Marc Palma looks into the largest self-described ‘right-to-die forum’, and considers what Psychologists should know.

Author's note: This is a descriptive history of a long-running self-described 'right-to-die' forum. It does not endorse the forum or its views; it omits operational details, links and methods; and includes help resources at the end.

Nobody likes to talk about suicide. It's hard, heavy, and often exhausting. We tend to change the subject and hope someone else will handle it. Avoidance, however, doesn't help. According to the latest World Health Organization estimate, someone dies by suicide about once every 40 seconds. That means around 13 people by the time you finish reading this article. Those losses are not individual statistics – they ripple through friends, family, and whole communities. They can never be undone.

Ignoring suicide, then, is something that we cannot continue to do. But how do we go about understanding it? Research and clinical interviews reveal a great deal, but only capture those who are willing to speak with a clinician. For many, especially now, the safer place to talk isn't seen to be a consultation room – it's the internet. 

There, much of the conversation takes place in semi-private corners: pseudonymous threads and niche forums that many clinicians never encounter. Many of these spaces frame suicide as a personal right, rather than stemming from mental torment where recovery is possible and desirable. Consequently, even when clinicians encounter these forums, they hesitate to engage with them in practice because of ethical concerns. 

In my view, understanding means stepping into uncomfortable places, including the digital forums where people gather in self-described 'right-to-die' communities. Ignoring these spaces, even when concerns are valid, not only limits our understanding of suicide but also risks doing a disservice to people there who might benefit from professional support. 

Therefore, to gain better insight into these understudied communities and how they function, I've spent the last 18 months doing research into the largest of those communities. Why are they growing in size? Why are people are turning to digital spaces to talk about suicide? What follows is a brief history of the community, intended to provide a better understanding of their beliefs, followed by key considerations for psychologists, researchers, and policymakers regarding these spaces.

Evolution and philosophy of the forum

The community's roots trace back to a subreddit created in March 2013. The community's founding creed indicated the following: that a right to die exists; that suicide should be discussable without censorship; and that, for some, suicide can appear to be the only logical conclusion. As the community grew, worries about 'normals', non-members who might try to persuade users away from the forum's prevailing views, began to fester; pressure from Reddit also began to build due to the content in the threads not aligning with the company's policies. Eventually, Reddit decided to ban the subreddit outright on 18 March 2018. That same day, an independent site under the same name as the subreddit was created, aiming to continue upholding the group's creed.

The independent site quickly surpassed the subreddit's size of 16,000 members and became the focal point of public scrutiny. Main criticisms of the site were around: 1. How the site allows members to discuss detailed 'methods' on how to carry out suicide, 2. How the site has no real checks to ensure minors aren't accessing the forum despite the rules stating that members must be over 18, and 3. How, even though the site claims to be pro-choice, talk can often skew so far into the negative that it can be viewed as more pro-suicide. As a result of these points, the independent site has weathered several high-profile government and media investigations since its formation, leading to temporary one-day closures and ownership transfers. Most recently, the site has been the target of the UK regulator Ofcom, which has opened an investigation. 

Through all this, however, the site has remained up and active, continuing to grow in membership size. As of the time of writing this article, the site has approximately 60,000 unique members and over 3,000,000 individual posts.

So what does the evolution of this specific community tell us about understanding suicide in less-visible online spaces? 

Reducing harm without amplifying defiance

First, outside pressure often influences where discussions occur more than whether they occur at all. Across bans, investigations, and policy shifts, the group moved and tightened access rather than disappearing, supporting the notion that a significant portion of individuals with suicidal thoughts need a space to discuss their feelings. Historically, these communities have persisted despite attempts to suppress them. In fact, scrutiny tends to harden public identity. In the historical record, external attention (bans, investigations, media coverage) simply reinforces an 'us vs. them' stance by users, something that is viewable all the way back to when the group was first forming. This may make engagement with professional mental health help harder, as an individual may feel like no-one but people on the forum understands them. 

This isn't to say that we shouldn't try to regulate these spaces through policy; rather, that policy needs to be tailored in ways that are effective and that acknowledge that there is a clear desire to talk about suicide in a way that is free from fears of judgement or repercussions. Many users report that they feel these spaces are the only place where they can share how they are truly feeling. The outright banning of spaces like this can therefore prove dangerous, as these members will feel like they have lost what might be their only coping mechanism. Investigating the creation of a safer online environment for sharing these thoughts could prove to be a worthwhile endeavor for those in policy and the mental health field, as the demand and apparent need for such spaces are clear.

Second, for individuals in the mental health field who interact with clients on a daily basis, understanding that these spaces exist and are widely accessible is also important. A practitioner may have a client who is engaging in these online communities without their knowledge, as they may not have realized the space existed in the first place. Asking a client who is thinking of suicide, especially one who seemingly uses the internet a lot, if they engage in online talks about their mental health (in a way that is non-revealing to the existence of these sites in the first place) could, as a result, be something beneficial for mental health providers to do. Asking this question to specific clients who are debating acting on suicidal thoughts is even more critical, as the site and ones like it could prove a significant risk in terms of increasing the risk of action due to them housing threads with specific methodology planning.

Third, there is a plethora of information on these sites that could prove beneficial for researchers. These forums have the potential to reveal the unfiltered thoughts and feelings of individuals who do not participate in research studies or in-person therapy. Proper ethical practices must be followed to ensure that the resulting research causes no harm; however, there is an opportunity to conduct critical research into an underreported and underrepresented, hard-to-reach group of the population.

Finally, the internet appears to be facilitating discussions based on personal autonomy that can lead to harmful behavior. Although the focus here is a suicide-discussion forum, many of the dynamics are familiar to clinicians who have tracked pro-ana communities: an emphasis on personal autonomy framed as a shield against 'outsider' judgement; migration patterns that follow moderation pressure rather than end participation; and in-group language that blurs 'support' and risk. Recognizing these shared features matters. It reinforces the idea that blanket suppression can strengthen identity and drive conversations into harder-to-reach spaces. Alternatively, calibrated, evidence-informed approaches – such as clear age-gating, active moderation that prioritizes distress-signaling over risk-amplifying content, and pathways to care that do not demand immediate disclosure – may reduce harm without amplifying defiance. 

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Creating safer alternatives

In conclusion, for policymakers leading the charge to regulate these sites, creating safer alternatives should be considered a high priority. For practitioners, being aware of the existence of these sites and listening to clients for the underlying narratives common to these spaces (autonomy, belonging, mistrust) or other general signs that an individual is using them is crucial to ensure the safety of clients. Lastly, for researchers, doing more work to understand how these environments shape user sentiment and overall how we discuss suicide in online spaces as a whole should be considered a top priority. https://standingabovethecrowd.com/?p=16193