Digital technology is ubiquitous in university life. It became indispensable during COVID as a means of delivering teaching and also therapy. University websites and intranets can be valuable repositories of respected health information, signposting and self-help resources, but these need to be kept up to date. There is still a generation gap in terms of being ‘media savvy’ and older people have different experiences online. Society is waking up to the relentless commercial interests driving our online interactions and the psychological conditioning involved. Society needs to protect young brains in particular from exploitation and harm. Long periods spent online mimic psychiatric disorders, by interfering with concentration, causing sleep deprivation, dysregulation, obsessional checking behaviours, body image dysphoria and abnormal interpersonal relations. Unmonitored content and algorithmic amplifications increase distress. Rising rates of deliberate self harm and suicide rates appear to be associated with online experience. Legal and institutional regulation is unlikely to occur without grass roots campaigning. Schools and families usually provides some protection and online safety education. This needs to be reinforced and revisited during the transition to university. Clinicians and others concerned about mental health or wellbeing should explicitly ask questions such as ‘what’s going on for you online?’

Suicide is a leading causes of student death, especially in young men, and appears to be increasing in prevalence. The most effective preventative measures so far involve limiting access to the means of self-destruction. Institutions can monitor the built environment for ‘suicide hotspots’ such as towers, bridges and car parks, and reduce access to chemicals and drugs on campus. Social media and other online activity appear to increase the likelihood of suicide. Alcohol and recreational drugs are strong risk factors. Individuals with autism are at high risk, as are those with a diagnosis of bipolar disorder. Students who have to take time out of academic studies – or to leave – are especially vulnerable. Warning signs include social withdrawal, academic failure and low mood. Asking about suicidal thoughts appears not to increase the likelihood of suicide, but may be protective. Support pathways for distressed students and staff should be regularly reviewed. Websites should be kept updated with helpful links, including simple instructions for crisis management. Information-sharing agreements should be reviewed to consider permissions to contact next of kin. All institutions need a suicide ‘postvention’ plan and team in readiness to compassionately manage the rare but devastating occurrence of suicide.