The CDC's National Center for Injury Prevention and Control and online safety company Bark Technologies worked together on a newly-released, first of its kind study tracking how previous online behaviors such as bullying, violence, drug-related content, hate speech, profanity, sexual content, depression and low-severity self-harm among youth can be used to predict the risk of a future suicide or self-harm related behavior.

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The study, published in JAMA Network Open, involves 13-months of examining the online activities of middle and high school-aged children. Youth who experienced a high-severity suicide or self-harm alert based on activity on school-issued devices were compared to students who did not have a high-severity alert.

Researchers compared both groups' online behaviors before the self-harm event or suicide occurred and found that the students who experienced a high-severity suicide/self-harm alert had significantly higher prior incidents of risky online behavior flagged by Bark. All eight of the online risk factors studied were associated with subsequent suicide related alerts.

Lead author, Dr. Steven Sumner of the CDC, said rates of suicide and self-harm have been rising among young people in the US over the past decade.

"It's important that we pay attention to and really understand the new online risk factors that children are facing today in order to strengthen our prevention efforts," Sumner said. 

Bark CEO Brian Bason said the earlier that risk factors and signs of distress can be detected, the sooner a child can get the help they need.

The study showed that all eight online risk factors studied exhibited differences between case and control populations and were significantly associated with subsequent severe suicide/self-harm alerts when examining total direct and indirect pathways.

"When considering the total number of different types of online risk factors among the 8 measured, there was an exponentially larger risk of severe suicide/self-harm alerts; youths with 5 or more of the 8 risk factors present in their online activity had a more than 70-fold increased odds of subsequently having a severe suicide/self-harm alert," researchers wrote.

"The findings of this study suggest that many discrete types of risk factors are identifiable from online data and associated with subsequent youth suicide-related behavior. Although each risk factor carries a specific association with suicide-related behavior, the greatest risk is evident for youths demonstrating multiple types of online risk factors."

Titania Jordan, CMO at Bark, told ZDNet that understanding the importance of how kids are communicating online is extremely important, particularly for parents. 

A lot of children's fears and thoughts are encrypted in their online interactions and Jordan said parents, educators and caretakers need tools that can help them identify risk factors and signs of distress earlier in order to provide help. 

Social media sites have faced significant backlash in recent years for the startling increase in youth suicides and youth depression. 

Last week, The Wall Street Journal released a trove of internal files from Facebook showing that researchers inside Instagram have found that the app is "harmful" and "toxic" for some younger users, particularly teenage girls.

"In response, Facebook says the negative effects aren't widespread, that the mental-health research is valuable and that some of the harmful aspects aren't easy to address," the newspaper reported. 

Jordan noted that while this study looked specifically at school-issued devices and accounts, she felt like it is more clear than ever that "social media platforms don't adequately prioritize online safety for kids."

"Oftentimes, the measures they announce to fix issues with the platform only provide the illusion of safety. The built-in 'parental controls' are typically easy for kids to turn off at any point without their parent's say-so. It's easy for tech-savvy kids to skirt supervision from non-tech savvy parents," Jordan said. 

"Big Tech needs to partner with parents to give them greater insight into their children's online worlds. Keeping kids safer online is ultimately a responsibility that falls on parents, but it's incredibly difficult to navigate the vast marketplace of platforms where kids encounter dangerous situations without the right monitoring tools."

She added that there are ways parents can monitor for warning signs without totally invading kids' privacy and that the CDC study confirms that past online behaviors can be predictors of future self-harm and suicide situations.

Jordan noted that more generally, mental health across almost all demographics has worsened through the COVID-19 pandemic. From January-March of 2021, the Bark platform saw a 143% increase in alerts for self-harm and suicidal ideation among youth ages 12-18.

While acceptance and understanding of mental health issues have increased greatly over the past few generations, technology has had mixed effects on the trend. 

"As much as we want to blame technology as the sole root of these issues, it's not realistic for a parent to completely ban their child from going online -- we live in a tech world. Instead, we have to give parents resources for how to have conversations with their kids when they start using the internet and have a smart device," Jordan said.

"Any parent knows when your teenager says 'I'm fine' there's a good chance that's not the whole story."