Online peer support and non-suicidal self-injury among adolescents and young adults: A systematic review

This systematic review examined the reported roles, associations, benefits, and risks of online peer support (OPS) on non-suicidal self-injury (NSSI) among adolescents and young adults. After screening 810 abstracts and assessing 37 full texts for eligibility, a total of eight studies (one RCT, one mixed-methods, two quantitative, and four qualitative) were included. OPS, delivered via purpose-built apps and social media, provided emotional connection, belonging, and coping strategies. The RCT found lower NSSI frequency and greater confidence in the ability to change, while qualitative studies highlighted perceived benefits such as feeling "less alone." However, challenges included exposure and reinforcement of NSSI, emotional burden and role strain, platform and moderation challenges, and reduced help-seeking intentions. Overall, it offers accessible peer support but carries significant risks, underscoring the need for careful design, moderation, and integration with professional care to maximize benefits while minimizing harm.