Background The positive and negative effects of interacting with web-based content on mental health, and especially self-harm, are well documented. Lived experience stories are one such type of static web-based content, frequently published on health care or third-sector organization websites, as well as social media and blogs, as a form of support for those seeking help via the web. Objective This study aimed to increase understanding about how people who self-harm engage with and evaluate web-based lived experience stories. Methods Overall, 4 web-based focus groups were conducted with 13 people with recent self-harm experience (aged 16-40 years). In total, 3 example lived experience stories were read aloud to participants, who were then asked to share their reactions to the stories. Participants were also encouraged to reflect on stories previously encountered on the web. Data were analyzed thematically. Results Overall, 5 themes were generated: stories of recovery from self-harm and their emotional impact, impact on self-help and help-seeking behaviors, identifying with the narrator, authenticity, and language and stereotyping. Conclusions Lived experience stories published on the web can provide a valuable form of support for those experiencing self-harm. They can be motivating and empowering for the reader, and they have the potential to distract readers from urges to self-harm. However, these effects may be moderated by age, and narratives of recovery may demoralize older readers. Our findings have implications for organizations publishing lived experience content and for community guidelines and moderators of web-based forums in which users share their stories. These include the need to consider the narrator’s age and the relatability and authenticity of their journey and the need to avoid using stigmatizing language.

BACKGROUND Self-harm/suicide (SH/S) are major public health concerns globally, with attention increasingly focused on the role of the online environment as a helpful or harmful influence. Longitudinal research on the impact of SH/S-related internet use is limited, highlighting a paucity of evidence on the long-term effects of engaging with such content. OBJECTIVE This study aims to explore why people view, search for, and post SH/S content online over a longitudinal period, and the consequences of doing this. METHODS This study employed qualitative and digital ethnographic methods over a 6- month period, including interviews at three time-points to explore individual narratives of online engagement with SH/S content. A trajectory analysis approach involving four steps was used to interpret data. RESULTS Findings from 14 participants established the online journey of people who engage with SH/S content. Five themes were identified, which were influenced by cognitive flexibility: initial interactions with SH/S content, changes in where and what SH/S content people engage with, changes in experiences of SH/S behaviours associated with online SH/S content engagement, the disengagement-re-engagement cycle, and future perspectives of online SH/S content engagement. Some participants used metacognition and digital efficacy to control online engagements but were still vulnerable due to the compelling nature of the content. CONCLUSIONS Results demonstrated the complexity of online interactions, with beneficial and harmful content closely intertwined. Participants found it challenging to disengage from SH/S content, highlighting the need for interventions that prioritise upskilling users to improve their control over behaviour. Moreover, the study underscores the responsibility of online industry leaders to develop tools that enhance the safety of online spaces.

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BACKGROUND The positive and negative effects of interacting with online content on mental health and especially self-harm, are well documented. Lived experience stories are one such type of static online content, frequently published on healthcare or third sector organization websites, as well as social media and blogs, as a form of support for those seeking help online. OBJECTIVE To increase understanding about how people who self-harm engage with and evaluate online lived experience stories. METHODS Four online focus groups were conducted with thirteen people with recent self-harm experience (aged 16-40 years). Three example lived experience stories were read aloud to participants, who were then asked to share their reactions to the stories. Participants were also encouraged to reflect on stories previously encountered online. Data were analysed thematically. RESULTS Five themes were generated: i) stories of recovery from self-harm and their emotional impact; ii) impact on self-help and help-seeking behaviors; iii) identifying with the narrator; iv) authenticity; v) language and stereotyping. CONCLUSIONS Lived experience stories published online can provide a valuable form of support for those experiencing self-harm. They can be motivating and empowering for the reader, as well as having the potential to distract from urges to self-harm. However, these effects are moderated by age, and narratives of recovery may demoralise older readers. Our findings have implications for organizations publishing lived experience content, and for community guidelines and moderators of online forums in which users share their stories. These include the need to consider the narrator’s age, relatability and authenticity of their journey, and to avoid using stigmatizing language.