Self-injurers on the social Web

Here's one example of the opportunities for social-Web safety as our field emerges from predator panic to focus on research-based strategies: how to help self-injuring teens. I was prompted to write about this by an article headlined "Self-injury on the rise among young people" in the Los Angeles Times. Cutting and embedding (embedding objects like paper clips or staples for recurring self-harm) is usually secretive behavior by someone seeking relief from more extreme emotional pain, experts say. It's less secret now, however, thanks to the social Web. Teens sometimes post images of scarred arms and other forms of self-harm in their profiles, which can be a step toward getting help.

Because the social or participatory Web is by definition user-driven, helping self-injuring teens isn't a top-down control proposition for social-networking sites any more than it is for self-injurers' friends and relatives (kids sensing efforts to control or stop them can just go to other, lesser-known sites, where help may be less available). There's no question public awareness of self-harm needs to be raised using all media available, and this is one thing the social-Web industry's marketing resources can help with. But this issue also cries out for the kind of help social-Web users can offer best: social-norming. Peers have a great deal of influence, for good and bad, and the social-networking industry (as well as parents and educators) can promote positive peer influencing or social norming. Through education, we can all enlist the help of our young people's peers as part of the healing process, knowing that, generally, they're the only ones who know what's happening where individual cases are concerned.

It's a "remarkably prevalent," underreported behavior, the L.A. Times cites researchers in the Journal of Consulting and Clinical Psychology (especially the 2/08 issue) as saying, "15-22% of all adolescents and young adults [having] intentionally injured themselves at least once in their lifetimes. One study of 94 girls, ages 10 to 14, found that 56% had hurt themselves at least once." It's important to know that there's a broad range of severity in self-harm. "Most self-injuries are not serious, and some people try it once and never again…. A small group self-injures to seek attention or as a cry for help. Another group self-injures excessively and is at high risk for suicide," the Times reports.

Both the Times and Canada's CBC tell of a Columbus, Ohio, radiologist, William Shiels, who uses ultra sound to find embedded objects and developed "a minimally invasive surgical technique to remove them," the CBC reported. Dr. Shiels recently reported at a medical conference that 9 of the 10 girls aged 15-18 in the study he presented "said they'd had thoughts of suicide or had attempted suicide previously"; 40% were victims of sexual abuse. "The high rates found among young people [as opposed to adults] seem to go hand in hand with other studies suggesting today's youth may suffer from more mental health problems than previous generations," the Times adds.

So back to where the social Web comes in. Beyond awareness-raising, how can the social-Web industry help this group – actually all groups – of at-risk teens? It can help bring psychological and risk-prevention expertise into the public discussions and conferences about online safety as well as into business practices, for example, in having such expertise available on-call to customer-support departments. To summarize, I suggest social Web sites consider…

* Raising awareness with apps or widgets, house ads, and any other advertising tools available, sending the message to users that everyone deserves help, and helping those in trouble – not standing by passively or, much worse, gossiping – is what friends do!
* Monitoring site activity for self-destructive behavior to whatever extent possible and at the very least…
* Providing a number to call. Have the number of the National Suicide Prevention Lifeline and psychiatric health-care advice at the fingertips of customer-service staff 24/7 to share with any user who points out a need.
* Prominently displaying the number and Web address of the Lifeline on at least the safety pages if not every page of their Web sites. [The Lifeline coordinates the work of more than 100 hotlines nationwide that deal with everything from suicidal thoughts to domestic violence to depression 24 hours a day for free (for more on this, see "The social Web's lifeline," 3/07).]

Related links

* "Self-injury 'support' online"
* "1 in 6 self-injure"
* Even as early as 2006, when social networking was a new concept to most adults, MySpace was one of the biggest sources of referrals to the National Suicide Prevention Lifeline; that's when I first blogged about the Lifeline. I'll be getting a thorough update on their work at a SAMHSA conference in DC in May.


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