Social media and suicide: What it's like being a moderator on r/SuicideWatch
What can you do when someone on social media says they are feeling suicidal?
Most social networks allow users to report posts anonymously so the site can send them links and numbers to organisations offering support.
But Reddit is also trying a different approach.
It hosts a thread called Suicide Watch. This subreddit is set up specifically for people who are feeling suicidal to talk through their feelings.
Someone submits a post to the sub with a title explaining how they feel and why, then other redditors reply to them.
The subreddit calls itself "a place of support" and it's been running for about six years.
Laura, from Canada, has been a moderator on suicide watch for five years. She also works as a suicide hotline responder.
She tells Newsbeat: "My first thought on discovering the sub was, 'Oh my god, I've gotta get this shut down' because Reddit is the worst place in the world to do suicide intervention.
"Then I looked into the background of the sub and discovered it had come about because no matter how much we tried to send people elsewhere or discourage people from talking about their thoughts of suicide, it just kept happening.
"In the end people threw up their hands and said, 'Well if people are going talk about this stuff no matter what, we might as well mitigate it as best we can and create a space specifically for this type of discussion.'"
Laura is one of a team who works on the site for free, monitoring the replies and offering their own assistance.
They provide information about helpful ways to support someone with suicidal thoughts and delete comments that break the rules.
Abuse or "tough love" is banned. Explicit discussion of suicide methods is forbidden. Posters aren't allowed to tell people "it gets better" or make other promises they can't keep. Trolls are kicked out.
There are big differences between the Reddit thread and where Laura volunteers at a suicide hotline. At the hotline, emergency services can be mobilised if a person is at risk. On Reddit it's completely anonymous.
Isn't this a worry?
She explains: "People who post on the sub say they will never call a hotline because of the fear emergency services are going to be called.
What to do if you see suicidal posts online, according to The National Suicide Prevention Alliance
- Take it seriously: Some people talk online about suicide very openly, whereas other people use euphemisms to describe how they feel. Even when it's not obvious whether someone is suicidal, it's important to take all posts about suicide seriously and ensure they get the support they need.
- Everyone can help.
- Everyone can provide a safe and supportive response to people posting suicidal content. Depending on how serious you think a situation is, anything from a one-off message of support, to suggesting forms of support available, to reporting suicidal content to a site moderator, might be appropriate.
"They need to be able to talk and open up in a way that is not going to follow them around. There is such a stigma around suicide, as well as the widespread unconscious belief that somehow if you've been suicidal there is something wrong with you.
"Anonymity in suicide intervention is a safety device. It saves far more lives than it costs. We really would prefer people to call the hotline than post in our sub, but since we can't stop it from happening, we continue to exist."
On an average day, Laura spends between one and three hours checking the moderation queue, looking at things that have been reported by other users.
"We do get trolls and we do get people who are not on the level," she says.
What to do if you see suicidal posts online, according to the NSPA
- If someone needs emergency help, encourage them to: Call their GP for an emergency out-of-hours appointment, call 999, go to A&E.
"It's not enormous but it's the internet, it is going to happen.
"Most of what we have to deal with though is people who think they know how to help but don't.
"And especially those who are in a messiah frame of mind - people who have found stuff that has been helpful for them and and they are absolutely certain it's going to help everybody.
"There's an awful lot of misconceptions about what's helpful when responding to people who are suicidal so we work really hard to dispel those myths."
There's a lot of advice on the subreddit about what to say and what not to say to someone feeling suicidal.
Despite all of the problem posts, Laura praises the community, saying: "It's kind of miraculous the people we get who just come up out of nowhere and support our people pouring their hearts out.
"Of course we always feel like there's never enough and sometimes people who are in real trouble do fall through the cracks and that's one thing that the moderation team try to watch out for."
The posts on the forum are raw.
On the page right now some of the top posts include...
"I am stuck, but I love my family and friends too much?"
What to do if you see a suicidal post online according to The National Suicide Prevention Alliance
- Don't expect a positive response. If a person is struggling to cope they may feel angry, upset or ambivalent. Try not to take this personally - they may well appreciate your help later when they're in a more positive space.
- Know when to step back
- If you have provided all the information and support you can, it's fine to stop the conversation and to reiterate where to get more help. Make sure you look after yourself too by thinking of a few things that help you relax and switch off.
"I'm too sick to start this new job and now I'd rather end my life than try to start everything fresh."
"Someone up for a talk before I end it?"
Laura spends up to three hours every day on the site looking at posts, alongside six to 10 other moderators.
Is it too much for the moderators sometimes?
"You have to be able to let go," says Laura.
"The outcome is never within our control. The one question in the screening for the real life hotline where most people walk out is when they are told, 'You're going to share these really intense, life changing moments with people and never know what happens to them afterwards - are you OK with that?'
"You get into an intense rapport with people very quickly, then you hang up and never hear from them again.
"You have be OK with that. The only way I know to stay sane is to be very rigorously disciplined and to not be emotionally invested in anything outside your control. There are always people outside your reach.
"The idea that there are all these people out there who have posted some absolutely heartrending things and you just don't know how they doing or whether they got any help. It's difficult to be confronted with that."
The mods get through it together, says Laura.
"We have a private space where we can talk to each other. When any one of us is having a hard time with a situation or something's getting to us or we're struggling to make a judgement call, we all support each other and reach out."