Motivations and perceived harms and benefits of online communication about self-harm: An interview study with young people

Background Self-harm behaviour is prevalent among young people and online communication about self-harm is frequent. These online communications are associated with potential harms and potential benefits. To date, few studies have explored the motivations and mechanisms involved in youth online communication about self-harm. Objective This study aimed to explore why young people communicate online about self-harm and the perceived benefits and harms of these communications. Methods Twenty young people aged between 18 and 25 years completed an online interview. Interviews were audio recorded and transcribed verbatim. Thematic analysis was used to identify themes. Results Four main themes are reported: (1) crossing from offline to online—the double-edged affordances of social media: young people engaged in online communication about self-harm because they were unable or unwilling to speak about their experiences in offline contexts. Online spaces afforded anonymity and peer support, which were associated with benefits and harms; (2) user-generated is not quite the same as user-resonated: perceptions were influenced by whether the young person created or viewed or responded to the content. Written and visual content had pros and cons; (3) it's not just you, it's mostly me—individual characteristics influence perceptions: age and mental state influenced perceptions and behavior; and (4) beyond individuals—parameters are protective: leadership and platform policies and procedures aided safety. Conclusions Online communication about self-harm is neither entirely helpful nor harmful. Perceptions are influenced by individual, social, and systematic factors. Evidence-based guidelines are needed to increase young people's online self-harm literacy and help them build effective communication skills to buffer psychological and potentially physical harm.