Content Warning: This article contains some descriptions of self-harm.

TAMPA, Fla. (WFLA) — Millions of young Americans use social media to the point that teenagers, students, and social media use are at times ubiquitous. The spread of social media use among teens, through apps like Facebook, Twitter, Instagram, and TikTok has grown as the number of young people has increased. A new study of online habits for Twitter users found that talk of self-harm has only increased, despite policies meant to cut down on posting about self-inflicted injuries and suicide.

Along with the rise in social media use, data from the Network Contagion Research Institute, a research organization, found the number of self-harm related posts on Twitter had increased, specifically from self-harm hashtags.

“Since October, the use of hashtags related to self-harm (e.g. like ‘#shtwt’ for Self-Harm TWiTter) has increased roughly 500%, averaging tens of thousands of mentions per month. Many community members appear to be adolescents and young adults,” NCRI reported.

America, online

Pew Research Center reported 97% of teenagers in America, those aged 13 to 17 years old, use the internet at least once a day in 2022. When it comes to social media, the Pew study found 95% of teens use YouTube, 67% use TikTok, 62% use Instagram, and 59% use Snap Chat. The different apps are not used exclusively, meaning the teens are using multiple apps.

The increase in self-harm posts on Twitter comes in spite of the company’s specific content policies to ban or prevent suicide and self-harm posts and messages.

Explicitly, the Twitter user guidelines on suicide and self-harm immediately start with the statement that users “may not promote or encourage suicide or self-harm.” The company says in its policy guide that they “recognize that suicide and self-harm are significant social & public health challenges that require collaboration between all stakeholders – public, private, and civil society – and that we have a role and responsibility to help people access and receive support when they need it.”

Speaking with The Hill, a representative said the company continues to review its safety policies with experts and reviews mental health research to “find a balance between” those who are struggling and content being removed that “exploits those struggles.”

“The safety of the people who use our service is our priority and we are committed to building a safer Internet and improving the health of the public conversation,” the Twitter spokesperson told The Hill.

Changes in behavior

Part of the issue is how users interact with various social platforms. For Twitter, NCRI said there’s a large community that encourages self-harm and related behavior.

While Twitter has said since October that it was working to take action against tweets and users which violate their self-harm content rules, NCRI said the hashtags and posts have instead seen “exponential growth,” as much as a 500% increase. Additionally, Twitter isn’t the only social media site with a mental health problem.

In October 2021, Meta, the parent company of Facebook and Instagram, contended with a former employee and whistleblower speaking with U.S. Congress about how the company’s own research reported the harm social media can cause to teenagers’ mental health.

Frances Haugen, testified to the Senate Commerce Subcommittee on Consumer Protection, saying that Meta’s products hurt children and divide Americans.

“The company’s leadership knows how to make Facebook and Instagram safer but won’t make the necessary changes because they have put their astronomical profits before people,” Haugen said. Less than a week after Haugen’s testimony, Meta made adjustments to their policies on Instagram for their teenage users.

The various worlds of online platforms each have their own types of environments. In addition to the social stresses that are inherent to online communities, a study from Scientific American notes an increase in self-harm and suicide risk during the school year.

“School comes with many things, good and bad. School can be wonderful, with learning experiences, social successes and a sense of connection to others,” a report on the study said. “But it can also be incredibly stressful because of academic burden, bullying, health- and disability-related barriers, discrimination, lack of sleep and sometimes abuse.”

Using data from the U.S. Center for Disease Control and Prevention’s Wonder system, which tracks a variety of public health data, the Scientific American analysis found what they call a “heat-map” of increased pediatric suicide during months that school is in session.

“On weekdays and during school months, there is a significant elevation of suicide deaths in children,” Scientific American reported. The data focused on pediatric deaths by suicide, or suicide deaths for those younger than 18.

CDC data shows there were 26,653 suicides among Americans younger than 18 from 1999 to 2020. Shrinking the timeline, the data shows 21,641 suicides from young Americans under 18 between 2004, the year Facebook debuted, and 2020.

Recognize the signs

The NCRI data and research has a section on background, which noted that before online internet forums were born, people in the 1990s who self-harmed without the intention to specifically commit suicide had “few opportunities to discuss” those “habits” with friends, family, or those in the medical field.

“Today, platforms such as Tumblr, Reddit, and Twitter are home to hundreds of communities of adolescents and young adults engaging in non-suicidal self harm” are instead going online to find support, validation, and information, according to NCRI.

The different messaging methods on Twitter and other platforms to identify self-harm related posts include hashtags like “shtwt” for “self-harm Twitter,” as well as other identifiers. NCRI notes a variety of them include “coded language.”

The research institute lists and explains the following examples in their report:

“Coded language includes labels for layers of skin, types of injuries, and patterns of resulting blood. These are often benign or even cute words such as “catscratch” for the superficial self-cutting that often looks like cat scratches; ‘beans’ (which refers to cutting deep enough that one gets to the subcutaneous layer, which, as the image reveals, has the appearance of beans); ‘armgills’ (as if cuts are like gills on fish); and ‘raspberry filling’ to refer to blood. Related coded terms include ‘moots’ (for ‘mutuals,’ as in ‘mutually engaging in self-harm’); ‘ed’ (for eating disorders) –– sometimes with “moots” or ‘twt’ (for ‘Twitter’); ‘ouchietwt’; and blunter terms, such as ‘gore,’ ‘gorey’ ‘gory,’ or ‘blood.’”

What’s more, the NCRI report said the data they have is just “the tip of the iceberg” with different online communities “rapidly growing and in some cases overlapping.” The communities on Twitter that NCRI monitors include those “dedicated to the glorification of eating disorders, mass shootings, and more.”