Building an online community to promote communication and collaborative learning between health professionals and young people who self-harm: an exploratory study

The young people were keen to share their lived experience of self-harm and its management with health professionals. They engaged in lively discussion and supported one another during emotional crises. Despite registering to take part, health professionals did not actively participate in the forums. Reported barriers included lack of confidence and concerns relating to workload, private–professional boundaries, role clarity, duty of care and accountability. In their absence, the young people built a vibrant lay community, supported by site moderators.

Participants reported that they avoided A&E where possible - due to negative experiences of their own and others. Shame and worthlessness were attached to being made to seek emergency care - reinforced by perception of punitive treatment by A&E staff and a perpetuation of shame, avoidance, further harm. Positive treatment was one in which the young person did not feel discriminated against, and kindness was perceived. Health professionals may not yet be ready to engage with young people who self-harm and to exchange knowledge and experience in an anonymous online setting. Further work is needed to understand and overcome their insecurities.