Feed recommendations are the most common way teens encounter self-harm content

An analysis of data from the 2025 OxWell Student Survey found that about a third of 11- to 18-year-old students in England had come across self-harm content online in the past month. Most of these encounters were unintentional, and about two-thirds of exposed students said the content had appeared in their social media feeds or been suggested while they were browsing. Students who were lonelier, had experienced other online harms, or had poorer mental health were more likely to report exposure. The paper was published in Nature Mental Health.

Social media has become an integral part of young people’s everyday lives. It provides wide opportunities for communication, entertainment, self-expression, and social connection. Platforms such as TikTok and Instagram offer an almost endless stream of content, much of which is selected by recommendation algorithms that personalize what users see based on their interests and online behavior.

While this personalization can help users discover content they enjoy, it can also expose them to potentially harmful material. One particular concern is content related to self-harm, which can range from personal stories of recovery and supportive discussions to graphic images and videos that portray self-injury in a positive or encouraging way.

Research suggests that repeated exposure to such content may increase emotional distress and the risk of self-harming thoughts and behaviors, particularly among vulnerable adolescents. However, the effects are not always negative, as some online communities that discuss self-harm also provide emotional support and encourage young people to seek help.

Adolescents also do not need to search for self-harm content to encounter it, as recommendation algorithms may place it in their feeds without them seeking it out. Their interactions with such content may then lead algorithms to recommend more similar material, potentially creating a cycle of repeated exposure.

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Study author Holly Bear of the University of Oxford and colleagues examined how often adolescents in England reported coming across self-harm content online in the past month and the routes through which this happened. They were particularly interested in whether exposure was passive (unintentional) or active, such as searching for the content or having it shared with them, and how these different routes related to students’ demographic characteristics, social experiences, and mental health.

The researchers analyzed data from the 2025 OxWell Student Survey, a school-based survey of young people in England run by researchers at the University of Oxford. The analysis drew on 32,102 students in school years 7 through 13 (ages 11 to 18) at 49 secondary schools and further education colleges, mainly in Liverpool and Oxfordshire, who completed the survey between February and May 2025.

Students were asked whether they had come across content about self-harm on online platforms in the past month and, if so, how. They also answered questions about loneliness, bullying, online aggression and coercion, and symptoms of anxiety and depression. A total of 28,797 students answered the question about exposure, 14,083 of whom were girls.

Of these students, 9,940 (34.5%) reported encountering self-harm content online in the past month. Most of them (55%) had seen it once or twice, while 26.5% had seen it a few times and 18.5% several times.

Among exposed students who described how they came across the content, 66% said it had appeared in their feed or been suggested while they were browsing, and 24% said it was embedded within other, unrelated content. Fewer said they had accidentally encountered it (12%), searched for it (8%), or had it shared with them by someone else (8%), and 15% reported some other route.

Based on these answers, the researchers sorted students into groups. Nearly three-quarters (73%) had been exposed only through passive routes, 12% through a mix of routes, 9% only through “other” routes, 3% only by having the content shared with them, and 3% only by searching for it.

How often students saw the content depended on how they encountered it. Most students exposed only passively (59%) or only through content shared by others (62%) had seen it just once or twice in the past month, compared with about 30% of those who had only searched for it or who were exposed through a mix of routes. The authors note this is consistent with a feedback loop in which actively engaging with self-harm content leads algorithms to show more of it.

Each exposure route was associated with higher levels of loneliness, online harms, anxiety, and depression compared with students who reported no exposure, though the patterns differed across groups. Girls had higher odds than boys of passive-only exposure but lower odds of having content shared with them, and trans and gender-diverse students had elevated odds across most routes, particularly searching for the content.

Black students and students from mixed ethnic backgrounds were more likely than white students to have only searched for the content, as were students who often went to bed hungry compared with those who rarely did. Searching was most strongly linked to depression, while having content shared by others was more closely tied to receiving aggressive or threatening messages online. Students exposed through a mix of routes had some of the most pronounced risk profiles, with especially strong links to online aggression and coercion.

“Exposure to online self-harm content is widespread and shaped by distinct pathways that differ according to adolescents’ wider vulnerabilities, social environments and digital behaviors. Around one-third of our large community sample reported recent exposure, underscoring the need for interventions that account for diverse exposure experiences, from passive, algorithmically driven delivery to more intentional searches and peer sharing,” study authors concluded.

The authors call for a public health approach that combines regulation to reduce self-harm content in feeds, efforts to direct young people who search for it toward supportive resources, and digital literacy education for adolescents and their parents.

The study contributes to the scientific understanding of how adolescents encounter self-harm content online. However, it should be noted that the survey was cross-sectional, so it cannot show whether loneliness, online harms, and mental health difficulties make exposure more likely, result from exposure, or both. The researchers also did not ask what kind of self-harm content students saw, which could range from graphic material to recovery stories and peer support.

In an earlier wave of the survey, about two-thirds of students who had actively sought out self-harm content cited potentially positive motivations, such as finding support or connecting with others with similar experiences. The data were self-reported and came mainly from two regions of England, and the wording of the exposure question, which asked whether students had “come across” such content, may have led some who sought it out to underreport.

The paper, “Algorithmically driven exposure to online self-harm content and its association with broader psychosocial risk in 32,000 adolescents,” was authored by Holly Bear, Emma Soneson, Galit Geulayov, and Mina Fazel.