Skip to main content Accessibility help
Hostname: page-component-848d4c4894-nmvwc Total loading time: 0 Render date: 2024-06-23T09:26:42.626Z Has data issue: false hasContentIssue false

3 - Social Media Platforms as Public Health Arbiters

Global Ethical Considerations on Privacy, Legal, and Cultural Issues Associated with Suicide Detection Algorithms

from Part I - Platforms, Apps and Digital Health

Published online by Cambridge University Press:  08 September 2022

Marcelo Corrales Compagnucci
University of Copenhagen
Michael Lowery Wilson
University of Turku, Finland
Mark Fenwick
Kyushu University, Japan
Nikolaus Forgó
Universität Wien, Austria
Till Bärnighausen
Universität Heidelberg
Get access


The emergence of Facebook’s suicide prevention algorithm has prompted discussion around whether social media platforms have a role to play in public health surveillance. Concerns have been raised about an entity that is not a public interest health authority collecting and acting on the private health information of its users, particularly sensitive data like an individual’s mental health status. Mental illnesses are still heavily stigmatised, despite continued efforts to normalise these conditions in some regions of the world. Depending on a user’s geographic location, the ramifications of the suicide detection algorithms generating false positives for suicide risk could have severe consequences. The present chapter continues this discourse by examining the ethical implications of Facebook’s suicide prevention algorithm from the privacy, legal, and cultural perspectives.

AI in eHealth
Human Autonomy, Data Governance and Privacy in Healthcare
, pp. 68 - 86
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Alloh, FT and others, ‘Mental Health in Low and Middle Income Countries (LMICs): Going Beyond the Need for Funding’ (2018) 17(1) Health Prospect, 12–17.Google Scholar
Bickmore, TW and others, ‘Patient and Consumer Safety Risks When Using Conversational Assistants for Medical Information: An Observational Study of Siri, Alexa, and Google Assistant’ (2018) 20(9) Journal of Medical Internet Research, e11510.Google Scholar
Calvó-Armengol, A and Jackson, MO, ‘The Effects of Social Networks on Employment and Inequality’ (June 2004) 94(3) American Economic Review, 426–54, Scholar
Celedonia, KL and others, ‘Legal, Ethical, and Wider Implications of Suicide Risk Detection Systems in Social Media Platforms’ (2021) 8(1) Journal of Law and the Biosciences, Scholar
Chandrashekar, P, ‘Do Mental Health Mobile Apps Work: Evidence and Recommendations for Designing High-Efficacy Mental Health Mobile Apps’ (2018) 4 mHealth, 6, Scholar
Childress, JF and Beauchamp, TL, Principles of Biomedical Ethics (Oxford University Press 2001).Google Scholar
Cohen, Y and others, ‘Physical and Sexual Abuse and Their Relation to Psychiatric Disorder and Suicidal Behaviour among Adolescents Who Are Psychiatrically Hospitalized’ (1996) 37(8) Journal of Child Psychology and Psychiatry, 989–93.Google Scholar
Dijkstra, AG and Hanmer, LC, ‘Measuring Socio-Economic Gender Inequality: Toward an Alternative to the UNDP Gender-Related Development Index’ (2000) 6(2) Feminist Economics, 41–75.Google Scholar
Freilich, A, ‘Fallen Soldier: Military (In)Justice and the Criminalization of Attempted Suicide after U.S. v. Caldwell’ (September 2014) 19 Berkeley Journal of Criminal Law, 74,, accessed 8 May 2020.Google Scholar
Gardner, JS and others, ‘Remote Telepsychiatry Workforce: A Solution to Psychiatry’s Workforce Issues’ (January 2020) 22(2) Current Psychiatry Reports, 8–9, Scholar
Heginbotham, C, ‘UK Mental Health Policy Can Alter the Stigma of Mental Illness’ (1998) 352(9133) The Lancet, 1052–53.Google Scholar
Heim, E and others, ‘Reducing Mental Health Related Stigma in Primary Health Care Settings in Low- and Middle-Income Countries: A Systematic Review’ (2020) 29 Epidemiology and Psychiatric Sciences, Scholar
Higgins, GL, ‘The History of Confidentiality in Medicine’ (April 1989) 35 Canadian Family Physician, 921, Scholar
Hilty, DM and others, ‘Telepsychiatry’ (August 2002) 16(8) Molecular Diagnosis and Therapy, 527–48, Scholar
Hogan, MF, ‘Suicide Prevention: Rising Rates and New Evidence Shape Policy Options’ in Goldman, HH, Frank, RG, Morrissey, JP (eds) The Palgrave Handbook of American Mental Health Policy (Springer 2020), 229–57.Google Scholar
Hunt, MG and others, ‘No More FOMO: Limiting Social Media Decreases Loneliness and Depression’ (December 2018) Guilford Publications Inc., Scholar
Krendl, AC and Pescosolido, BA, ‘Countries and Cultural Differences in the Stigma of Mental Illness: The East–West Divide’ (February 2020) 51(2) Journal of Cross-Cultural Psychology, 149–67, Scholar
Larsen, ME, Nicholas, J and Christensen, H, ‘A Systematic Assessment of Smartphone Tools for Suicide Prevention’ (2016) 11(4) PLOS One, e0152285.Google Scholar
Lund, C and others, ‘Mental Illness and Lost Income among Adult South Africans’ (2013) 48(5) Social Psychiatry and Psychiatric Epidemiology, 845–51.CrossRefGoogle ScholarPubMed
Lund, C and others, ‘Mental Health Services in South Africa: Taking Stock’ (2012) 15(6) African Journal of Psychiatry, 402–05.Google Scholar
Mascayano, F, Armijo, JE and Yang, LH, ‘Addressing Stigma Relating to Mental Illness in Low- and Middle-Income Countries’ (March 2015) 6 Front Psychiatry, Scholar
Mishara, BL and Weisstub, DN, ‘The Legal Status of Suicide: A Global Review’ (2016) 44 International Journal of Law and Psychiatry, 54–74.CrossRefGoogle ScholarPubMed
Morreim, EH, ‘Playing Doctor: Corporate Medical Practice and Medical Malpractice’ (1998) 32 University of Michigan Journal of Law Reform, 939.Google Scholar
Mościcki, EK, ‘Gender Differences in Completed and Attempted Suicides’ (1994) 4(2) Annals of Epidemiology, 152–58.Google Scholar
Pourmand, A and others, ‘Social Media and Suicide: A Review of Technology-Based Epidemiology and Risk Assessment’ (October 2019) 25(10) Telemedicine and e-Health, 880–88, Scholar
Rawbone, R, ‘Principles of Biomedical Ethics’ (January 2015) 65(1) 7th Edition Occupational Medicine (Lond), 88–89, Scholar
Robustelli, BL and others, ‘Marital Discord and Suicidal Outcomes in a National Sample of Married Individuals’ (2015) 45(5) Suicide and Life-Threatening Behavior, 623–32.Google Scholar
Rodríguez Herrero, P, de la Herrán Gascón, A and de Miguel Yubero, V, ‘The Inclusion of Death in the Curriculum of the Spanish Regions’ (2020) 52(1) Compare: A Journal of Comparative and International Education, 1–19.Google Scholar
Savci, M and Aysan, F, ‘Relationship between Impulsivity, Social Media Usage and Loneliness’ (March 2016) 5(2) Educational Process: International Journal, 106–15, Scholar
Schneble, CO, Elger, BS and Shaw, D, ‘The Cambridge Analytica Affair and Internet Mediated Research’ (August 2018) 19(8) EMBO Reports, Scholar
Shealy, KM and others, ‘Delivering an Evidence-Based Mental Health Treatment to Underserved Populations Using Telemedicine: The Case of a Trauma-Affected Adolescent in a Rural Setting’ (2015) 22(3) Cognitive and Behavioral Practice, 331–44.Google Scholar
Sheftall, AH and others, ‘Suicide in Elementary School-Aged Children and Early Adolescents’ (October 2016) 138(4) Pediatrics e20160436, Scholar
Shibre, T and others, ‘Perception of Stigma among Family Members of Individuals with Schizophrenia and Major Affective Disorders in Rural Ethiopia’ (June 2001) 36(6) Social Psychiatry and Psychiatric Epidemiology, 299–303, Scholar
Singer, N, ‘In Screening for Suicide Risk, Facebook Takes on Tricky Public Health Role’, New York Times, June 2019, Scholar
Solano, P and others, ‘A Google-Based Approach for Monitoring Suicide Risk’ (2016) 246 Psychiatry Research, 581–86, Scholar
Stravynski, A and Boyer, R, ‘Loneliness in Relation to Suicide Ideation and Parasuicide: A Population-Wide Study’ (June 2005) Guilford Publications Inc., Scholar
Szeto, ACH and Dobson, KS, ‘Reducing the Stigma of Mental Disorders at Work: A Review of Current Workplace Anti-Stigma Intervention Programs’ (June 2010) 14(1–4) Applied and Preventive Psychology, 41–56, Scholar
Tanaka, C and others, ‘A Qualitative Study on the Stigma Experienced by People with Mental Health Problems and Epilepsy in the Philippines’ (October 2018) 18(1) BMC Psychiatry, 325–13, Scholar
Thielking, M, ‘Experts Raise Questions about Facebook’s Suicide Prevention Tools – STAT’ (February 2019), Scholar
Venkatesh, BT and others, ‘Perception of Stigma Toward Mental Illness in South India’ (2015) 4(3) Journal of Family Medicine and Primary Care, 449.Google Scholar
Westerlund, M, Hadlaczky, G and Wasserman, D, ‘Case Study of Posts before and after a Suicide on a Swedish Internet Forum’ (December 2015) 207(6) British Journal of Psychiatry, 476–82, Scholar
World Health Organization, ‘Preventing Suicide: A Global Imperative’ (May 2014), Scholar
World Health Organization, ‘Suicide in the World: Global Health Estimates’ (2019) World Health Organization, Scholar
Wright, JH and Caudill, R, ‘Remote Treatment Delivery in Response to the COVID-19 Pandemic’ (2020) 89(3) Psychotherapy and Psychosomatics, 1, Scholar
Young, CC and Calloway, SJ, ‘Assessing Mental Health Stigma: Nurse Practitioners’ Attitudes Regarding Managing Patients with Mental Health Disorders’ (March 2020) 33(4) Journal of the American Association of Nurse Practitioners, 278–82, Scholar

Save book to Kindle

To save this book to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the or variations. ‘’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats