Building an online community to promote communication and collaborative learning between health professionals and young people who self-harm: an exploratory study.
BACKGROUND
Online communities are known to break down barriers between supposed experts and non-experts and to promote collaborative learning and 'radical trust' among members. Young people who self-harm report difficulties in communicating with health professionals, and vice versa.


OBJECTIVE
We sought to bring these two groups together online to see how well they could communicate with each other about self-harm and its management, and whether they could agree on what constituted safe and relevant advice.


METHODS
We allocated 77 young people aged 16-25 with experience of self-harm and 18 recently/nearly qualified professionals in relevant health-care disciplines to three separate Internet discussion forums. The forums contained different proportions of professionals to young people (none; 25%; 50% respectively) to allow us to observe the effect of the professionals on online interaction.


RESULTS
The young people were keen to share their lived experience of self-harm and its management with health professionals. They engaged in lively discussion and supported one another during emotional crises. Despite registering to take part, health professionals did not actively participate in the forums. Reported barriers included lack of confidence and concerns relating to workload, private-professional boundaries, role clarity, duty of care and accountability. In their absence, the young people built a vibrant lay community, supported by site moderators.


CONCLUSIONS
Health professionals may not yet be ready to engage with young people who self-harm and to exchange knowledge and experience in an anonymous online setting. Further work is needed to understand and overcome their insecurities.
Devon Partnership NHS Trust, Exeter, UK; Peninsula Medical School, University of Exeter, Exeter, UK.
Christabel
C
Owens
Siobhan
S
Sharkey
Janet
J
Smithson
Elaine
E
Hewis
Tobit
T
Emmens
Tamsin
T
Ford
Ray
R
Jones
D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D003299:Cooperative Behavior; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D020407:Internet; D008297:Male; D011369:Professional-Patient Relations; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000523:psychology*; D012944:Social Support; D013336:Students, Health Occupations; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult