Barriers and enablers to the moderation of self-harm content for a young person’s online forum
Open accessAbstract
BACKGROUND: Self-harm amongst young people in the United Kingdom is higher than in other European countries. Young people who self-harm are often reluctant to seek professional help, turning increasingly to the internet for support, including online forums. There are concerns about misinformation or harmful content being shared, potentially leading to self-harm contagion. Moderation of online forums can reduce risks, improving forum safety. Moderation of self-harm content, however, is an under-researched area. AIMS: Using the Behaviour Change Wheel (BCW), this study examines the barriers and enablers to moderation of self-harm content and suggests behaviour change techniques (BCTs) to address barriers. METHOD: Qualitative interviews with 8 moderators (of a total of 16) from the UK's leading young people's support service for under 25s, The Mix, were conducted. RESULTS: Thematic analysis identified eleven enablers, four barriers and one both an enabler and a barrier. Barriers included emotional exhaustion, working with partial information, access to timely support, vagueness within the guidelines and influence of community users. BCTs selected included increasing social support through a moderation buddy. CONCLUSIONS: Optimisation strategies focus on increasing the support and level of information available to moderators and could be considered by other organisations providing similar services.
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Social media platforms' failure to adequately address harmful content exacerbates the cyberbullying crisis, as harmful messages and images can be rapidly disseminated and repeatedly viewed.
“Furthermore, social media platforms’ failure to adequately address harmful content exacerbates this crisis, as harmful messages and images can be rapidly disseminated and repeatedly viewed [81].”
From The Impact of Social Media & Technology on Child and Adolescent Mental Health (2025) · cites this paper as [81]
The available Results and Discussion passages (page numbers unavailable) list headings about moderating self-harm content but provide no substantive account of cyberbullying or platform failures. Searches for cyberbullying and for rapidly disseminated or repeatedly viewed harmful messages and images found no passage addressing the claim. (LLM, conf=0.72)
Experimental — accuracy not yet measuredAutomated moderation systems often struggle to differentiate between harmful content and casual interactions, leading to inconsistencies in enforcement.
“Automated moderation systems often struggle to differentiate between harmful content and casual interactions, leading to inconsistencies in enforcement [81].”
From The Impact of Social Media & Technology on Child and Adolescent Mental Health (2025) · cites this paper as [81]
The Results discuss moderators’ judgment of the “greyness” of self-harm content, and the Discussion lists vague guidelines as a barrier. Neither section addresses whether automated systems confuse harmful content with casual interactions or enforce rules inconsistently (searched: automated moderation, algorithms, casual interactions, enforcement). (LLM, conf=0.74)
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“Questions were based on COM-B and TDF domains with additional, broader questions added allowing participants to give freer responses (McGowan et al., 2020).”
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Behaviour change theory and evidence: a presentation to Government
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“For example, an intervention involving Acceptance and Commitment Therapy (ACT) showed positive impacts on anxiety and burnout of dementia healthcare workers (Montaner et al., 2021).”
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The Impact of Social Media & Technology on Child and Adolescent Mental Health
Masri-zada, T., Martirosyan, S., Abdou, A., Barbar, R., Kades, S., Makki, H., Haley, G., & K Agrawal, D. (2025) · Journal of Psychiatry and Psychiatric Disorders · doi:10.26502/jppd.2572-519x0242 · Cited by 45 · see citing works
- Authors
- Perowne, R., & Gutman, L. M.
- Affiliations
- University College London (GB)
- Corresponding author
- Gutman, Leslie Morrison
- Venue
- Journal of Mental Health
- Publisher
- Informa UK Limited
- Published
- 2022-05-16
- Volume
- 33
- Issue
- 3
- Pages
- 357-365
- ISSN
- 0963-8237 (ISSN-L)
- 1360-0567
- OpenAlex
- W4280490674
- Cited by
- 14
- References
- 7
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 4 · 2023: 1 · 2022: 1
- FWCI
- 2.52
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Mental Health (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion, cc-by-nc-nd)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Social Psychology › Mental Health via Writing
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Keywords
- self-harm, youth, Behaviour Change Wheel, behaviour change techniques, moderators, emotional exhaustion, online support services, social support
- MeSH terms
- Adolescent, Adult, Female, United Kingdom, Humans, Male, Social Support, Self-Injurious Behavior, Internet, Qualitative Research, Young Adult
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