Objectives: To explore the nature of images tagged as self-harm on popular social media sites and what this might tell us about how these sites are used.
Design: A visual content and thematic analysis of a sample of 602 images captured from Twitter, Instagram and Tumblr.
Results: Over half the images tagged as self-harm had no explicit representation of self-harm. Where there was explicit representation, self-injury was the most common; none of these portrayed images of graphic or shocking self-injury. None of the images we captured specifically encouraged self-harm or suicide and there was no image that could be construed as sensationalising self-harm.Four themes were found across the images: communicating distress, addiction and recovery, gender and the female body, identity and belonging.
Conclusions: Findings suggest that clinicians should not be overly anxious about what is being posted on social media. Although we found a very few posts suggesting self-injury was attractive, there were no posts that could be viewed as actively encouraging others to self-harm. Rather, the sites were being used to express difficult emotions in a variety of creative ways, offering inspiration to others through the form of texts or shared messages about recovery.
Keywords: images; self-harm; social media.
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.