Self-Harm in the Digital Age

How Digital Content Affects the Mental Health of Children and Adolescents

Author: Dionysia Kostagianni*

In recent years, the internet and social media have become an inseparable part of children's and adolescents' daily lives. Their widespread use has raised questions about their role in young people's mental health, and in self-harming behaviors in particular. Non-suicidal self-injurious behaviors — such as cutting, burning, or hitting the body — are often associated with anxiety, depression, low self-esteem, traumatic experiences, and difficulty regulating emotions. Scientific research has turned its attention to the role of exposure to online content related to self-harm. Exposure alone is not a cause of self-harm, but it can act as a risk or reinforcing factor, particularly in children and adolescents who are already experiencing psychological distress.

What do we mean by "self-harm-related online content"?
The term refers to images, videos, posts, or personal narratives that describe, depict, or discuss experiences or methods of self-harm. This content may appear on social media platforms, video-sharing sites, forums, or blogs. In many cases it is created by young people themselves, as a way of seeking support or personal expression. However, research indicates that repeated or uncontrolled exposure to such content has been associated with increased psychological distress, particularly in children and adolescents who are already struggling with mental health difficulties.

What does research tell us about the relationship between exposure and self-harm?
Studies examining children's and adolescents' experiences online and on social media show that frequent contact with self-harm content has been linked to increased reporting of self-harming thoughts and behaviors. It is important to note that exposure does not necessarily lead to self-harm, but appears to interact with pre-existing psychological difficulties such as depression, anxiety, and feelings of loneliness.

A significant finding concerns the concept of normalization. When young people are repeatedly exposed to images and narratives related to self-harm, a sense of familiarity develops, and the perception may take hold that self-harm is a common way of managing emotional pain. This normalization can potentially increase the likelihood of imitative self-harming behaviors, particularly in emotionally vulnerable individuals who are seeking ways to express or regulate their distress.

What is the role of algorithms and repeated exposure?

Another important factor concerns the way online platforms operate. Most platforms are now driven by powerful algorithms designed to retain users' attention by recommending content based on previous searches and interactions. As a result, a child who has viewed or searched for self-harm-related material may be exposed to similar content with increasing frequency, creating a cycle of repeated exposure.

This repeated exposure has been associated in some young people with emotional distress, obsessive preoccupation, and difficulty disengaging from negative patterns of thought. Researchers have noted that the risk is greater when content is not accompanied by prevention messaging or referrals to support services.

Which young people are most affected?

It is important to remember that not all children and adolescents are affected in the same way. Most young people who encounter this type of content will not engage in self-harming behaviors. However, self-harm-related online content may place an additional burden on children and adolescents with pre-existing difficulties. Heightened vulnerability has been observed in individuals with symptoms of depression or anxiety, a history of self-harm, social isolation, or difficulties in interpersonal relationships.

Is self-harm-related online content always harmful?

Despite the concerns, it is worth noting that references to self-harm do not always carry a negative valence. The internet can also function as a space for support. Some online narratives focus on recovery, healthy ways of coping with distress, help-seeking, and the sharing of experiences with the aim of supporting others. Research suggests that this type of content has been associated with reduced feelings of loneliness and a greater likelihood of seeking help and professional support. Distinguishing between harmful and supportive content remains a key challenge for parents, educators, and mental health professionals.

How does CAMHI support prevention and protection?

Research evidence highlights that effective prevention should not rely on an outright ban on internet use, but on strengthening digital literacy so that children and adolescents can navigate the internet safely and critically. Equipping young people to recognize harmful content, limit their exposure, and ask for help when something troubles them is a crucial element of prevention.

Equally important is open communication with trusted adults whom young people can approach without fear to talk about what they see and experience online. Early intervention by mental health professionals when signs of psychological distress or changes in online behavior are observed is also essential.

Overall, exposure to self-harm-related online content has been associated with increased psychological distress and self-harming thoughts in some children and adolescents, particularly those in a state of vulnerability. It bears emphasizing that the internet is not in itself a cause of self-harm, but a factor that interacts with many others. In today's digital age, promoting the mental health of children and adolescents must be supported through strengthened digital literacy and the creation of supportive communication environments.

CAMHI has developed evidence-based resource guides for every child and adolescent mental health difficulty, including self-harm, designed specifically for adolescents, parents, or educators. Additional information on disorders related to self-harm is available in Disorder Guides developed by CAMHI specifically for healthcare professionals (pediatricians, family physicians, et al.). Beyond the guides, CAMHI offers free training programs designed to support professionals and individuals working with children and adolescents in Greece. These are comprehensive programs with flexible learning options, including asynchronous modules as well as synchronous, in-person and online sessions. Each program is designed for a different audience and professional group — including educators, psychologists, child psychiatrists, social workers, parents and caregivers, pediatricians, judicial officers, prosecutors, and staff in child care institutions — and provides targeted knowledge and practical tools to strengthen their capacity to effectively support children and adolescents.

Dionyssia Kostagianni is a Psychologist. She worked at the Child & Adolescent Mental Health Initiative as an intern through the Stavros Niarchos Foundation (SNF) Internship Program.

The Children & Adolescent Mental Health Initiative (CAMHI) program is designed and implemented by a nationwide network of public-sector mental health providers and professionals, in collaboration with the Child Mind Institute (New York) and with the support of the Ministry of Health.

The Children & Adolescent Mental Health Initiative is supported exclusively by the Stavros Niarchos Foundation (SNF) as part of the SNF's Global Health Initiative (GHI).