Experiences of Moderation, Moderators, and Moderating by Online Users Who Engage with Self-Harm and Suicide Content

Abstract Despite the growing role of content moderation online, particularly in mental health spaces, there is limited research into the effectiveness of platform practices and a lack of user-driven evidence for regulatory guidance. This study aimed to explore user accounts of moderation related to self-harm and suicide (SH/S) content online, including their experiences of being moderated and perspectives on moderation practices. Additionally, where participants were also moderators, their experiences of moderating SH/S content were explored. 14 participants were interviewed at baseline, n = 8 at 3-months and n = 7 at 6-months. They also completed daily diaries of online use between interviews. Thematic analysis was used to explore perspectives. Three key themes were identified: ‘content reporting behaviour’, exploring factors influencing decisions to report content; ‘perceptions of having content blocked’, exploring experiences and speculative accounts of SH/S content moderation; and ‘content moderation and moderators’, examining participant views on moderation approaches and their experiences of moderating. This study revealed challenges in moderating SH/S content online, and highlighted inadequacies with current procedures. Participants struggled to self-moderate online SH/S spaces, showing the need for proactive platform-level strategies. Additionally, whilst the lived experience of moderators was valued, associated risks emphasised the need for supportive measures. Policymakers and industry leaders should prioritise transparent and consistent moderation practices.