# When “Self‐Harm” Means “Suicide”: A Topic Modeling Study of Adolescent Online Help‐Seeking for Self‐Harm

## TL;DR

This study explores how adolescents use online platforms to seek help for self-harm, finding that posts often lack context and include equal amounts of non-suicidal and suicidal themes.

## Contribution

The study introduces a novel use of topic modeling to analyze adolescent online help-seeking behavior in self-harm contexts.

## Key findings

- Posts contained little context about self-harm behavior.
- Minimal pro-self-harm content was found in the posts.
- Topics were evenly split between non-suicidal self-injury and morbid/suicidal themes.

## Abstract

The 15%–20% of adolescents worldwide who engage in nonsuicidal self‐injury (NSSI) face an increased risk of transitioning from suicidal ideation to suicide attempt. To resist NSSI urges, young people often seek peer support online. We examined adolescent help‐seeking on a purpose‐built online mental health peer support platform, which is a critically understudied help‐seeking venue.

Adolescents' help‐seeking posts in the “Self Harm” category on a large online peer support platform (575,261 posts from 114,937 users) were analyzed using topic modeling. We assessed the prevalence of NSSI‐related topics versus morbid/suicidal topics.

Our 12‐topic model produced interpretable themes. Three main findings emerged: posts included little information about the context of self‐harm behavior; there was minimal evidence of pro‐self‐harm content in posts; and the primary topics of the posts were evenly split between NSSI‐related topics and morbid/suicidal topics.

Our findings have important implications for online mental health communities: requiring users to select a narrow category for their post may limit contextual information; moderation of pro‐self‐harm content may reduce its prevalence; and the absence of dedicated spaces for suicidal users may funnel those users into NSSI‐focused spaces, potentially increasing risk for all users.