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Tuesday, April 16, 2024

Are TikTok Algorithms Changing How People Talk About Suicide?

Kayla Williams has never said the word “suicide” on TikTok, even though she uses the platform to discuss mental health issues with her 80,000 followers. Since the beginning of the pandemic, the 26-year-old student from Berkshire, England, has posted multiple videos about suicidal ideation and her stay in a psychiatric ward. Some of these clips are lighthearted, others far more serious. Yet Williams does not utter the word “suicide” to her front-facing camera, or type it in her captions, for fear the TikTok algorithm will censor or remove her content. Instead, she uses the word “unalive.”

The hashtag #unalivemeplease has 9.2 million views on TikTok; #unaliving has 6.6 million; #unaliveawareness has an additional 2.2 million. Though #suicideprevention is a frequently used tag on the app, the hashtags #suicide and #suicideawareness do not exist—if you search for them, TikTok pulls up the number for a local crisis helpline. It’s a well-intentioned policy, initiated in September 2021, a year after a graphic video of a suicide spread across the app. But users have also come to fear elusive content moderation filters that seemingly suppress or remove videos discussing death, suicide, or self-harm.

While the word “unalive” first became popular in 2013 (when it was used in an episode of Ultimate Spider-Man), Google searches for the term have spiked dramatically in 2022. From TikTok, “unalive” has spread to Twitter and Reddit; YouTubers also use it so their content isn’t demonetized. Depending on the context, the word can refer to suicide, murder, or death. Though “unalive” is often used comedically on TikTok, people like Williams also use it to talk candidly, forge a community, and signpost resources on the app. The rapid rise of “unalive” therefore raises a worrying question: What happens when we don’t openly say “suicide”?

“I think it kind of makes a joke out of such a serious subject,” Williams says of the term. Though she likes saying “unalive” when she intentionally wants to make videos “less heavy,” she adds: “It doesn’t sit right with me because we should be able to talk about the heavy stuff without being censored.”

Williams worries that the word “unalive” could entrench stigma around suicide. “I think as great as the word is at avoiding TikTok taking videos down, it means the word “suicide” is still seen as taboo and a harsh subject to approach,” she says. She also swaps out other mental health terminology so her videos aren’t automatically flagged for review—“eating disorder” becomes “ED,” “self-harm” is “SH,” “depression” is “d3pression.” (Other users on the site use tags like #SewerSlidel and #selfh_rm).

Prianka Padmanathan is a clinical academic in psychiatry at the University of Bristol; in 2019, she conducted a study on language use and suicide, surveying slightly less than 3,000 people affected by suicide. Padmanathan asked the participants to rate the acceptability of descriptors on the topic and found that “attempted suicide,” “took their own life,” “died by suicide,” and “ended their life” were considered the most acceptable phrases to discuss nonfatal and fatal suicidal behavior.

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A number of those surveyed raised concerns regarding the complete avoidance of the word “suicide.” One participant said it was “dangerous” and “isolating” to avoid the word, while another said, “My brother committed suicide and my sister attempted suicide. I don’t think we should be scared of using the word.”

“Overall, respondents indicated a preference for terms that were perceived to be factual, clear, descriptive, commonly used, non-emotive, non-stigmatizing, respectful, and validating,” Padmanathan says. Further research is needed to determine whether “unalive” could potentially be stigmatizing, but she notes that words can and do affect the way we think about suicide, citing a 2018 study.

The study—led by a communication scientist at the University of Munich—presented participants with news reports about suicide which were identical except for the word used to describe suicide itself. Some of the reports included the neutral German term “Suizid” (suicide), while others used the more problematic terms “Freitod” (free death) and “Selbstmord” (self-murder). The study found that people were more likely to subsequently use the word they had read, and that people’s attitudes to the suicides they read about did differ depending on the word in the piece.

Such research is crucial because, Padmanathan notes, the words we use can determine whether or not people seek help for their issues. Without controlled studies, it’s impossible to know the effect “unalive” has on people accessing resources. Padmanathan says it’s not clear-cut whether euphemisms perpetuate stigma—in her 2019 study, some participants felt euphemisms trivialized suicide, while others felt they were preferable in certain contexts.

Yet Deborah Tannen, a professor of linguistics at Georgetown University, expresses concern when asked about “unalive.” “Coming up with alternate or roundabout ways to say things, in order to avoid saying them outright, sends a message that the meaning is unsayable,” Tannen says. She cites the term “pro-choice”: “Ostensibly it means support for abortion rights, but by avoiding the word ‘abortion’ it helps to stigmatize it,” she says.

Tannen says not every alternative wording for “suicide” is stigmatizing—she believes “taking one’s own life” is still explicit enough to avoid stigma. But she often scrutinizes the “meta-message” of words—a meaning that isn’t in the word itself but can be determined from the way the words are said, or their context. “You could say that forbidding the word ‘suicide’ sends a meta-message that suicide is so terrible as to be unmentionable,” she says.

TikTok did not respond to a request for comment, but its official blog explains, “While we don’t allow content that promotes, glorifies, or normalizes suicide, self-harm, or eating disorders, we do support people who choose to share their experiences to raise awareness, help others who might be struggling, and find support among our community.” It is undoubtedly a difficult balance.

Padmanathan believes that “people have a right to talk about their own experiences in their own words”—yet right now it’s unclear how many TikTokers use “unalive” out of personal preference, and how many would drop the word if they didn’t have to worry about censorship. There’s also a question of where such censorship ends—while a search for “unalive” on TikTok produces countless videos, the hashtag #unalive isn’t indexed, meaning it has zero results.

Williams values TikTok as a space to talk about mental health—she also enjoys looking back over her videos to trace her recovery and see how far she has come. “I think it’s a good platform for talking about such subjects, and there’s loads of people using the platform to raise awareness,” she says. “But I also think TikTok has limited that by not allowing certain words to be posted.”

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