Suicide memes are memes used to express suicide-related thoughts or comment on suicide-related issues. Suicide memes are increasingly common on social media, yet remain poorly understood and potentially harmful. There is an urgent need to better understand their characteristics and to develop appropriate content moderation strategies that limits users’ exposure to potentially harmful content. Currently, the absence of annotated datasets of suicide memes remains a key barrier to developing and evaluating automated moderation approaches. In this paper, we introduce FigSIM, the first dataset designed for fine-grained analysis of suicide memes. The dataset consists of 1049 memes, each annotated for (1) fine-grained suicide severity levels, (2) figurative phenomena (e.g. metaphors), and (3) suicide-related content (e.g. suicide method depiction). We benchmark 16 unimodal and multimodal models across three tasks: figurative language, suicide severity, and suicide-related content detection. Overall, FigSIM demonstrates that suicide memes pose unique challenges for both modeling and content moderation. Analysis revealed biases, such as underprediction of higher suicide severity levels, especially for figurative memes.

Self-harm presentations to emergency departments (EDs) are strongly associated with higher suicide risk. NLP models have shown strong performance in detecting self-harm from triage notes within single hospitals, yet performance often declines across institutions. To examine potential causes, we compare ED triage notes from two hospitals by analyzing lexical characteristics, highly associated predictive features, and salient topics. Our results reveal variation in lexical expression and feature importance related to self-harm across hospitals, despite consistent core themes such as self-poisoning and self-injury. These documentation differences are associated with reduced cross-site performance. These findings provide insight into how institutional variation affects the identification of self-harm in clinical text and highlight potential methods to improve model generalisability.