Content area
Full text
Background
Worldwide, 1.3% of deaths are from suicide (World Health Organisation, 2021) and rates of non-fatal self-harm are increasing, particularly in young girls (Morgan et al., 2017). Prospective studies show that self-harm is a major risk factor for subsequent suicide (Carroll et al., 2014) and the majority of those who die by suicide have a previous history of self-harm, and yet only a minority seek professional help following self-harm. Many people who die by suicide have not had recent contact with services (National Confidential Inquiry into Suicide and Safety in Mental Health, 2021), so there is a need to understand more about informal help-seeking, including the use of online resources.
Online access to good quality advice and support is important given that self-harm and suicidal thinking are often difficult to talk about directly. Many people who self-harm have never talked about it with anyone (Armiento et al., 2014) and for those who do, the internet is often the first medium for self-disclosure (Rowe et al., 2014). Social media, in particular, are widely used as a resource to share experiences and seek support (Lavis and Winter, 2020). Reviews have highlighted the potential benefits of posting and viewing content – such as reduction in feelings of isolation, increased access to peer support and a resulting sense of community (Dyson et al., 2016).
However, there is concern that some online content may be contributing to increased rates of self-harm and may be linked to suicides, for example, through so-called normalising of behaviour, reinforcing negative thoughts and feelings or connecting people with others who encourage it (Lewis and Seko, 2016). Recent research suggests that the time spent online may be associated with mental health problems in young people, although this seems to be related at least in part to the loss of displaced activities, lack of sleep or increased sedentary behaviour (Viner et al., 2019). A review published in 2017 suggested that there was significant potential for harm with the best evidence for high internet use and internet addiction as having negative influences and some evidence to suggest that searching for suicide content online may be associated with self-harm and suicidal thinking (Marchant et al., 2017).
There are two aspects to the...