JMIR Publications

ABSTRACT

Background:

There is growing interest in using social media data to detect and address non-suicidal self-injury (NSSI) among adolescents. Because adolescents often do not seek clinical help for NSSI and may adopt strategies to obscure detection, social media platforms may be able to facilitate early detection and treatment by using machine learning models to screen posts for harmful content and subsequently alerting an adult. However, such efforts have raised privacy and ethical concerns among health researchers. Little is currently known about how adolescents perceive such efforts.

Objective:

The purpose of this study was to examine perceptions of automated alerts for NSSI posts on social media among Latinx adolescents, who are at risk for NSSI yet underrepresented in both NSSI and health informatics research. Additionally, we considered perspectives on preferred recipients of automated alerts.

Methods:

We conducted semi-structured qualitative interviews with 42 Latinx adolescents between the ages of 13 and 17 who were recruited from a non-profit organization serving the Latinx community in Milwaukee, WI. All interviews were conducted between June to July 2019. Transcripts were analyzed using framework analysis to discern perceptions of automated alerts sent by social media platforms and potential alert recipients.

Results:

Participants felt automated alerts would make adolescents safer and expedite aid before situations escalate. However, some worried that hyperbolic statements would generate false alerts and instigate conflict. Interviews revealed strong opinions about ideal alert recipients. Parents were most commonly endorsed, but conditional on perceptions that the parent would respond appropriately. Emergency services were judged safer, but inappropriate for situations considered lower risk. Alerts sent to school staff generated the strongest privacy concerns. Altogether, preferred alert recipients varied by individual adolescent and the perceived risks in the situation. None raised ethical concerns about the collection, analysis, or storage of personal information regarding their mental health status.

Conclusions:

Overall, Latinx adolescents expressed broad support for automated alerts for NSSI on social media, which indicates opportunities to address NSSI. However, these efforts should be co-constructed with adolescents to ensure that preferences and needs are met, as well as embedded within broader approaches for addressing structural and cultural barriers to care. Clinical Trial: N/A