The good, the bad and the unknown: how online activity influences self-harm and suicide in young people - Swansea University Medical School

Online activity can increase young people’s exposure to self-harm, but it can also provide support to those in crisis or who feel isolated, according to a review of evidence in the field, led by a Swansea University expert in suicide prevention, who is also a doctor.

Research on internet use and self-harm is rapidly expanding, amidst concerns about the influence of on-line activities on self-harm and suicide, especially in young people. The research team wanted to see what overall themes and results emerged from work already published in this field.

The team consisted of experts from Swansea University Medical School, Oxford University and Oxford Health NHS Foundation Trust.

They systematically reviewed 46 different studies, all of which related to internet use in relation to self-harm/suicidal behaviour by people under 25.

Their review, published in Plos One, is the first to focus on a wide range of internet mediums: general internet use; internet addiction; online intervention/treatment; social media; dedicated self-harm websites; forums; video/image sharing and blogs.

The researchers’ review of evidence concluded:

• There is significant potential for harm from online behaviour (normalisation, triggering, competition, contagion) but also the potential to exploit its benefits (crisis support, reduction of social isolation, delivery of therapy, outreach).

• A relationship between internet use and self-harm/suicidal behaviour was particularly associated with internet addiction, high levels of internet use, and websites with self-harm or suicide content.

• Young people appear to be increasingly using social media to communicate distress, particularly to peers.

They recommended:

• The focus should now be on how specific mediums (social media, video/image sharing) might be used in therapy and recovery.

• Clinicians working with young people who self-harm or have mental health issues should engage in discussion about internet use. This should be a standard item during assessment.

The research was led by Professor Ann John, Professor of Public Health and Psychiatry, and deputy Head of Swansea University Medical School

Professor Ann John of Swansea University said:

“There is no doubt that the internet is changing the experience of growing up. There is a lot of anxiety about harmful effects of the internet but it’s hard to know if these changes are for good, for bad or whether they make any difference at all.

We looked at how on-line activity influences self-harm and suicide. Online activity can potentially increase exposure to self-harm, trigger it or make it seem more normal. However, the online world also has the potential to provide support to those in crisis or who feel isolated, increase access to therapy and enable professionals to reach out to vulnerable marginalised groups.

Online activity in young people is not going away and we need to focus on how we can deliver therapy and recovery through social media and video sharing. We also need programmes in schools to teach digital citizenship which include ways to respond to distressed posts on social media.”