We can all agree the Internet brings us together. It improves our lives in tons of ways (think: social media, online shopping, access to health-improving information). At the same time, this large virtual space also accommodates niche communities that encourage unhealthy or harmful behavior.
One example is the online communities that share self-harm experiences and, in some cases, encourage self-harm or suicide [1]. Self-harm behavior involves intentionally injuring or hurting oneself (e.g., cutting) [2]. Although self-harming behavior may indicate depression or serious mental health conditions that are associated with suicidal intentions, people do not always self-harm because they want to die by suicide [2]. It is important to understand that this behavior is not the same as a suicide attempt. While the causes of self-harm are complicated, self-harm can often be a way that some people cope with emotional or mental distress [3]. Nonetheless, these behaviors are short-term fixes and do not relieve distress in the long run. Self-harm can also lead to more serious health consequences [2].
The vast majority of teenagers – and by that I mean over 99% – do not visit websites that discuss or encourage self-harm or suicide [1]. Furthermore, popular social media sites have rules against their users promoting harmful behaviors [4]. However, enforcement of these rules can be inconsistent, allowing online communities to form around mutual interests in self-harm behavior [5]. Although less than 1% of youth have visited websites that encourage self-harm or suicide [1], followings on a particular self-harm site or social media platform can number in the thousands [5].
There are major gaps in our understanding of why youth go to sites about self-harm and what their experiences are on these sites. Emerging research suggests, however, that these online communities can give young people a sense of shared-identity and belonging [5, 6]. Accordingly, youth who visit self-harm websites and websites that talk about suicide also use the Internet, interact with people they first met online, visit chatrooms, discuss sexual topics online, and share personal information to someone met online at significantly higher rates than youth who do not visit these types of websites [7]. Together, this research suggests that youth who visit self-harm and suicide websites are seeking connection to others. Although some behaviors that are being reinforced may be unhealthy for youth [5], the online social support that some young people find in these spaces can be important – especially if isolation or emotional distress are reasons they are engaging in self-harm [7].
Perhaps not surprisingly, research suggests that youth who have visited self-harm and suicide websites are 11 times more likely to have thought about hurting themselves, compared to youth who have not visited such websites [1]. Youth who visit such sites are also more likely to report a history of physical or sexual abuse, substance use, or delinquent behavior [1]. As such, one might view visiting self-harm and suicide websites as a cause for concern.
On the other hand, though, it could also be seen as an opportunity to have a conversation with a young person about what’s going on in their lives. Often, it can seem like teens move through an invisible online world where we only catch glimpses of what they see or do. Knowing where young people are going and with whom they spend time online can be an incredibly important way to fill some of these gaps in our knowledge and be a way to start valuable conversations with them. Connecting youth who gravitate to potentially harmful sites to positive and supportive online social spaces can also be a very powerful opportunity to connect with like-others who are struggling to recover.
Additionally, building emotional support in offline spaces can be very beneficial: Connecting to supportive friends and family may help greatly. Getting youth involved in extracurricular activities that raise self-esteem and confidence can also be a healthy way to cope with emotional distress. If needed, counseling, both short-term and long-term, can also provide support and teach healthier coping mechanisms [1].
So, if you know someone who is going to websites about self-harm or suicide, talk to them about it. Try to understand what is going on and why they are going to these sites. Think with them about other spaces they might explore where they can find support and understanding, and offer going to these other places with them, if they find it useful. Being able to reach out and talk with others who “get it” may very well be the step for reaching youth who need help.
To learn more about self-harm and suicide and what you can do to help someone who is struggling with these experiences, visit You Matter.
You can learn more about our research at Center for Innovative Public Health Research. Find us on Google+, Twitter, and Facebook.
Acknowledgments: Thanks to Dr. Kimberly Mitchell and Emilie Chen for their contributions to this blog.
References:
[1] Mitchell KJ, Wells M, Priebe G, Ybarra ML. Exposure to websites that encourage self-harm and suicide: prevalence rates and association with actual thoughts of self-harm and thoughts of suicide in the United States. Journal of Adolescence. 2014;37(8):1335-1344.
[2] Mayo Clinic Staff. Self-injury/cutting. 2012; http://www.mayoclinic.org/diseases-conditions/self-injury/basics/definition/con-20025897.
[3] ‘Direct link’ between self-harming and the internet. BBC News. 2015. http://www.bbc.com/news/uk-wales-31878391
[4] Tumblr Staff. A New Policy Against Self-Harm Blogs. 2012. http://staff.tumblr.com/post/18132624829/self-harm-blogs.
[5] Vine S. My chilling journey into the self-harm websites that drove a much loved daughter to suicide. Telegraph. 2014. http://www.telegraph.co.uk/news/health/11025101/Self-harming-among-children-surges-to-unprecedented-levels.html
[6] Baker D, Fortune S. Understanding Self-Harm and Suicide Websites. Crisis.29(3):118-122.
[7] Mitchell KJ, Ybarra ML. Online behavior of youth who engage in self-harm provides clues for preventive intervention. Preventive Medicine. 2007;45(5):392-396.