JMIR Publications

ABSTRACT

Background:

Engagement with suicide-related content online is often assumed to be harmful, yet many individuals with lived experience describe such content as supportive or even life-preserving. Despite policy and clinical concerns, little is known about how people intentionally or unintentionally encounter this content, how they interpret it, and how these experiences shape perceived harm or benefit.

Objective:

To explore how intent and context influence the ways individuals with lived experience of suicidality encounter, interpret, and respond to suicide-related online content, and to identify factors associated with perceived harm and benefit.

Methods:

An exploratory mixed-methods online survey was conducted with a convenience sample of 713 UK-based participants aged 16 years and over, 96% of whom reported lived experience of suicidality. Quantitative data were analysed using descriptive and inferential statistics, including chi-square tests, to examine associations between engagement patterns, intent, and suicidality. Free-text responses were analysed inductively using thematic content analysis to identify themes relating to motivations for engagement, emotional responses, and perceived impact.

Results:

Participants reported a broad range of experiences. While some described suicide-related content as distressing or as contributing to suicidal thoughts or attempts, others reported relief, validation, or reduced feelings of isolation, with some attributing content to preventing an attempt. Clear differences emerged between participants who actively sought out content - ‘seekers’ and those who encountered it unintentionally - ‘stumblers’. Seekers more frequently reported positive or understanding responses, often in the context of unmet offline support needs, whereas stumblers were more likely to report shock or distress. Approximately 40% of participants described their engagement as neither intentional nor accidental, suggesting the influence of algorithmic feeds and shifting emotional states. Emotional responses also changed over time, with initial encounters more often negative and later experiences more mixed or positive.

Conclusions:

Engagement with suicide-related online content cannot be characterised as uniformly harmful. Outcomes depend on user intent, emotional state, and the context of engagement, and may change over time. Clinical, regulatory, and policy approaches should move beyond risk-only frameworks to account for the nuanced and sometimes supportive roles such content plays in how individuals make sense of suicidal thoughts, while still protecting those at risk. Clinical Trial: Not applicable