JMIR Publications

ABSTRACT

Background:

Lived experience stories are often used on formal help sites as a support resource for individuals who self-harm. While self-harm related internet use provides an alternative for individuals who are not yet ready or are unwilling or unable to access support offline, it has also been shown to unintentionally reinforce self-harm behaviour. There are several components which might influence whether a lived experience story is perceived as helpful, unhelpful, or potentially harmful, and the evidence supporting that these encourage help-seeking in the reader is limited.

Objective:

The present study is the quantitative component of a mixed-methods project which aimed to investigate how variations in help-seeking messages contained within online lived experience stories are interpreted by and psychologically impact those with a history of self-harm.

Methods:

In an online experiment, individuals with a recent history of self-harm, were randomised to read stories that either mentioned: i) self-help strategies, ii) seeking help from informal and formal sources, or iii) did not mention help-seeking. Help-seeking intentions, mood, entrapment, and expectations of future self-harm was measured, and participants provided feedback on the stories.

Results:

There was limited evidence for an effect of story type on future help-seeking intentions and stronger evidence for an effect of story type on negative affect. Participants in the “Self-help” condition reported lower negative affect after reading the stories compared to participants in the “No help” condition (Mean difference = -3.97, 95% CI -7.72 to -0.22, p = .04) and the “Informal/formal” help condition (Mean difference = -3.70, 95% CI -7.55 to 0.14, p =.06). A key criticism of the stories was that they were unrelatable, but this sentiment was less prevalent among those in the “No help” condition. Key positives were that the stories included a realistic but hopeful outlook of recovery (less prevalent in the “Informal/formal help” condition) and were supportive (less prevalent in the “No help” condition).

Conclusions:

While the inclusion of self-help strategies in a lived experience story reduced its impact on negative affect, the inclusion of self-help strategies or seeking help from others did not encourage future help-seeking intentions. Making stories relatable, authentic, and providing multiple strategies for support might be key to encourage help-seeking, but more research is needed.