Searching About Suicide and Crisis Hotlines Online: A Temporal and Geospatial Infodemiological Analysis.

Abstract

Background: Suicide remains a leading global public health concern, and crisis hotlines are a critical preventive intervention. However, there is a paucity in studies about how population-level digital information-seeking behaviors for suicide and crisis hotlines evolve across time and countries.

Aims: This study aimed to (1) examine temporal trends and seasonality of global Google searches for "Suicide" and "Crisis Hotline," (2) analyze their temporal associations through cross-lagged correlations, and (3) identify country clusters based on all-time relative search volumes (RSVs).

Method: Monthly global RSVs (2004-2025) and country-level all-time RSVs were extracted from Google Trends. Time-series analyses included Seasonal and Trend decomposition using Loess (STL) decomposition, Kruskal-Wallis tests for seasonality, Autoregressive Integrated Moving Average (ARIMA) forecasting, Pearson correlations, and cross-lagged correlations of raw and detrended series. K-means clustering was applied to country-level data.

Results: Suicide searches showed persistent baseline levels with spikes in 2009-2010, 2014, 2017-2018, and 2020-2021. Crisis hotline searches rose sharply from the late 2010s, accelerating during the COVID-19 period. Seasonality was significant for suicide but not for hotlines. Cross-lagged analysis showed a +22-month raw lag (r = .22) that disappeared after detrending, leaving only a contemporaneous association (r = .31). Four global clusters highlighted disparities in suicide versus crisis hotline interest.

Conclusion: Google Trends can serve as a proxy for real-time public demand for suicide prevention resources. Findings emphasize the need for agile, context-sensitive strategies to strengthen hotline visibility and accessibility globally.