholm, Sweden, Stockholm, Sweden Vladimir Carli*, Karolinska Institutet, Stockholm, Sweden Danuta Wasserman, Karolinska Institutet, Stockholm, Sweden, Stockholm, Sweden Track: Research Presentation Topic: Health information on the web: Supply and Demand Presentation Type: Poster presentation Submission Type: Single Presentation Last modified: 2012-09-10

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Background: Suicide is one of the major causes of death in the world, leading to approximately 1 million deaths per year. Internet can provide good and cost-effective opportunities for mental health promotion and suicide prevention, due to its availability and reach. It can promote a non-stigmatizing and open environment for help-seeking individuals. The possibility for users to remain anonymous has shown to increase people’s willingness to communicate about problematic life circumstances. Objectives: To present an overview of the preventive websites that users in six European countries (Estonia, Hungary, Lithuania, Spain, Sweden, UK) are likely to find when seeking suicide- and mental health related information on the web. Method: A large number of suicide-related terms were identified by the use of focus groups. These search terms were then analyzed with Google Trends, to establish their frequency in searches. Terms with low use-frequencies were excluded. The terms with the highest correlations were suicide, depression, anxiety and stress. The first thirty hits on the Google search engine were then examined for the four different search terms. The searches were executed and coded in six different research centers in Europe in March 2011, in the language of each center and using their specific country code top-level domain. Additionally, a search was made for Google’s international site in English (google.com). A total of 960 hits were examined. Results: The results show that 40.8 per cent of the websites were coded as having a preventive content, although large differences were found between the countries. For example, the proportion of preventive websites for the UK was 69.2 per cent, while the proportion for Spain was 10.8 per cent. There are 42.4% fewer preventive websites for suicide (63) than for depression (107), anxiety (116) and stress (106). In regards to the senders behind the preventive websites, it is corporations that represent the largest share, 33.2% in total. Overall, the most common form of communication on the preventive websites was monological and semi-dialogical (80.9 per cent). Whilst 72.9% of the preventive websites were not aimed towards a specific age group, 20.1% had adults/ elderly as their target age group, and only 6.9% were coded as being specifically aimed towards children/ adolescents/ young adults. In other words, from the total sample of 960 websites there were only 27 preventive websites aimed at young people (i.e. 2.8%), and only eight of these used a dialogical form of communication (0.83%). Conclusion: Although this study shows that there are relatively many preventive websites in total, the differences between the participating countries are significant. Also of importance, preventive websites concerning suicide are considerably less frequent than preventive websites on depression, anxiety, and stress. Only one-fifth of the preventive websites use dialogical communication, and less then seven per cent of them are targeted at youth. This lack of existing mental health related web sites with dialogical communication opportunities, along with the knowledge of their possible effectiveness suggested by the scientific literature, demands a course of action.