Prevalence, Themes, and Partisan Differences in US State Legislator X Posts Mentioning Suicide: Content Analysis.

Background: Suicide is a leading cause of death in the United States, and state policies can be effective tools to prevent suicide. State legislators are increasingly active on social media, communicating about their legislative priorities and signaling information about their knowledge and attitudes about issues. Objective: This study aimed to characterize US state legislators' social media posts mentioning suicide on X (formerly Twitter) and explore differences in how Democrat and Republican legislators communicate about suicide. Methods: We used Quorum, a public affairs database, to identify all state legislator X posts mentioning suicide (N=1049) between December 1, 2023, and November 30, 2024. We developed a codebook and used content analysis to characterize posts and document the frequency of communication about suicide and themes related to causes, solutions, and consequences of suicide. We assessed concordance between the social media post language used and guidelines for reporting about suicide. We conducted univariate analysis and chi-square tests to assess differences in the content of posts between Democrat and Republican legislators. Differences in the frequency of posts about suicide were analyzed using 2-tailed t tests. Results: Of 1049 posts identified, 849 (80.9%) were included in the final sample. The annual suicide post rate per 10,000 posts was 13.2 (0.1% of all posts) among Democrats and 7.4 (0.1% of all posts) among Republicans (P=.09). Suicide related to a specific population was identified in 52.2% (443/849) of posts, with youth, veterans, firearm owners, and the LGBTQ+ (lesbian, gay, bisexual, transgender, queer, and more) population being identified most frequently. Causes of suicide were identified in 37.1% (315/849) of posts, with no significant difference between Democrats and Republicans. However, the types of causes identified varied, with Democrats more likely to identify lethal means (eg, firearms) as a cause of suicide than Republicans (115/573, 20.1% vs 20/172, 7.5%; P<.001). About two-thirds (558/849, 65.7%) of posts identified at least one solution to prevent suicide, with Democrats more likely to identify a solution than Republicans (443/573, 77.3% vs 114/268, 42.5%; P<.001). General awareness was the most frequent solution, while policy-specific solutions were present in only 23.3% (198/849) of posts. Collateral consequences of suicide were infrequently mentioned. Conclusions: This study found differences between Democrats and Republicans in their X posts about suicide and areas of misalignment with research evidence. When considered within the context of research on the epidemiology of suicide and evidence supporting suicide prevention policies, the study highlights the need to improve communication about suicide with state legislators and to encourage further collaboration with suicide prevention organizations and experts. Furthermore, given the differences observed, study findings suggest potential value in tailoring messages about suicide for legislators based on their political party.