臺灣網站上自殺相關資訊可近性之變化：自殺防治法施行前後之比較

Abstract

背景：過往研究中發現，若經常接觸社群媒體及其它網路平台上支持自殺的網頁內容，可能影響患者的自殺意念與自殺方法的選擇，增加自殺身亡之風險。本研究以 Chen et al. (2017); Huang et al. (2022) 兩篇研究為基礎，追蹤 2016-2024 年間在臺灣最常使用的搜尋引擎上自殺相關網頁內容的變化，並探討《自殺防治法》在2019年實施後對網路內容的影響。

方法：分別於 2023 年 11 月及 2024 年 2 月，使用Google 和 Yahoo 搜尋六個與自殺相關的關鍵詞彙，並將搜尋到網頁內容區分為支持自殺、反對自殺、中立或不相關等，與 2016年、2019 年的搜尋結果進行比較，以卡方分析比較2016-2019、2019-2023、2023-2024間支持自殺之網頁比例的變化，以及與網頁特性的關聯性。

結果：支持自殺網頁的比例在 2019-2023 年間顯著下降，從 2019 年的12.2%（417 篇網頁中有 51 篇）下降至 2023年的5.4%（351 篇網頁中有 19 篇，p=0.001）。2024 年之搜尋結果與 2023 年相似，支持自殺網頁佔 6.6%（350 篇網頁中有 23 篇，p=0.52）。根據2023年的搜尋結果，支持自殺的網頁較常出現在搜尋結果第一頁，網路論壇性質的網站是支持自殺網頁的主要來源（19 篇支持自殺網頁當中有18篇來自網路論壇）。最常出現支持自殺網頁的搜尋詞彙為「怎樣自殺」（12.3% 的網頁為支持自殺內容）與「無痛自殺」（10.0% 的網頁為支持自殺內容）。

結論：臺灣在 2019 年發布實施《自殺防治法》後，與2016-2019年相比，2023 及 2024年支持自殺之網頁內容比例顯著下降。自殺防治法當中對媒體與網路報導自殺的規範，可能促進了網頁內容品質的提升，將來可進一步了解其對防治自殺的效果，並研擬改善網路論壇中自殺相關內容的策略。

Background: Past research has found that frequent exposure to pro-suicide content on social media and other online platforms may influence individuals' suicidal ideation and choice of suicide methods, increasing the risk of suicide. Building upon the studies by Chen et al. (2017) and Huang et al. (2022), this study investigated changes in suicide-related online content identified by searching relevant keywords using the most used search engines in Taiwan from 2016 to 2024 and investigated the impact of the Suicide Prevention Act implemented in 2019.Past research has found that frequent exposure to pro-suicide content on social media and online platforms may influence individuals' suicidal ideation and choice of suicide methods, increasing the risk of suicide. Building upon the studies by Chen et al. (2017) and Huang et al. (2022), this study investigated changes in suicide-related content of websites identified by searching relevant keywords on the most used search engines in Taiwan from 2016 to 2024 and explored the impact of the Suicide Prevention Act implemented in 2019 on online content.

Methods: In November 2023 and February 2024, we searched the Taiwanese versions of Google and Yahoo using six suicide-related terms and compared the results to those from online searches performed in 2016 and 2019. The online content was categorized into pro-suicide, anti-suicide, neutral/mixed, or irrelevant to suicide. The chi-square test was used to compare changes in the proportion of pro-suicide webpages in 2016-2019, 2019-2023, and 2023-2024, as well as their associations with webpage characteristics.

Results: The proportion of pro-suicide webpages decreased from 12.2% (=51/417) in 2019 to 5.4% (=19/351) in 2023 (p=0.001). Between 2023 and 2024, the proportion of pro-suicide sites was similar (p=0.52), with pro-suicide webpages accounting for 6.6% (=23/350) of webpages in 2024. Based on the 2023 search results, pro-suicide web pages were more likely to appear on the first page of search results, and internet forums were the main source of pro-suicide webpages (18 of 19 pro-suicide webpages were from internet forums). The search terms that yielded the highest proportions of pro-suicide webpages were "ways to kill yourself" (12.3% of webpages contained pro-suicide content) and "painless suicide" (10.0% of webpages contained pro-suicide content).

Conclusions: The proportions of pro-suicide websites decreased in Taiwan in 2023-2024 compared with 2016-2019, following the implementation of the Suicide Prevention Act (2019). The regulations on media and online suicide reporting in the Suicide Prevention Act may have contributed to the improvement of the quality of suicide-related online content. Further research is needed to investigate the effect on reducing suicide of the regulations in Suicide Prevention Act. It is also needed to formulate strategies to improve suicide-related content on the internet forum.