Viewing self-harm images online can trigger young people to hurt themselves and usually causes harm, a new study from the University of Oxford suggests.
Experts looked at 15 existing studies and concluded that viewing such material does more harm than good, with all the studies finding harmful effects.
These include escalation of self-harm, reinforcing self-harming through commenting on and sharing images, comparing self-harm with others and the “development of a self-harm identity”.
People who feel connected through self-harming may be more likely to hurt themselves, while images can trigger the urge to self-harm, the studies found.
However, the team said further studies are needed as nine of the research papers also indicated some “protective” effects for some young people, including reduction in urges to self-harm, social connection with other people and providing and receiving support.
This review of studies from across the world, mostly on young people, provides strong support for concerns about the potential impact of viewing images of self-harm— Professor Keith Hawton, University of Oxford
Writing in the Journal of Child Psychology and Psychiatry, the researchers concluded: “Viewing self-harm images online may have both harmful and protective effects, but harmful effects predominated in the studies.”
Keith Hawton, professor of psychiatry and director of the centre for suicide research at Oxford, and a lead author on the article, said: “This review of studies from across the world, mostly on young people, provides strong support for concerns about the potential impact of viewing images of self-harm.
“However, the mixed nature of the evidence indicates the complexity of issues regarding restrictions on online images of self-harm.
“While most people would agree that platforms which allow promotion of self-harm or suicide should be restricted, the situation regarding sharing of self-harm images between individuals or groups of individuals is less clear, especially as, while this can clearly be harmful, it can also be a source of support and recovery.
“I believe that the results of our review provide evidence that is helpful for the current debate on influences of viewing images of self-harm online and in social media. This needs to be supplemented by more in-depth research.”
Images can trigger powerful emotions which increase the likelihood of individuals engaging in self-harm-related behaviours— Dr Karima Susi
The Government’s Online Safety Bill, which is currently with the House of Lords, would mean technology companies have to stop children from seeing content that poses a risk of causing significant harm.
Earlier this month, Rishi Sunak said his daughter getting her own phone made him more aware of the risks to children of going online.
The Prime Minister said the Bill is a “necessary piece of legislation” to reassure parents about the content their children view online.
Last September, a coroner ruled schoolgirl Molly Russell died from “an act of self-harm while suffering from depression and the negative effects of online content”.
The 14-year-old schoolgirl from Harrow, north-west London, was found dead in her bedroom after viewing content related to suicide, depression and anxiety online.
Giving his findings, coroner Andrew Walker said the “particularly graphic” content she saw “romanticised acts of self-harm”, “normalised her condition” and focused on a “limited and irrational view without any counterbalance of normality”.
He said it “sought to isolate and discourage discussion” with people who could have helped her, and instead “tended to portray self-harm and suicide as an inevitable consequence of a condition that could not be recovered from”.
The results of this review highlight the importance for clinicians, and anyone working with young people, to be aware of the potential impact of self-harm imagery online or in social media— Dr Anne Stewart
Since her death in November 2017, Molly’s father Ian has campaigned for better protections for children when using social media and going online.
Dr Karima Susi, the clinical psychologist who led the Oxford review, said: “Images can trigger powerful emotions which increase the likelihood of individuals engaging in self-harm-related behaviours.
“Viewing images also provide a means whereby individuals can connect with one another and get support, which might not be available offline.
“Our findings highlight the need to address the factors that may contribute to individuals seeking support online, despite the potential for harm.
“The findings could be used to inform further research and widen awareness about the potentially harmful and protective effects of viewing self-harm images online.”
Dr Anne Stewart, consultant child and adolescent psychiatrist with Oxford Health NHS Foundation Trust and another author of the new study, added: “The results of this review highlight the importance for clinicians, and anyone working with young people, to be aware of the potential impact of self-harm imagery online or in social media and to check out whether the young person is accessing such material and is being harmed by it.”
It is extensive, solidly executed and clearly communicated, and summarises the best quality evidence we currently have available on this topic— Dr Amy Orben, University of Cambridge
Richard Collard, head of child safety online policy at the NSPCC, said: “This research shows the devastating impact that being exposed to self-harm material can have on children and it’s high time vital that social media companies finally get their houses in order.
“Despite high-profile cases, self-harm content is still being promoted to children on major platforms with tech firms failing to take the bold action required to genuinely make their sites safe.
“The Online Safety Bill will help protect young users from harmful content but it could be strengthened by creating a statutory child safety advocate to ensure children’s experiences are heard by the regulator Ofcom and acted on consistently by the companies.”
Dr Amy Orben, a scientist from the University of Cambridge, said the study “is both timely and important”, adding: “It is extensive, solidly executed and clearly communicated, and summarises the best quality evidence we currently have available on this topic.”
