{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:08:35Z","timestamp":1773706115041,"version":"3.50.1"},"reference-count":67,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Digit. Health"],"abstract":"<jats:p>This study examines the digital representation of Non-Suicidal Self-Injury (NSSI) on TikTok, with particular attention to the emergence of online communities and the communicative strategies users employ to share content while evading platform moderation. As TikTok becomes increasingly influential among adolescents and young adults, understanding how sensitive mental health topics like NSSI circulate on the platform is critical for developing effective digital health interventions. We conducted a qualitative content analysis of 400 posts referencing NSSI, collected using a mixed-method approach: 25.5% using TikTok's official API and 74.5% via the \u201cFor You\u201d feed of a simulated account designed to mirror organic user experience. Posts were selected based on visual indicators (e.g., scars, tools), textual cues (e.g., hashtags, metaphors), and thematic references to emotional distress, recovery, or relapse. The analysis focused on user profile characteristics, linguistic strategies, and audiovisual aesthetics. Findings reveal a loosely structured yet emotionally resonant digital community characterized by subcultural codes, such as euphemisms, ambiguous hashtags, and stylized imagery. Despite content moderation policies, most accounts remained active and visible, with minimal enforcement of warnings or restrictions. While some posts portray NSSI as a coping strategy or seek to normalize the behavior, others subtly encourage recovery or offer indirect support. However, explicit messaging that discourages self-harm is notably rare. These dynamics suggest that TikTok unintentionally enables both the concealment and dissemination of self-harm-related content, functioning as a space for affective connection but also as a vector for potential normalization of harmful behaviors. The study underscores the need for targeted, ethically grounded prevention strategies that address not only the psychological functions of these communities but also the algorithmic infrastructures that sustain their visibility. These findings contribute to ongoing debates about digital mental health, platform responsibility, and the design of safer online environments.<\/jats:p>","DOI":"10.3389\/fdgth.2025.1645276","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T14:46:26Z","timestamp":1759502786000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Digital mental health and hidden support: a qualitative analysis of non-suicidal self-injury communities on TikTok"],"prefix":"10.3389","volume":"7","author":[{"given":"Esther","family":"Mart\u00ednez-Pastor","sequence":"first","affiliation":[]},{"given":"Marian","family":"Blanco-Ruiz","sequence":"additional","affiliation":[]},{"given":"Sandra","family":"Feij\u00f3o","sequence":"additional","affiliation":[]}],"member":"1965","published-online":{"date-parts":[[2025,10,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1177\/0829573516645563","article-title":"Non-suicidal self-injury in our schools: a review and research-informed guidelines for school mental health professionals","volume":"32","author":"De Riggi","year":"2016","journal-title":"Canad J School Psychol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1177\/20563051231157595","article-title":"Tiktok as a key platform for youth political expression: reflecting on the opportunities and stakes involved","volume":"9","author":"Literat","year":"2023","journal-title":"Soc Med Soc"},{"key":"B3","doi-asserted-by":"publisher","first-page":"29","DOI":"10.24198\/jkk.v10i1.29384","article-title":"Communication patterns of adolescent self-harm suffering in interpersonal relationships.","volume":"10","author":"Gustina Sari","year":"2022","journal-title":"Jurnal Kajian Komunikasi."},{"key":"B4","doi-asserted-by":"publisher","first-page":"61","DOI":"10.62161\/revvisual.v16.5292","article-title":"Digital community of children\u2019s self-injuries in TikTok: quantitative and qualitative methodological approach","volume":"16","author":"Mart\u00edn Mu\u00f1oz","year":"2024","journal-title":"Int Vis Cult Rev Rev"},{"key":"B5","doi-asserted-by":"publisher","first-page":"238","DOI":"10.5565\/rev\/redes.996","article-title":"Visualizaci\u00f3n e interpretaci\u00f3n de las interacciones en los mensajes de autolesiones no suicidas (ANS) en twitter [visualising and interpreting interactions in non-suicidal self-harm (NSA) messages on twitter]","volume":"34","author":"Mart\u00ednez-Pastor","year":"2023","journal-title":"Redes Rev Hispana Para An\u00e1lisis Redes Soc"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1690","DOI":"10.1111\/jocn.13575","article-title":"Unveiling self-harm behaviour: what can social media site Twitter tell us about self-harm? 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